Effects of an over-the-counter lactic-acid containing intra-vaginal douching product on the vaginal microbiota.

Autor: van der Veer C; Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands. charlottevdveer@gmail.com., Bruisten SM; Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands.; Amsterdam Infection & Immunity Institute Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands., van Houdt R; Department of Medical Microbiology and Infection prevention, VU University Medical Center, Amsterdam, the Netherlands., Matser AA; Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands., Tachedjian G; Disease Elimination Program Life Sciences Discipline, Burnet Institute, Melbourne, Victoria, Australia.; Department of Microbiology, Monash University, Clayton, Victoria, Australia.; Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia., van de Wijgert JHHM; Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.; Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands., de Vries HJC; Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands.; Amsterdam Infection & Immunity Institute Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.; Academic Medical Centers, Department of Dermatology, Amsterdam, the Netherlands., van der Helm JJ; Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: BMC microbiology [BMC Microbiol] 2019 Jul 25; Vol. 19 (1), pp. 168. Date of Electronic Publication: 2019 Jul 25.
DOI: 10.1186/s12866-019-1545-0
Abstrakt: Background: Over-the-counter intra-vaginal lactic-acid containing douches are marketed as vaginal hygiene products that support optimal vaginal pH balance. We report the effect of a commercially available douche (Etos®) on the vaginal microbiota (VM) in a prospective study.
Results: Twenty-five healthy women were recruited through advertisements in 2015-2017 (ethical approval: METC-2014_413) and followed over three menstrual cycles. The participants had a median age of 24 years [IQR: 22-29], were mostly Dutch-Caucasian (88%), and 60% used combined oral contraceptives. All participants douched three times a week during the second cycle, starting on the first day of that cycle. Participants completed a questionnaire at baseline, kept a daily diary to report douching, menses, and sexual activity, self-collected vaginal swabs every other day during the first and third cycle and daily during the second cycle, and measured vaginal pH mid-cycle. A median of 44 vaginal swabs [inter-quartile range (IQR): 41-50] were assessed per participant by 16S rRNA gene (V3-V4 region) sequencing and a Candida albicans PCR was done at four time-points. At baseline, 21 participants (84%) had Lactobacillus-dominated VM (Lactobacillus crispatus (n = 14), L. iners (n = 6), or diverse Lactobacillus species (n = 1) and 4 participants (16%) had VM consisting of diverse anaerobes. In multinomial logistic regression models, a trend towards increased odds were observed for having diverse anaerobic VM in the second and third cycle, compared to the first cycle, after adjusting for menses [odds ratio (OR) = 1.4 (95% CI: 0.9-2.1) and OR = 1.7 (95% CI: 0.9-3.1), respectively] (p = 0.376). Douching did not affect vaginal pH. Menses increased the odds for having VM consisting of diverse anaerobes almost two-fold (OR = 1.7; 95% CI: 1.0-2.8), while douching during menses increased the odds 2.6 fold (OR = 2.6; 95% CI: 1.0-6.5), compared to not menstruating (p = 0.099). Participants were more likely to test positive for C. albicans after cycle 2, compared to cycle 1 [OR = 3.0 (95% CI: 1.2-7.2); p = 0.017].
Conclusion: The Etos® douche did not significantly affect the vaginal pH or VM composition, although increased odds for having diverse anaerobic VM was observed, especially when douching during menses. Furthermore, douching may promote C. albicans infections.
Databáze: MEDLINE
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