Franco Gasparri, Claudio Benvenuti, Vincenzo De Leo, Andrea Zanardi

Candida is usually present in the vaginal microbioma in which lactobacilli (LB) are predominant. An imbalance in LB production leads to yeast overgrowth and to the occurrence of vulvovaginal candidiasis. This common vaginal infectionis caused by Candida species, is associated with intense itching, swelling, and irritation, and frequent relapses.A new cleanser for feminine intimate hygiene (SA2.1) was designed to increase the microbiological activity of the traditional cleanser, adding zinc, surfactant with antibacterial properties and a muco-adhesive system. This study evaluated the in-vitro effect of SA2.1 on Candida spp. compared with the reference SA in a double-blind design.Two cleansers for intimate hygiene were provided:the reference one containing thymol from Thymus vulgaris extract at pH 3.5 (SA= Saugella Attiva, Mylan), and the test one(SA2.1= Saugella Attiva new, Mylan) in which Zinc Cocethsulfate with antimicrobial action, and Xanthan gum and Chondruscrispus extract asmuco-adhesive agents were added to the reference formula.The anti-fungal activity of the products above described was evaluated in 12 strains of Candida spp. isolated from vaginal swabs from women with vaginitis, and in two strains from the American Type Culture Collection (ATCC-MYA 276 C. glabrata, ATCC-24433 C. albicans) belonging to the same species as the wild samples. The minimum inhibitory concentration (MIC) was determined. MIC values showed a statistically significant difference considering all Candida species: 0.18% vs 0.29% (p=0.001 at Student’s t test two-tail) in favour of SA2.1. SA2.1 evidenced a significant improvement in the microbiological potency, showing comparable MICs between C. Albicans and C. glabrata, even if the last one is more virulent.Comparing the MIC within each species, SA was 20.7% and 44.4% less potent than SA2.1, respectively for C. albicans and C. glabrata. Detergents for feminine intimate hygiene should have documented effective formulations for maintaining genital health and preventing bacterial and fungal contamination. The combination of thymol, zinc and antibacterial surfactant improved the inhibitory activity of the traditional cleanser against Candida albicans and Candida glabrata

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