Ramesh Bhat, Department of Dermatology, Fr. E-mail: moc. This article has been cited by other articles in PMC. Trichomoniasis, bacterial vaginosis, and yeast infections are the three most frequent causes of vaginal discharge. It is characterized by abundant growth of Lactobacilli resulting in lysis of vaginal epithelial cells; and therefore, it is called as cytolytic vaginosis.
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Lactobacilli[ edit ] This article needs to be updated. Please update this article to reflect recent events or newly available information. December The primary colonizing bacteria of a healthy individual are of the genus Lactobacillus.
Lactobacilli have been shown to inhibit in vitro growth of pathogenic microorganisms, e. Bacteroides fragilis, Escherichia coli, Gardnerella vaginalis , Mobiluncus spp. It is generally accepted that this is achieved mainly through the action of lactic acid. This usually reduces pathogens from infecting to the vaginal epithelium. A concentration of mM H2O2 is approximately fold higher than lactobacilli are capable of producing even under optimal aerobic, low-antioxidant conditions, and approximately 5,fold higher than the estimated H2O2 concentration in vivo.
Possible explanations may be that cervicovaginal fluid and semen contain proteins, glycoproteins, polysaccharides, lipids, and other molecules with the potential to react with and inactivate H2O2.
In addition, the vagina is hypoxic most of the time, whereas lactobacilli require oxygen to produce hydrogen peroxide. It is also remarkable that catalase, which provides bacteria protection against toxic H2O2, is absent in lactobacilli,   and as such they would be unprotected against their own H2O2 production. In contrast, under optimal anaerobic growth conditions, physiological concentrations of lactic acid inactivated the BV-associated pathogens without affecting the vaginal lactobacilli.
Several studies have indicated that the activity of bacteriocins is favored by low pH. The inhibitory substances produced by vaginal Lactobacillus is a primary factor in protecting the vaginal microbiota, with organic acids, bacteriocins, and hydrogen peroxide.
These act synergistically against infection by pathogens. Not all Lactobacillus spp. The limited number of Lactobacillus spp. Non-pathogenic vaginal species are part of the normal microbiota of some women. The pH further decreases during pregnancy.
Some of the obligate and facultative anaerobic bacteria are associated with BV.
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