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Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis.
PLoS Pathog. 2020 06; 16(6):e1008559.PP

Abstract

Antibiotics continue to be the standard-of-care for bacterial vaginosis (BV), although recurrence rates are high. Vaginal probiotics may improve durability of BV treatment, although few probiotics for vaginal health contain Lactobacillus spp. that commonly colonize the lower female genital tract. Characteristics of vaginal Lactobacillus strains from South African women were evaluated for their probiotic potential in vitro compared to strains from commercial vaginal products, including growth at varying pHs, ability to lower pH, produce D-/L-lactate and H2O2, influence growth of BV-associated Gardnerella vaginalis and Prevotella bivia, adherence to cervical cells and susceptibility to antibiotics. Fifty-seven Lactobacillus strains were purified from cervico-vaginal fluid, including L. crispatus, L. jensenii, L. gasseri, L. mucosae, and L. vaginalis. L crispatus strains grew better at pHs below 4.5 and lowered pH more effectively than other strains. Production of D-/L-lactate and H2O2 varied between Lactobacillus species and strains. Lactobacillus strains generally inhibited P. bivia more uniformly than G. vaginalis isolates. All vaginal Lactobacillus isolates were resistant to metronidazole while susceptibility to clindamycin varied. Furthermore, vaginal Lactobacillus strains tended to be broadly susceptible to penicillin, amoxicillin, rifampicin and rifabutin. Whole-genome-sequencing of five of the best-performing vaginal Lactobacillus strains confirmed their likely safety, due to antimicrobial resistance elements being largely absent, while putative intact prophages were present in the genomes of two of the five strains. Overall, vaginal Lactobacillus strains largely performed better in these in vitro assays than probiotic strains currently used in probiotics for vaginal health. Including the best-performing vaginal Lactobacillus isolates in a region-specific probiotic for vaginal health may result in improved BV treatment options.

Authors+Show Affiliations

Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa. Seattle Children's Hospital, Seattle, United States of America.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa. Seattle Children's Hospital, Seattle, United States of America.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa. Family Centre for Research with Ubuntu (FAMCRU), Stellenbosch University, Tygerberg, South Africa.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa. Desmond Tutu HIV Foundation, University of Cape Town, Cape Town, South Africa.UMR MIVEGEC CNRS-IRD-UM, University Montpellier, Montpellier, France.Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa. NRF-DST CAPRISA Centre of Excellence in HIV Prevention, Cape Town, South Africa. National Health Laboratory Service (NHLS), Cape Town, South Africa.

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32497109

Citation

Happel, Anna-Ursula, et al. "Exploring Potential of Vaginal Lactobacillus Isolates From South African Women for Enhancing Treatment for Bacterial Vaginosis." PLoS Pathogens, vol. 16, no. 6, 2020, pp. e1008559.
Happel AU, Kullin B, Gamieldien H, et al. Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis. PLoS Pathog. 2020;16(6):e1008559.
Happel, A. U., Kullin, B., Gamieldien, H., Wentzel, N., Zauchenberger, C. Z., Jaspan, H. B., Dabee, S., Barnabas, S. L., Jaumdally, S. Z., Dietrich, J., Gray, G., Bekker, L. G., Froissart, R., & Passmore, J. S. (2020). Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis. PLoS Pathogens, 16(6), e1008559. https://doi.org/10.1371/journal.ppat.1008559
Happel AU, et al. Exploring Potential of Vaginal Lactobacillus Isolates From South African Women for Enhancing Treatment for Bacterial Vaginosis. PLoS Pathog. 2020;16(6):e1008559. PubMed PMID: 32497109.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis. AU - Happel,Anna-Ursula, AU - Kullin,Brian, AU - Gamieldien,Hoyam, AU - Wentzel,Nicole, AU - Zauchenberger,Chambrez Z, AU - Jaspan,Heather B, AU - Dabee,Smritee, AU - Barnabas,Shaun L, AU - Jaumdally,Shameem Z, AU - Dietrich,Janan, AU - Gray,Glenda, AU - Bekker,Linda-Gail, AU - Froissart,Remy, AU - Passmore,Jo-Ann S, Y1 - 2020/06/04/ PY - 2019/06/07/received PY - 2020/04/16/accepted PY - 2020/6/5/entrez PY - 2020/6/5/pubmed PY - 2020/8/11/medline SP - e1008559 EP - e1008559 JF - PLoS pathogens JO - PLoS Pathog VL - 16 IS - 6 N2 - Antibiotics continue to be the standard-of-care for bacterial vaginosis (BV), although recurrence rates are high. Vaginal probiotics may improve durability of BV treatment, although few probiotics for vaginal health contain Lactobacillus spp. that commonly colonize the lower female genital tract. Characteristics of vaginal Lactobacillus strains from South African women were evaluated for their probiotic potential in vitro compared to strains from commercial vaginal products, including growth at varying pHs, ability to lower pH, produce D-/L-lactate and H2O2, influence growth of BV-associated Gardnerella vaginalis and Prevotella bivia, adherence to cervical cells and susceptibility to antibiotics. Fifty-seven Lactobacillus strains were purified from cervico-vaginal fluid, including L. crispatus, L. jensenii, L. gasseri, L. mucosae, and L. vaginalis. L crispatus strains grew better at pHs below 4.5 and lowered pH more effectively than other strains. Production of D-/L-lactate and H2O2 varied between Lactobacillus species and strains. Lactobacillus strains generally inhibited P. bivia more uniformly than G. vaginalis isolates. All vaginal Lactobacillus isolates were resistant to metronidazole while susceptibility to clindamycin varied. Furthermore, vaginal Lactobacillus strains tended to be broadly susceptible to penicillin, amoxicillin, rifampicin and rifabutin. Whole-genome-sequencing of five of the best-performing vaginal Lactobacillus strains confirmed their likely safety, due to antimicrobial resistance elements being largely absent, while putative intact prophages were present in the genomes of two of the five strains. Overall, vaginal Lactobacillus strains largely performed better in these in vitro assays than probiotic strains currently used in probiotics for vaginal health. Including the best-performing vaginal Lactobacillus isolates in a region-specific probiotic for vaginal health may result in improved BV treatment options. SN - 1553-7374 UR - https://www.unboundmedicine.com/medline/citation/32497109/Exploring_potential_of_vaginal_Lactobacillus_isolates_from_South_African_women_for_enhancing_treatment_for_bacterial_vaginosis_ DB - PRIME DP - Unbound Medicine ER -