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1.
ISME J ; 17(9): 1382-1395, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37311937

RESUMEN

Managed honey bee (Apis mellifera) populations play a crucial role in supporting pollination of food crops but are facing unsustainable colony losses, largely due to rampant disease spread within agricultural environments. While mounting evidence suggests that select lactobacilli strains (some being natural symbionts of honey bees) can protect against multiple infections, there has been limited validation at the field-level and few methods exist for applying viable microorganisms to the hive. Here, we compare how two different delivery systems-standard pollen patty infusion and a novel spray-based formulation-affect supplementation of a three-strain lactobacilli consortium (LX3). Hives in a pathogen-dense region of California are supplemented for 4 weeks and then monitored over a 20-week period for health outcomes. Results show both delivery methods facilitate viable uptake of LX3 in adult bees, although the strains do not colonize long-term. Despite this, LX3 treatments induce transcriptional immune responses leading to sustained decreases in many opportunistic bacterial and fungal pathogens, as well as selective enrichment of core symbionts including Bombilactobacillus, Bifidobacterium, Lactobacillus, and Bartonella spp. These changes are ultimately associated with greater brood production and colony growth relative to vehicle controls, and with no apparent trade-offs in ectoparasitic Varroa mite burdens. Furthermore, spray-LX3 exerts potent activities against Ascosphaera apis (a deadly brood pathogen) likely stemming from in-hive dispersal differences, whereas patty-LX3 promotes synergistic brood development via unique nutritional benefits. These findings provide a foundational basis for spray-based probiotic application in apiculture and collectively highlight the importance of considering delivery method in disease management strategies.


Asunto(s)
Probióticos , Varroidae , Abejas , Animales , Suplementos Dietéticos , Bacterias/genética , Lactobacillus , Apicultura
2.
Urolithiasis ; 51(1): 19, 2022 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-36547746

RESUMEN

Kidney stone disease affects nearly one in ten individuals and places a significant economic strain on global healthcare systems. Despite the high frequency of stones within the population, effective preventative strategies are lacking and disease prevalence continues to rise. Osteopontin (OPN) is a urinary protein that can inhibit the formation of renal calculi in vitro. However, the efficacy of OPN in vivo has yet to be determined. Using an established Drosophila melanogaster model of calcium oxalate urolithiasis, we demonstrated that a 16-residue synthetic OPN phosphopeptide effectively reduced stone burden in vivo. Oral supplementation with this peptide altered crystal morphology of calcium oxalate monohydrate (COM) in a similar manner to previous in vitro studies, and the presence of the OPN phosphopeptide during COM formation and adhesion significantly reduced crystal attachment to mammalian kidney cells. Altogether, this study is the first to show that an OPN phosphopeptide can directly mitigate calcium oxalate urolithiasis formation in vivo by modulating crystal morphology. These findings suggest that OPN supplementation is a promising therapeutic approach and may be clinically useful in the management of urolithiasis in humans.


Asunto(s)
Oxalato de Calcio , Cálculos Renales , Osteopontina , Fosfopéptidos , Animales , Oxalato de Calcio/metabolismo , Drosophila melanogaster , Cálculos Renales/tratamiento farmacológico , Cálculos Renales/metabolismo , Osteopontina/farmacología , Osteopontina/uso terapéutico , Fosfopéptidos/farmacología , Fosfopéptidos/uso terapéutico , Modelos Animales de Enfermedad
3.
mSphere ; 7(6): e0044622, 2022 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-36321825

RESUMEN

Renal impairment associated with chronic kidney disease (CKD) causes the buildup of uremic toxins that are deleterious to patient health. Current therapies that manage toxin accumulation in CKD offer an incomplete therapeutic effect against toxins such as para-cresol (p-cresol) and p-cresyl sulfate. Probiotic therapies can exploit the wealth of microbial diversity to reduce toxin accumulation. Using in vitro culture techniques, strains of lactobacilli and bifidobacteria from a 24-strain synbiotic were investigated for their ability to remove p-cresol. Four strains of bifidobacteria internalized p-cresol from the extracellular environment. The oral supplementation of these toxin-clearing probiotics was more protective than control strains in a Drosophila melanogaster toxicity model. Bifidobacterial supplementation was also associated with higher abundance of lactobacilli in the gut microbiota of p-cresol-exposed flies. The present findings suggest that these strains might reduce p-cresol in the gut in addition to increasing the prevalence of other beneficial bacteria, such as lactobacilli, and should be tested clinically to normalize the dysbiotic gut microbiota observed in CKD patients. IMPORTANCE Chronic kidney disease (CKD) affects approximately 10% of the global population and has limited treatment options. The accumulation of gut microbiota-derived uremic toxins, such as para-cresol (p-cresol) and p-cresyl sulfate, is associated with the onset of comorbidities (i.e., atherosclerosis and cognitive disorders) in CKD. Unfortunately, dialysis, the gold standard therapy is unable to remove these toxins from the bloodstream due to their highly protein-bound nature. Some strains of Bifidobacterium have metabolic properties that may be useful in managing uremic toxicity. Using a Drosophila model, the present work highlights why dosing with certain probiotic strains may be clinically useful in CKD management.


Asunto(s)
Proteínas de Drosophila , Probióticos , Insuficiencia Renal Crónica , Animales , Drosophila melanogaster , Tóxinas Urémicas , Probióticos/uso terapéutico , Insuficiencia Renal Crónica/terapia , Insuficiencia Renal Crónica/microbiología , Sulfatos , Canales de Sodio
4.
Front Microbiol ; 13: 1011102, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36620050

RESUMEN

Oxalobacter formigenes is a unique bacterium with the ability to metabolize oxalate as a primary carbon source. Most kidney stones in humans are composed of calcium and oxalate. Therefore, supplementation with an oxalate-degrading bacterium may reduce stone burden in patients suffering from recurrent calcium oxalate-based urolithiasis. Strains of O. formigenes are divided into two groups: group I and group II. However, the differences between strains from each group remain unclear and elucidating these distinctions will provide a better understanding of their physiology and potential clinical applications. Here, genomes from multiple O. formigenes strains underwent whole genome sequencing followed by phylogenetic and functional analyses. Genetic differences suggest that the O. formigenes taxon should be divided into an additional three species: Oxalobacter aliiformigenes sp. nov, Oxalobacter paeniformigenes sp. nov, and Oxalobacter paraformigenes sp. nov. Despite the similarities in the oxalyl-CoA gene (oxc), which is essential for oxalate degradation, these strains have multiple unique genetic features that may be potential exploited for clinical use. Further investigation into the growth of these strains in a simulated fecal environment revealed that O. aliiformigenes strains are capable of thriving within the human gut microbiota. O. aliiformigenes may be a better therapeutic candidate than current group I strains (retaining the name O. formigenes), which have been previously tested and shown to be ineffective as an oral supplement to mitigate stone disease. By performing genomic analyses and identifying these novel characteristics, Oxalobacter strains better suited to mitigation of calcium oxalate-based urolithiasis may be identified in the future.

5.
mSphere ; 5(5)2020 09 09.
Artículo en Inglés | MEDLINE | ID: mdl-32907948

RESUMEN

Kidney stones affect nearly 10% of the population in North America and are associated with high morbidity and recurrence, yet novel prevention strategies are lacking. Recent evidence suggests that the human gut microbiota can influence the development of nephrolithiasis, although clinical trials have been limited and inconclusive in determining the potential for microbially based interventions. Here, we used an established Drosophila melanogaster model of urolithiasis as a high-throughput screening platform for evaluation of the therapeutic potential of oxalate-degrading bacteria in calcium oxalate (CaOx) nephrolithiasis. The results demonstrated that Bacillus subtilis 168 (BS168) is a promising candidate based on its preferential growth in high oxalate concentrations, its ability to stably colonize the D. melanogaster intestinal tract for as long as 5 days, and its prevention of oxalate-induced microbiota dysbiosis. Single-dose BS168 supplementation exerted beneficial effects on D. melanogaster for as long as 14 days, decreasing stone burden in dissected Malpighian tubules and fecal excreta while increasing survival and behavioral markers of health over those of nonsupplemented lithogenic controls. These findings were complemented by in vitro experiments using the established MDCK renal cell line, which demonstrated that BS168 pretreatment prevented increased CaOx crystal adhesion and aggregation. Taking our results together, this study supports the notion that BS168 can functionally reduce CaOx stone burden in vivo through its capacity for oxalate degradation. Given the favorable safety profile of many B. subtilis strains already used as digestive aids and in fermented foods, these findings suggest that BS168 could represent a novel therapeutic adjunct to reduce the incidence of recurrent CaOx nephrolithiasis in high-risk patients.IMPORTANCE Kidney stone disease is a morbid condition that is increasing in prevalence, with few nonsurgical treatment options. The majority of stones are composed of calcium oxalate. Unlike humans, some microbes can break down oxalate, suggesting that microbial therapeutics may provide a novel treatment for kidney stone patients. This study demonstrated that Bacillus subtilis 168 (BS168) decreased stone burden, improved health, and complemented the microbiota in a Drosophila melanogaster urolithiasis model, while not exacerbating calcium oxalate aggregation or adhesion to renal cells in vitro These results identify this bacterium as a candidate for ameliorating stone formation; given that other strains of B. subtilis are components of fermented foods and are used as probiotics for digestive health, strain 168 warrants testing in humans. With the severe burden that recurrent kidney stone disease imposes on patients and the health care system, this microbial therapeutic approach could provide an inexpensive therapeutic adjunct.


Asunto(s)
Bacillus subtilis/metabolismo , Oxalato de Calcio/metabolismo , Urolitiasis/microbiología , Animales , Modelos Animales de Enfermedad , Perros , Drosophila melanogaster/microbiología , Femenino , Ensayos Analíticos de Alto Rendimiento , Intestinos/microbiología , Células de Riñón Canino Madin Darby , Masculino , Urolitiasis/tratamiento farmacológico
6.
ISME J ; 14(2): 476-491, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31664160

RESUMEN

American foulbrood (AFB) is a highly virulent disease afflicting honey bees (Apis mellifera). The causative organism, Paenibacillus larvae, attacks honey bee brood and renders entire hives dysfunctional during active disease states, but more commonly resides in hives asymptomatically as inactive spores that elude even vigilant beekeepers. The mechanism of this pathogenic transition is not fully understood, and no cure exists for AFB. Here, we evaluated how hive supplementation with probiotic lactobacilli (delivered through a nutrient patty; BioPatty) affected colony resistance towards a naturally occurring AFB outbreak. Results demonstrated a significantly lower pathogen load and proteolytic activity of honey bee larvae from BioPatty-treated hives. Interestingly, a distinctive shift in the microbiota composition of adult nurse bees occurred irrespective of treatment group during the monitoring period, but only vehicle-supplemented nurse bees exhibited higher P. larvae loads. In vitro experiments utilizing laboratory-reared honey bee larvae showed Lactobacillus plantarum Lp39, Lactobacillus rhamnosus GR-1, and Lactobacillus kunkeei BR-1 (contained in the BioPatty) could reduce pathogen load, upregulate expression of key immune genes, and improve survival during P. larvae infection. These findings suggest the usage of a lactobacilli-containing hive supplement, which is practical and affordable for beekeepers, may be effective for reducing enzootic pathogen-related hive losses.


Asunto(s)
Abejas/microbiología , Paenibacillus larvae/patogenicidad , Animales , Apicultura , Suplementos Dietéticos/microbiología , Infecciones por Bacterias Grampositivas/terapia , Lactobacillus , Probióticos/uso terapéutico , Estados Unidos
7.
J Med Microbiol ; 68(8): 1244-1252, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31184571

RESUMEN

The high incidence of urinary tract infection (UTI) among women and children, in combination with a lack of antibiotic efficacy with regard to pathogen eradication and recurrence prevention, as well as the negative side effects associated with antibiotics, has led researchers to explore the role of non-steroidal anti-inflammatory drugs as a primary management strategy. The aim of this study was to determine whether ibuprofen (IBU) or one of its major metabolites, 2-carboxyibuprofen (CIBU), could affect the growth and adhesion of the two most common uropathogens, Escherichia coli and Enterococcus faecalis. The bacterial growth and adhesion to the urothelial cells of E. coli UTI89 and E. faecalis 1131 in the presence of physiologically relevant concentrations of IBU and CIBU were assessed. The effect of IBU on bacterial adhesion to urothelial cells was also assessed following exposure to trimethoprim/sulfamethoxazole (TMP/SMX) and nitrofurantoin. Bacterial growth was not affected by IBU. Further, only at high levels of IBU not regularly found in the bladder was there a significant increase in E. faecalis 1131 attachment at growth inhibitory concentrations of TMP/SMX. There was no effect on the attachment of E. faecalis or E. coli to urothelial cells in the presence of nitrofurantoin. These studies indicate that the beneficial effects of IBU for UTI management are likely mediated through its anti-inflammatory properties rather than direct interactions with uropathogens in the bladder.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Enterococcus faecalis/aislamiento & purificación , Escherichia coli/aislamiento & purificación , Ibuprofeno/farmacología , Infecciones Urinarias/microbiología , Antiinfecciosos Urinarios/farmacología , Bacterias/efectos de los fármacos , Adhesión Bacteriana/efectos de los fármacos , Línea Celular , Enterococcus faecalis/efectos de los fármacos , Enterococcus faecalis/crecimiento & desarrollo , Enterococcus faecalis/fisiología , Escherichia coli/efectos de los fármacos , Escherichia coli/crecimiento & desarrollo , Escherichia coli/fisiología , Humanos , Ibuprofeno/análogos & derivados , Pruebas de Sensibilidad Microbiana , Viabilidad Microbiana/efectos de los fármacos , Nitrofurantoína/farmacología , Combinación Trimetoprim y Sulfametoxazol/farmacología , Urotelio
8.
Dis Model Mech ; 11(11)2018 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-30082495

RESUMEN

Kidney stone disease involves the aggregation of stone-forming salts consequent to solute supersaturation in urine. The development of novel therapeutic agents for this predominantly metabolic and biochemical disorder have been hampered by the lack of a practical pre-clinical model amenable to drug screening. Here, Drosophila melanogaster, an emerging model for kidney stone disease research, was adapted as a high-throughput functional drug screening platform independent of the multifactorial nature of mammalian nephrolithiasis. Through functional screening, the therapeutic potential of a novel compound commonly known as arbutin that specifically binds to oxalate, a key component of kidney calculi, was identified. Through isothermal titration calorimetry, high-performance liquid chromatography and atomic force microscopy, arbutin was determined to interact with calcium and oxalate in both free and bound states, disrupting crystal lattice structure, growth and crystallization. When used to treat patient urine samples, arbutin significantly abrogated calculus formation in vivo and outperformed potassium citrate in low pH urine conditions, owing to its oxalate-centric mode of action. The discovery of this novel antilithogenic compound via D. melanogaster, independent of a mammalian model, brings greater recognition to this platform, for which metabolic features are primary outcomes, underscoring the power of D. melanogaster as a high-throughput drug screening platform in similar disorders. This is the first description of the use of D. melanogaster as the model system for a high-throughput chemical library screen. This article has an associated First Person interview with the first authors of the paper.


Asunto(s)
Drosophila melanogaster/metabolismo , Ensayos Analíticos de Alto Rendimiento/métodos , Cálculos Renales/tratamiento farmacológico , Modelos Biológicos , Animales , Arbutina/análisis , Arbutina/farmacología , Arbutina/uso terapéutico , Birrefringencia , Calcio/metabolismo , Oxalato de Calcio , Difosfonatos , Evaluación Preclínica de Medicamentos , Heces , Células HEK293 , Humanos , Iones , Nanopartículas
9.
Future Microbiol ; 13: 1095-1115, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-30132694

RESUMEN

AIM: Enterococcus faecalis is one of the most common causes of recurrent urinary tract infection (RUTI), yet enterococcal pathogenesis is poorly understood. Our aims were to identify the prevalence of enterococci in RUTI patients and characterize the enterococcal response to nitrofurantoin and trimethoprim-sulfamethoxazole. MATERIALS & METHODS: We studied pediatric patients receiving antibiotic prophylaxis and those only under clinical observation for 12 months (n = 39). We then assessed the response of uropathogenic E. faecalis to nitrofurantoin and trimethoprim-sulfamethoxazole. RESULTS: Enterococci were isolated from almost half of patients and exposure of Enterococcus to nitrofurantoin increased virulence properties; this did not correlate with increased expression of virulence factors. CONCLUSION: Our results demonstrate that antibiotic prophylaxis may not be suitable for treatment of enterococcal RUTI (NCT02357758).


Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Enterococcus faecalis/aislamiento & purificación , Infecciones Urinarias/tratamiento farmacológico , Antibacterianos/farmacología , Adhesión Bacteriana/efectos de los fármacos , Canadá/epidemiología , Niño , Preescolar , Citocinas/orina , Enterococcus faecalis/efectos de los fármacos , Femenino , Regulación Bacteriana de la Expresión Génica/efectos de los fármacos , Humanos , Pruebas de Sensibilidad Microbiana , Nitrofurantoína/farmacología , Nitrofurantoína/uso terapéutico , Prevalencia , Recurrencia , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Factores de Virulencia/genética
11.
Appl Environ Microbiol ; 81(15): 4965-75, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25979893

RESUMEN

The nutritional status of pregnant women is vital for healthy outcomes and is a concern for a large proportion of the world's population. The role of the microbiota in pregnancy and nutrition is a promising new area of study with potential health ramifications. In many African countries, maternal and infant death and morbidity are associated with malnutrition. Here, we assess the influence of probiotic yogurt containing Lactobacillus rhamnosus GR-1, supplemented with Moringa plant as a source of micronutrients, on the health and oral, gut, vaginal, and milk microbiotas of 56 pregnant women in Tanzania. In an open-label study design, 26 subjects received yogurt daily, and 30 were untreated during the last two trimesters and for 1 month after birth. Samples were analyzed using 16S rRNA gene sequencing, and dietary recalls were recorded. Women initially categorized as nourished or undernourished consumed similar calories and macronutrients, which may explain why there was no difference in the microbiota at any body site. Consumption of yogurt increased the relative abundance of Bifidobacterium and decreased Enterobacteriaceae in the newborn feces but had no effect on the mother's microbiota at any body site. The microbiota of the oral cavity and GI tract remained stable over pregnancy, but the vaginal microbiota showed a significant increase in diversity leading up to and after birth. In summary, daily micronutrient-supplemented probiotic yogurt provides a safe, affordable food for pregnant women in rural Tanzania, and the resultant improvement in the gut microbial profile of infants is worthy of further study.


Asunto(s)
Bacterias/clasificación , Bacterias/aislamiento & purificación , Dieta/métodos , Microbiota , Moringa , Probióticos/administración & dosificación , Yogur , Bacterias/genética , Análisis por Conglomerados , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Femenino , Tracto Gastrointestinal/microbiología , Humanos , Lactante , Recién Nacido , Leche Humana/microbiología , Datos de Secuencia Molecular , Mucosa Bucal/microbiología , Filogenia , Embarazo , ARN Ribosómico 16S/genética , Población Rural , Análisis de Secuencia de ADN , Tanzanía , Vagina/microbiología
12.
Appl Environ Microbiol ; 78(7): 2190-9, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22267663

RESUMEN

Oral candidiasis is often accompanied by severe inflammation, resulting in a decline in the quality of life of immunosuppressed individuals and elderly people. To develop a new oral therapeutic option for candidiasis, a nonpathogenic commensal oral probiotic microorganism, Streptococcus salivarius K12, was evaluated for its ability to modulate Candida albicans growth in vitro, and its therapeutic activity in an experimental oral candidiasis model was tested. In vitro inhibition of mycelial growth of C. albicans was determined by plate assay and fluorescence microscopy. Addition of S. salivarius K12 to modified RPMI 1640 culture medium inhibited the adherence of C. albicans to the plastic petri dish in a dose-dependent manner. Preculture of S. salivarius K12 potentiated its inhibitory activity for adherence of C. albicans. Interestingly, S. salivarius K12 was not directly fungicidal but appeared to inhibit Candida adhesion to the substratum by preferentially binding to hyphae rather than yeast. To determine the potentially anti-infective attributes of S. salivarius K12 in oral candidiasis, the probiotic was administered to mice with orally induced candidiasis. Oral treatment with S. salivarius K12 significantly protected the mice from severe candidiasis. These findings suggest that S. salivarius K12 may inhibit the process of invasion of C. albicans into mucous surfaces or its adhesion to denture acrylic resins by mechanisms not associated with the antimicrobial activity of the bacteriocin. S. salivarius K12 may be useful as a probiotic as a protective tool for oral care, especially with regard to candidiasis.


Asunto(s)
Candida albicans/crecimiento & desarrollo , Candidiasis Bucal/terapia , Probióticos/farmacología , Probióticos/uso terapéutico , Streptococcus/crecimiento & desarrollo , Animales , Bacteriocinas/farmacología , Candida albicans/efectos de los fármacos , Candida albicans/aislamiento & purificación , Candidiasis Bucal/microbiología , Candidiasis Bucal/patología , Adhesión Celular/efectos de los fármacos , Modelos Animales de Enfermedad , Femenino , Humanos , Hifa/efectos de los fármacos , Hifa/crecimiento & desarrollo , Ratones , Ratones Endogámicos ICR , Pruebas de Sensibilidad Microbiana/métodos , Probióticos/administración & dosificación , Streptococcus/clasificación , Streptococcus/metabolismo , Lengua/microbiología , Resultado del Tratamiento
13.
J Med Food ; 7(2): 223-8, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15298771

RESUMEN

Bacterial vaginosis (BV) is a common condition in women that represents an imbalance of the vaginal microflora, lactobacilli depletion, and excess growth of mainly anaerobic Gram-negative pathogens. Diagnosis is made using a series of tests or a Gram stain of a vaginal smear. Treatment with antibiotics is quite effective, but recurrences are common. A study of 55 vaginal samples from 11 postmenopausal women showed the presence of BV by the Gram stain-based Nugent scoring system, and polymerase chain reaction-denaturing gradient gel electrophoresis showed that Bacteroides or Prevotella species were the most common isolates recovered (24 of 25), with Escherichia coli, Staphylococcus aureus, and Streptococcus agalactiae also found in some samples. In one case, only Gardnerella vaginalis was found. These findings illustrate that BV remains common even among otherwise healthy women, but it is not caused solely by either Gardnerella or Mobiluncus. Use of a FemExam system (Cooper Surgical, Shelton, CT), based upon elevated pH and trimethylamine levels, to screen vaginal smears from 59 healthy women showed poor correlation with the Gram stain method. A randomized, placebo-controlled trial of these subjects showed that the lactobacilli-dominant microbiota was restored in subjects with BV but not in controls, following 2 months of daily oral intake of Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14. These studies show that nucleic acid-based methods are effective at identifying bacteria responsible for BV. If such methods could be used to develop a commercially available, self-use kit, women would be much better placed to take control of their own health, for example, using medicinal food or dietary supplement products such as the clinically proven probiotic strains L. rhamnosus GR-1 and L. fermentum RC-14.


Asunto(s)
ADN Bacteriano/análisis , Lactobacillus , Probióticos , Vaginosis Bacteriana/diagnóstico , Vaginosis Bacteriana/terapia , Adulto , Bacteroides/genética , Bacteroides/aislamiento & purificación , Electroforesis en Gel de Poliacrilamida , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Femenino , Humanos , Placebos , Reacción en Cadena de la Polimerasa , Posmenopausia , Prevotella/genética , Prevotella/aislamiento & purificación , Recurrencia , Staphylococcus aureus/genética , Staphylococcus aureus/aislamiento & purificación , Streptococcus agalactiae/genética , Streptococcus agalactiae/aislamiento & purificación , Frotis Vaginal , Vaginosis Bacteriana/microbiología
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