THE ROLE OF LACTOBACILLI IN PREVENTING UROGENITAL AND INTESTINAL INFECTIONS

The gastrointestinal and urogenital tracts are complex microbial habit ats, which for the most part, are infection-free throughout life. Give n the diversity of the world's people, the enormous variation in diet and differences in climate, sexual practices, and exposure to antimicr obials which disrupt and change the flora, it is quite remarkable that naturally occurring infections are not even more common than reported . The composition, dynamics and structure of the normal flora biofilms appear to play a role in protecting the host from infectious upset. S pecifically, lactobacilli and in the gut bifidobacteria, have been fou nd to possess properties which enhance the host's ability to compete a gainst pathogens. The search for 'good' probiotic organisms continues, but recent findings of biosurfactant production and an ability to col onize the vagina, suggest that such strains do exist. Molecular typing has made it possible to follow the strains as they colonize or move t hrough the host, and to investigate the genetic basis for their capabi lities. Increasing concerns over drug resistance, and a growing desire by patients to have a more natural approach to their health managemen t, is driving further scientific and clinical enquiry. This has led to some studies showing that potentially nutrients can be used to regula te, restore and stimulate the normal flora. Also of interest is the ab ility of probiotic organisms to reduce the risk of device-associated i nfections, and to deliver vaccines to the mucosal tissue. Subject to a vailability of grant funding for this non-traditional approach, the ne xt 10 years should see some major breakthroughs of great benefit to th e health of people around the globe. (C) 1998 Elsevier Science Ltd. Al l rights reserved.