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Lactobacillus, in vaginitis [keywords]
- [Probiotic monotherapy of bacterial vaginosis: a open, randomized trial]. [English Abstract, Journal Article]
- Akush Ginekol (Sofiia) 2013.:36-42.
The aim of the current research is to establish the clinical and microbiological efficacy of the therapy with local probiotics in the treatment of anaerobic vaginal infections and the therapy's effect upon vaginal flora.381 (100%) women with bacterial vaginitis are included in the research. They were randomized into three groups. In the first group 143 women who were treated with local (10 applications) probiotics vaginal medicine, containing live lactobacillus types Lactobacillus acidophilus, Lactobacillus rhamnosus. In the second group 126 patients were treated with five days oral administration of Clindamycin (tabl.x 600 mg) BID and local therapy of two vaginal ovules containing each 1000 mg Metronidazole, which were administered intravaginal every other day. In the third group 112 women were treated with the same therapy as the second group and in addition started from the day 5 after it were administered locally probiotic medicine containing Lactobacillus acidophilus u Lactobacillus rhamnosus. The efficacy of the therapeutic scheme was evaluated via comparison of patients' clinical complains in the different groups, of data from clinical examinations (Amsel) and microbiological tests (Nugent) for each patient.Thirty five-forty days after the probiotic therapy, the clinical efficacy in this group (Amsel) is 42.7% and microbiological efficacy (Gram preparation - Nugent)--41.3%. They are lower than the results which we received in the groups where the combine nitroimidazole/incozamide treatment was performed with or without local probiotic. The second group: clinical efficacy--51.6%, microbiological (Nugent)--46.4%. The highest clinical--87.5% and microbiological--80.3% efficacy showed the combine nitroimidazole/lincozamide/probiotic treatment in the third group.Our results show that the local monotherapy with probiotics has fewer efficacies in comparison to the combine therapeutic schemes for treatment of vaginal disbacteriosis with dominant anaerobic species.
- Administration of oral and vaginal prebiotic lactoferrin for a woman with a refractory vaginitis recurring preterm delivery: Appearance of lactobacillus in vaginal flora followed by term delivery. [JOURNAL ARTICLE]
- J Obstet Gynaecol Res 2013 Oct 7.
Lactoferrin (LF) is one of the prebiotics present in the human body. A 38-year-old multiparous woman with poor obstetrical histories, three consecutive preterm premature rupture of membrane at the 19th, 23rd and 25th week of pregnancy, was referred to our hospital. She was diagnosed as having refractory vaginitis. Although estriol vaginal tablets were used for 4 months, the vaginitis was not cured. We administrated vaginal tablets and oral agents of prebiotic LF, resulting in a Lactobacillus predominant vaginal flora. When she was pregnant, she continued to use the LF, and the Lactobacillus in the vaginal flora was continuously observed during pregnancy. An elective cesarean section was performed at the 38th week of pregnancy. When the administration of LF was discontinued after the delivery, Lactobacillus in the vaginal flora was disappeared.
- Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. [JOURNAL ARTICLE]
- Menopause 2013 Oct 21.
The vaginal microbiota helps protect the female genital tract from disease. We sought to describe the composition of the vaginal microbiota in premenopausal, perimenopausal, and postmenopausal women and to explore the association between the microbiota and vulvovaginal atrophy (VVA).Eighty-seven women (aged 35-60 y) were classified as premenopausal (n = 30), perimenopausal (n = 29), or postmenopausal (n = 28) according to Stages of Reproductive Aging Workshop guidelines. Midvaginal bacterial community composition was characterized by 16S ribosomal RNA gene analysis.Bacterial communities clustered into six community state types (CSTs), of which four were dominated by Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, or Lactobacillus jensenii, and two (CST IV-A and CST IV-B) had low relative abundance of Lactobacillus. CST IV-A was characterized by Streptococcus and Prevotella, whereas CST IV-B was characterized by Atopobium. There were significant associations between menopause stage and CST (P = 0.004) and between VVA and CST (P = 0.002). Perimenopausal women were more likely to be classified as CST IV-A or L. gasseri CST, whereas postmenopausal women were often classified as CST IV-A. CSTs dominated by L. crispatus and L. iners were more prevalent in premenopausal women. Nineteen participants had signs of mild or moderate VVA. Compared with women with no VVA, the vaginal microbiota of women with mild or moderate atrophy had 25-fold greater odds of being classified as CST IV-A versus L. crispatus CST (adjusted odds ratio, 25.89; 95% credible interval, 2.98-406.79).A distinct bacterial community state (CST IV-A) with a low relative abundance of Lactobacillus is associated with VVA. Future studies recruiting a larger number of women are needed to replicate the findings. This study provides an impetus for future longitudinal studies designed to manage, modulate, and restore vaginal microbiota homeostasis, which would provide stronger evidence for a causal relationship with VVA and ultimately improve the treatment and prevention of atrophic vaginitis in menopause.
- The effect of Lacto- and Bifidobacteria in monoculture on the vaginal microflora in norm and in cases of intravaginal staphylococcosis. [Journal Article]
- Mikrobiol Z 2013 May-Jun; 75(3):46-55.
The influence of probiotic strains of Lactobacillus casei IMV B-7280, Lactobacillus acidophilus IMV B-7279, Bifidobacterium animalis VKL, Lactobacillus delbrueckii subsp. bulgaricus IMV B-7281 and Bifidobacterium animalis VKB, each strain separately, to the range of the urogenital tract microflora in physiological norm and in cases of experimental intravaginal staphylococcosis of mice induced by Staphylococcus aureus 8325-4. It was found that all these strains had different efficiency in Staphylococcus aureus 8325-4 growth suppression in the vagina of infected mice and affect the spectrum of microorganisms. Lactobacillus casei IMV B-7280 strain had effective antistaphylococcal effect and reduced the number of coliform bacteria and fungi in the vagina in cases of intravaginal staphylococcosis of mice. Lactobacillus casei IMV B-7280 strain is promising to create probiotic drugs effective in treating intravaginal staphylococcosis.
- [Vaginal disbacteriosis--social and sexual risk factors]. [English Abstract, Journal Article, Review]
- Akush Ginekol (Sofiia) 2013; 52(2):17-25.
The vaginal microbe equilibrium could be impaired by different agents. Many of the risk factors can change the preventive mechanisms of the vagina and can lead to inflammation and disease. We even do not suppose about the role of most of them in impairing of vaginal microbe equilibrium. The exact understanding of those risk factors and mechanisms by which they disturb the vaginal microbe balance could reduce female morbidity of vaginal disbacteriosis and vaginal inflammations. The aim of this literature synopsis is to review some of the most frequent risk factors for vaginal disbacteriosis and about how they change vaginal micro-flora with dominant lactobacillus within it. The most informative and detailed articles on the theme which were found in the resent literature as well as in Medline for the period between 1990 and 2012 were selected. The risk agents for vaginal disbacteriosis are: endogenetic, social, sexual, infectious and iatrogenic. The social and sexual factors are the most frequent in our daily round. The intensity and the kind of sexual life, smoking, homosexual connections, vaginal douching and contraception methods are included in them. All these factors depend on us. Thus we hope that through their popularization and discussion will help to prevent the females' health.
- Prevalence of lactobacilli in normal women and women with bacterial vaginosis. [Comparative Study, Journal Article]
- J Med Assoc Thai 2013 May; 96(5):519-22.
To study the prevalence and the number of lactobacilli in normal subjects and in women with bacterial vaginosis (BV).The studied subjects consisted of 60 normal and 60 BV women. The diagnosis of BV was based on at least three of five indicators of Chandeying criteria. The vaginal specimens were collected and cultured on MRS plates for determination of lactobacilli counts.The number of lactobacilli was highly significant (p < 0.001) in the women with diagnosis of BK and the mean count of lactobacilli in BV was markedly decreased (5.3 +/- 1.8 log colony-forming unit--CFU/ml), compared with normal women (8.8 +/- 2.9 log CFU/ml). Among the treated BV group, follow-up vaginal specimen was encountered in 47 of 60 cases (78.3%). The proportion of lactobacilli isolation was slightly increased from 12 (25.5%) to 15 (31.9%) in 47 cases. Concordance with quantitative settlement of lactobacilli in BV was increased from 1.4 +/- 2.6 log CFU/ml, to 1.8 +/- 2.9 log CFU/ml in treated BV. Treated BV the lactobacilli had not restored significance (p = 0.5831), as well as the total bacteria.Lactobacilli dominantly occur in healthy women, and markedly decline in BV. However, the vaginal ecosystem is dynamically changed in the lactobacilli of either normal or BV women.
- The role of vaginal Lactobacillus Rhamnosus (Normogin®) in preventing Bacterial Vaginosis in women with history of recurrences, undergoing surgical menopause: a prospective pilot study. [Clinical Trial, Journal Article]
- Eur Rev Med Pharmacol Sci 2013 May; 17(10):1399-403.
Bacterial vaginosis (BV), a poly-microbial clinical syndrome, is the most common cause of vaginal symptoms among women. The recurrence rate of BV is up to 30% after traditional antimicrobial therapy. Lactobacillus rhamnosus vaginal tablets have demonstrated to be a reliable topical effective and safe treatment to reduce the BV recurrence rate.to assess topical long-lasting (6 months) Lactobacillus rhamnosus effectiveness in decreasing recurrences in women with positive anamnesis of recurrent BV and concomitant hypo-estrogenism as consequence of surgical menopause.A total of 22 consecutive patients affected by recurrent BV and treated for surgical menopause for benign pathology were enrolled. All women were treated with Lactobacillus rhamnosus vaginal tablets (Normogin(®)) according to the following protocol: 1 tablet/day for 6 days, than two tablets per week for 2 months and then one tablet once a week till 6 months.Of the 22 women enrolled only one has been lost after the first visit. A total of 21 cases were reported; 7 out of 21 had only one case of recurrence, while 2 out of 21 had two episodes of BV during the year successive to menopause. No side effects have been reported.Considering the low recurrence rate of BV during follow-up it seems that long-lasting treatment with vaginal tablets of Lactobacillus rhamnosus could reduce the BV recurrence also in women at high risk with positive history of pathology and undergoing surgical menopause with a safe profile. This study supports the use of vaginal Lactobacillus rhamnosus administration in high risk population without side effects.
- Novel PCR-based methods enhance characterization of vaginal microbiota in a bacterial vaginosis patient before and after treatment. [Journal Article, Research Support, Non-U.S. Gov't]
- Appl Environ Microbiol 2013 Jul; 79(13):4181-5.
Deep characterization, even by next-generation sequencing, of the vaginal microbiota in healthy women or posttreatment bacterial vaginosis patients is limited by the dominance of lactobacilli. To improve detection, we offer two approaches: quantitative PCR (qPCR) using phylogenetic branch-inclusive primers and sequencing of broad-spectrum amplicons generated with oligomers that block amplification of lactobacilli.
- Fluorescence in situ Hybridization method using Peptide Nucleic Acid probes for rapid detection of Lactobacillus and Gardnerella spp. [Evaluation Studies, Journal Article, Research Support, Non-U.S. Gov't]
- BMC Microbiol 2013.:82.
Bacterial vaginosis (BV) is a common vaginal infection occurring in women of reproductive age. It is widely accepted that the microbial switch from normal microflora to BV is characterized by a decrease in vaginal colonization by Lactobacillus species together with an increase of Gardnerella vaginalis and other anaerobes. Our goal was to develop and optimize a novel Peptide Nucleic Acid (PNA) Fluorescence in situ Hybridization assay (PNA FISH) for the detection of Lactobacillus spp. and G. vaginalis in mixed samples.Therefore, we evaluated and validated two specific PNA probes by using 36 representative Lactobacillus strains, 22 representative G. vaginalis strains and 27 other taxonomically related or pathogenic bacterial strains commonly found in vaginal samples. The probes were also tested at different concentrations of G. vaginalis and Lactobacillus species in vitro, in the presence of a HeLa cell line. Specificity and sensitivity of the PNA probes were found to be 98.0% (95% confidence interval (CI), from 87.8 to 99.9%) and 100% (95% CI, from 88.0 to 100.0%), for Lactobacillus spp.; and 100% (95% CI, from 92.8 to 100%) and 100% (95% CI, from 81.5 to 100.0%) for G. vaginalis. Moreover, the probes were evaluated in mixed samples mimicking women with BV or normal vaginal microflora, demonstrating efficiency and applicability of our PNA FISH.This quick method accurately detects Lactobacillus spp. and G. vaginalis species in mixed samples, thus enabling efficient evaluation of the two bacterial groups, most frequently encountered in the vagina.
- Composition of the vaginal microbiota in women of reproductive age--sensitive and specific molecular diagnosis of bacterial vaginosis is possible? [Journal Article, Research Support, Non-U.S. Gov't]
- PLoS One 2013; 8(4):e60670.
Bacterial vaginosis (BV) is the most common vaginal disorder, characterized by depletion of the normal lactobacillus-dominant microbiota and overgrowth of commensal anaerobic bacteria. This study aimed to investigate the composition of the vaginal microbiota in women of reproductive age (healthy women and women with BV), with the view of developing molecular criteria for BV diagnosis.Vaginal samples from 163 women (79 control, 73 BV and 11 intermediate (Lactobacillary grade II flora) cases) were analyzed using 454 pyrosequencing of the hypervariable regions V3-V4 of the 16S rRNA gene and 16 quantitative bacterial species/genus-specific real-time PCR assays. Sensitivities and specificities of potential BV markers were computed using the Amsel criteria as reference standard for BV. The use of quantitative thresholds for prediction of BV, determined for both relative abundance measured with 454 pyrosequencing and bacterial load measured with qPCR, was evaluated.Relative to the healthy women, the BV patients had in their vaginal microbiota significantly higher prevalence, loads and relative abundances of the majority of BV associated bacteria. However, only Gardnerella vaginalis, Atopobium vaginae, Eggerthella, Prevotella, BVAB2 and Megasphaera type 1 detected at or above optimal thresholds were highly predictable for BV, with the best diagnostic accuracy shown for A. vaginae. The depletion of Lactobacillus species combined with the presence of either G. vaginalis or A. vaginae at diagnostic levels was a highly accurate BV predictor.Quantitative determination of the presence of G. vaginalis, A. vaginae, Eggerthella, Prevotella, BVAB2 and Megasphaera type 1 as well as the depletion of Lactobacillus was highly accurate for BV diagnosis. Measurements of abundance of normal and BV microbiota relative to total bacteria in vaginal fluid may provide more accurate BV diagnosis, and be used for test-of-cure, rather than qualitative detection or absolute counts of BV related microorganisms.