Effect of a yoghurt drink containing Lactobacillus strains on bacterial vaginosis in women – a double-blind, randomised, controlled clinical pilot trial

Abstract

Bacterial vaginosis (BV) is characterised by a depletion of lactobacilli in favour of an overgrowth of anaerobic bacteria. It is associated with increased risk for urogenital infections and abortion. In this study we assessed the effect of a yoghurt drink containing Lactobacillus strains on BV. The strains had been isolated from healthy pregnant women and selected for acidification capacity, production of HO, glycogen utilisation, bile salt tolerance and inhibition of pathogens. Using Amsel criteria BV was diagnosed in 36 women aged ≥18 years with stable menstrual cycle or menopause. They were treated with oral metronidazole for 7 days (2×500 mg/d). Starting with the treatment, women consumed twice daily either verum or placebo during 4 weeks. Verum was 125 g yoghurt containing (besides Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus) living strains Lactobacillus crispatus LbV 88 (DSM 22566), Lactobacillus gasseri LbV 150N (DSM 22583), Lactobacillus jensenii LbV 116 (DSM 22567) and Lactobacillus rhamnosus LbV96 (DSM 22560), each 1×107 cfu/ml; placebo was 125 g chemically acidified milk. After 4 weeks of intervention 0 of 17 had BV in the verum group versus 6 of 17 in the s.a. control (0.018 in Fisher Exact test). Amsel score decreased during the intervention period by 4.0 (median) (4.0; 3.0) (25; 75 percentile) in the verum group compared to 2.0 (4.0; 0.0) in the control group (P=0.038 in Mann-Whitney test). Discharge and odour (Amsel criteria 2+3) also decreased by 2.0 (2.0; 1.0) in the verum compared to 1.0 (2.0; 0.0) in the control group (P=0.01) and differed after 4 weeks intervention between the groups 0.0 (0.0; 0.0) versus 1.0 (0.0; 2.0) (P=0.001). Nugent score decreased during the intervention period by 5.5 (7.0;2.3) in the verum compared to 3.0 (6.0;0.5) in the control group (P=0.158). Additional intake of yoghurt containing these probiotic strains improved the recovery rate and symptoms of BV and tended to improve the vaginal microbial pattern.

Treating vaginitis with probiotics in non‑pregnant females: A systematic review and meta‑analysis

“…The majority of studies adopted a type I treatment design for BV and/or VVC infections and those with 1-and/or 6-months follow-up data were included in the meta-analysis. These comprised of a total of 21 articles (10 articles on BV, 9 studies on VVC and 2 on BV/VVC) (15,17,18,20,(22)(23)(24)(25)(26)29,31,32,(35)(36)(37)(38)(39)(40)(41). The total number of patients evaluated in the 21 type I studies was 1,788 (probiotic test group, n=910; control group, n=878).…”

The Role of the Cervicovaginal Microbiome on the Genesis and as a Biomarker of Premalignant Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer

“…Based on in vitro assays, L. crispatus LbV 88, L. gasseri LbV 150N, L. jensenii LbV 116, and L. rhamnosus LbV96 strains, originally obtained from healthy pregnant women, were selected as relevant for vaginal health [136] and further used in a pilot clinical trial in which a yoghurt preparation containing those beneficial microbes were administered to BV-diagnosed women together with metronidazole. The study showed that the group receiving probiotics significantly improved the recovery rate from BV when compared to patients treated only with antibiotics [137].…”

Evaluation of the Inhibitory Effects of Lactobacillus gasseri and Lactobacillus crispatus on the Adhesion of Seven Common Lower Genital Tract Infection-Causing Pathogens to Vaginal Epithelial Cells

“…Various clinical studies have indicated that microecological preparations, administered orally or vaginally, can significantly reduce the incidence and recurrence rates (11)(12)(13), prolong the recurrence period, improve the recovery rate (14), relieve the symptoms (15), and improve the vaginal microecological patterns (16) of BV and VVC. There is a significant correlation between Lactobacillus colonization in the vagina and clinical outcomes (12,13,17).…”