Abstract
This study includes the using therapeutic bacteria isolate in topical ointment for bacterial vaginosis treatment and to compare it with metronidazole ointment that use in a clinical trial under medical supervision. Four active Lactobacillus probiotics bacteria were cultured in %12 skim milk , three of these bacteria were commercial types and one Iraqi local isolate , the total bacterial count of probiotics bacteria were around ≥ 1012 cfu/ml . %10 of individually culture free cells filtrate were added to Muller Hinton broth with secretions of patients infected with bacterial vaginosis "BV", %50 of natural organic components and %50 of local isolate Lactobacillus plantarum cultured in skim milk were mixed to prepare the natural ointment. Eighty-nine BV volunteers were divided into two group, first was 43 volunteers used probiotic ointment, the second group was 46 volunteers used metronidazole ointment "as control group", both groups were under medical observation for two weeks. The results shown that Iraqi local isolate Lb . plantarum gave best inhibition in vitro, according to Amsel criteria the rate of healing with Lb . plantarum ointment group was %97.87, it was higher than metronidazole ointment %91.30 and the healed cases numbers were increased at the day 7 and 14,it has been noticed that the results were positive based on vaginal secretions, and whiff test, clue cell and the pH was above 4.5 shown significant progress. According to Nugent criteria Lb . plantarum ointment gave higher healing percentage which was %95.35.
Highlights
Therapeutic or bacteria probiotics defined as living microorganisms that help, encourage and support the restoration of microbial balance and granting of health benefits in host's body [15]
Global marketing trends suggest that therapeutic bacteria can be a promising alternative to traditional drugs because of their constants prevention and healing actions against many diseases and bacterial pathogens [12]. vaginal bacteria infections considered as one of important global health problems, WHO reports that one out three of adults females suffering from vaginal bacteria infections at, adulthood an abnormal condition caused by the microbial imbalance of vaginal flora, caused by an excessive growth of some bacterial strains led to vaginal infections [13], which is one of the most common diseases in adults females, especially in the fertility age, the incidence rate of the infection is more than 70%
MATERIALS AND METHODS Samples collection Twenty two vaginal swabs were collected from patients women suffering from bacterial vaginosis visiting the "women's obstetrics and gynecology hospital in Samawah city in Muthanna province– Iraq " these samples were collected by a specialist physician . all cases were diagnosed as a bacterial infection based on symptoms and clinical signs according to approved diagnostic criteria. swabs were taken from the vagina by using Sims' vaginal speculum (A double-blade surgical instrument used to examine the vagina and cervix) sterile cotton swabs were inserted at a depth of 2 cm in gentle with rotation on the wall of the vagina [6] The swabs placed in stuart transport media and transferred to the laboratory
Summary
Therapeutic or bacteria probiotics defined as living microorganisms that help, encourage and support the restoration of microbial balance and granting of health benefits in host's body [15]. The activation was repeated three times for each type of therapeutic bacteria separately [4] Total numbers count were estimated in Pour Plate Count by using MRSL.Cysteine.HCL agar (Himedia company – India ) with anaerobic conditions (5% CO2 ,37OC ,48hrs.). Culture cells filtrate preparing Culture cells Filtrate of Lb. rhamnosus GG , Lb. plantarum , Lb. casei and local isolate Lb. plantarum live cells were prepared by transfer a single colony to sterilized skim milk 12% and incubated at 37 ° C until coagulation, The numbers of each type of therapeutic bacteria were estimated (≥1012) centrifuged using a high-speed refrigerant centrifuge (Huttich, Germany) 4000 rpm for 20 min at 20 ̊C. It was noticed that the bacterial numbers were incubation enabled to obtain high initial variant in the growth and that variety in the numbers, a requirement for the use of study, may due to use different species and therapeutic bacteria in the field of medical strain and have different metabolic activities, treatment and prevention [28]
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