Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis

Autoři: Anna-Ursula Happel aff001;  Brian Kullin aff001;  Hoyam Gamieldien aff001;  Nicole Wentzel aff001;  Chambrez Z. Zauchenberger aff001;  Heather B. Jaspan aff001;  Smritee Dabee aff001;  Shaun L. Barnabas aff001;  Shameem Z. Jaumdally aff001;  Janan Dietrich aff004;  Glenda Gray aff004;  Linda-Gail Bekker aff001;  Remy Froissart aff007;  Jo-Ann S. Passmore aff001
Působiště autorů: Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa aff001;  Seattle Children’s Hospital, Seattle, United States of America aff002;  Family Centre for Research with Ubuntu (FAMCRU), Stellenbosch University, Tygerberg, South Africa aff003;  Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa aff004;  Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa aff005;  Desmond Tutu HIV Foundation, University of Cape Town, Cape Town, South Africa aff006;  UMR MIVEGEC CNRS-IRD-UM, University Montpellier, Montpellier, France aff007;  NRF-DST CAPRISA Centre of Excellence in HIV Prevention, Cape Town, South Africa aff008;  National Health Laboratory Service (NHLS), Cape Town, South Africa aff009
Vyšlo v časopise: Exploring potential of vaginal Lactobacillus isolates from South African women for enhancing treatment for bacterial vaginosis. PLoS Pathog 16(6): e1008559. doi:10.1371/journal.ppat.1008559
Kategorie: Research Article
doi: 10.1371/journal.ppat.1008559


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.

Klíčová slova:

African people – Antibiotics – Bacterial vaginosis – Clindamycin – Cytokines – Lactobacillus – Microbiome – Probiotics


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