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Open Access Highly Accessed Research article

Identification and characterisation of vaginal lactobacilli from South African women

Sonal Pendharkar1, Tebogo Magopane2, Per-Göran Larsson3, Guy de Bruyn2, Glenda E Gray2, Lennart Hammarström1 and Harold Marcotte14*

Author Affiliations

1 Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden

2 Perinatal HIV Research Unit (PHRU), Chris Hani Baragwanath Hospital, Soweto, Johannesburg, South Africa

3 Department of Obstetrics and Gynaecology Kärnsjukhuset, Skaraborg hospital and University of Skövde, Skövde, SE-541 85, Sweden

4 Department of Laboratory Medicine, Division of Clinical Immunology, F79, Karolinska Institutet, Stockholm, S-141 86, Sweden

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BMC Infectious Diseases 2013, 13:43  doi:10.1186/1471-2334-13-43

Published: 26 January 2013

Abstract

Background

Bacterial vaginosis (BV), which is highly prevalent in the African population, is one of the most common vaginal syndromes affecting women in their reproductive age placing them at increased risk for sexually transmitted diseases including infection by human immunodeficiency virus-1. The vaginal microbiota of a healthy woman is often dominated by the species belonging to the genus Lactobacillus namely L. crispatus, L. gasseri, L. jensenii and L. iners, which have been extensively studied in European populations, albeit less so in South African women. In this study, we have therefore identified the vaginal Lactobacillus species in a group of 40 African women from Soweto, a township on the outskirts of Johannesburg, South Africa.

Methods

Identification was done by cultivating the lactobacilli on Rogosa agar, de Man-Rogosa-Sharpe (MRS) and Blood agar plates with 5% horse blood followed by sequencing of the 16S ribosomal DNA. BV was diagnosed on the basis of Nugent scores. Since some of the previous studies have shown that the lack of vaginal hydrogen peroxide (H2O2) producing lactobacilli is associated with bacterial vaginosis, the Lactobacillus isolates were also characterised for their production of H2O2.

Results

Cultivable Lactobacillus species were identified in 19 out of 21 women without BV, in three out of five women with intermediate microbiota and in eight out of 14 women with BV. We observed that L. crispatus, L. iners, L. jensenii, L. gasseri and L. vaginalis were the predominant species. The presence of L. crispatus was associated with normal vaginal microbiota (P = 0.024). High level of H2O2 producing lactobacilli were more often isolated from women with normal microbiota than from the women with BV, although not to a statistically significant degree (P = 0.064).

Conclusion

The vaginal Lactobacillus species isolated from the cohort of South African women are similar to those identified in European populations. In accordance with the other published studies, L. crispatus is related to a normal vaginal microbiota. Hydrogen peroxide production was not significantly associated to the BV status which could be attributed to the limited number of samples or to other antimicrobial factors that might be involved.

Keywords:
Bacterial vaginosis; Lactobacillus; South Africa; Hydrogen peroxide