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Characterisation and selection of a Lactobacillus species to re-colonise the vagina of women with recurrent bacterial vaginosis

Imperial College of Science, Technology and Medicine, Department of GenitoUrinary Medicine, Jefferiss Research Trust Laboratories, Praed Street, London W2 1PG

Corresponding author: Dr I. Rosenstein, Scientific Programmes Division, PHLS Headquarters, 61 Colindale Ave, London NW9 5DF. *Present address: Rowett Research Services, Greenburn Road, Bucksburn, Aberdeen AB21 9SB.

Received 2 July 1999; accepted 22 Sept. 1999.

Abstract

This paper reports the results of characterising and selecting a strain of Lactobacillus for potential use as a probiotic in regenerating the vaginal flora of women with recurrent episodes of bacterial vaginosis (BV). BV is a condition characterised by a depletion of vaginal lactobacilli accompanied by an overgrowth of a mixed vaginal flora of aerobic, anaerobic and micro-aerophilic species in very large numbers. BV has been associated with various gynaecological and obstetric complications and has an extremely high recurrence rate, due in part to the failure to establish a normal vaginal flora after antimicrobial therapy. A total of 60 vaginal isolates of lactobacilli was assessed for characteristics considered important for vaginal re-colonisation. The characteristics studied were the in-vitro inhibitory activity of the lactobacilli against bacterial species isolated from women with recurrent BV, acid production after growth of the lactobacilli in liquid culture, production of hydrogen peroxide (H₂O₂) and adhesiveness of the lactobacilli to exfoliated vaginal epithelial cells (VEC). Four strains of lactobacilli, L. acidophilus (61701 and 61880), L. crispatus (55730) and L. delbrueckii subsp. delbrueckii (65407), demonstrated the greatest inhibitory activity against the BV-associated bacterial species. Two of these isolates (55730 and 61880) produced H₂O₂. All four isolates produced a highly acidic environment after growth in liquid medium (pH < 4). Only one of these (strain 61701) was strongly adherent to VEC (>100 bacteria/VEC). A further isolate (L. acidophilus 48101) did not demonstrate maximum inhibitory activity against BV-associated bacteria, but was found to be a strong producer of H₂O₂ and was also highly adherent to VEC. Isolates 61701 and 48101 could be candidates for use as probiotics for vaginal re-colonisation.

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