Prevotella bivia (P. bivia) is an anaerobic, non-pigmented, gramnegative bacillus which is naturally present in the human female vaginal tract, and it is also occasionally seen in the oral cavity. It has a high proliferative potential in the presence of estrogen. Therefore, its involvement in, vaginal tract infections such as endometritis and pelvic inflammatory disease, has been well described in the literature. If left untreated, it may cause more serious conditions, such as cuff abscess, abdominal wall empyema, or septic arthritis.
The DNA of P. bivia has been detected from human vaginal epithelia in 40% of healthy women. The prevalence is relatively higher in women with bacterial vaginosis (BV). Its detection from the glans penis indicates that it is a causative factor of BV in female sex partners. It is also probable, however, that traumatic events such as human bite might cause P. bivia infections leading to suppurative inguinal adenitis during orogenital sex. It is also a normal oral and vaginal flora as well as a predominant type of bacillus isolated from the respiratory tract infections and their complications, including aspiration pneumonia, lung abscess, chronic otitis media, chronic sinusitis, abscesses in the oral cavity, human bites, brain abscesses, and osteomyelitis. Moreover, P. bivia is the important pathogen in obstetric and gynecologic infections.
There is a report suggesting that the concentrations of P. bivia and lipopolysaccharide in the vaginal fluid may contribute to the severity of BV and to the development of adverse pregnancy outcomes, such as preterm labor, premature rupture of membranes, postpartum endometritis, and postoperative pelvic infection.
References:
1. Riesbeck K. Paronychia due to Prevotella bivia that resulted in amputation: fast and correct bacteriological diagnosis is crucial. J Clin Microbiol 2003;41: 4901-3. [L]
2. Hsu GJ, Chen CR, Lai MC, Luh SP. Chest wall abscess due to Prevotella bivia. J Zhejiang Univ Sci B 2009;10: 233-6. [L]
3. Laiho K, Kotilainen P. Septic arthritis due to Prevotella bivia after intra-articular hip joint injection. Joint Bone Spine 2001;68: 443-4. [L]
4. Purushothaman B, Lakshmanan P, Gatehouse S, Fender D. Spondylodiscitis due to Prevotella associated with ovarian mass: a rare case report and review of literature. World Neurosurg 2010;73: 119-22. [L]
5. Salman SA, Baharoon SA. Septic arthritis of the knee joint secondary to Prevotella bivia. Saudi Med J 2009;30: 426-8.
6. Mirza A, Bove JJ, Litwa J, Appelbe G. Mixed Infections of the Paronychium with Prevotella bivia. J Hand Microsurg 2012;4: 77-80.
7. Srinivasan S, Fredricks DN. The human vaginal bacterial biota and bacterial vaginosis. Interdiscip Perspect Infect Dis 2008;2008: 750479. [L]
8. Price LB, Liu CM, Johnson KE, Aziz M, Lau MK, Bowers J, et al. The effects of circumcision on the penis microbiome. PLoS One 2010;5: e8422. [L]
9. Aroutcheva A, Ling Z, Faro S. Prevotella bivia as a source of lipopolysaccharide in the vagina. Anaerobe 2008;14: 256-60. [L]
10. Smayevsky J, Canigia LF, Lanza A, Bianchini H. Vaginal microflora associated with bacterial vaginosis in nonpregnant women: reliability of sialidase detection. Infect Dis Obstet Gynecol 2001;9: 17-22. [L]
11. Managing recurrent bacterial vaginosis, J Wilson [L]
Prescribable antibiotics are included as prescribing options due to lack of detected antibiotic resistance genes. Physicians should use this as a guide and prescribe antibiotics based upon patient symptoms and medical history, including such factors as allergies, other medications, and pregnancy status: Metronidazole, Secnidazole, Tinidazole
What therapeutic options do we have to manage or try to prevent further recurrences of BV?
Bacteriotherapy
Bacteriotherapy, using harmless bacteria to displace pathogenic organisms is considered ‘‘natural’’ and without any side effects, but there is lack of efficacy data with few randomised controlled trials (RCT). The lactobacilli (LB) used need to be able to adhere to vaginal epithelial cells, and to produce hydrogen peroxide. If given orally the LB need to pass through the intestinal tract and ascend from the perianal area into the vagina. There have been several publications of attempts to restore vaginal flora by recolonising with LB using both intravaginal and oral administration. However, the LB used have not been vaginal strains. LB strains from yoghurt adhere less well to vaginal cells than clinical isolates. In a double blind RCT looking at LB as a treatment for BV, vaginal pessaries containing L acidophilus were used for 6 days. With active therapy 57% of women cleared their infection compared with 0% of those given placebo, but only three remained BV free after menstruation.
It was thought there was a problem with LB adherence. One group of researchers has published case reports and small case series of vaginal and oral LB replacement. They report successful vaginal colonisation following administration by both routes. This group have recently published a RCT of oral capsules of L rhamnosus GR-1 and L fermentum RC-14 for 60 days. Microscopy showed restoration to normal flora from asymptomatic BV in 37% women receiving LB treatment compared with 13% receiving placebo. This significant improvement in vaginal flora was also accompanied by a significant increase in LB at day 60.
These results are encouraging but we do not know if the nonvaginal LB will remain in the vagina to protect against further episodes of BV. A RCT of oral Lactobacillus GG drink for the prevention of recurrent urinary tract infection (UTI) showed no reduction in UTIs over 12 months. The principles of UTI prevention by this method are similar to that of BV prevention—that is, LB replacement to protect against bacterial overgrowth, so it is unlikely that oral Lactobacillus GG would be beneficial for BV prevention. In a study looking at mechanisms of LB blockage of uropathogen adherence to vaginal epithelial cells, L crispatus showed greater capacity to block uropathogen adherence than other LB. A study looking at sustained vaginal colonisation of LB showed 40% of women remained colonised with L crispatus and L jensenii for over 8 months compared with 5% of women colonised with other LB spp indicating better ability to adhere to vaginal cells.
There is currently a RCT using vaginal pessaries containing L crispatis to attempt to recolonise the vagina with LB (S Hillier, personal communication). This is the first study of replacement with one of the main vaginal hydrogen peroxide producing LB.
Maintaining vaginal pH at 4.5
The main goal of therapy here is to keep the vaginal pH at 4.5 or less, in order to prevent overgrowth of pathogens until the normal LB are re-established and able to maintain the pH themselves. In a RCT of 42 women with recurrent BV using intravaginal lactate gel to try to prevent BV recurrences, 17 women used lactate gel for 3 days immediately after menstruation for 6 months, the remainder used placebo. The 6 months on-treatment analysis showed that 88% were clear of BV with active treatment compared with only 10% with placebo. Intent to treat analysis at 6 months showed 71% were clear with treatment and 4.8% were clear with placebo. The treatment was well tolerated but there was a large dropout rate, particularly in the placebo arm because of malodour. The authors suggested more intensive treatment might have improved this.
Preventing overgrowth of BV associated organisms
Although intermittent therapy, on an episodic or prophylactic basis, is frequently used for recurrent BV, there are very few publications on this. Hay et al advised women with recurrent BV to collected daily vaginal specimens for between 1– 12 months, to try to identify the times of recurrence. BV recurrences most often arose within the first 7 days of the menstrual cycle, and frequently followed candida infection.2 Consequently they advised oral or intravaginal metronidazole for 3 days at the onset of menstruation for 3– 6 months, and add antifungal treatment if there is a history of candidiasis.
Better treatments and/or combined treatments
Using oral or vaginal preparations of metronidazole and clindamycin, 80–90% of women will have an initial response to treatment but 15–30% will get a recurrence within 3 months.
In women with recurrent BV the initial response rate appears to be lower. The heterogeneity of microorganisms involved in BV may contribute to treatment failure and high recurrence rates. Clindamycin has better activity against M hominis, Mobiluncus spp, and G vaginalis than metronidazole, but metronidazole has the advantage of not affecting LB. In trials comparing treatments, cure rates for metronidazole 400 mg or 500 mg twice daily for 7 days have been equivalent to clindamycin vaginal cream daily for 3–7 days, and to metronidazole vaginal gel once or twice per day for 5 days. In the absence of better treatments would women with recurrent BV benefit from longer courses of current treatment? This question remains unanswered. In view of the association between lactobacilli, hydrogen peroxide production, vaginal pH, and overgrowth of BV associated bacteria, just trying to adjust one of these may help some women with recurrent BV, but it may not be enough to resolve all cases. Would a combined approach work better? There are very few publications on this, but they do suggest that the answer might be yes. A small study using single dose oral metronidazole followed by vaginal lactate tablets compared to no vaginal maintenance treatment reported an improved rate of normal vaginal flora of 94% compared to 71%.
Another small study compared tinidazole 2 g single oral dose followed by acidic vaginal gel for 3 weeks with 2% clindamycin vaginal cream 5 g per night for 7 nights. At 4 weeks the clinical cure rate was 94% versus 77%. The vaginal pH was ,4.5 in 78% and 38% respectively.
Conclusions
There is an important inter-relation between lactobacilli, hydrogen peroxide production, vaginal pH, and overgrowth of BV associated bacteria, but the initiating factor for BV remains a mystery. From current evidence it appears that a rise in vaginal pH allowing the overgrowth of bacteria may be more important than reduction of LB+. However long term colonisation with LB+ is necessary to help maintain an acidic pH and support the LB+/myeloperoxidase/chloride system. Therapies aimed at one aspect of this inter-relation may help some women with recurrent BV, but a combined approach might work better. Probably the ideal way of managing recurrent BV would be to tackle all aspects of the interrelation by replacing the lactobacilli, at the same time maintaining the vaginal pH at 4.5, and if necessary also adding in prophylactic treatment to control overgrowth of bacteria. If the current RCT of vaginal LB+ replacement proves successful this approach may soon be possible.
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Easily upload lab results from any provider, whether it's a hospital, independent lab, or home testing service. We support PDFs, scanned documents, and JPEGs from patient portals. No need to log in to multiple platforms — everything is centralized in one secure space.
Easily upload lab results from any provider — we support PDFs, scans, and images. Keep all your reports organized in one secure place.
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Every lab result is automatically organized on a chronological timeline, giving you a complete picture of your health journey. Whether you're tracking a condition, managing treatments, or staying proactive, the timeline helps you and your doctor understand how things progress over time.
Every lab result is automatically organized on a chronological timeline, giving you a complete picture of your health journey.
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Whether it's a blood test, GI panel, urinalysis, or something else, lab reports measure numerous biomarkers that reveal what's happening inside your body. Our extensive database covers over 10,000 biomarkers, providing clear, simple explanations of what each result means and how you can take action—no matter your membership level. Say goodbye to confusion and get the insights you need to better understand your health.
Our database covers over 10,000 biomarkers with clear, simple explanations—so you can finally understand your results and what to do next.
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Enter Your Lab Reports — Always Free
If you'd like to handle inputting your health data into your account, you can do so with our easy-to-use data entry forms. Our user-friendly form is designed to guide you through the quick and easy submission process, making it simple to keep track of your health metrics. This is available to both Complete plan and Unlimited plan members.
Our user-friendly form guides you through a quick, simple submission process, making it easy to enter your health metrics.
Add your results anytime with our easy entry form. It's quick, guided, and helps you stay organized — free for all members.
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View your lab data through easy-to-read graphs and tables. Quickly spot patterns, track changes, and compare results across different dates — all without digging through multiple reports. You can also select and compare graphs of specific biomarkers side-by-side to better understand how they relate and change over time.
See your lab reports in clear graphs and tables. Spot patterns, track changes, and compare results over time — all in one place.
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Export Your Complete Lab History
After collecting lab results from different providers, you can download your entire history combined into a single file. Choose from PDF, Excel, or CSV formats to easily review, share, or get a second opinion—no more juggling multiple reports.
After collecting lab results from different providers, you can download your entire history combined into a single file.
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Data Entry Service for Your Reports
Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest. Complete plan members receive one report entered for free, then $15 per report after that. Unlimited plan members receive ten report entries for free, then $15 per report after that.
Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest.
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Whether you're working with a doctor, nutritionist, caregiver, or wellness coach, you can securely share your complete lab history by sending an invite link to anyone you trust. You have full control over who sees your information and for how long, ensuring your privacy and peace of mind at every step.
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I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
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As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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Healthmatters is a personal health dashboard that helps you organize and understand your lab results. It collects and displays your medical test data from any lab in one secure, easy-to-use platform.
With a Healthmatters account, you can:
Professionals can also analyze client data more efficiently and save time managing lab reports.
Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you're on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
The Complete Plan ($15/month) is perfect for individuals who want ongoing access to their health data. It includes unlimited lab imports, visual tracking, custom ranges, result explanations, full account exports, and secure sharing — all with a simple monthly subscription. You can cancel anytime and restart your plan whenever you're ready — your data will still be there waiting for you. You can also upgrade to the Unlimited Plan at any time, with the cost prorated based on what you've already paid.
The Unlimited Plan ($250 one-time) is also designed for individuals but offers lifetime access with no ongoing subscription. You'll get all the same features as the Complete Plan, plus a larger initial data entry allowance (10 reports), making it a great choice if you prefer a one-time payment and long-term use without monthly fees.
In short:
There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our Data Entry Service is for when you don't want to manually type in your lab results yourself. You simply upload your report (PDF, image, or screenshot), and our trained team enters the information into your Healthmatters account for you — accurately and neatly organized, ready to view in graphs, tables, and timelines.
The $15 per report covers the time and care it takes for a real person to review your file, make sure each result is entered correctly, and double-check for accuracy. This ensures your health data is precise and easy to work with — without you having to spend the time doing it yourself.
Prefer to do it yourself? You can always use our free self-entry tool to add results manually — it just takes a bit more time and attention.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.
Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.
All professional accounts allow you to import and onboard an unlimited number of clients and their lab results. The distinction between professional plans lies solely in the data entry service.
The Pro Monthly Plus plan is priced at $75 per month and includes a data entry service for five reports each month. Additional reports can be self-entered at no extra cost or, if preferred, you can use our data entry service for an additional fee of $15 per report.
The Pro Monthly plan is priced at $45 per month and does not include a data entry service. Self-entry is free for an unlimited number of reports, and you can opt for the data entry service at a fee of $15 per report.
You also have the option to upgrade to higher monthly or to annual plans, which come with substantial discounts. All upgrades can be done directly from your account.
Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Our goal has been to make your Healthmatters account as intuitive as possible.
We've crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
2. All Tests ViewExplore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.
3. Table View:For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.
Yes, you can download your information anytime. We offer two easy ways to export your lab data:
This makes it simple to save, back up, or share your health data whenever you need.
Yes, you can print your report. To do so, navigate to "All tests" and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.
Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.
Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.
To learn more about Healthmatters Pro, please refer to the professional page.
At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.
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