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Longitudinal study of the dynamics of vaginal microflora during two consecutive menstrual cycles

Guido Lopes dos Santos Santiago (UGent) , Piet Cools (UGent) , Hans Verstraelen (UGent) , Marijke Trog (UGent) , Griet Missine, Nabil El Aila (UGent) , Rita Verhelst, Inge Tency (UGent) , Geert Claeys (UGent) , Marleen Temmerman (UGent) , et al.
(2011) PLOS ONE. 6(11).
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Abstract
Background: Although the vaginal microflora (VMF) has been well studied, information on the fluctuation of the different bacterial species throughout the menstrual cycle and the information on events preceding the presence of disturbed VMF is still very limited. Documenting the dynamics of the VMF during the menstrual cycle might provide better insights. In this study, we assessed the presence of different Lactobacillus species in relation to the BV associated species during the menstrual cycle, assessed the influence of the menstrual cycle on the different categories of vaginal microflora and assessed possible causes, such as menstruation and sexual intercourse, of VMF disturbance. To our knowledge, this is the first longitudinal study in which swabs and Gram stains were available for each day of two consecutive menstrual cycles, whereby 8 grades of VMF were distinguished by Gram stain analysis, and whereby the swabs were cultured every 7th day and identification of the bacterial isolates was carried out with a molecular technique. Methods: Self-collected vaginal swabs were obtained daily from 17 non pregnant, menarchal volunteers, and used for daily Gram staining and weekly culture. Bacterial isolates were identified with tDNA-PCR and 16 S rRNA gene sequencing. Results: Nine women presented with predominantly normal VMF and the 8 others had predominantly disturbed VMF. The overall VMF of each volunteer was characteristic and rather stable. Menses and antimicrobials were the major disturbing factors of the VMF. Disturbances were always accompanied by a rise in Gram positive cocci, which also appeared to be a significant group within the VMF in general. Conclusions: We observed a huge interindividual variability of predominantly stable VMF types. The importance of Gram positive cocci in VMF is underestimated. L. crispatus was the species that was most negatively affected by the menses, whereas the presence of the other lactobacilli was less variable.
Keywords
BACTERIAL VAGINOSIS, HYDROGEN-PEROXIDE PRODUCTION, GARDNERELLA-VAGINALIS, ATOPOBIUM-VAGINAE, PREGNANT-WOMEN, HEALTHY WOMEN, GENITAL-TRACT, RISK-FACTORS, L.-GASSERI, GRAM STAIN

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Chicago
Lopes dos Santos Santiago, Guido, Piet Cools, Hans Verstraelen, Marijke Trog, Griet Missine, Nabil El Aila, Rita Verhelst, et al. 2011. “Longitudinal Study of the Dynamics of Vaginal Microflora During Two Consecutive Menstrual Cycles.” Plos One 6 (11).
APA
Lopes dos Santos Santiago, G., Cools, P., Verstraelen, H., Trog, M., Missine, G., El Aila, N., Verhelst, R., et al. (2011). Longitudinal study of the dynamics of vaginal microflora during two consecutive menstrual cycles. PLOS ONE, 6(11).
Vancouver
1.
Lopes dos Santos Santiago G, Cools P, Verstraelen H, Trog M, Missine G, El Aila N, et al. Longitudinal study of the dynamics of vaginal microflora during two consecutive menstrual cycles. PLOS ONE. 2011;6(11).
MLA
Lopes dos Santos Santiago, Guido, Piet Cools, Hans Verstraelen, et al. “Longitudinal Study of the Dynamics of Vaginal Microflora During Two Consecutive Menstrual Cycles.” PLOS ONE 6.11 (2011): n. pag. Print.
@article{1957484,
  abstract     = {Background: Although the vaginal microflora (VMF) has been well studied, information on the fluctuation of the different bacterial species throughout the menstrual cycle and the information on events preceding the presence of disturbed VMF is still very limited. Documenting the dynamics of the VMF during the menstrual cycle might provide better insights. In this study, we assessed the presence of different Lactobacillus species in relation to the BV associated species during the menstrual cycle, assessed the influence of the menstrual cycle on the different categories of vaginal microflora and assessed possible causes, such as menstruation and sexual intercourse, of VMF disturbance. To our knowledge, this is the first longitudinal study in which swabs and Gram stains were available for each day of two consecutive menstrual cycles, whereby 8 grades of VMF were distinguished by Gram stain analysis, and whereby the swabs were cultured every 7th day and identification of the bacterial isolates was carried out with a molecular technique.
Methods: Self-collected vaginal swabs were obtained daily from 17 non pregnant, menarchal volunteers, and used for daily Gram staining and weekly culture. Bacterial isolates were identified with tDNA-PCR and 16 S rRNA gene sequencing.
Results: Nine women presented with predominantly normal VMF and the 8 others had predominantly disturbed VMF. The overall VMF of each volunteer was characteristic and rather stable. Menses and antimicrobials were the major disturbing factors of the VMF. Disturbances were always accompanied by a rise in Gram positive cocci, which also appeared to be a significant group within the VMF in general.
Conclusions: We observed a huge interindividual variability of predominantly stable VMF types. The importance of Gram positive cocci in VMF is underestimated. L. crispatus was the species that was most negatively affected by the menses, whereas the presence of the other lactobacilli was less variable.},
  articleno    = {e28180},
  author       = {Lopes dos Santos Santiago, Guido and Cools, Piet and Verstraelen, Hans and Trog, Marijke and Missine, Griet and El Aila, Nabil and Verhelst, Rita and Tency, Inge and Claeys, Geert and Temmerman, Marleen and Vaneechoutte, Mario},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  language     = {eng},
  number       = {11},
  pages        = {11},
  title        = {Longitudinal study of the dynamics of vaginal microflora during two consecutive menstrual cycles},
  url          = {http://dx.doi.org/10.1371/journal.pone.0028180},
  volume       = {6},
  year         = {2011},
}

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