Worldwide, an estimated one billion women are affected by urogenital infections, including vaginal and urinary tract infections. The urinary tract is inhabited by micro-organisms and has its own unique microbial community. A urinary tract infection (UTI) is a bacterial infection of the urinary tract and occurs at least once in a lifetime among one third of women. A recurrent UTI (rUTI) is defined as two episodes of UTI in six months or three or more in one year. Between 35% to 53% of women treated for UTIs will experience an rUTI within twelve months.
Risk factors for urinary tract infections.
Studies have shown that the urinary tract is inhabited by micro-organisms and has its own unique microbial community. While it is still unknown what causes a UTI, some factors thought to disturb the urinary tract are changes in hygiene, medication, sexual activity and diet (see figure 1). The treatment standard for UTIs are antibiotics. Although antibiotics are very effective initially, they don’t work the same way for every patient and are not ideal for long term use, as happens in preventative use for rUTIs. Also, there is no consensus on the ideal dose, duration, and schedule within UTIs. Antibiotics cannot support the host and therefore don’t help to resolve the risk of longterm infection recurrence5. Finally, antibiotics come with many negative side effects such as antibiotic resistance. These side effects have prompted researchers to look into alternatives such as probiotics to support treatment and to prevent rUTIs.
Vaginal infections caused by Candida species (candidiasis / yeast vaginitis) are a very common problem and frequently associated with improper use of vaginal medications, hormone replacement therapy, high-estrogen contraceptives, and other practices that change the vaginal microbiota1. Common offending organisms in candidiasis are Candida albicans, though C. glabrata and other Candida species are increasingly identified. Antifungals and antimicrobials are frequently used as treatment options, however they can disrupt the vaginal microbiota’s balance even further. C. albicans is a normal resident of the vagina but can overgrow and become pathogenic if the opportunity arises. Overgrowth of Candida and development of an infection is generally associated with changes in the vaginal microbiota, estrogen production, and vaginal pH1. One frequent problem with Candida infections is that they have a high recurrence rate (60%).
The microbial species that inhabit the vaginal tract play an important role in the maintenance of health and prevention of infections. The most common offender in candidiasis is C. albicans showing below.
Lactobacilli are the most prevalent microorganisms in a healthy vaginal microbiota. These lactobacilli play a major role in protecting the host against bacterial vaginosis and yeast vaginitis. Evidence suggests that there is an association between decreased vaginal lactobacilli and the development of vaginosis and vaginitis. Several mechanisms have been identified by which lactobacilli can help to prevent infections. Firstly, Lactobacillus spp. produce antimicrobial substances such as bacteriocins and hydrogen peroxide (H2O2), which kill pathogens. Secondly, lactic acid produced by lactobacilli acidifies the vaginal environment and thereby prevents colonization and proliferation of potential pathogens. Thirdly, lactobacilli adhere and compete for adhesion sites in the vaginal epithelium, thereby inhibiting adhesion of pathogens. Clinical studies with probiotics have shown good results in preventing and alleviating vaginal infections.
Winclove has developed the following probiotic formulations for urogentital health:
|Prevention of (recurrent) vaginal infections|
|Prevention of recurrent urinary tract infections|