title: The In Vitro Effectiveness of Lactobacillus fermentum Against Different Candida Species Compared With Broadly Used Azoles.
abstract: To investigate the possible use of Lactobacillus strains in the prophylaxis and/or adjuvant therapy of acute vulvovaginal candidiasis and other vaginal infections sustained by Candida yeasts.
  
  
  
  The incidence of Candida infections has substantially increased in recent years. Treatment of vaginal infections with lactobacilli has a long tradition, starting with Döderlein's description of the vaginal microbiota.
  
  
  
  We assessed the activity of serially diluted fluconazole and miconazole (from 3 ng/mL to 1 mg/mL) against Candida strains. Serial dilutions of the azoles were prepared in Sabouraud Dextrose Broth in the presence of Candida strains. Broths were incubated under aerobic condition at 30°C, and the optical density was measured at 560 nm. Minimum inhibitory concentration was defined as the lowest concentration of the antibiotic that completely inhibited visible growth.
  
  
  
  An evident resistance to the azoles used was recorded for all species of Candida, with the exception of Candida parapsilosis. For this species, a minimum inhibitory concentration ≤1 mg/mL was obtained, thus confirming the slight sensitivity to fluconazole and miconazole.All Lactobacillus strains tested, namely LF5, LF09, LF10, and LF11, have the ability to significantly inhibit the growth of the five species of Candida of at least 4 logarithms. Furthermore, the best result obtained with miconazole on C. parapsilosis is still 2 logarithms lower.
  
  
  
  The use of beneficial bacteria, especially lactobacilli, could be regarded as a good alternative for the prevention and treatment of Candida infections.
authors.affiliation: *Biolab Research Ltd., Novara †Gastroenterology Department, Santa Rita Hospital-Policlinico di Monza, Vercelli, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Deidda
authors.forename: Angela
authors.initials: A
authors.lastname: Amoruso
authors.forename: Stefania
authors.initials: S
authors.lastname: Nicola
authors.forename: Teresa
authors.initials: T
authors.lastname: Graziano
authors.forename: Marco
authors.initials: M
authors.lastname: Pane
authors.forename: Serena
authors.initials: S
authors.lastname: Allesina
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Raiteri
authors.forename: Mario
authors.initials: M
authors.lastname: Del Piano
authors.forename: Luca
authors.initials: L
authors.lastname: Mogna
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D001393:Azoles / Q000494:pharmacology*; D002175:Candida / Q000254:growth & development*; D002181:Candidiasis, Vulvovaginal / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D015725:Fluconazole / Q000494:pharmacology; D006801:Humans; D052197:Limosilactobacillus fermentum; D008825:Miconazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D019936:Probiotics / Q000627:therapeutic use*; D014621:Vagina / Q000187:drug effects / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D008825:Miconazole; D015725:Fluconazole