Which bacterium causes bacterial vaginosis most strongly through biofilms dominated by its cells?

Gardnerella vaginalis is a major bacterium associated with bacterial vaginosis and its characteristic vaginal biofilms.

Bacterial vaginosis is a shift in the vaginal microbial community in which protective lactobacilli decrease and several anaerobic or aerotolerant bacteria become more abundant. G. vaginalis can attach to vaginal epithelial cells and help form a biofilm, creating a surface community that includes multiple bacterial species rather than a single isolated pathogen.

The condition may produce a thin discharge and a fish-like odor, although many people have no symptoms. It is diagnosed using clinical criteria or laboratory testing, and it is treated with antibiotics such as metronidazole or clindamycin when treatment is indicated.

G. vaginalis is not the cause of vaginal yeast infections; Candida albicans is the most common cause of those infections. Modern research also emphasizes that bacterial vaginosis is polymicrobial, so G. vaginalis is an important contributor rather than the only organism involved.