Lactobacillus crispatus protects against bacterial vaginosis
In medicine, the 20th century was marked by one of the most important revolutions in infectious-disease management, the discovery and increasing use of antibiotics. However, their indiscriminate use has led to the emergence of multidrug-resistant (MDR) bacteria. Drug resistance and other factors, such as the production of bacterial biofilms, have resulted in high recurrence rates of bacterial diseases. Bacterial vaginosis (BV) syndrome is the most prevalent vaginal condition in women of reproductive age, leading to considerable discomfort. BV can be a consequence of gynecological and obstetric complications, as well as sexually transmitted diseases. Given the decrease in efficiency of antibiotic therapy and high rates of recurrence, probiotics have become promising alternatives for both prevention and treatment of BV, or as an adjuvant to conventional therapy. Currently, Lactobacillus species are the most extensively studied for use as probiotics. Probiotics act through stimulation of the host immune system, competitive exclusion and antimicrobial activity; the latter involves production of substances such as lactic acid, hydrogen peroxide and bacteriocins. Lactobacillus crispatus is considered to be a biomarker of a healthy vaginal tract and is indicated for a probiotic approach to maintaining and restoring of a healthy vaginal ecosystem. Some L. crispatus probiotic strains are already commercially available with encouraging results; however, control of BV syndrome still presents many challenges.