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Urinary Tract Infections and Lactobacillus Crispatus

Image result My last post discussed Lactobacillus crispatus as an important bacteria for womens' vaginal health and as a possible treatment for bacterial vaginosis (BV) - a condition where the vaginal microbes are out of whack (dysbiosis). It appears that Lactobacillus crispatus may also be a possible treatment for women with urinary tract infactions (UTIs), a condition where again microbes are out of whack.

The bacteria Lactobacillus crispatus is part of the vaginal microbiome of many healthy women and thought to be protective. It is unknown whether L. crispatus would also work for men with UTIs.

In the US, the vaginal suppository product Lactin-V (containing the freeze dried human vaginal strain of L. crispatus CTV-050) is currently being tested for both bacterial vaginosis and recurring urinary tract infections (UTIs). So far there are positive results for this product (manufactured by Osel, Inc.) in phase 2 clinical trials, but it may be years away from FDA approval.

The following article excerpts are from April 2011, but these are still the most recent published research results for this probiotic (beneficial bacteria). The results are pretty convincing that beneficial bacteria might some day replace standard medical treatment (antibiotics) for UTIs.  The Lactin-V treatment in women with recurrent UTIs resulted in "robust and prolonged colonization with Lcrispatus" in the vagina, which resulted in reducing the incidence of UTIs by about 50%.

But...the results also showed that which strain of L. crispatus the women had was important - some women had lots of one strain of "endogenous" L. crispatus - naturally occurring in them - that was not protective. could be that other microbes that are not being looked at are also important.

Of course researchers are also looking at other beneficial bacteria and there has been more recent research. D-Mannose and cranberry supplements have also been found to be effective in treating UTIs of many women (see herehere, and here), as well as changing the urine's acidity through diet.

While studies typically focus on women, these other products also work for UTIs in men (D-Mannose and cranberry supplements seem to be especially effective). Looks like probiotics and alternative treatments (D-mannose, cranberry supplements, etc.) are the future in treating UTIs!

From Medscape: Pro biotic May Help Prevent Recurrent Urinary Tract Infection

In a randomized, double-blind phase 2 study, an intravaginal probiotic composed of Lactobacillus crispatus CTV-05 (Lactin-V, Osel Inc) reduced the rate of recurrent urinary tract infection (rUTI) in UTI-prone women by roughly one half, which compares favorably with historical data on antimicrobial prophylaxis, the researchers say. They add that larger trials are warranted to see whether use of vaginal Lactobacillus could replace long-term antimicrobial preventive treatments in women susceptible to rUTI.

UTIs are common in women and frequently recur, Ann Stapleton, MD, from the University of Washington in Seattle, and colleagues note in their report. It has been shown, they add, that women with rUTIs [recurrent UTIs] often have alterations in vaginal microbiota, including depletion of lactobacilli.

A phase 1 study of Lactobacillus crispatus CTV-05 showed that the probiotic can be given as a vaginal suppository with minimal adverse effects to healthy women with a history of rUTI. In the phase 2 study, 100 premenopausal women (median age, 21 years) with a history of rUTI received antimicrobials for acute UTI and then were randomly assigned to receive either Lactobacillus crispatus CTV-05 or placebo vaginal suppository gelatin capsules administered once daily for 5 days, followed by once weekly for 10 weeks.

"We found that Lactin-V reduced the risk of rUTI approximately as effectively as antimicrobial prophylaxis, achieved high-level vaginal colonization in most women, and was well tolerated," Dr. Stapleton and colleagues report. According to the investigators, culture-confirmed rUTI occurred in 7 (15%) of 48 of women who received Lactobacillus crispatus CTV-05 compared with 13 (27%) of 48 women who received placebo.

A high level of vaginal colonization with L crispatus throughout follow-up was associated with a significant reduction in rUTI only among women receiving Lactobacillus crispatus CTV-05. What was "striking," the investigators add, was that placebo-treated women often had high concentrations of vaginal L crispatus during follow-up, yet this failed to protect them from rUTI.

In contrast, women who received Lactobacillus crispatus CTV-05 and achieved high colonization were protected from rUTI. "Lactin-V after treatment for acute UTI," they conclude, "confers a significant advantage over repopulation of the vaginal microbiota with endogenous L. crispatus." [The original study.]

Image result Lactobacillus crispatus  Credit:MicrobeWiki

6 thoughts on “Urinary Tract Infections and Lactobacillus Crispatus

  1. Robin Michetti

    Hello! I have had recurrent UTIs for 2 1/2 years; that is 35 in all with 35 rounds of antibiotics, to which 5 my system is now resistant.
    I have had success in preventing a UTI from recurring on 2 occasions. One was vaginal estrogen therapy with a hiatus lasting 3 months (until I had a cystoscopy and developed a nosocomial UTI which initiated back to back UTIs. The second success was 2 years later with Utiva (36 mg of Proanthocyanidins). Again, after 3 months of no UTIS, I had a nasal catheter inserted in my nose for a test and came away with a klebsiella infection and continued infections from then on.
    If you need a test subject for Lactin-V, I would be a willing guinea pig.
    Robin Michetti (Montreal, Quebec, Canada)

    1. Sima

      The good news is that Lactobacillus crispatus is now available in at least one women's probiotic (e.g. in a product sold by Jarrow Formulas).

        1. Smilla

          I think Crispatus helped me after many years of Escherichia.
          I used Physioflor vag.probiotic for long time after that last antibiotic and infection never came back. This probiotic is from France.
          Before that I was at least 10 times on very strong antibiotics and Escherichia was always coming back.
          Look up also for Symbioflor2, probiotic from Germany. I used it at the same time.
          I tried literally everything before that.
          I was drinking special vaccine made specially for me (by taking my culture and producing not live bacteria vaccine) ... This may help someone but it didn't helped me. I tried all kind of supplements, herbs, teas... Just name it.
          Good luck to everyone! I know how frustrating those infections could be.

          1. Smilla

            I was also using oral probiotic, during and after antibiotic theraphy. Mostly Lactobacillus rhamnosus but you can use more stains

            1. Sima

              I'm glad that Lactobacillus crispatus finally helped you. That appears to be a keystone bacteria for women's health.


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