Abstract
The knowledge about the normal and abnormal vaginal microbiome has changed over the last years. Culturing techniques are not suitable any more for determination of a normal or abnormal vaginal microbiota. Non culture-based modern technologies revealed a complex and dynamic system mainly dominated by lactobacilli.
The normal and the abnormal vaginal microbiota are complex ecosystems of more than 200 bacterial species influenced by genes, ethnic background and environmental and behavioral factors. Several species of lactobacilli per individuum dominate the healthy vagina. They support a defense system together with antibacterial substances, cytokines, defensins and others against dysbiosis, infections and care for an normal pregnancy without preterm birth.
The numbers of Lactobacillus (L.) iners increase in the case of dysbiosis.
Bacterial vaginosis (BV) – associated bacteria (BVAB), Atopobium vaginae and Clostridiales and one or two of four Gardnerella vaginalis – strains develop in different mixtures and numbers polymicrobial biofilms on the vaginal epithelium, which are not dissolved by antibiotic therapies according to guidelines and, thus, provoke recurrences.
Aerobic vaginitis seems to be an immunological disorder of the vagina with influence on the microbiota, which is here dominated by aerobic bacteria (Streptococcus agalactiae, Escherichia coli). Their role in AV is unknown.
Vaginal or oral application of lactobacilli is obviously able to improve therapeutic results of BV and dysbiosis.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Abdo CL, Safdar N (2009) The role of Lactobacillus probiotics in the treatment or prevention of urogenital infections – a systematic review. J Chemother 21:243–252
Adams MR (1999) Safety of industrial lactic acid bacteria. J Biotechnol 68:171–178
af Heurlin M (1914) Bakteriologische Untersuchungen des Genitalsekretes. Karger, Berlin
Amsel R, Totten PA, Spiegel CA, Chen KCS, Eschenbach DA (1983) Non specific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 74:14–22
Antonio MA, Meyn LA, Murray PJ, Busse B, Hillier SL (2009) Vaginal colonization by probiotic Lactobacillus crispatus CTV-05 is decreased by sexual activity and endogenous Lactobacilli. J Infect Dis 199:1506–1513
Anukam K, Osazuwa E, Ahonkhai I, Ngwu M, Osemene G, Bruce AW, Reid G (2006) Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo-controlled trial. Microbes Infect 8:1450–1454
Babula O, Lazdana G, Kroica J, Ledger WJ, Witkin SS (2003) Relation between recurrent vulvovaginal candidiasis, vaginal concentrations of mannose-binding lectin, and mannose-binding lectin gene polymorphism in Latvian women. Clin Infect Dis 37:733–737
Barrons R, Tassone D (2008) Use of Lactobacillus probiotics for bacterial genitourinary infections in women: a review. Clin Ther 30:453–468
Barton PT, Gerber S, Skupsky DW, Witkin SS (2003) Interleukin-1 receptor antagonist gene polymorphism, vaginal interleukin-1 receptor antagonist concentrations, and vaginal Ureaplasma urealyticum colonization in pregnant women. Infect Immun 71:271–274
Bohbot JM, Cardot JM (2012) Vaginal impact of the oral administration of total freeze-dried culture of LCR-35 in healthy women. Infect Dis Obstet Gynecol 2012: 503648
Cherpes TL, Hillier SL, Meyn LA, Busch JL, Krohn MA (2008) A delicate balance: risk factors for acquisition of bacterial vaginosis include sexual activity, absence of hydrogen peroxide-producing lactobacilli, black race, and positive herpes simplex virus type 2 serology. Sex Transm Dis 35:78–83
Cibley LJ, Cibley LJ (1991) Cytolytic vaginosis. Am J Obstet Gynecol 165:1245–1249
Coudeyras S, Marchandin H, Fajon C, Forestier C (2008a) Taxonomic and strain – specific identification oft he probiotic strain Lactobacillus rhamnosus 35 within the Lactobacillus casei group. Appl Environ Microbiol 74:2679–2689
Coudeyras S, Jugie G, Vermerie M, Forestier C (2008b) Adhesion of human probiotic Lactobacillus rhamnosus to cervical and vaginal cells and interaction with vaginosis-associated pathogens. Infect Dis Obstet Gynecol. doi:10.1155/2008/549640
Curtis AH (1913) A motile curved anaerobic bacillus in uterine discharges. J Infect Dis 13:165–169
de Vos WM, Engstrand L, Drago L, Reid G, Schauber J, Hay R, Mendling W, Schaller M, Spiller R, Gahan CG, Rowland I (2012) Human microbiota in health and disease. Self Care 3(S1):1–68
Demirezen S (2003) Cytolytic vaginosis: examination of 2947 vaginal smears. Cent Eur J Public Health 11:23–24
Döderlein A (1892) Das Scheidensekret und seine Bedeutung für das Puerperalfieber. Besold, Leipzig
Donders GG, Vereecken A, Bosmans E, Dekeersmaecker A, Salambier G, Spitz B (2002) Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG 109:34–43
Donders G, Bellen G, Rezeberga D (2011) Aerobic vaginitis in pregnancy. BJOG 118:1163–1170
Edwards L (2010) Dermatologic causes of vaginitis: a clinical review. Dermatol Clin 28:727–735
Ehrström S, Daroczy K, Rylander E, Samuelsson C, Johannesson U, anzén B, Pahlson C (2010) Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidosis. Microbes Infect 12:691–699
Eschenbach DA, Davick PR, Williams BC, Klebanoff SJ, Young-Smith K, Critchlow CM, Holmes KK (1989) Prevalence of hydrogen peroxid-producing Lactobacillus species in normal women and women with bacterial vaginosis. J Clin Microbiol 27:251–256
Falsen E, Pascual C, Sjoden B, Ohlen M, Collins MD (1999) Phenotypic and phylogenetic characterization of a novel Lactobacillus species from human sources: description of Lactobacillus iners sp. nov. Int J Syst Bacteriol 49:217–221
Fan A, Yue Y, Geng N, Zhang H, Wang Y, Xue F (2013) Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings. Arch Gynecol Obstet 287:329–335
Fettweis JM, Serrano MG, Girerd PH, Jefferson PH, Buck GA (2012) A new era oft he vaginal microbiome: advances using next-generation sequencing. Chem Biodivers 9:965–976
Fredricks DM, Fiedler TL, Marazzo JM (2005) Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 353:1899–1910
Gajer P, Brotman RM, Bai G, Sakamoto J, Schütte UME, Zhong X, Koenig SSK, Li F, Ma Z, Zhou X, Abdo Z, Forney LJ, Ravel J (2012) Temporal dynamics of the human vaginal microbiota. Sci Transl Med 4:132ra52. doi:10.1126/scitranslatmed.3003605
Gardner HL, Dukes CD (1955) Haemophilus vaginals vaginitis – a newly defined specific infection previously classified “non-specific” vaginitis. Am J Obstet Gynecol 69:962–976
Genc MR, Onderdonk A (2011) Endogenous bacterial flora in pregnant women and the influence of maternal genetic variation. BJOG 118:154–163
Gray RH, Kigozi G, Serwadda D, Makumbi F, Nalugoda F, Watya S, Moulton L, Chen MZ, Sewankambo NK, Kiwanuka N, Sempijja V, Lutalo T, Kagayi J, Wabwire-Mangen F, Ridzon R, Bacon M, Wawer MJ (2009) The effects of male circumcision on female partner’s genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda. Am J Obstet Gynecol 200:42e1–42e7
Greenwood JR, Pickett MJ (1980) Transfer of Haemophilus vaginalis Gaedner and Dukes to a new genus, Gardnerella: G. vaginalis (Gardner and Dukes) comb. nov. Int J Syst Bacteriol 30:170–178
Guédou FA, van Damme L, Deese J, Crucitti T, Becker M, Mirembe F, Solomon S, Alary M (2013) Behavioural and medical predictors of bacterial vaginosis recurrence among female sex workers: longitudinal analysis from a randomized controlled trial. BMC Infect Dis 13:208. doi:10.1186/1471-2334-13-208
Hemmerling A, Harrison W, Schroeder A, Park J, Korn A, Shiboski S, Foster-Rosales A, Cohen CR (2010) Phase 2a study assessing colonization efficiency, safety, and acceptability of Lactobacillus crispatus CTV-05 in women with bacterial vaginosis. Sex Transm Dis 37:745–750
Hickley RJ, Zhou X, Pierson JD, Ravel J, Forney LJ (2012) Understanding vaginal microbiome complexity from an ecological perspective. Transl Res 160:267–282
Hillier SL, Meyn L, Macio I, Antonio M, Rabe L (2010) The back door reservoir for Lactobacilli and risk of BV (bacterial vaginosis) acquisition. Infect Dis Soc Obstet Gynecol. In: Proceedings of the 37th Annual Scientific Meeting, August 5, Santa Fe, New Mexico
Hilton E, Isenberg HD, Alperstein P, France K, Borenstein M (1992) Ingestion of yoghurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med 116:353–357
Homayouni A, Bastani P, Ziyadi S, Mohammad-Alizadeh-Charandabi S, Ghalibaf M, Mortazavian AM, Mehrabany EV (2014) Effects of probiotics on the recurrence of bacterial vaginosis: a review. J Low Genit Tract Dis 18; 79–86
Horowitz BJ, Mardh PA, Nagy E, Rank EL (1994) Vaginal lactobacillosis. Am J Obstet Gynecol 170:857–861
Hoyme UB, Hübner J (2010) Prevention of preterm birth is possible by vaginal pH screening, early diagnosis of bacterial vaginosis or abnormal vaginal flora and treatment. Gynecol Obstet Invest 70:286–290
Huang H, Song L, Zhao W (2013) Effects of probiotics for bacterial vaginosis in adult women: a meta-analysis of randomized clinical trials. Arch Gynecol Obstet 289: 1225–1234
Jahic M, Mulavdic M, Hadzimehmedovic A, Jahic E (2013) Association between aerobic vaginitis, bacterial vaginosis and squamous intraepithelial lesion of low grade. Med Arh 67:94–96
Jayaprakash TP, Schellenberg JJ, Hill JE (2012) Resolution and character-ization of distinct cpn60-based subgroups of gardnerella vaginalis in the vaginal microbiota. PLoS One 7(8):e43009. doi:10.1371/journal.pone.0043009
Jespers V, Menten J, Smet H, Poradosú S, Abdellati S, Verhelst R, Hardy L, Buvé A, Crucitti T (2012) Quantification of bacterial species of the vaginal microbiome in different groups of women, using nucleid acid amplification tests. BMC Microbiol 12:83
Jirovec O, Peter R, Malek J (1948) Neue Klassifikation der Vaginalbiocoenose auf sechs Grundbildern. Gynaecologia (Basel) 126:77
Kern AM, Bohbot JM, Cardot JM (2012) Traitement préventive de la candidose vulvovaginale récidivante par probiotique vaginal: résultats de l’étude observationelle Candiflore. Lett Gynécol 370:34–37
Köhler GA, Assefa S, Reid G (2012) Probiotic interference of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 with the opportunistic fungal pathogen Candida albicans. Infect Dis Obstet Gynecol 2012:636474. doi:10.1155/2012/636474
Krönig B (1895) Über die Natur der Scheidenkeime, speciell über das Vorkommen anaerober Streptokokken im scheidensekret Schwangerer. Centrbl Gynäkol 16:409–412
Lamont RF, Sobel JD, Akins RA, Hassan SS, Chaiworapongsa T, Kusanovic JP, Romero R (2011) The vaginal microbiome: new information about the genital tract flora using molecular based techniques. BJOG 118:533–549
Li J, McCormick J, Bocking A, Reid G (2012) Importance of vaginal microbes in reproductive health. Reprod Sci 19:235–242
Linhares IM, Giraldo PC, Baracat EC (2010) New findings about vaginal bacterial flora. Rev Assoc Med Bras 56: doi 10.1590/S0104-4230210000300026
Machado A, Jefferson KK, Cerca N (2013) Interactions between Lactobacillus crispatus and bacterial vaginosis (BV)-associated bacterial species in initial attachment and biofilm formation. Int J Mol Sci 14:12004–12012
Manhart MC, Fiedler TK, Fredricks DN, Marrazzo J (2012) Behavioral predictors of colonization with Lactobacillus crispatus or Lactobacillus jensenii after treatment for bacterial vaginosis: a cohort study. Infect Dis Obstet Gynecol 2012:706540. doi:10.1155/1012/706540. Epub 2012 May 30
Marrazzo JM, Fiedler TL, Srinivasan S, Thomas KK, Liu C, Ko D, Xie H, Saracino M, Fredricks DN (2012) Extravaginal reservoirs of vaginal bacteria as risk factors for incident bacterial vaginosis. J Infect Dis 205:1580–1588
Martin DH (2012) The microbiota of the vagina and its influence on women’s health and disease. Am J Med Sci 343:2–9
Martin R, Langa S, Reviriego C, Jiminez E, Marin M, Xaus J, Fernandez L, Rodriguez J (2003) Human milk as a source of lactic acid bacteria for the infant gut. J Pediatr 143:754–758
Martinez RC, Seney SL, Summers KL, Nomizo A, de Martinis EC, Reid G (2009a) Effect of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 on the ability of Candida albicans to infect cells and induce inflammation. Microbiol Immunol 53:487–495
Martinez RCR, Franceschini SA, Patta MC, Quintana SM, Candido RC, Ferrera JC, de Martinis ECP, Reid G (2009b) Improved treatment of vulvovaginal candidiasis with fluconazole plus probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Lett Appl Microbiol 48:269–274
McMillan A, Dell M, Zellar MP, Cribby S, Martz S, Hong E, Abbas A, Dang T, Miller W, Reid G (2011) Disruption of urogenital biofilms by lactobacilli. Colloids Surf B Biointerfaces 86:58–64
Mendling W, Martius J, Hoyme UB (2013) S1 – guideline on bacterial vaginosis in gynecology and obstetrics. Geburtshilfe Frauenheilkd 73:1–4
Mirmonsef P, Gelbert D, Zariffard MR, Hamaker BR, Kaur A, Landay AL, Spear GT (2011) The effects of commensal bacteria on innate immune responses in the female genital tract. Am J Reprod Immunol 65:190–195
Mitchell C, Gottsch ML, Liu C, Fredricks DN, Nelson DB (2013) Association between vaginal bacteria and levels of vaginal defensins in pregnant women. Am J Obstet Gynecol 208:132.e1–132.e7
Nivoliez A, Camarez o, Paquet-Gachinat M, Bornes S (2012) Influence of manufacturing processes on in vitro properties of the probiotic strain Lactobacillus rhamnosus Lcr35. J Biotechnol 160:236–241
Nugent RP, Krohn MA, Hillier SL (1991) Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Pathol 29:297–300
Nürnberger L (1930) Die Erkrankungen der Scheide. In: Stoeckel (ed) Handbuch der Gynäkologie, revised 3rd edition of Handbuch der Gynäkologie by Veit J, vol 5. Bergmann, Munich
Petricevic L, Witt A (2008) The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis. BJOG 115:1369–1374
Petricevic L, Unger FM, Viernstein Kiss H (2008) Randomized, double-blind, placebo-controlled study of oral lactobacilli to improve the vaginal flora of postmenopausal women. Eur J Obstet Gynecol Reprod Biol 141:54–57
Petricevic L, Domig KJ, Nierscher FJ, Krondorfer I, Janitschek C, Kneifel W, Kiss H (2012) Characterisation oft he oral, vaginal and rectal Lactobacillus flora in healthy pregnant and postmenopausal women. Eur J Obstet Gynecol Reprod Biol 160:93–99
Pirotta M, Gunn J, Chondros P, Grover S, O’Malley P, Hurley S, Garland S (2004) Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial. BMJ 329:458–51
Price LB, Liu CM, Johnson KE, Aziz M, Lau MK, Bowers J, Ravel J, Keim PS, Serwadda D, Wawer MJ, Gray RH (2010) The effects of circumcision on the penis microbiome. PLoS One 5:e8422
Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SSK, McCulle SL, Karlebach S, Gorle R, Russell J, Tacket CO, Brotman RM, Davis CC, Ault K, Peralta L, Forney LJ (2011) Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci U S A 108(S1):4680–4687
Reid G (2001) Probiotic agents to protect the urogenital tract against infection. Am J Clin Nutr 73(Suppl):S437–S443
Reid G (2012) Probiotic and prebiotic applications for vaginal health. J AOAC Int 95:31–34
Rodriguez JM, Collins MD, Sjoden B, Falsen E (1999) Characterization of a novel Atopobium isolate from the human vagina: description of Atopobium vaginae sp. nov. Int J Syst Bacteriol 49:1573–1576
Sanchez D, Wagener J, Schaller M (2008) Impact of Lactobacillus species on localised Candida albicans infection and the mucosal innate immune response. Mycoses 51:434
Sanu O, Lamont RF (2011) Periodontal disease and bacterial vaginosis as genetic and environmental markers for the risk of spontaneous preterm labor and preterm birth. J Matern-Fetal Neonatal Med 24:1476–1485
Schaller M (2012) Lactobacilli in mucosal Candida albicans infections. In: de Vos WM, Engstrand L, Drago L, Reid G, Schauber J, Hay R, Mendling W, Schaller M, Spiller R, Gahan CG, Rowland I (eds) Human microbiota in health and disease. SelfCare 3(S1):S41–S45
Schröder R (1921) Zur Pathogenese und Klinik des vaginalen Fluors. Zbl Gynäkol 38:1350–1361
Senok AC, Verstraelen H, Temmerman M, Botta GA (2009) Probiotics for the treatment of bacterial vaginosis. Cochrane Database Syst Rev 7(4):CD006289
Shalev E, Battino S, Weiner E, Colodner R, Keness Y (1996) Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis. Arch Fam Med 5:593–596
Sherman P, Ossa JC, Johnson-Henry K (2009) Unraveling mechanisms of action of probiotics. Nutr Clin Pract 24:10–14
Spiegel CA, Roberts M (1984) Mobiluncus gen. nov. Mobiluncus curtisii subsp. curtisii sp. nov., Mobiluncus curtisii subsp. holmesi subsp. nov., and Mobiluncus mulieris sp. nov., curved rods from the human vagina. Int Syst Bacteriol 34:177–184
Spurbeck RR, Arvidson CG (2011) Lactobacilli at the front line of defense against vaginally acquired infections. Future Microbiol 6:567–582
Strus M, Chmielarczyk A, Kochan P, Adamski P, Chelmicki Z, Chelmicki A, Palucha A, Heczko P (2012) Studies on the effect of probiotic Lactobacillus mixture given orally on vaginal and rectal colonization and on parameters of vaginal health in women with intermediate vaginal flora. Eur J Obstet Gynecol Reprod Biol 163:210–215
Swidsinski A, Mendling W, Loening-Baucke V, Ladhoff A, Swidsinski S, Hale LP, Lochs H (2005) Adherent biofilms in bacterial vaginosis. Obstet Gynecol 106:1013–1023
Swidsinski A, Mendling W, Loening-Baucke E, Swidsinki S, Dörfel Y, Scholze J, Lochs H, Verstraelen H (2008) An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium following standard therapy of bacterial vaginosis with oral metronidazole. Am J Obstet Gynecol 198:97e1–97e6
Swidsinski A, Dörffel Y, Loening-Baucke V, Mendling W, Schilling J, Patterson JL, Verstraelen H (2010) Dissimilarity in the occurrence of Bifidobacteriaceae in the vaginal and peranal microbiota in women with bacterial vaginosis. Anaerobe 16:478–482
Swidsinski A, Loening-Baucke V, Mendling W, Dörffel Y, Schilling J, Halwani Z, Jiang XF, Verstraelen H, Swidsinski S (2013) Infection through structured polymicrobial Gardnerella biofilms (StPM-GB). Histol Histopathol 29:567–597
Thies FL, König W, König B (2007) Rapid characterization of the normal and disturbed vaginal microbiota by application of 16S rRNA gene terminal RFLP fingerprinting. J Med Microbiol 56:755–761
Thomas S (1928) Döderlein’s bacillus: Lactobacillus acidophilus. J Infect Dis 43:218–227
Vasquez A, Jakobsson T, Ahrné S, Forsum U, Maey olin G (2002) Vaginal Lactobacillus flora of healthy Swedish women. J Clin Microbiol 40:2746–2749
Verhelst R, Verstraelen H, Claeys G, Verschraegen G, Delanghe J, van Simaey L, de Ganck C, Temmermann M, Vaneechoutte M (2004) Cloning of 16S rRNA genes amplified from normal and disturbed vaginal microflora suggests a strong association between Atopobium vaginae, Gardnerella vaginalis and bacterial vaginosis. BMC Microbiol 4:16
Verhoeven V, renard N, Makar A, van Royen P, Bogers JP, Lardon F, Peeters M, Baay M (2013) Probiotics enhance the clearance of human papillomavirus-related cervical lesions: a prospective controlled pilot study. Eur J Cancer Prev 22:46–51
Verstaelen H, Verhelst R, Nuytinck L, Roelens K, de Meester E, de Vos D, van Thielen M, Rossau R, Delva W, de Bakker E, Vaneechoutte M, Temmermann M (2009) Gene polymorphisms of Toll-like and related recognition receptors in relation to the vaginal carriage of G.vaginalis and A. vaginae. J Reprod Immunol 79:163–173
Verstraelen H, Swidsinski A (2013) The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment. Curr Opin Infect Dis 26:86–89
Verstraelen H, Verhelst R, Claeys G, de Bakker E, Temmermann M, Vaneechoutte M (2009) Longitudinal analysis of the vaginal microflora in pregnancy suggests that L. crispatus promotes stability of the normal vaginal microflora and that L. gasseri and/or L. iners are more conducive to the occurrence of abnormal vaginal microflora. BMC Microbiol 9:116. doi:10.1186/1471-2180-9-116
Weström L (Working Group Co-ordinator), Evaldson G, Holmes KK, van der Meijden W, Rylander E, Fredriksson B (1984) Taxonomy of bacterial vaginosis; bacterial vaginosis – a definition. Symposium on bacterial vaginosis, Stockholm, Jan. 1984. In: Mardh PA, Taylor-Robinson D (eds) Bacterial vaginosis. Almquist & Wiksell, Stockholm, pp 259–260
Ya W, Reifer C, Miller LE (2010) Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study. Am J Obstet Gynecol 203:120.e1–120.e6
Zhou X, Bent SJ, Schneider MG, Davis CC, Islam MR, Forney LJ (2004) Characterization of vaginal microbial communities in adult healthy women using cultivation-independent methods. Microbiology 150:2565–2573
Zhou X, Hansmann MA, Davis CC, Siuzuki H, Brown CJ, Schütte U, Pierson JD, Forney LJ (2010) The vaginal bacterial communities of Japanese women resemble those of women in other racial groups. FEMS Immunol Med Microbiol 58:169–181
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Mendling, W. (2016). Vaginal Microbiota. In: Schwiertz, A. (eds) Microbiota of the Human Body. Advances in Experimental Medicine and Biology, vol 902. Springer, Cham. https://doi.org/10.1007/978-3-319-31248-4_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-31248-4_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-31246-0
Online ISBN: 978-3-319-31248-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)