Vaginal flora

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The naturally existing microbial colonization of the female vagina is referred to as vaginal flora . The vaginal flora takes on a placeholder function and thus prevents other, harmful germs from taking over. In addition to this so-called colonization resistance , the pH value caused by the vaginal flora also prevents pathogens from overgrowing . There are considerable differences in the composition of the vaginal flora in the various mammals. The vaginal flora belongs to the microbiome of a multicellular cell.

Vaginal flora of the woman

View of the front third of a human vagina , starting from the introitus vaginae , the vaginal entrance with the rugae vaginales and the reflective vaginal epithelium with the vaginal flora

In a sexually mature, healthy woman, the vaginal flora consists mainly of different types of lactic acid bacteria , the so-called Döderlein bacteria .

physiology

For a long time it was assumed that Lactobacillus acidophilus was the most common microorganism , but it has now been found that the most common vaginal inhabitant is L. iners , followed by L. crispatus (according to some published studies, the other way around). Other common lactobacilli of the vagina are L. delbruekii , L. jensenii , L. buchneri. , L. gasseri and Bifidobacterium spp . The composition of the vaginal microflora can vary greatly from woman to woman, which is why various parameters of the colonization in the so-called Nugent Score are used to quantify and evaluate the flora in the vagina. This enables the need for treatment and the success of the therapy to be assessed.

Under the cyclical influence of estrogen and gestagen, the lactobacilli ferment the glycogen provided by the vaginal epithelial cells via glucose to lactic acid ( lactic acid fermentation ). This creates an acidic environment in the vagina , the pH of which is normally 3.8–4.5. This acidic vaginal environment provides effective protection against some infections and changes in the microbiome , because the vast majority of (potentially) pathogenic bacteria ( bacterial infections ) cannot thrive under such conditions. The low pH also has an inhibitory effect on vaginal yeast infections , but cannot offer complete protection.

Disruptions

The vaginal flora is an important natural prophylaxis against pathological germs and thus also against various sexually transmitted diseases. However, the necessary acidic environment can be severely disturbed and in particular lead to a decrease in the acid-forming Döderlein rods. Vaginal douches can cause this disruption of the vaginal bacterial flora.

Normally about 2 billion of the useful lactobacilli can be found in 1 mm³ of vaginal epithelium . If their number is reduced, however, this also leads to a lower degree of acidity (= higher pH value). This means a considerable reduction in the natural protection, which is why bacterial vaginitis or vaginosis can occur much more easily .

So far, the following causes for the impairment of the vaginal acid protection are known:

The most common pathogens causing vaginal inflammation are Gardnerella vaginalis , but also pathogenic chlamydia , enterobacteria , staphylococci and the fungus Candida albicans .

Vaginal flora of mammals

At z. B. the bitch is a mixed flora of about two to four different types of bacteria detectable.

In contrast to the vaginal flora of women, bacteria are regularly found that are potentially disease-causing (facultative pathogenic). The most common types are:

After antibiotic treatment, the evidence of bacteria in the vaginal secretions is mostly negative, but the physiological flora is restored a few days after the antibiotic has been discontinued. In dogs, the pH value is physiologically in the alkaline range, which is why fungal infections do not play a role in dogs and drugs from human medicine that lower the pH value are completely unsuitable for bitches.

literature

  • From Martina Lenzen-Schulte: Delicate intimate zone. The microflora of women, a swap forum for bacteria - and a source of new risks? Frankfurter Allgemeine Zeitung of October 4, 2017, p. N 2. (About five recent papers)

Individual evidence

  1. ↑ JE Hill et al. a .: Characterization of vaginal microflora of healthy, nonpregnant women by chaperonin-60 sequence-based methods. In: Am J Obstet Gynecol. 2005, Vol. 193, pp. 682-692, PMID 16150261 .
  2. ↑ R. Verhelst u. a .: Comparison between Gram stain and culture for the characterization of vaginal microflora: definition of a distinct grade that resembles grade I microflora and revised categorization of grade I microflora. In: BMC Microbiol. 2005, Vol. 5, p. 61, PMID 16225680 .
  3. ↑ H. Nam et al. a .: Analysis of vaginal lactic acid producing bacteria in healthy women. In: J Microbiol. 2007, Vol. 45, pp. 515-520, PMID 18176534 .
  4. ↑ a b Pharmaceutical Tribune 03/2009 ( Memento of the original from January 20, 2011 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (Registration required). @1@ 2Template: Webachiv / IABot / www.pharmaceutical-tribune.at
  5. ↑ JF Culhane et al. a .: Maternal stress is associated with bacterial vaginosis in human pregnancy. In: Matern Child Health J. 2001, Vol. 5, pp. 127-134, PMID 11573838 .
  6. ↑ a b Katja Trasch, Axel Wehrend: Sense and Nonsense of bacteriological examination before coverage . In: Small animal concrete. No. 10, 2008, No. 6, pp. 6-8.