Hydrogen peroxide-producing lactobacilli and acquisition of vaginal infections.
This cohort study of 182 women attending a sexually transmitted disease clinic evaluated the hypothesis that women colonized by lactobacilli have decreased acquisition of vaginal infections. During a 2-year follow-up, 50 women acquired bacterial vaginosis (BV), 25 acquired symptomatic vulvovaginal candidiasis (VVC), and 7 acquired vaginal trichomoniasis. By multivariate analysis, utilizing Cox proportional hazards modeling with time-dependent covariates, acquisition of BV was independently associated with lack of vaginal H2O2-producing lactobacilli (hazard ratio [HR] = 4.0, P < .001) or presence of only non-H2O2-producing lactobacilli (HR = 2.2, P = .02). Acquisition of BV was associated with having a new sex partner (HR = 2.5, P = .004) and with douching for hygiene (HR = 2.1, P = .05). Absence of lactobacilli did not increase acquisition of VVC. Trichomoniasis was associated only with having a new sex partner (HR = 4.7, P = .05). These results support the hypothesis that H2O2-producing vaginal lactobacilli protect against acquisition of BV but do not protect against VVC or vaginal trichomoniasis.
Department of Medicine, Univesity of Washington, Seattle 98109, USA.
S E
SE
Hawes
S L
SL
Hillier
J
J
Benedetti
C E
CE
Stevens
L A
LA
Koutsky
P
P
Wolner-Hanssen
K K
KK
Holmes
D000293:Adolescent; D000328:Adult; D002181:Candidiasis, Vulvovaginal / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000378:metabolism*; D007778:Lactobacillus / Q000502:physiology*; D008137:Longitudinal Studies; D008875:Middle Aged; D014247:Trichomonas Vaginitis / Q000517:prevention & control*; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000517:prevention & control*
D006861:Hydrogen Peroxide