CC BY-NC-ND 4.0 · J Lab Physicians 2020; 12(02): 111-114
DOI: 10.1055/s-0040-1716604
Original Article

Identification and Sensitivity of Vaginal and Probiotic Lactobacillus species to Urinary Antibiotics

Lipika Singhal
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
Varsha Gupta
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
Menal Gupta
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
Poonam Goel
2   Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Chandigarh, India
Jagdish Chander
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
› Author Affiliations
Funding This study was part of a research project funded by the Department of Science and Technology, Government of India.


Objectives Healthy vaginal microbiota is mainly dominated by Lactobacillus species namely L. crispatus, L. gasseri, L. jensenii, and L. iners. Lactobacilli are thought to play an important role in the prevention of urogenital infections, and Lactobacillus probiotics to restore and/or maintain vaginal health has been advocated. These can interfere with the adherence, growth, and colonization by uropathogenic bacteria, thus reducing the risk of urinary tract infection (UTI). This study aims to isolate and evaluate the susceptibility of healthy vaginal and probiotic Lactobacillus spp. to urinary antibiotics.

Materials and methods A total of 50 premenopausal, nonmenstruating women with no symptoms of vaginal infection or UTI or antimicrobial use in the past 2 weeks were enrolled. Two high vaginal swabs were collected for Nugent’s scoring and anaerobic culture. Colonies yielding gram-positive rods were confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Lactobacillus strains in a vaginal probiotic tablet were also isolated, and the sensitivity of both sets to urinary antibiotics was determined.

Results A total of 29 Lactobacillus spp. were isolated, including L. crispatus (15), L. gasseri (5), L. vaginalis (4), L. paracasei (2), L. curvatus (1), L. fermentum (1), and L. paraplantarum (1). All strains were susceptible to nitrofurantoin and resistant to norfloxacin, gentamicin, and cotrimoxazole (except L. paracasei). The probiotic strains were pan-sensitive.

Conclusions Prophylactic antibiotics are capable of eliminating the normal vaginal inhabitants, which may increase the probability of UTI. The administration of vaginal probiotics as an alternate or multidrug therapy can restore vaginal microbiota and help prevent recurrent UTI.

Publication History

Article published online:
02 September 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

  • References

  • 1 Das Purkayastha S, Bhattacharya MK, Prasad HK. et al. Contrasting diversity of vaginal Lactobacilli among the females of Northeast India. BMC Microbiol 2019; 19 (01) 198
  • 2 Mastromarino P, Hemalatha R, Barbonetti A. et al. Biological control of vaginosis to improve reproductive health. Indian J Med Res 2014; 140 (Suppl) S91-S97
  • 3 Al-Badr A, Al-Shaikh G. Recurrent urinary tract infections management in women - a review. Sultan Qaboos Univ Med J 2013; 13 (03) 359-367
  • 4 Reid G, Bruce AW, Cook RL, Llano M. Effect on urogenital flora of antibiotic therapy for urinary tract infection. Scand J Infect Dis 1990; 22 (01) 43-47
  • 5 Gupta V, Nag D, Garg P. Recurrent urinary tract infections in women: how promising is the use of probiotics?. Indian J Med Microbiol 2017; 35 (03) 347-354
  • 6 Barrons R, Tassone D. Use of Lactobacillus probiotics for bacterial genitourinary infections in women: a review. Clin Ther 2008; 30 (03) 453-468
  • 7 Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol 1991; 29 (02) 297-301
  • 8 Madhivanan P, Raphael E, Rumphs A. et al. Characterization of culturable vaginal Lactobacillus species among women with and without bacterial vaginosis from the United States and India: a cross-sectional study. J Med Microbiol 2014; 63 (Pt 7) 931-935
  • 9 Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966; 45 (04) 493-496
  • 10 Gupta K, Stapleton AE, Hooton TM, Roberts PL, Fennell CL, Stamm WE. Inverse association of H2O2-producing Lactobacilli and vaginal Escherichia coli colonization in women with recurrent urinary tract infections. J Infect Dis 1998; 178 (02) 446-450
  • 11 Garg KB, Ganguli I, Das R, Talwar GP. Spectrum of Lactobacillus species present in healthy vagina of Indian women. Indian J Med Res 2009; 129 (06) 652-657
  • 12 Madhivanan P, Alleyn HN, Raphael E. et al. Identification of culturable vaginal Lactobacillus species among reproductive age women in Mysore, India. J Med Microbiol 2015; 64 (06) 636-641
  • 13 Pramanick R, Parab S, Mayadeo N, Warke H, Aranha C. Cross sectional analysis of vaginal Lactobacillus in asymptomatic women of reproductive age in Mumbai, India. J Infect Dev Ctries 2018; 12 (12) 1096-1104
  • 14 Vásquez A, Jakobsson T, Ahrné S, Forsum U, Molin G. Vaginal Lactobacillus flora of healthy Swedish women. J Clin Microbiol 2002; 40 (08) 2746-2749
  • 15 Pino A, Bartolo E, Caggia C, Cianci A, Randazzo CL. Detection of vaginal Lactobacilli as probiotic candidates. Sci Rep 2019; 9 (01) 3355
  • 16 Zhang R, Daroczy K, Xiao B, Yu L, Chen R, Liao Q. Qualitative and semiquantitative analysis of Lactobacillus species in the vaginas of healthy fertile and postmenopausal Chinese women. J Med Microbiol 2012; 61 (Pt 5) 729-739
  • 17 Pendharkar S, Magopane T, Larsson PG. et al. Identification and characterisation of vaginal Lactobacilli from South African women. BMC Infect Dis 2013; 13: 43
  • 18 Grin PM, Kowalewska PM, Alhazzan W, Fox-Robichaud AE. Lactobacillus for preventing recurrent urinary tract infections in women: meta-analysis. Can J Urol 2013; 20 (01) 6607-6614
  • 19 Uehara S, Monden K, Nomoto K, Seno Y, Kariyama R, Kumon H. A pilot study evaluating the safety and effectiveness of Lactobacillus vaginal suppositories in patients with recurrent urinary tract infection. Int J Antimicrob Agents 2006; 28 (Suppl. 01) S30-S34