Click through the PLOS taxonomy to find articles in your field. Both studies described above do not use well-characterized probiotic Lactobacillus strains. 2017 Mar 10;38(3):406-410. doi: 10.3760/cma.j.issn.0254-6450.2017.03.026. In our study, the inclusion of women with intermediate vaginal flora was based on the scoring system of Nugent et al. (2013). J. Med. Furthermore, BV is also often detected in HIV-seropositive women (Spear et al., 2011; Borgdorff et al., 2014). confidence interval; Lactobacillus spp., J. Infect. Vaginal lactobacilli profile in pregnant women with normal & abnormal vaginal flora. All women except those with a normal flora (Nugent score 0–3) were asked to undergo a follow-up smear between 14 + 0 (14 weeks plus 0 days) and 22 + 0 (22 weeks plus 0 days) gestational weeks at our department. 4:16. doi: 10.1186/1471-2180-4-16, Verhelst, R., Verstraelen, H., Claeys, G., Verschraegen, G., Van, S. L., De, G. C., et al. ISME J. Fig 1. 190, 1059–1067. (2012). Preliminary characterization of vaginal microbiota in healthy Chinese women using cultivation-independent methods. Lactobacillus crispatus modulates epithelial cell defense against Candida albicans through Toll-like receptors 2 and 4, interleukin 8 and human beta-defensins 2 and 3. Most of the available studies on VMB are cross-sectional studies and thus only based on the collection of vaginal samples at a single time point. Hereby, the adherence pattern of lactobacilli appears to be more loose than that of (BV) pathogens that occur in thicker biofilms (Machado et al., 2013). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Wagner and Johnson (2012) investigated the influence of L. rhamnosus GR-1 and L. reuteri RC-14 on the inflammatory response of VK2/E6E7 to C. albicans and observed that the probiotic strains modulate the VK2/E6E7 inflammatory immune response to C. albicans by suppressing the expression of induced NF-κ B inhibitor kinase alpha (Iκ κ α), TLR2, TLR6, IL-8, and TNF, suggesting that they inhibit NF-κ B signaling (Wagner and Johnson, 2012). BV was associated with the acquisition or reactivation of HPV infection, whereas no association was found with HPV persistence or the development of squamous intraepithelial lesions (SIL) (Watts et al., 2005). at between 25 and 35 gestational weeks, data with regard to the Nugent scoring system are lacking [12]. Med. Andersch, B., Forssman, L., Lincoln, K., and Torstensson, P. (1986). (2012) also showed that the vaginal bacterial communities of some women markedly change over time, switching from one class to another, whereas others stay relatively stable. (2010). Koleva PT, Tun HM, Konya T, Guttman DS, Becker AB, Mandhane PJ, Turvey SE, Subbarao P, Sears MR, Scott JA, Kozyrskyj AL; CHILD Study Investigators. For example, Rose et al. 49(Pt 1), 217–221. (2013). doi: 10.1128/CDLI.8.1.31-39.2001, Kiss, H., Kogler, B., Petricevic, L., Sauerzapf, I., Klayraung, S., Domig, K., et al. The authors suggested that PTD was associated with intermediate flora, rather than with BV, and that this shift might be the reason for the failure in the prevention of PTD reported in several studies [20]. Furthermore, exclusion and competition of S. aureus, Group B streptococci (Zarate and Nader-Macias, 2006), Pseudomonas aeruginosa, Klebsiella pneumonia, and E. coli (Osset et al., 2001), uropathogenic E. coli (UPEC), G. vaginalis and P. bivia (Atassi et al., 2006), and of T. vaginalis (Phukan et al., 2013) by Lactobacillus species have also been observed. For more information about PLOS Subject Areas, click Infect. FEMS Immunol. For instance, an Italian group investigated capsules containing at least 109 CFU of L. brevis CD2, L. salivarius subsp. Please enable it to take advantage of the complete set of features! Nevertheless, in recent years, the microbiota from other body sites, such as the skin, oronasopharyngeal cavity and genital tract, have also gained more attention. The identification of L. crispatus as the most frequently occurring species, has also been reported in other populations such as Turkish, Swedish, Mexican, Belgian, Japanese, American and Canadian women (Kilic et al., 2001; Vasquez et al., 2002; Verhelst et al., 2005; Ravel et al., 2011; Martinez-Pena et al., 2013; Chaban et al., 2014). doi: 10.1016/j.anaerobe.2011.04.022, Mastromarino, P., Di, P. M., Schiavoni, G., Nardis, C., Gentile, M., and Sessa, R. (2014). For example, Ya et al. PLoS ONE 7:e32728. Association between chlamydia trachomatis genital infection and the vaginal microbiome. Department of Obstetrics and Gynaecology, Division of Obstetrics and Fetomaternal Medicine, Medical University of Vienna, Vienna, Austria, Affiliation 2014 Nov-Dec;48 Suppl 1:S106-12. Acad. Cell Host. Vaginal microbiota and its role in HIV transmission and infection. Interaction between lactobacilli, bacterial vaginosis-associated bacteria, and HIV Type 1 RNA and DNA genital shedding in U.S. and Kenyan women. Analysis of the role of Lactobacillus spp. Characterization of vaginal microbial communities in adult healthy women using cultivation-independent methods. doi: 10.1371/journal.pone.0040425, Spear, G. T., Gilbert, D., Landay, A. L., Zariffard, R., French, A. L., Patel, P., et al. doi: 10.2436/20.1501.01.70, Martin, R., and Suarez, J. E. (2010). However, the overall risk reduction of PTD through antibiotic treatment of an abnormal flora was disproved by large and well-designed studies in a general obstetrical population [5,6]. doi: 10.1159/000298923. Nevertheless, more research is needed to substantiate the expression of specific cytokines and immune factors as potential biomarkers of vaginal health. BMC Infect. doi: 10.1073/pnas.1002601107, Donders, G. G., Van, C. K., Bellen, G., Reybrouck, R., Van den, B. T., Riphagen, I., et al. Lab. Diagn. We attempted to detect a shift towards BV later in pregnancy by evaluating vaginal follow-up smears, as this shift could be responsible for the high risk of PTD in the Non-Lactobacilli group. We apologize to all colleagues who have not been cited here due to space limitation. BMC Infect. (2012) observed that the cervical microbiota clusters in six distinct community types of which clusters I–IV are similar to the vaginal community types reported by Ravel and co-workers. Martin, H. L., Richardson, B. Med. Curr. Use of probiotic strains for the treatment of BV. Human lactobacilli as supplementation of clindamycin to patients with bacterial vaginosis reduce the recurrence rate; a 6-month, double-blind, randomized, placebo-controlled study. doi: 10.1002/dc.21786, Dominguez-Bello, M. G., Costello, E. K., Contreras, M., Magris, M., Hidalgo, G., Fierer, N., et al. 2003;189: 139–147. 11:10. doi: 10.1186/1471-2334-11-10, Gong, Z., Luna, Y., Yu, P., and Fan, H. (2014). doi: 10.1126/scitranslmed.3003605, Gallo, M. F., Warner, L., Macaluso, M., Stone, K. M., Brill, I., Fleenor, M. E., et al. were identified as potential microbiological markers of HPV infection, although the specificity for HPV should be further verified (Lee et al., 2013). Med. (2010). for 6 days to rebuild the physiological flora [16]. For example, it has been shown that L. jensenii ATCC 25258 could both reduce adhesion and invasion of N. gonorrhoeae, whereas L. gasseri ATCC 33323 could displace adherent N. gonorrhoeae (Spurbeck and Arvidson, 2008). Transl. 1991;4: 485–502. The gestational age at delivery was considered the primary outcome variable, and was recorded as term delivery at or after 37 + 0 (37 weeks plus 0 days) gestational weeks. (1996). doi: 10.1016/j.micinf.2008.07.032, Wagner, R. D., and Johnson, S. J. 12:83. doi: 10.1186/1471-2180-12-83, Juarez Tomas, M. S., Ocana, V. S., Wiese, B., and Nader-Macias, M. E. (2003). Cherpes, T. L., Hillier, S. L., Meyn, L. A., Busch, J. L., and Krohn, M. A. Longitudinal study of the dynamics of vaginal microflora during two consecutive menstrual cycles. A., Bukusi, E., John-Stewart, G., Jaoko, W., et al. Dis. Hopefully, this will result in the identification of clinically relevant microbiota clusters that could be good biomarkers of the VMB state. 56, 397–402. (2011). play an important role in the intermediate vaginal flora and that their absence may be associated with a pathological condition. Scand. (1999) and has escaped the attention of scientists for a long time, since it grows only on blood agar, but not on MRS or Rogosa (Falsen et al., 1999). Taken together, the studies of Srinivasan et al. Evaluation of the vaginal flora in pregnant women receiving opioid maintenance therapy: a matched case-control study. Since the effect of treating pregnant women with an abnormal vaginal flora was introduced, BV has gained interest and is now a well-known risk factor for ascending infections and subsequent PTD [4]. Discrete data are presented as number (percentage).  |  (2010). Interestingly, lysogeny of phage particles was observed recently in most of the vaginal isolates of L. crispatus, which could explain the large number of genes encoding mobile genetic elements (Damelin et al., 2011). J. Infect. This mucus and glycogen degradation may cause micro-abrasions or epithelial cell alterations which could facilitate binding of pathogens to the underlying epithelial cell receptors. (2012). 8, 1781–1793. 45, 3145. doi: 10.1086/345761. Arzneimittelforschung 46, 68–73. Lett. U.S.A. 108, 4688–4695. https://doi.org/10.1371/journal.pone.0144181.t004. Relationship of vaginal bacteria and inflammation with conception and early pregnancy loss following in-vitro fertilization. Of note, the first conducted systematic review (only based on 4 studies) did not provide conclusive evidence that probiotics can enhance or are better than antibiotics in the treatment of BV (Senok et al., 2009). Med. A randomized trial of metronidazole in asymptomatic bacterial vaginosis to prevent the acquisition of sexually transmitted diseases. Incidence of herpes simplex virus type 2 infection in 5 sexually transmitted disease (STD) clinics and the effect of HIV/STD risk-reduction counseling. doi: 10.1371/journal.pone.0037818, Srinivasan, S., Liu, C., Mitchell, C. M., Fiedler, T. L., Thomas, K. K., Agnew, K. J., et al. 83, 365–368. doi: 10.1371/journal.pone.0082599, Larsson, P. G., Stray-Pedersen, B., Ryttig, K. R., and Larsen, S. (2008). The Amsel criteria are often used in clinical practice (Amsel et al., 1983) and require the presence of at least three of the following criteria to diagnose BV: (i) thin, homogeneous vaginal discharge; (ii) vaginal pH higher than 4.5; (iii) “fishy” odor of vaginal fluid before or after addition of 10% potassium hydroxide (KOH) (whiff test); (iv) presence of clue cells on microscopic evaluation of saline wet preparations. doi: 10.1371/journal.pone.0096659, Gillet, E., Meys, J. F., Verstraelen, H., Bosire, C., De, S. P., Temmerman, M., et al. AIDS Res. PLoS ONE 7:e45281. doi: 10.1016/j.ajog.2004.12.069, Chaban, B., Links, M. G., Jayaprakash, T. P., Wagner, E. C., Bourque, D. K., Lohn, Z., et al. One of the advantages of using probiotics unlike antibiotics is the fact that these beneficial bacteria can be used over a long period of time without interfering with the normal VMB. 210, 1723–1733. 76, 400–405. doi: 10.1086/423323, Graver, M. A., and Wade, J. J. 304, 654–661. 30, 405–410. in the total absence of any bacteria. L. iners-dominated communities shift more often to community type IV-B, which is dominated by a diverse number of bacteria belonging mainly to the genus Atopobium, Prevotella, Parvimonas, Sneathia, Gardnerella, or Mobiluncus, but in rare cases to IV-A. The species was discovered by Falsen et al. BV was found to be a strong predictor of C. trachomatis and N. gonorrhoeae infection among women with recent exposure to a male partner with chlamydial or gonococcal urethritis (Wiesenfeld et al., 2003). PLoS Med. Analyzed the data: MH AF. Adherence of clinically isolated lactobacilli to human cervical cells in competition with Neisseria gonorrhoeae.

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