Bifidobacterium spp. vulvovaginal infections

Bifidobacterium are considered a probiotic and commensal in the human gut, understood as nonpathogenic, however, there is at least one case report​1​ of this bacteria being a possible cause of a urinary tract infection. Bifidobacterium may be implicated as a pathogen in some circumstances.

What we know about bifidobacterium

  • Anaerobic commensal of human intestine
  • Part of healthy flora of the mouth and vagina
  • Generally considered non-pathogenic
  • Advocated as a probiotic
  • Used to reduce diarrhoea
  • May have caused sepsis and necrotising pancreatitis and urinary tract infections
  • Over 30 species known
  • Helps in normal bowel function
  • Protects against gut infections
  • Decreases gut inflammation
  • Decreases symptoms of irritable bowel syndrome
  • Implicated in case reports of necrotising pancreatitis, sepsis, epidural abscess, pulmonary infection and dental caries
  • Other infections may have gone misdiagnosed due to commensal status
  • Very slow to grow
  • Difficult to identify, best to use rRNA gene sequencing
  • May be misdiagnosed as Actinomyces spp.
  • If isolated in large quantities from a specimen, should be considered causative agent of infection
  • Bifidobacteria UTIs are rare, but have been identified
  • Probiotics containing Bifidobacteria should be used carefully

References

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  1. 1.
    Pathak P, Trilligan C, Rapose A. Bifidobacterium–friend or foe? A case of urinary tract infection with Bifidobacterium species. Case Reports. Published online September 24, 2014:bcr2014205122-bcr2014205122. doi:10.1136/bcr-2014-205122
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