Behavioral predictors of colonization with Lactobacillus crispatus or Lactobacillus jensenii after treatment for bacterial vaginosis: a cohort study

Caroline Mitchell, Lisa E Manhart, Kathy Thomas, Tina Fiedler, David N Fredricks, Jeanne Marrazzo, Caroline Mitchell, Lisa E Manhart, Kathy Thomas, Tina Fiedler, David N Fredricks, Jeanne Marrazzo

Abstract

Objective: Evaluate predictors of vaginal colonization with lactobacilli after treatment for bacterial vaginosis (BV).

Methods: Vaginal fluid specimens from women with BV underwent qPCR for Lactobacillus crispatus, L. jensenii, and L. iners pre- and posttreatment.

Results: Few women with BV were colonized with L. crispatus (4/44, 9%) or L. jensenii (1/44, 2%), though all had L. iners. One month posttreatment 12/44 (27%) had L. crispatus, 12/44 (27%) L. jensenii, and 43/44 (98%) L. iners. Presence of L. jensenii posttreatment was associated with cure (Risk Ratio (RR) 1.67; 95% CI 1.09-2.56); L. crispatus showed a similar trend (RR 1.41; 95% CI 0.89-2.24, P = 0.14). Receptive oral sex was associated with 2.2-log(10) lower concentration of L. crispatus (95% CI -4.38, -.02), and digital-vaginal sex with 2.6-log(10) lower concentration (95% CI -4.87, -.33).

Conclusion: One month after BV treatment, few women established colonization with L. crispatus or L. jensenii. Few behaviors were associated with colonization.

Figures

Figure 1
Figure 1
Change in concentrations of three different species of lactobacilli, as measured by species-specific quantitative PCR, 4 weeks after treatment for bacterial vaginosis with vaginal metronidazole. Each line represents an individual patient and her concentration of each bacterium before and after treatment. The dotted line represents the lower limit of detection of the qPCR assay.

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