Rectal and Vaginal Eradication of Streptococcus agalactiae (GBS) in Pregnant Women by Using Lactobacillus salivarius CECT 9145, A Target-specific Probiotic Strain

Abstract

Streptococcus agalactiae (Group B Streptococci, GBS) can cause severe neonatal sepsis. The recto-vaginal GBS screening of pregnant women and intrapartum antibiotic prophylaxis (IAP) to positive ones is one of the main preventive options. However, such a strategy has some limitations and there is a need for alternative approaches. Initially, the vaginal microbiota of 30 non-pregnant and 24 pregnant women, including the assessment of GBS colonization, was studied. Among the Lactobacillus isolates, 10 Lactobacillus salivarius strains were selected for further characterization. In vitro characterization revealed that L. salivarius CECT 9145 was the best candidate for GBS eradication. Its efficacy to eradicate GBS from the intestinal and vaginal tracts of pregnant women was evaluated in a pilot trial involving 57 healthy pregnant women. All the volunteers in the probiotic group (n = 25) were GBS-positive and consumed ~9 log10 cfu of L. salivarius CECT 9145 daily from week 26 to week 38. At the end of the trial (week 38), 72% and 68% of the women in this group were GBS-negative in the rectal and vaginal samples, respectively. L. salivarius CECT 9145 seems to be an efficient method to reduce the number of GBS-positive women during pregnancy, decreasing the number of women receiving IAP during delivery.

Application of Ligilactobacillus salivarius CECT5713 to Achieve Term Pregnancies in Women with Repetitive Abortion or Infertility of Unknown Origin by Microbiological and Immunological Modulation of the Vaginal Ecosystem

“…L. salivarius CECT5713 has a high acidifying ability by producing high amounts of L-lactic acid and small amounts of acetic acid [37]. Eubiosis and dysbiosis in the vaginal communities are distinguished by the high concentration of lactic acid and the high acidity that characterize the eubiosis state [79][80][81], as a direct result of the metabolic activity of the local lactobacilli, which is enough to inactivate reproductive tract pathogens, including viruses, bacteria and yeasts [49,[82][83][84][85][86][87]. The capability and rate of production of lactic acid by lactobacilli is strain-specific and only high levels of lactic acid and a concomitant very low pH can inhibit microbial growth efficiently in the local vaginal biofilm [88,89].…”

“…Adherence was measured as the number of lactobacilli adhered to the vaginal cells in 20 random microscopic fields. L. salivarius CECT9145 was used as a control strain because of its high adherence to vaginal cells [49]. The assay was performed in triplicate.…”

Lactobacillus strains vary in their ability to interact with human endometrial stromal cells

“…are considered to be safe, their efficacy as a probiotic in the urogenital tract during pregnancy is still under investigation. Most prior studies have primarily focused on examining the ability of individual strains or species of lactobacillus to reduce pathogen colonization in the vaginal tract [ 15 , 24 , 25 ].…”

Rückgang von Infektionen durch Streptokokken der Gruppe B bei Neugeborenen: Analyse von Krankenversicherungsdaten 2005 bis 2017

“…Ein weiteres alternatives Erklärungsmodell für den Rückgang der EOS wäre auch der vermehrte Einsatz von Probiotika in der Schwangerschaft. Die Datenlage zur Eliminierung positiver GBS Screening Befunde durch eine standardisierte Probiotika Therapie bis zur Geburt ist nicht konklusiv [11,12,18,23]. Um die beobachtete deutliche Abnahme der EOS zu erklären, müsste ein entsprechender Probiotikakonsum bei fast allen Schwangeren postuliert werden, worauf es bislang keinen Hinweis gibt.…”