Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study

Hemalatha, R.; Mastromarino, Paola; Ramalaxmi, Baru Anantha; Balakrishna, N.; Sesikeran, B.

doi:10.1007/s10096-012-1671-1

Cited by 54 publications

(49 citation statements)

References 30 publications

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“…(32) In a small study of 42 Indian women with normal Nugent scores, use of a vaginal probiotic tablet containing L. brevis, L. salivarius and L. plantarum for 8 days was associated with a decrease in vaginal IL1β and IL6 on day 9, which was not seen in women randomized to a placebo tablet. (33) In vitro, Rose et al showed that adding L. crispatus or L. jensenii to cultured vaginal epithelial cells in the presence of the toll-like receptor agonists PIC and FSL-1 decreased levels of IL6, IL8 and/or TNF-α compared to the agonist alone. This effect varied by strain: a laboratory isolate of L. jensenii had less of an effect than a clinical isolate.…”

Section: Discussionmentioning

confidence: 99%

Hydrogen Peroxide–Producing Lactobacilli Are Associated With Lower Levels of Vaginal Interleukin-1β, Independent of Bacterial Vaginosis

Mitchell¹,

Fredricks²,

Agnew³

et al. 2015

Sexually Transmitted Diseases

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Background The presence of hydrogen peroxide (H2O2)-producing lactobacilli in the vagina is associated with decreased rates of preterm birth and HIV acquisition. We hypothesize that this is due to immunomodulatory effects of these species. Methods Concentrations of IL1β, IL6, IL8, secretory leukocyte protease inhibitor (SLPI) and human beta defensin 2 (HBD2) were quantified from vaginal swabs from 4 groups of women: women with and without bacterial vaginosis (BV) by Nugent score, further stratified by detection of H2O2-producing lactobacilli by semi-quantitative culture. Ten quantitative PCR assays characterized presence and quantity of select Lactobacillus and BV-associated species in each group. Levels of immune markers and bacteria were compared between the four groups using ANOVA, Kruskal-Wallis, Mann Whitney U or chi-square tests. Results Swabs from 110 women from four groups were included: 26 had a normal Nugent score (BV−), and no H2O2-producing lactobacilli detected(H2O2−), 47 were BV−, H2O2+, 27 BV+, H2O2− and 10 BV+, H2O2+. The groups were similar in age, marital status and reproductive history, but not ethnicity: the BV−, H2O2− group had more Caucasian participants(p = 0.02). In women with and without BV, IL1β was lower in the H2O2+ groups. HBD2 was lowest in BV+ H2O2− women and highest in BV−, H2O2−. SLPI was lower in women with BV, and did not differ by the presence of H2O2–producing lactobacilli. In regression analysis higher quantities of L. crispatus were associated with lower quantities of IL1β. Detection and quantity of BV-associated species by qPCR was significantly different between women with and without BV, but not between women with and without H2O2-producing lactobacilli within those groups. Conclusions The presence of H2O2-producing lactobacilli is associated with lower levels of some vaginal pro-inflammatory cytokines, even in women with BV.

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Section: Discussionmentioning

confidence: 99%

Hydrogen Peroxide–Producing Lactobacilli Are Associated With Lower Levels of Vaginal Interleukin-1β, Independent of Bacterial Vaginosis

Mitchell¹,

Fredricks²,

Agnew³

et al. 2015

Sexually Transmitted Diseases

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“…belonging to the normal microbiota of the vaginal tract. Hemalatha et al [36] demonstrated that a probiotic lactobacilli tablet was found to be better than a pH lowering vaginal tablet in preventing BV in healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

Effects of Processing and Storage onPediococcus pentosaceusSB83 in Vaginal Formulations: Lyophilized Powder and Tablets

Borges

Costa

Silva

et al. 2013

BioMed Research International

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Vaginal probiotics have an important role in preventing the colonization of the vagina by pathogens. This study aimed to investigate different formulations with Pediococcus pentosaceus SB83 (lyophilized powder and tablets with and without retarding polymer) in order to verify its stability and antilisterial activity after manufacture and during storage. The bacteriocinogenic activity of P. pentosaceus SB83 against Listeria monocytogenes was evaluated in simulated vaginal fluid. Suspension of Pediococcus pentosaceus SB83 reduced the pathogen only after 2 h and the lyophilized bacteria after 24 h of contact, and, in the tablets, P. pentosaceus SB83 lost the antimicrobial activity. The pH of simulated vaginal fluid decreased for all the tested conditions. As lyophilized powder demonstrated better results concerning antimicrobial activity, this formulation was selected to evaluate the antilisterial activity during the 12 months of storage. During storage at room temperature, lyophilized bacteria totally inhibited the pathogen only until one month of storage. At 4°C, P. pentosaceus SB83 showed antimicrobial activity during all the time of storage investigated. Therefore, the better formulation of P. pentosaceus SB83 is the lyophilized powder stored at 4°C, which may be administered intravaginally as a washing solution.

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“…19 In addition, chlorhexidine gluconate cloths for preoperative wash don't have the same warning against use in the genital area as 2% and 4% chlorhexidine gluconate solution. 22 This acidic environment provides a natural protection for the vagina from invading microorganisms. All of the products that state "don't use in genital area" contain isopropyl alcohol.…”

Section: Baby Shampoo's Effectivenessmentioning

confidence: 99%

Vaginal prep in the operating room

Roberson¹

2014

OR Nurse

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A According to the CDC, approximately 17% of hospital-acquired infections in the United States are surgical site infections (SSIs). 1 Patients who undergo surgery have a 10% to 30% chance of developing an SSI, increasing the hospital stay up to 8.2 days at an additional cost of $20,842. 1-3 Cleansing the surgical site prior to the procedure-with the goal of reducing soil and transient microorganisms-is one way to lower the chance of an SSI according to the Association of periOperative Registered Nurses (AORN). 4 Preparation (prep) solutions that are FDA approved for the vagina are limited. Povidone-iodine (PI) 10% solution is the only FDA-approved prep solution currently available for use as a vaginal prep. Chlorhexidine 4% is FDA approved for skin prep but isn't approved for use on genital areas at this time. 4 So, what's the alternative for vaginal procedures when the patient has an iodine allergy? The challenge for the surgical staff is finding a good prep solution to cleanse the vagina that's nonirritating and still meets surgical standards. Baby shampoo has been used as a vaginal prep solution in some facilities, but there isn't enough research to determine if it's an acceptable alternative to prevent SSIs. However, does the vagina need the same preparation as the skin prior to procedures? Clinical practice issueThere's an abundance of information available regarding intraoperative prep of the surgical site; however, Vaginal in the operating ro m prep By Amy L. Roberson, BSN, MAED/AET, MSN, RN, Maj, USAF, CNOR Baby shampoo may be considered as a possible alternative agent for vaginal prep, but with only one study found on the subject, a recommendation for a change in clinical practice can't be made at this time.

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Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study

Cited by 54 publications

References 30 publications

Hydrogen Peroxide–Producing Lactobacilli Are Associated With Lower Levels of Vaginal Interleukin-1β, Independent of Bacterial Vaginosis

Hydrogen Peroxide–Producing Lactobacilli Are Associated With Lower Levels of Vaginal Interleukin-1β, Independent of Bacterial Vaginosis

Effects of Processing and Storage onPediococcus pentosaceusSB83 in Vaginal Formulations: Lyophilized Powder and Tablets

Vaginal prep in the operating room

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