Prevention Of Vaginal Infections Research Articles

ADJUVANT AND BENEFICIAL PROBIOTIC THERAPY FOR WOMEN HEALTH

Probiotics are living microbial strains, also considered functional foods, that improve the human intestine and mucosal sites' functionality and normalize the immune system balance. This symbiosis between the human body and microorganisms has attracted scientists and showed a notable role in maintaining human health. The microbiota composition within different sites of the organs can change rapidly and unfavorably, leading to the development of infections or abnormal conditions. The treatments with antibiotics affect and disturb the overall normal microflora, and specifically to the vaginal tract, by inhibiting the spread of the normal microflora of Lactobacillus species. In this sense, probiotics have shown to be an integrative and complementary therapy for the amelioration and prevention of vaginal infections in women. The main objective of the current review is to highlight the importance of probiotics to prevent and treat antibiotic-associated acute and chronic diseases and highlight their possible beneficial impact on women reproductive health. Moreover, the review discusses the recent clinical findings of probiotic therapy concerning protection against vaginal diseases, well-being, infant development, and human body detoxification from the chemical compounds.

Observational prospective study on Lactobacillus plantarum P 17630 in the prevention of vaginal infections, during and after systemic antibiotic therapy or in women with recurrent vaginal or genitourinary infections

We performed a prospective cohort parallel observational study on the use of Lactobacillus plantarum P 17630 in the prevention of vaginal infections. Eligible were women with a diagnosis of bacterial vaginosis (<15 days) and documented history of recurrent vaginal infections; and/or cystitis (<15 days); and/or treatment with antibiotics for bacterial respiratory tract infections during the week before the study entry. Study subjects were prescribed Lactobacillus plantarum P 17630 > 100.000.000 UFC one vaginal capsule per day for 6 days, then a capsule per week for 16 weeks. Eligible subjects were enrolled in two parallel cohorts: 85 women using (group A) and 39 not using (group B) Lactobacillus plantarum P 17630. The risk of recurrent infection within 4 months from the study entry, was higher among untreated women: multivariate OR 2.6 (95%CI 0.7–9.4). The modification of presence/intensity or symptoms was significant in both the study groups (p < .001).Impact statementWhat is already known on this subject? The Lactobacillus plantarum P 17630 has been shown to be active in the treatment of bacterial vaginosis and vaginal candidiasis. No data are available on its efficacy in the prevention of recurrent vaginal or urological infection or as a prevention strategy during systemic treatment with antibiotics.What do the results of this study add? This observational study suggests that Lactobacillus plantarum given for 4 months may lower the risk of recurrent infection in women with recurrent vaginal or genitourinary infection or after antibiotic systemic treatment for bacterial respiratory tract infection. The finding, however, is not statistically significant, possibly due to the lower than expected rate of infection observed in our population and consequently the limited power of the study.What are the implications of these findings for clinical practice and/or further research? New studies are needed in order to evaluate in different populations the role of Lactobacillus plantarum in lowering the risk of recurrent infection in a high-risk populations.

Local therapy as a modern trend in the treatment of vaginal infections

Инфекционно-воспалительные заболевания влагалища (вагиниты) во всем мире представляют собой проблему с серьезными социальными и экономическими последствиями. Вагиниты различаются в зависимости от своего происхождения: их разделяют на неинфекционные и инфекционные. Неинфекционные вагиниты развиваются в отсутствие инфекционного возбудителя, их могут вызвать термические, химические, механические и аллергические факторы. Позже к воспалительному процессу может присоединиться и бактериальный фактор. К этой группе также относится атрофический вагинит. В группу инфекционных вагинитов входят бактериальные вагинозы, неспецифические вагиниты, кандидозный вагинит, гонорейный вагинит, трихомонадный вагинит. Обилие лечебных схем, применяемых для лечения инфекционно-воспалительных заболеваний влагалища, свидетельствует об их невысокой терапевтической эффективности. Так, длительное антибактериальное лечение хронических вульвовагинитов изменяет эндогенную микрофлору, обусловливая увеличение числа штаммов, устойчивых к действию антибактериальных препаратов. Именно поэтому большинство исследователей отводят главную роль комплексному лечению, включающему в себя общую и местную терапию. В частности, высокую эффективность в лечении вагинитов показали комбинированные местные средства, которые работают комплексно: обладают антимикробным, противогрибковым и противовирусным действием, способствуют восстановлению «положительного» баланса микрофлоры, а также устраняют сухость наружных половых органов, восстанавливают слизистую, имеют противовоспалительные свойства. В качестве средства такой локальной терапии особое внимание привлекает современный препарат в форме вагинального геля Gynodek®, который в последние годы с успехом применяется для местного лечения и профилактики вагинальных инфекций. При упорном, выраженном течении вагинита следует использовать местные антибиотики с учетом чувствительности возбудителя. На заключительной стадии назначаются препараты, способствующие восстановлению естественной флоры влагалища и повышению его защитных свойств. Для контроля излеченности у женщин репродуктивного периода берутся мазки на 4–5-й день менструации, а у девочек и женщин в менопаузе – после прохождения курса лечения. С целью профилактики рецидивов заболевания курс местной терапии следует повторить через 4–5 месяцев.

In vitro and in vivo adherence of Candida albicans to mucosal surfaces

In continuation of a previous study, chitin soluble extract (CSE) and anti-Candida albicans antibodies were found to inhibit the in vitro adherence of C. albicans to human vaginal epithelial cells by 60-70%. Pretreatment of epithelial cells with chitin, CSE or N-acetyl-glucosamine (NAG) decreased the percentage of adherence, while pretreatment of yeasts had no such effect, indicating that chitin or its derivatives may be involved in mediating the adherence of C. albicans. In vivo attachment of C. albicans to epithelial cells was studied in an experimental murine vaginitis created by inoculating mice intravaginally with yeasts at the oestrus stage. Attachment of the yeasts to exfoliated vaginal epithelial cells was followed microscopically, and the course of infection was assessed histopathologically in tissue sections at various times post-yeast inoculation. The infection rate at 24-h post-yeast inoculation was approximately 50%. Attempts were made to block in vivo attachment and prevent infection by pretreating 208 mice with either CSE, NAG, mannan or phosphate-buffered saline (PBS) prior to inoculation with yeasts. The infection rate among mice pretreated with mannan or PBS was 41.6% and 43.8%, respectively. Among CSE- or NAG-pretreated animals, the rate ranged from 0-9%. Treatment of mice with CSE or NAG after inoculation of the yeasts did not prevent infection. The data from the in vivo experiments reveal that pretreatment of animals with chitin derivatives blocks attachment of yeasts to the vaginal mucosal surfaces and leads to the prevention of vaginal infection in an experimental model.