1.Streptococcus mitis (32.88%): Normally a commensal of the oral microbiome, Streptococcus mitis is occasionally found in vaginal samples. It is generally non-pathogenic but can cause infections in immunocompromised individuals. Over-representation in the vagina may indicate an abnormal flora possibly associated with inflammation or infection.
2.Gemella haemolysans (24.41%): Gemella haemolysans is also a common inhabitant of the upper respiratory tract and is less frequently detected in the vagina. High levels of this bacterium may be associated with dysbiosis, indicating a vaginal environment that is not dominated by protective lactobacilli.
3.Streptococcus agalactiae (8.62%): This species, also known as Group B Streptococcus, is potentially pathogenic and can lead to neonatal infections in pregnant women. In the vagina, an increase in S. agalactiae can increase the risk of infections and complications, especially during pregnancy.
4.Streptococcus salivarius (7.25%): Streptococcus salivarius is also part of the normal oral flora. Its presence in the vagina could indicate contamination or dysbiosis, as it is not common in the healthy vaginal flora.
5.Sneathia vaginalis (4.71%): This bacterial species is frequently detected in bacterial vaginosis and is an indication of a disturbance in the microbial balance. Its association with inflammation and vaginal infections makes it a potential indicator of vaginal dysbiosis.
6.Staphylococcus hominis (3.77%): These skin bacteria are not typically present in high proportions in the vagina. Their increased prevalence may indicate a disturbed flora that may have been influenced by external factors such as hygiene products or mechanical irritation.
Overall, this microbiome composition shows a significant deviation from the protective, lactobacillus-dominated vaginal flora, which could be associated with a higher risk of infection and inflammation. Further clinical evaluation may be advisable, particularly in relation to the potential role of Sneathia vaginalis and Streptococcus agalactiae. It would also be useful to consider measures to promote a healthy vaginal microbiota, including the use of probiotics or other therapeutic approaches (5-22).
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1.Promotion of lactobacilli to inhibit Streptococci and Gemella spp. Since Lactobacillus species should dominate in a healthy vaginal microbiota, probiotic preparations containing Lactobacillus crispatus or Lactobacillus gasseri can help to restore the microbial balance. Studies show that these Lactobacilli species can acidify the vaginal environment and thus inhibit the growth of streptococci such as Streptococcus mitis and Streptococcus agalactiae as well as Gemella haemolysans. Regular use of probiotics, e.g. in the form of vaginal suppositories or oral preparations, could help to restore lactobacilli dominance and suppress pathogenic bacteria (Mei and Li 2022).
2.Sneathia vaginalis ist häufig mit bakterieller Vaginose (BV) assoziiert. Therapy should aim to eliminate the conditions that favour the growth of Sneathia. Probiotics containing Lactobacillus reuteri and Lactobacillus rhamnosus have been shown to be effective in the treatment of BV by promoting microbial balance and displacing pathogenic organisms.
Oral ingestion of products such as Lactobacillus reuteri RC-14 and Lactobacillus rhamnosus GR-1 can help restore a healthy vaginal microbiota and alleviate BV symptoms. Several clinical studies have shown that these strains can reduce the recurrence of BV and stabilise vaginal health in the long term (Reid et al., 2018).
3.As Staphylococcus hominis is typically a skin bacterium, the increased presence in the vagina could indicate external contamination or a weakening of the vaginal barrier function. To reduce the growth of S. hominis, probiotics aimed at promoting the natural vaginal microflora, such as Lactobacillus crispatus, could be useful.
Studies have shown that Lactobacillus crispatus is able to both strengthen the immune system of the vaginal mucosa and inhibit the growth of unwanted microorganisms (Ravel et al., 2011).
4.General approach to supporting vaginal health
In addition to specific probiotics, the general use of multi-Lactobacilli preparations may be recommended to stabilise the vaginal microbiota. Preparations containing Lactobacillus acidophilus, Lactobacillus plantarum and Bifidobacterium bifidum may be helpful as they have been shown to improve vaginal health, support the immune system and promote the formation of a healthy biofilm.
Summary of recommended probiotics:
• Lactobacillus crispatus and Lactobacillus gasseri to inhibit Streptococci and Gemella spp.
• Lactobacillus reuteri and Lactobacillus rhamnosus to inhibit Sneathia vaginalis.
• Lactobacillus crispatus for the reduction of Staphylococcus hominis.
• Multi-lactobacilli preparations for the general promotion of vaginal health.
The targeted use of these probiotics could significantly improve the chances of restoring healthy vaginal microflora and reducing the risk of infections and dysbiosis.
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Note: We would like to point out that the results of molecular genetic tests should always be considered and interpreted in a clinical context.
Dr. med. Martin Gencik Dr. phil. Alfred Schöller Vivien Horvath MSc
Specialist in Medical Genetics Biologist Nutrition scientist