세균성 질증 치료의 주요 표적 세균(Gardnerella vaginalis)에 대한 프로바이오틱스와 항생제 효과

Abstract

ABSTRACT

Effects of Probiotics and Antibiotics on Major Target Bacterium(Gardnerella vaginalis) for Treatment of Bacterial Vaginosis

Kim Jung-A Advisor: Prof. Park Sang-Hag, M.D., Ph.D. Department of Complementary and Alternative Medicine, Graduate School of Chosun University

Objective: Gardnerella vaginalis is a major predisposing bacterium of Bacterial vaginosis (BV). It helps to obligate anaerobic bacteria to adhere on vaginal squamous epithelia, increasing the risk of BV. This study aims to test probiotic effect of Steroidobacter denitrificans YH1 and Lactobacillus crispatus YH2 against wild strains of G. vaginalis and search vaginal antibiotic suppository that inhibits growth of G. vaginalis wild strains as pre-treatment before administrating probiotics. Methods: Thirty-three G. vaginalis wild strains were isolated from BV patients diagnosed using Amsel’s criteria then identified by several confirmative characteristics and tests, i.e. β-hemolytic tiny colony, Gram-variable pleomorphic short rods, oxidase test (-), catalase test (-), metronidazole disc (5 ㎍) resistance and clue cell. Biotype was determined by the results of hippurate test, β-galactosidase test and lipase egg-yolk plate test. The effective vaginal antibiotic suppository was searched using antibiotic disc diffusion test on thirty-four strains of G. vaginalis. Probiotic effects of S. denitrificans YH1 and L. crispatus YH2 strains isolated from a healthy woman's vagina were also measured using a similar antibiotic disc diffusion method. Results: Biotypes of 33 wild strains were as following: three type 1, two type 2, two type 3, four type 4, fifteen type 5, one type 6, two type 7 and four type 8. The distinct β-hemolysis (+++) was caused by type 1, 2, 5, 6 and the weak β-hemolysis (+) by type 4, 8. The average inhibition zone diameters of augmentin and clindamycin against G. vaginalis wild strains were 44.9±9.5 ㎜ and 55.5±5.5 ㎜ each. Twenty-one strains (64%) among the 33 wild strains of G. vaginalis showed inhibition zones of 0 ㎜ against metronidazole (50 ㎍) disc. The average inhibition zone diameters by S. denitrificans YH1 and L. crispatus YH2 were 27.4±9.7 ㎜ and 23.9±9.0 ㎜ respectively against randomly selected 15 strains of G. vaginalis. Metronidazole resistance showed a close relation among G. vaginalis biotypes, but there was no relation between probiotic inhibition and biotype. Conclusion: The results of this study showed that S. denitrificans YH1 and L. crispatus YH2 have probiotic effects to most G. vaginalis wild strains without any relation to biotype. All wild strains showed high susceptibility to clindamycin and augmentin, while many were resistant to metronidazole. This means that clindamycin vaginal suppository needs to be used as a pre-treatment means of BV therapy prior to administration of probiotics S. denitrificans YH1 or L. crispatus YH2 strain.

Key words: Bacterial vaginosis, Gardnerella vaginalis, Probiotics, Clindamycin, Augmentin, Metronidazole