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dc.contributor.authorvan de Wijgert, J.H.H.M.
dc.contributor.authorVerwijs, M.C.
dc.contributor.authorRavel, J.
dc.date.accessioned2020-03-16T15:58:25Z
dc.date.available2020-03-16T15:58:25Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85080942029&doi=10.1038%2fs41598-020-60671-6&partnerID=40&md5=9074a3811e15e3e6f7dc35eda7273345
dc.identifier.urihttp://hdl.handle.net/10713/12231
dc.description.abstractBacterial vaginosis (BV) is associated with HIV acquisition and adverse pregnancy outcomes. Recurrence after metronidazole treatment is high. HIV-negative, non-pregnant Rwandan BV patients were randomized to four groups (n = 17/group) after seven-day oral metronidazole treatment: behavioral counseling only (control), or counseling plus intermittent use of oral metronidazole, Ecologic Femi+ vaginal capsule (containing multiple Lactobacillus and one Bifidobacterium species), or Gynophilus LP vaginal tablet (L. rhamnosus 35) for two months. Vaginal microbiota assessments at all visits included Gram stain Nugent scoring and 16S rRNA gene qPCR and HiSeq sequencing. All interventions were safe. BV (Nugent 7-10) incidence was 10.18 per person-year at risk in the control group, and lower in the metronidazole (1.41/person-year; p = 0.004), Ecologic Femi+ (3.58/person-year; p = 0.043), and Gynophilus LP groups (5.36/person-year; p = 0.220). In mixed effects models adjusted for hormonal contraception/pregnancy, sexual risk-taking, and age, metronidazole and Ecologic Femi+ users, each compared to controls, had higher Lactobacillus and lower BV-anaerobes estimated concentrations and/or relative abundances, and were less likely to have a dysbiotic vaginal microbiota type by sequencing. Inter-individual variability was high and effects disappeared soon after intervention cessation. Lactobacilli-based vaginal probiotics warrant further evaluation because, in contrast to antibiotics, they are not expected to negatively affect gut microbiota or cause antimicrobial resistance. Copyright 2020, The Author(s).en_US
dc.description.sponsorshipUniversity of Liverpool MR/M017443/1en_US
dc.description.urihttps://doi.org/10.1038/s41598-020-60671-6en_US
dc.language.isoen_USen_US
dc.publisherNature Researchen_US
dc.relation.ispartofScientific Reports
dc.subject.meshLactobacillusen_US
dc.subject.meshVaginosis, Bacterialen_US
dc.subject.meshProbioticsen_US
dc.subject.meshMetronidazoleen_US
dc.subject.meshPilot Projectsen_US
dc.subject.meshMicroscopyen_US
dc.titleIntermittent Lactobacilli-containing Vaginal Probiotic or Metronidazole Use to Prevent Bacterial Vaginosis Recurrence: A Pilot Study Incorporating Microscopy and Sequencingen_US
dc.typeArticleen_US
dc.identifier.doi10.1038/s41598-020-60671-6
dc.identifier.pmid32127550


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