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Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora

Hans Verstraelen UGent, Rita Verhelst UGent, Geert Claeys UGent, Ellen De Backer UGent, Marleen Temmerman UGent and Mario Vaneechoutte UGent (2009) BMC MICROBIOLOGY. 9. p.116-1-116-10
abstract
Background: Despite their antimicrobial potential, vaginal lactobacilli often fail to retain dominance, resulting in overgrowth of the vagina by other bacteria, as observed with bacterial vaginosis. It remains elusive however to what extent interindividual differences in vaginal Lactobacillus community composition determine the stability of this microflora. In a prospective cohort of pregnant women we studied the stability of the normal vaginal microflora (assessed on Gram stain) as a function of the presence of the vaginal Lactobacillus index species (determined through culture and molecular analysis with tRFLP). Results: From 100 consecutive Caucasian women vaginal swabs were obtained at mean gestational ages of 8.6 (SD 1.4), 21.2 (SD 1.3), and 32.4 (SD 1.7) weeks, respectively. Based on Gram stain, 77 women had normal or Lactobacillus-dominated vaginal microflora (VMF) during the first trimester, of which 18 had grade Ia (L. crispatus cell morphotypes) VMF (23.4%), 16 grade Iab (L. crispatus and other Lactobacillus cell morphotypes) VMF (20.8%), and 43 grade Ib (non-L. crispatus cell morphotypes) VMF (55.8%). Thirteen women with normal VMF at baseline, converted in the second or third trimester (16.9%) to abnormal VMF defined as VMF dominated by non-Lactobacillus bacteria. Compared to grade Ia and grade Iab VMF, grade Ib VMF were 10 times (RR = 9.49, 95% CI 1.30 - 69.40) more likely to convert from normal to abnormal VMF (p = 0.009). This was explained by the observation that normal VMF comprising L. gasseri/iners incurred a ten-fold increased risk of conversion to abnormal VMF relative to non-L. gasseri/iners VMF (RR 10.41, 95% CI 1.39-78.12, p = 0.008), whereas normal VMF comprising L. crispatus had a five-fold decreased risk of conversion to abnormal VMF relative to non-L. crispatus VMF (RR 0.20, 95% CI 0.05-0.89, p = 0.04). Conclusion: The presence of different Lactobacillus species with the normal vaginal microflora is a major determinant to the stability of this microflora in pregnancy: L. crispatus promotes the stability of the normal vaginal microflora while L. gasseri and/or L. iners predispose to some extent to the occurrence of abnormal vaginal microflora.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
journal title
BMC MICROBIOLOGY
BMC Microbiol.
volume
9
pages
116-1 - 116-10
Web of Science type
Article
Web of Science id
000267924000001
JCR category
MICROBIOLOGY
JCR impact factor
2.89 (2009)
JCR rank
35/94 (2009)
JCR quartile
2 (2009)
ISSN
1471-2180
DOI
10.1186/1471-2180-9-116
language
English
UGent publication?
yes
classification
A1
id
761340
handle
http://hdl.handle.net/1854/LU-761340
date created
2009-10-07 09:16:00
date last changed
2009-11-06 11:02:09
@article{761340,
  abstract     = {Background: Despite their antimicrobial potential, vaginal lactobacilli often fail to retain dominance, resulting in overgrowth of the vagina by other bacteria, as observed with bacterial vaginosis. It remains elusive however to what extent interindividual differences in vaginal Lactobacillus community composition determine the stability of this microflora. In a prospective cohort of pregnant women we studied the stability of the normal vaginal microflora (assessed on Gram stain) as a function of the presence of the vaginal Lactobacillus index species (determined through culture and molecular analysis with tRFLP).
Results: From 100 consecutive Caucasian women vaginal swabs were obtained at mean gestational ages of 8.6 (SD 1.4), 21.2 (SD 1.3), and 32.4 (SD 1.7) weeks, respectively. Based on Gram stain, 77 women had normal or Lactobacillus-dominated vaginal microflora (VMF) during the first trimester, of which 18 had grade Ia (L. crispatus cell morphotypes) VMF (23.4\%), 16 grade Iab (L. crispatus and other Lactobacillus cell morphotypes) VMF (20.8\%), and 43 grade Ib (non-L. crispatus cell morphotypes) VMF (55.8\%). Thirteen women with normal VMF at baseline, converted in the second or third trimester (16.9\%) to abnormal VMF defined as VMF dominated by non-Lactobacillus bacteria. Compared to grade Ia and grade Iab VMF, grade Ib VMF were 10 times (RR = 9.49, 95\% CI 1.30 - 69.40) more likely to convert from normal to abnormal VMF (p = 0.009). This was explained by the observation that normal VMF comprising L. gasseri/iners incurred a ten-fold increased risk of conversion to abnormal VMF relative to non-L. gasseri/iners VMF (RR 10.41, 95\% CI 1.39-78.12, p = 0.008), whereas normal VMF comprising L. crispatus had a five-fold decreased risk of conversion to abnormal VMF relative to non-L. crispatus VMF (RR 0.20, 95\% CI 0.05-0.89, p = 0.04).

Conclusion: The presence of different Lactobacillus species with the normal vaginal microflora is a major determinant to the stability of this microflora in pregnancy: L. crispatus promotes the stability of the normal vaginal microflora while L. gasseri and/or L. iners predispose to some extent to the occurrence of abnormal vaginal microflora.},
  author       = {Verstraelen, Hans and Verhelst, Rita and Claeys, Geert and De Backer, Ellen and Temmerman, Marleen and Vaneechoutte, Mario},
  issn         = {1471-2180},
  journal      = {BMC MICROBIOLOGY},
  language     = {eng},
  pages        = {116-1--116-10},
  title        = {Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora},
  url          = {http://dx.doi.org/10.1186/1471-2180-9-116},
  volume       = {9},
  year         = {2009},
}

Chicago
Verstraelen, Hans, Rita Verhelst, Geert Claeys, Ellen De Backer, Marleen Temmerman, and Mario Vaneechoutte. 2009. “Longitudinal Analysis of the Vaginal Microflora in Pregnancy Suggests That L. Crispatus Promotes the Stability of the Normal Vaginal Microflora and That L. Gasseri And/or L. Iners Are More Conducive to the Occurrence of Abnormal Vaginal Microflora.” Bmc Microbiology 9: 116–1–116–10.
APA
Verstraelen, H., Verhelst, R., Claeys, G., De Backer, E., Temmerman, M., & Vaneechoutte, M. (2009). Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora. BMC MICROBIOLOGY, 9, 116–1–116–10.
Vancouver
1.
Verstraelen H, Verhelst R, Claeys G, De Backer E, Temmerman M, Vaneechoutte M. Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes the stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora. BMC MICROBIOLOGY. 2009;9:116–1–116–10.
MLA
Verstraelen, Hans, Rita Verhelst, Geert Claeys, et al. “Longitudinal Analysis of the Vaginal Microflora in Pregnancy Suggests That L. Crispatus Promotes the Stability of the Normal Vaginal Microflora and That L. Gasseri And/or L. Iners Are More Conducive to the Occurrence of Abnormal Vaginal Microflora.” BMC MICROBIOLOGY 9 (2009): 116–1–116–10. Print.