Influence of the spermicidal compound nonoxynol-9 on the growth and adhesion of urogenital bacteria in vitro

Abstract

Lactobacilli and uropathogenic bacteria isolated from the female urogenital tract were tested for their susceptibility to nonoxynol-9. Nonoxynol-9 is a spermicidal compound, generally used at a concentration of 5% in cream and 12.5% in foam. The growth of 67% of fresh, vaginal lactobacillus isolates was inhibited by concentrations of nonoxynol-9 between 0.1% and 1.0%; these were termed sensitive. Of a total of 47 lactobacilli from various sources, 55% were found to be sensitive to nonoxynol-9, being bacteriostatic for 42% of these isolates and bactericidal for the remaining 58% at N-9 concentrations ⩾1.0%. The remaining lactobacilli and 96% (48/50) of uropathogenic organisms had minimal inhibitory concentrations of ⩾25% for nonoxynol-9. Inhibition of the lactobacilli did not appear to be species specific nor related to the source of the lactobacilli. The adhesion of Gram-positive bacteria, namely lactobacilli and enterococci, to HeLa cells in tissue culture was significantly increased over 60 min in the presence of physiologically used concentrations of nonoxynol-9; however, adhesion ofEscherichia coli was not affected. We believe that nonoxynol-9 has the potential to increase susceptibility to urinary tract infection in women using spermicidal preparations for contraception by inhibiting the growth of lactobacilli, which are believed to have a protective function in the vagina, and allowing overgrowth of uropathogenic bacteria.