乳杆菌优良菌株的筛选及对小鼠阴道白假丝酵母菌过度增殖干预

目的探讨乳杆菌优良菌株的筛选及其对小鼠阴道白假丝酵母菌过度增殖干预作用。方法对德氏乳杆菌DM8909菌株进行诱变筛选,得到耐抗生素突变株208,以ICR小鼠为实验对象,用甲硝唑进行小鼠阴道菌群脱污染,将白假丝酵母菌接种到小鼠阴道内,构建小鼠阴道白假丝酵母菌过度增殖模型。采用阴道接种德氏乳杆菌DM8909突变株208菌液（2×108CFU/mL）处理,取其阴道冲洗液进行阴道菌群分析,并进行阴道上皮细胞的电镜检查。结果乳杆菌干预后显著清除阴道内的假丝酵母菌,肠杆菌恢复正常水平,与模型组比较,差异有统计学意义（P〈0.05）。结论德氏乳杆菌DM8909抗性菌株208能调整白假丝酵母菌在小鼠阴道内定植,对小鼠阴道上皮细胞有恢复作用。     

新疆传统发酵乳品中乳酸菌与 酵母菌的益生特性

目的观察新疆传统发酵乳品中分离的14种菌株的生长特点及产酸能力,筛选出具有较强耐胆盐能力,并能在人工胃肠液中存活的菌株。方法对10株乳酸菌和4株酵母菌进行生长曲线、pH、耐胆盐能力和耐人工胃肠液检测。结果 10株乳酸菌和4株酵母菌具有良好的生长曲线和产酸能力;马乳酒样乳杆菌具有较强的耐胆盐能力;希氏乳杆菌、马乳酒样乳杆菌、乙醇假丝酵母和东方伊萨酵母具有较强的耐人工胃液能力;乳酸乳球菌、哈尔滨乳杆菌、瑞士乳杆菌、马乳酒样乳杆菌、乙醇假丝酵母和东方伊萨酵母具有较强的耐人工肠液能力。结论 10株乳酸菌和4株酵母菌具有优良的益生特性,有望成为益生菌制剂的备用菌株。     

女性阴道中产细菌素的乳杆菌筛选与鉴定

目的对从60例健康女性阴道中筛选出产生细菌素的优势乳杆菌进行鉴定,并为研制开发微生态制剂提供优良可靠菌种。方法利用牛津杯法筛选出19株乳杆菌,其菌株发酵乳酸量高并且产生细菌素。对19株乳杆菌进行了多项理化鉴定。结果19株乳杆菌分别为：格氏乳杆菌9株,唾液乳杆菌1株,卷曲乳杆菌9株。结论筛选的19株乳杆菌是健康女性阴道中的优势有益菌,具有较强的产酸能力,都产生细菌素,其中16株产生过氧化氢,某些菌株具有较高的生产应用价值。     

对阴道炎主要致病菌有抑菌活性乳杆菌的筛选及特性

目的从实验室保藏的乳杆菌中筛选出对阴道炎主要致病菌有抑菌活性的乳杆菌,研究其生物学特性从而作为防治阴道炎的潜在益生菌株。方法采用琼脂扩散法检测乳杆菌对大肠埃希菌、金黄色葡萄球菌和阴道加德纳菌的抑菌效果。采用共培养法探究乳杆菌在不同时间对白假丝酵母生长的抑制效果。检测乳杆菌产过氧化氢和产酸能力、对低pH环境的耐受性以及对家兔阴道黏膜的刺激性。结果植物乳杆菌LP45和鼠李糖乳杆菌LR519对大肠埃希菌、金黄色葡萄球菌和阴道加德纳菌的抑菌效果最佳。经24 h共培养后,LP45和LR519对白假丝酵母的抑制率分别为95.27%和98.85%。LP45和LR519产过氧化氢量分别为11.28μg/mL和15.15μg/mL,能耐受pH 4.5酸环境。LP45和LR519复合菌在37℃培养48 h可持续产乳酸,且对家兔阴道黏膜无刺激性。结论植物乳杆菌LP45和鼠李糖乳杆菌LR519具有优良的生物学特性,可作为阴道微生态制剂的候选菌株来预防和缓解由菌群紊乱而引起的阴道炎症。     

抗生素诱导小鼠阴道菌群失衡及乳杆菌调节作用的研究

目的 构建抗生素诱导的小鼠阴道菌群失衡模型,并研究乳杆菌对假丝酵母菌的阴道菌群失调的调整作用.方法 以IRC小鼠为实验对象,用头孢曲松造成阴道菌群失调,并将白假丝酵母接种到小鼠阴道内,造成小鼠阴道白假丝酵母过度增殖模型.对抗生素作用后的小鼠,采用乳杆菌预防、同步、治疗3种方式,阴道接种德氏乳杆菌DM8909菌液(2×108CFU/ml);取其阴道分泌物进行假丝酵母菌及乳杆菌的阴道菌群分析,并同时进行分泌物镜检,取阴道组织标本做病理组织学检查.结果 模型组小鼠阴道内细菌总数显著下降(P<0.01),出现阴道红肿、分泌物涂片镜检查到白细胞及假丝酵母.乳杆菌对小鼠抗生素导致的阴道菌群失衡的调节作用明显,受损小鼠阴道菌群的多样性和数量恢复至正常(P>0.05),其中乳杆菌预防组阴道菌群破坏程度最小(P<0.01);乳杆菌干预后的小鼠都可以显著性清除阴道内的假丝酵母菌(P<0.01),以乳杆菌预防组效果最好.结论 德氏乳杆菌DM8909能阻止白假丝酵母对阴道上皮的黏附作用,能调整阴道的菌群,对阴道黏膜有一定的修复功能.     

阴道中益生特性乳杆菌的分离与功能评价

目的分离健康女性阴道中的乳杆菌并鉴定其益生特性,为开发治疗妇科疾病的复方益生菌制剂提供新型菌株。方法采集健康女性阴道分泌物并分离筛选乳杆菌,通过16SrDNA序列分析鉴定乳杆菌分离株,并对其产酸性能、产H2O2能力、抑菌能力、产生物膜能力进行检测。结果从50名健康女性阴道内共分离出179株乳杆菌,其中卷曲乳杆菌101株、詹氏乳杆菌42株、格氏乳杆菌26株、植物乳杆菌5株、唾液乳杆菌3株以及干酪乳杆菌2株。179株乳杆菌中有146株具有产酸能力,发酵液pH值的最低的5株菌分别为卷曲乳杆菌J3、卷曲乳杆菌J8、詹氏乳杆菌J87,植物乳杆菌J75以及格氏乳杆菌J35,其pH分别为4.20、4.23、4.24、4.26及4.36;产H2O2弱阳性菌株有87株、阳性有37株、强阳性有9株,这9株菌分别为卷曲乳杆菌J3、卷曲乳杆菌J8、卷曲乳杆菌J20、詹氏乳杆菌J87,詹氏乳杆菌J90、詹氏乳杆菌J15、格氏乳杆菌J11、植物乳杆菌J75、植物乳杆菌J69以及植物乳杆菌J40;能拮抗大肠埃希菌的菌株有115株、拮抗金黄色葡萄球菌的有84株、拮抗白假丝酵母的有52株;经统计,对三者同时有拮抗作用且作用最强的只有6株,分别为卷曲乳杆菌J3、卷曲乳杆菌J50、卷曲乳杆菌J62、詹氏乳杆菌J87、詹氏乳杆菌J16和格氏乳杆菌J66;不同乳杆菌产生物膜能力数值范围在1.0~5.4,卷曲乳杆菌、詹氏乳杆菌、干酪乳杆菌的生物被膜形成能力显著高于其他三种菌(P0.05)。在全部179株菌中,卷曲乳杆菌J3和詹氏乳杆菌J87既具有强的产酸能力和产过氧化氢能力,又有较强抑菌活性,同时产生物膜能力也最强。结论卷曲乳杆菌J3和詹氏乳杆菌J87具有优良的生物学特性,有望成为用于治疗妇科疾病微生态制剂的备选菌株。     

阴道白假丝酵母菌过度增殖的小鼠模型建立

目的建立阴道白假丝酵母菌过度增殖的小鼠模型。方法甲硝唑溶液（浓度为12．5mg／mL）30μL注入小鼠阴道内,1次／d,连续5d,白假丝酵母菌菌液（1×10^8CFU／mL）30μL接种到小鼠阴道内,1次／d,连用5d。取阴道冲洗液进行阴道菌群分析,并做阴道组织标本电镜观察。结果模型组小鼠阴道内白假丝酵母菌活菌数显著增加,乳杆菌活菌数量显著下降（P〈0．01）,出现阴道红肿、分泌物多和黏膜充血等白假丝酵母菌过度增殖的典型症状。结论通过抗生素脱污染后,小鼠阴道内接种白假丝酵母菌,能在小鼠阴道内定植,成功建立阴道白假丝酵母菌过度增殖的小鼠模型。     

乳杆菌对外阴道白假丝酵母菌病治疗的分子机制

目的通过应用乳杆菌代谢产物提取物治疗外阴道白假丝酵母菌的效果,探讨乳杆菌治疗白假丝酵母菌病的可能分子机制。方法选择符合外阴道白假丝酵母菌病患者57例,随机分为2组,组应用乳杆菌代谢产物提取物治疗7d(试验组);另一组采用常规治疗(对照组),观察治疗前后阴道pH的变化,白假丝酵母菌、乳杆菌的变化及临床治疗效果的变化。结果采用乳杆菌代谢产物提取物治疗后阴道pH值恢复正常,白假丝酵母菌降低,乳杆菌变化不明显,临床治疗效果明显。结论乳杆菌治疗白假丝酵母菌病的分子机制可能是乳杆菌持续产生的乙酸、9-十六碳烯酸、十六烷酸、9,12-十八碳二烯酸和9-十八碳烯酸作用的结果。     

乳杆菌代谢物脂肪酸组分对白假丝酵母菌的抑制及临床疗效观察

目的观察乳杆菌DM9811代谢物中脂肪酸组分（以下称抑菌液）在体内外对白假丝酵母菌的抑制效果,探索外阴阴道假丝酵母菌病（VVC）的安全、有效、无副作用的生态制剂疗法。方法不同浓度抑菌液对白假丝酵母菌的作用及作用不同时间的抑菌效果;对2003年9月～2004年1月57例VVC患者分别给予抑菌液（试验组）及达克宁栓（对照组）进行治疗,并做相关细菌培养及疗效判定。结果（1）体外试验中抑菌液对白假丝酵母菌的抑制作用随着浓度的降低而降低;在1：2浓度（乙酸含量0．8mg／ml）抑制作用随着时闻的延长而增强,12h达100％;对乳杆菌无抑制作用。（2）体内试验中抑菌液使阴道白假丝酵母菌数量明显减少（P〈0．05）,使阴道pH明显降低（P〈0．05）,阴道内乳杆菌数量差异无显著性（P〉0．05）;达克宁栓使阴道内白假丝酵母菌数量明显减少,乳酸杆菌数量明显下降（P〈0．05）,而阴道pH无变化。（3）2组1疗程治愈率及1个月复查治愈率均差异无显著性。（4）副反应：两者比较差异有显著性（P〈0．05）。结论抑菌液在体内外对白假丝酵母茵均有明显的抑杀作用;降低阴道pH;对阴道乳杆菌数量无影响;无副作用;可用于VVC的治疗。     

口腔黏膜真菌鉴定方法的比较

比较常见用于黏膜真菌菌种鉴别的多种方法,探寻最佳的鉴别方法。采集230例普通人群口腔黏膜样本,分别用玉米吐温-80培养观察厚膜孢子法、糖发酵生化反应法、CHROMagar假丝酵母菌显色培养基法、ITS基因的PCR-RFLP(聚合酶链反应-限制性片段长度多态性)法、ITS测序菌种鉴定法,鉴别真菌各菌株。结果显示:有56例菌株至少通过1种方法检出真菌;玉米吐温-80分离培养假丝酵母菌37株;50例菌株ITS基因测序共鉴定出8个菌种,白假丝酵母菌(C.albicans)29株,近平滑假丝酵母菌(C.parapsilosis)10株,热带假丝酵母菌(C.tropicalis)5株,Candida metapsilosis 1株,Lodderomyces elongisporus 1株,克柔假丝酵母菌(Candida krusei)1株,乙醇假丝酵母菌(C.ethanolica)1株,季也蒙毕赤酵母菌(Pichia guilliermondii)2株;CHROMagar假丝酵母菌显色培养基法鉴定出3种菌株,分别是白假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌;PCR-RFLP法检出5种菌株,分别是白假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌、季也蒙毕赤酵母菌、克柔假丝酵母菌,与基因的测序鉴定一致率为91%;糖发酵生化反应法阳性标本占被检出真菌例数的46.4%(26/56)。结果表明:ITS基因的测序法可以准确鉴定真菌各个菌种;PCR-RFLP法能鉴定常见的菌种,但操作繁琐;CHROMagar假丝酵母菌显色培养基法能快速准确鉴别3种常见假丝酵母菌菌种;玉米吐温-80可以准确培养鉴别白假丝酵母菌;糖发酵生化反应法,缺乏足够的敏感度和特异性,难以准确鉴别各个菌种。     

Lactobacillus rhamnosus L60, a potential probiotic isolated from the human vagina

The vagina has been increasingly viewed as an "ecosystem" whose normal microflora help protect it from invading pathogens, including those that cause urinary tract infections and sexually transmitted diseases. We tested new strains of lactobacilli as potential probiotics for maintenance of urogenital tract health, as well as prevention and therapy of urogenital infections. A strain of lactobacilli isolated from the vagina of nonpregnant, healthy, premenopausal women was identified as Lactobacillus rhamnosus L60 by 16S rDNA sequence homology. L60 was evaluated for antimicrobial activity, in vitro antibiotic resistance, autoaggregation, surface hydrophobicity, co-aggregation with other bacterial species, hydrogen peroxide (H(2)O(2)) production, and bacterial adherence. It displayed a wide spectrum of antimicrobial activity against urogenital pathogens, and resistance to antibiotics commonly prescribed for infections caused by these pathogens. L60 produced H(2)O(2), adhered to vaginal epithelial cells, co-aggregated with Escherichia coli and Candida albicans, and displayed self-aggregation. In view of these characteristics, L60 is considered a potential probiotic, and will be further evaluated for preventive and therapeutic application locally in the vaginal tract.     

Occurrence and the sensitivity to drugs of fungi other than Candida albicans isolated from the vagina

Frequency of occurrence of fungal species distinct from C. albicans isolated from vaginal mucosa and their sensitivity to antimycotic chemotherapeutics was determined. Material consisted of 452 fungal strains isolated from vagina from patients suffering from afflictions within genital area. Fungal strains isolated belonged to 13 genera. Fungi distinct from C. albicans constituted 27.1% of all the strains. Fungi the most frequently isolated from vagina belonged to following genera: T. glabrata 35.2% C. krusei 18.4% C. pseudotropicalis 15.2% S. cerevisiae 10.4%. In the majority of cases of vaginal infections caused by fungi distinct from C. albicans, Lactobacillus sp. was present and normal pH values of vaginal content 3/4 with variable number of leucocytes were observed. Evaluation of sensitivity to antimycotic drugs of fungal strains was performed by agar dilution technique. In this study the following chemotherapeutics were assayed: nystatin, pimaricin, amphotericin B, flucytosine, clotrimazole, miconazole and ketoconazole. It is worth to underline resistance of T. glabrata and S. cerevisiae to clotrimazole and ketoconazole. Moreover, resistance of strains belonging to genera C. krusei and C. pseudotropicalis to amphotericin B and C. krusei strains to nystatin and flucytosine was noted.     

Ultrastructural localization of the secretory aspartyl proteinase in Candida albicans cell wall in vitro and in experimentally infected rat vagina

Detection and ultrastructural localization of aspartyl proteinase (Sap) in Candida albicans experimentally infecting rat vagina were studied. Two Sap-positive (Sap+) and one Sap-negative (Sap-) strains of the fungus, endowed with high and low experimental vaginopathic potential, respectively, were used. Both Sap+ strains produced consistent Sap levels in the rat vagina, while the Sap- strain did not produce any measurable Sap. Electron microscopy of thin sections of chemically-fixed vaginal scrapings showed clear evidence of hyphae of proteolitic strains of C. albicans invading the keratinized epithelial cell layer of the vagina. The fungal cells exhibited a pronounced fibrillar layer on the cell wall with a marked intermixing of fungal and vaginal materials especially pronunced at the hyphal tip. Post-embedding immunogold techniques with the use of anti-Sap polyclonal and the specifically generated monoclonal antibody GF1 showed that Sap was essentially localized in the cell wall of C. albicans early during infection, in a cytological pattern mirroring Sap localization in C. albicans cells grown in Sap-inductive media in vitro. In summary, the data offer a new biochemical and ultrastructural evidence that Sap is actively secreted during experimental rat vaginitis by C. albicans. Cell wall localization of Sap is probably inherent to this active secretion process. This revised version was published online in August 2006 with corrections to the Cover Date.     

Influence of manufacturing processes on in vitro properties of the probiotic strain Lactobacillus rhamnosus Lcr35®

Probiotics are administered as complex manufactured products and yet most studies on probiotic bacterial strains have been performed with native culture strains. Little is known about the influence of industrial processes on the properties of the microorganisms. In this study, we comparatively assessed the characteristics of the probiotic bacterial strain Lactobacillus rhamnosus (Lcr35(?)) together with four of its commercial formulations, including three intestinal formulas (BACILOR with Lcr Restituo(?) packet and capsule and FLOREA Lcr Lenio(?)) and one vaginal formula (GYNOPHILUS Lcr Regenerans(?)). Lcr35(?) grown from the intestinal formulas displayed increased resistance to acidic pH and bile stress, especially FLOREA (Lcr Lenio(?)), which showed a 4.5log higher number of viable bacteria compared to the results obtained with the control native Lcr35(?) strain. Adhesion to intestinal cells was significantly higher with Lcr Restituo(?) packet and Lcr Restituo(?) capsule vs Lcr35(?). Bacteria from the vaginal formulation GYNOPHILUS had increased ability to metabolize glycogen thereby increasing lactic acid production. In vitro growth inhibition of the pathogen Candida albicans was significantly higher with bacteria from the vaginal formulation (4.5 log difference) and in the presence of vaginal epithelial cells than with the native strain. Our results show that the manufacturing process influences strain properties and should therefore be adapted according to the strain and the therapeutic indication.     

Bacteriocin production and gene sequencing analysis from vaginal Lactobacillus strains

The human vagina is a complex and dynamic ecosystem containing an abundance of microorganisms. In women of childbearing age, this system is dominated by Lactobacillus spp. In the present work, seventeen newly isolated vaginal strains were identified by 16S rDNA sequencing and were investigated for their antimicrobial properties. Twelve of the isolated Lactobacillus strains showed activity against one or more microorganisms. Six and five of them produced substances that inhibited the growth of two different Klebsiella strains and Staphylococcus aureus, respectively. Two lactobacilli strains were active against an Escherichia coli strain, one isolate was active against an Enterococus faecalis strain and another lactobacilli strain showed antimicrobial activity against a Candida parapsilosis strain. The nature of the active compounds was additionally studied, and the presence of bacteriocin-like substances was proved. The genes related to the bacteriocin production in three of the newly isolated strains were identified and sequenced. The presence of gassericin A operon in the genome of the species Lactobacillus crispatus was described for the first time. The presence of antimicrobial activity contributes to their possible use as potential probiotic strains after further research.     

Identification of lactobacilli isolated from the cloaca and vagina of laying hens and characterization for potential use as probiotics to control Salmonella Enteritidis

AIMS: To select Lactobacillus strains from laying hens for potential use as probiotic to control Salmonella Enteritidis infection. METHODS AND RESULTS: One hundred and eighty-six lactobacilli were isolated from the cloaca and vagina of laying hens, and identified at the species level by a polyphasic taxonomic approach. All isolates belonged to the Lactobacillus acidophilus, Lactobacillus reuteri or Lactobacillus salivarius phylogenetic groups, with the L. reuteri group being the most predominant group. Based on genetic diversity, about 50 representative strains were selected and tested for in vitro properties that could be predictive for probiotic activity in laying hens. Salmonella inhibition was shown to be species dependent, and correlated to some extent with the production of lactic acid. A selection of strains was evaluated in a S. Enteritidis challenge experiment. Two strains, L. reuteri R-17485 and Lactobacillus johnsonii R-17504 significantly decreased the colonization of chicks by S. Enteritidis in caeca, liver and spleen. CONCLUSIONS: Lactobacilli isolated from laying hens were observed to inhibit Salmonella growth in vitro, most probably through production of lactic acid, and to decrease in vivo the S. Enteritidis colonization of chicks. SIGNIFICANCE AND IMPACT OF THE STUDY: The data demonstrate that Lactobacillus isolates from laying hens may have probiotic potential in reducing S. Enteritidis infection.     

Selection and identification of anaerobic lactobacilli producing inhibitory compounds against vaginal pathogens

Two strains of Lactobacillus crispatus (15L08 and 21L07) and one strain of Lactobacillus jensenii (5L08) were selected from amongst 100 isolates from the vaginas of healthy premenopausal women for properties relevant to mucosal colonization and the production of H2O2 and/or bacteriocin-like compound. All three strains self-aggregated and adhered to vaginal epithelial cells, displacing well-known vaginal pathogens, such as Gardnerella vaginalis and Candida albicans. Lactobacillus crispatus 15L08 was characterized as a potential H2O2 producer. A high level of bacteriocin-like compound was synthesized by L. jensenii 5L08, with a bactericidal mode of action for G. vaginalis, C. albicans and Escherichia coli. However, H2O2-dependent activity alone was not sufficient to inhibit the growth of C. albicans. Simultaneous actions of H2O2 and bacteriocin-like compound produced by lactobacilli may be important for antagonizing pathogenic bacteria. These strains of lactobacilli may be excellent candidates for eventual use as probiotics to restore the normal microbial communities in the vaginal ecosystem.     

Identification method based on PCR combined with automated ribotyping for tracking probiotic Lactobacillus strains colonizing the human gut and vagina

AIMS: A molecular methodology based on PCR-associated automated ribotyping was developed to specifically detect the Lactobacillus strains of two probiotic products (an orally administered lyophilized preparation and vaginal tablets) in human faeces and vaginal swabs. METHODS AND RESULTS: The 16S-23S rDNA sequences and the ribotype profiles of the probiotic lactobacilli were characterized and new species-specific primer sets were designed. The identification of faecal and vaginal lactobacilli isolated from subjects administered with the probiotic products was performed by using PCR with species-specific primers followed by strain-specific automated ribotyping. CONCLUSIONS: The PCR-ribotyping identification allowed to study the colonization patterns of the probiotic lactobacilli in the human gut and vagina evidencing the strains with the best survival capability. SIGNIFICANCE AND IMPACT OF THE STUDY: The proposed molecular method represents a powerful tool of strain-specific identification, useful for differentiating exogenous from indigenous strains in any microbial ecosystem and for rationally choosing probiotic bacteria with the best chance of survival in the host.     

Prebiotic effects of oligosaccharides on selected vaginal lactobacilli and pathogenic microorganisms

The purpose of this study was to select endogenous human vaginal lactobacilli strains on the basis of the main probiotic properties observed in the vaginal environment in order to use them for the evaluation of the potential prebiotic properties of oligosaccharides. From vaginal samples of 50 women with a normal flora, 17 lactobacilli strains were first isolated because of their high level of hydrogen peroxide production. Then six strains were selected mainly for their ability (i) to adhere to vaginal cells, (ii) to produce compounds in sufficient amount, such as lactic acid, having an inhibitory action on pathogens, and less importantly, (iii) to demonstrate arginine deiminase activity. These six strains were found to belong to three distinct species: Lactobacillus crispatus, L. jensenii and L. vaginalis. One strain of each species was chosen as a potential vaginal probiotic strain with regard to our criteria. These three strains were then used to evaluate the prebiotic properties of different oligosaccharide series: two fructooligosaccharide series (FOS Actilight and FOS Raftilose) and two glucooligosaccharide series varying by their osidic linkages (alpha-1,6/alpha-1,4 GOS and alpha-1,2/alpha-1,6/alpha-1,4 GOS). The test was based on the ability of the oligosaccharides to promote the growth of the three beneficial strains selected but not of pathogenic microorganisms often encountered in urogenital infections such as Candida albicans, Escherichia coli and Gardnerella vaginalis. Oligosaccharide hydrolysis was followed by HPLC analysis. This revealed that two oligosaccharide series (FOS Actilight DP3 and all alpha-1,6/alpha-1,4 GOS DP > or = 4) were used only by the lactobacilli strains, the pathogenic microorganisms being unable to metabolise them. The selected lactobacilli and oligosaccharides are good candidates for incorporation in a formula to prevent vaginal infections.