Friberg Maria, Woeller Kara, Iberi Vighter, Mancheno Paolo Palacio, Riedeman James, Bohman Lisa, Davis Catherine C
Baby, Feminine and Family Care Microbiology, The Procter & Gamble Company, Mason, OH, United States.
Baby, Feminine and Family Care, Global Product Stewardship, The Procter & Gamble Company, Cincinnati, OH, United States.
Front Reprod Health. 2023 Aug 21;5:1162746. doi: 10.3389/frph.2023.1162746. eCollection 2023.
Menstrual cups (MC) are a reusable feminine hygiene product. A recent publication suggested that () biofilms can form on MCs which may lead to increased risk of menstrual Toxic Shock Syndrome (mTSS). Additionally, there is concern that buildup of residual menses may contribute to microbial growth and biofilm formation further increasing mTSS risk. Quantitative and qualitative analysis of tests were utilized to determine if biofilm could form on MC in the presence of the keystone species after 12 h of incubation. The methodology was based on a modification of an anaerobic method that harnesses the keystone species hypothesis by including a representative of vaginal lactic acid bacteria.
MCs were incubated anaerobically for 12 h in Vaginal Defined Media (VDM) with the two morphologically distinct bacteria, () and . Colony Forming Units (CFU) for each organism from the VDM broth and sonicated MC were estimated. In addition, a separate experiment was conducted where was grown for 12 h in the absence . Qualitative analysis for biofilm formation utilized micro-CT (µ-CT) and cryogenic scanning electron microscopy (Cryo-SEM).
Samples collected from the media control had expected growth of both organisms after 12 h of incubation. Samples collected from VDM broth were similar to media control at the end of the 12-h study. Total cell density on MC following sonication/rinsing was minimal. Results when using a monoculture of demonstrated that there was a significant growth of the organism in the media control and broth as well as the sonicated cups indicating that the presence of was important for controlling growth and adherence of . Few rod-shaped bacteria ( and cocci ( could be identified on the MCs when grown in a dual species culture inoculum and no biofilm was noted via µ-CT and cryo-SEM. Additionally, efforts to model and understand the validity of the current labeled recommendations for MC cleaning in-between uses are supported.
The data support continued safe use of the Tampax® cup when used and maintained as recommended.
月经杯是一种可重复使用的女性卫生用品。最近的一篇出版物表明，月经杯上可能形成生物膜，这可能会增加月经性中毒性休克综合征（mTSS）的风险。此外，人们担心残留月经的积累可能会促进微生物生长和生物膜形成，进一步增加mTSS风险。利用定量和定性分析测试来确定在关键菌种存在的情况下，经过12小时培养后，月经杯上是否会形成生物膜。该方法基于对一种厌氧方法的改进，该方法通过纳入阴道乳酸菌的代表来利用关键菌种假说。
将月经杯在阴道限定培养基（VDM）中与两种形态不同的细菌——卷曲乳杆菌（Lactobacillus crispatus）和惰性乳杆菌（Lactobacillus iners）一起厌氧培养12小时。估计来自VDM肉汤和超声处理后的月经杯上每种微生物的菌落形成单位（CFU）。此外，还进行了一项单独的实验，在没有惰性乳杆菌的情况下，将卷曲乳杆菌培养12小时。利用微型计算机断层扫描（µ-CT）和低温扫描电子显微镜（Cryo-SEM）对生物膜形成进行定性分析。
从培养基对照中收集的样本在培养12小时后，两种微生物均有预期的生长。在12小时研究结束时，从VDM肉汤中收集的样本与培养基对照相似。超声处理/冲洗后月经杯上的总卷曲乳杆菌细胞密度极小。使用卷曲乳杆菌单培养物的结果表明，在培养基对照、肉汤以及超声处理后的杯子中，该微生物有显著生长，这表明惰性乳杆菌的存在对于控制卷曲乳杆菌的生长和黏附很重要。当在双菌种培养接种物中生长时，在月经杯上几乎无法识别出杆状细菌（卷曲乳杆菌）和球菌（惰性乳杆菌），并且通过µ-CT和Cryo-SEM未观察到生物膜。此外，对当前月经杯使用间隔期清洁标签建议的有效性进行建模和理解的努力得到了支持。
数据支持按照建议使用和维护丹碧丝（Tampax®）月经杯时可继续安全使用。
