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Title:
HYGIENE TISSUE IMPREGNATED WITH A COMPOSITION COMPRISING A LACTIC PRODUCING BACTERIUM SUSPENDED IN A LIPID
Document Type and Number:
WIPO Patent Application WO/2003/053397
Kind Code:
A1
Abstract:
The present invention pertains to a hygiene tissue to be used for cleaning and caring of the skin and the urogenital area, simultaneously as it delivers lactic acid produc-ing bacteria, thereby reestablishing and maintaining a healthy microbial flora in these areas. The hygiene tissue is characterized in that it is impregnated with a com-position comprising a lactic acid producing bacterium/bacteria suspended in a lipid and optionally (an) additional components. Encapsulating the lactic acid producing bacterium in a lipid provided a moisturefree environment that enhanced the survival of the bacterium keeping the bacterium fit for growth after delivery to the skin. Therefore, by this approach, hygiene tissues, comprising lactic acid producing bac-teria that could be stored for long time periods, were provided. Also, the hygiene tis-sue of the present invention improved the efficiency of transfer of the lactic acid producing bacterium to the skin and urogenital area. In addition, the lipid provided a cleaning function, so that the skin was cleaned simultaneously as the lactic acid bacteria were delivered.

Inventors:
Runeman, Bo (Jons väg 6, Partille, S-433 75, SE)
Forsgren-brusk, Ulla (Plommonvägen 35, Pixbo, S-435 43, SE)
Gran, Håkansson Eva (Glimmerv. 5E, Umeå, S-907 40, SE)
Application Number:
PCT/SE2002/002303
Publication Date:
July 03, 2003
Filing Date:
December 12, 2002
Export Citation:
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Assignee:
SCA HYGIENE PRODUCTS AB (Göteborg, S-405 03, SE)
International Classes:
A47K7/00; A47K10/16; A61K8/02; A61K8/99; A61L15/34; A61L15/36; A61M35/00; A61Q19/00; B65D30/02; B65D81/24; (IPC1-7): A61K7/50; A47K10/16; A61K35/74
Domestic Patent References:
WO2001013956A2
WO1998047374A1
WO1997029762A1
WO2000076878A1
Foreign References:
EP1118342A1
US4518696A
Attorney, Agent or Firm:
ALBIHNS STOCKHOLM AB (P.O Box 5581, Linnégatan 2, STOCKHOLM, S-114 85, SE)
Download PDF:
Claims:
Claims
1. Hygiene tissue suitable for cleaning and simultaneously reestablishing and main taining a beneficial microbial flora on the skin or the urogenital area, said hygiene tissue comprising a matrix characterized in that said matrix is impregnated by a composition consisting of A) a preparation of one or more lactic acid producing bacterial strains, said prepa ration having a water activity of 0.30 or less, more preferably 0.25 or less, most preferably 0.20 or less; and B) a lipid phase, preferably a liquid lipid phase, comprising at least one lipid.
2. Hygiene tissue according to claim 1 which further comprises at least one addi tional component, chosen from the group comprising caring agents, water absorbent agents, tensides, pH buffering agents, perfume, antioxidants, hydrocortisone and other antiinflammatory steroids.
3. Hygiene tissue according to claim 12 where the lactic acid producing bacterial strain (s) is isolated from the skin or urogenital area of a healthy person.
4. The hygiene tissue of claim 13, where the lactic acid producing bacterial strain (s) is selected from the genera Pediococcus, Lactococcus, Lactobacillus, or mixes thereof.
5. The hygiene tissue of claim 4, where the lactic acid producing bacterial strain (s) involves at least Lactobacillus plantarum.
6. The hygiene tissue of claim 5, where the lactic acid producing bacterial strain (s) involves at least Lactobacillus plantarum 931 (deposition No. (DSM): 11918).
7. The hygiene tissue according to claims 16, wherein the lipid is chosen from the group comprising olive oil, canola oil, coconut oil, palm kernel oil, peanut oil, soy bean oil, Dimethicone, paraffin oil, and petrolatum.
8. A hygiene tissue according to claims 17, wherein the amount of lactic acid pro ducing bacteria are 104_1011 colony forming units (CFU) per tissue.
9. A hygiene tissue according to claim 8, wherein the amount of lactic acid produc ing bacteria are 106_101 1colony forming units (CFU) per tissue.
10. A moisture impervious packaging unit containing a hygiene tissue according to claim 19, said impervious packing unit having a highest water vapor transmission rate of 6 g/m2/calendar day in accordance with ASTME 39883.
Description:
Hygiene tissue impregnated with a composition comprising a lactic acid producing bacterium suspended in a lipid The present invention relates to hygiene tissues to be used to reestablish and main- tain a beneficial microbial flora on the skin and the urogenital area in combination with cleaning and caring of these areas.

Background of the invention The urogenital area harbors a complex microbial ecosystem comprising more than 50 different bacterial species (Hill et al. , Scand. J. Urol. Nephrol. 1984; 86 (suppl.) 23-29). The dominating species in this area are lactic acid producing bacteria be- longing to the genus Lactobacillus. These lactic acid producing members are im- portant for retaining a healthy microbial flora in these areas, and act as probiotic bacteria with an antagonistic effect against pathogenic microbial species. Lactic acid producing bacteria inhibit growth and colonization by other microorganisms by oc- cupying suitable niches for colonization, by forming biofilms and competing for available nutrients, thereby excluding colonization by harmful microorganisms.

Also, the production of enzymes, such as hydrogen peroxidase, and specific inhib- iting substances, such as toxins and bacteriocines, and organic acids (including lac- tic acid and acetic acid) that lower the pH, inhibit colonization by other microor- ganisms. However, the microbial ecosystem of a healthy individual can be disturbed by the use of antibiotics, in people suffering from diabetes, during hormonal changes, such as during pregnancy or use of contraceptives with estrogen, during menstruation, after menopause, etc. Also, microorganisms can spread from the anus to the urogenital area, thereby causing infections. This results in a disturbance of the normal microbial flora and leaves the individual susceptible to microbial infections that cause vaginitis, urinary tract infections and ordinary skin infections. Microor- ganisms commonly associated with these kind of infections belong to the genera Es- cherichia, Enterococcus, Psedomonas, Proteus, Klebsiella, Streptococcus, Staphy- lococcus, Gardnerella and Candida. Women are at particular risk due to their

shorter distance between the anus and the urogenital tract; specially at risk are young women, who not yet have a well developed microflora in the urogenital area and older women, who no longer have a protective flora.

Similarly to the urogenital area, the skin is colonized by an array of organisms, which forms its normal flora. The numbers and identity of the organisms vary be- tween different skin sites. This, together with the skin's structural barrier, provides the host with an excellent defense against invading microbes. The number of bacte- ria on the skin vary from a few hundred per cm2 on the arid surfaces of the forearm and back, to tens of thousands per cm2 on the moist areas such as the axilla and groin. This normal flora plays an important role in preventing'foreign'organisms from colonizing the skin, but it to needs to be kept in check, in order to avoid skin infections.

Staphylococcus aureus is the most common cause of minor skin infections, such as boils or abscesses, as well as more serious post-operative wound infection. Treat- ment involves drainage and this is usually sufficient for minor lesions, but antibiot- ics may be given in addition when the infection is severe and the patient has fever.

Toxic shock syndrome is a systemic infection caused by S. aureus strains which produce toxic shock syndrome toxin. The disease came to prominence through its association with tampon use by healthy women, but it is not confined to women and can occur as a result of S. aureus infection at non-genital sites.

Other common skin infections are caused by Streptococcus pyogenes (group A streptococci). The organisms are acquired through contact with other people with infected skin lesions and may first colonize and multiply on normal skin prior to in- vasion through minor breaks of the epithelium and the development of lesions.

Treatment with penicillin or erythromycin may be necessary to combat the infection.

Propionibacterium acnes are found on normal human skin. The organism is no longer believed to be the cause of acne, but have been assigned a role in inflamma- tion of acne.

Malassezia (formerly Pityrosporum) are probably universal inhabitants of the head and thorax in adult humans. Species of this organism are known to be involved in the skin diseases seborrhoeic dermatitis and pityriasis versicolor and to play a part in the aetiology of severe dandruff. These yeasts may also play a part in exacerbation of atopic dermatitis.

So called ringworm infections of the skin may be caused by dermatophyte fungi, e. g. Tricophyton, Epidermophyton and Microsporum.

The relative dryness of most areas of skin limits the growth of Candida, which therefore are found in low numbers on healthy skin. However Candida rapidly colo- nizes damaged skin and intertriginous sites (apposed skin sites which are moist and become chafed). Candida also colonizes the oral and vaginal mucosa and over- growth may result in disease in these sites (so called thrush). C. albicans is associ- ated with diaper dermatitis. A study has shown that C. albicans induced lesions are remarkably influenced by pH, a lower skin pH giving less lesions (B. Runeman, Acta Derm Venereol 2000; 80: 421-424).

One way to reduce the problems with the kind of infections described above is to have a good personal hygiene. However, excessive use of cleaning agents not only decrease the amount of harmful microbes, but can harm the beneficial microbial flora, again render it susceptible for pathogenic species to colonize and cause infec- tions. Alternatively, administration of lactic acid producing bacteria to the urogeni- tal area and the skin in order to outcompete pathogenic species and facilitating re- establishment and maintenance of a beneficial microbial flora in these areas, have been found to be a successful means to treat and prevent microbial infections.

It has been suggested that lactic acid producing bacteria can be delivered via ab- sorbent articles, such as diapers, sanitary napkins, panty liners and tampons, as de- scribed in, for example, in W097/02846, W099/17813, W099/45099 and WO00/35502. However, absorbent articles may not always be an optimal admini- stration route, since carrying of an absorbent article often is apprehended as uncom- fortable, indiscrete and warm. This administration route can also be inconvenient as repeated administration of lactic acid producing bacteria often is necessary to retain the efficacy of the treatment or the preventative effect. Also, these products cannot be used for delivery of the bacteria to other regions of the body than the urogenital area. Therefore, for some applications it can be more convenient to administer lactic acid producing bacteria by other means than absorbent products. A second problem with administration of lactic acid producing bacteria via absorbent articles relates to the manufacturing of such products, since all possible variants and sizes of the product have to be supplied with the bacteria. Therefore the administration via a product that could be used without individual adjustments could provide a manu- facturing advantage over the absorbent products.

However, a major problem with providing articles intended to be used for transfer of lactic acid producing bacteria, is that the bacteria have to retain viability during transport and storage of the articles. Lactic acid producing bacteria rapidly lose vi- ability under moist conditions, and it is therefore important that the products are not exposed to moisture. One way to partly overcome this problem has been to supply articles with freeze-dried lactic acid producing bacteria, thereby providing long shelf-life products containing viable lactic acid producing bacteria. However, the bacteria still have to be protected against moisture during the time between manu- facturing and use.

Alternatively, research experiments have shown that storage in sterile vaseline oil results in a high level of viable lactobacilli cells after 8 months of storage, although

survival of the bacterial cells is not discussed in the context of transferring bacteria to the skin (Arkadéva et al., N A. Nauchnye Doklady Vysshei Shkoly. Biologiches- kie Nauki, 1983,2 : 101-104). In contrast, Stoianova et al. (Mikrobiologiia, 2000, 69: 98-104) found that immersion in mineral oil was not effective to preserve viabil- ity of lactic acid producing bacteria. There are additional examples of the combina- tion lactic acid producing bacteria and a fatty composition, although these do not describe the effect of the fatty composition on the survival. WO01/13956 describes pharmaceutical compositions comprising Emu oil, antimicrobial agents and/or Ba- cillus coagulans to be used for antimicrobial treatments. However, the object of us- ing compositions described in WO01/13956 is to treat microbial infections by add- ing components that kill undesirable microorganisms and the Emu oil is not added to enhance survival of bacteria included in the compositions. W092/13577 relates to a tampon or sanitary napkin that is coated with a compound with adhesive properties and subsequently added bacteria that attach to the adhesive compound.

W092/13577 neither relates to hygiene tissues nor mentions anything about a com- position containing bacteria suspended in a lipid phase. US 4,518, 696 describes that suspensions comprising lactobacilli can be stabilised by dispersing the bacteria in sun flower oil. However, US 4,518, 696 relates to the field of providing preparations of lactobacilli for oral administration to animals.

In conclusion, there is still a need to develop products for delivery of lactic acid producing bacteria to the skin and urogenital area that are convenient to use, result in efficient transfer of the bacteria to the area where they are applied and can be stored for long time periods without loss of viability of the bacterial cells.

Object of the invention The object of the present invention is to provide a convenient device for the delivery of lactic acid producing bacteria to the skin and urogenital area. This is obtained by providing a hygiene tissue, comprising viable lactic acid producing bacteria, that can

be used for cleaning and caring the skin while simultaneously delivering the lactic acid producing bacteria, to reestablish and maintain a beneficial microflora on the skin and the urogenital area. In order to provide products that can be stored for long time periods, without loss of viability of the lactic acid producing bacteria, the bac- terial cells are suspended in a lipid that protects the bacteria from moisture. Also an object of the present invention is to provide moisture impervious packing units comprising the hygiene tissue of the invention.

Summary of the invention The present invention pertains to a hygiene tissue to be used for cleaning and caring of the skin and the urogenital area simultaneously as it delivers lactic acid producing bacteria, thereby reestablishing and maintaining a healthy microbial flora in these areas. The hygiene tissue is characterized in that it is impregnated with a composi- tion comprising a lactic acid producing bacterium/bacteria suspended in a lipid and optionally (an) additional components. The present inventors surprisingly found that encapsulating the lactic acid bacterium in a lipid provided a moisturefree environ- ment keeping the bacterium in a shape that resulted in enhanced longevity, high transfer rates to the skin, and still keeping fitness for survival and growth on the skin. Therefore, by this approach, bacterial survival was enhanced during long term storage. Also, the hygiene tissue of the present invention improved the efficiency of transfer of the lactic acid producing bacterium to the skin and urogenital area, si- multaneously as the lipid served as a cleaning agent with skin caring properties.

Furthermore, the invention relates to an impervious packing unit comprising the hy- giene tissue described above.

Short description of drawings In all figures l. OOE+02 is 1.00x102, 1. OOE+03 is 1. 00x103, etc..

Figure 1 shows the survival of Lactobacillus plantarum 931 in olive oil on hygiene tissues Spun Lace Dupont (.) and SCA Absbond (#).

Figure 2 shows the survival of Lactobacillus plantarum 931 in suspensions of water and olive oil on hygiene tissues (Spun Lace Dupont). (#) 10% olive oil in water, 30% olive oil in water.

Figure 3 shows the survival of Lactobacillus plantarum 931 in olive (.) and rape- seed (#) oil.

Figure 4 shows the survival of Lactobacillus phantarum 931 in lipids with different chemical compositions. (#) vaseline, (#) paraffin, (A) glycerolum, (x) olive oil, (*) Dimeticonum, (#) Akoline MCM, (i) Akomed R, (-) Akorex L.

Figure 5 shows the survival of Lactobacillus plantarum 931 in suspensions of water and olive oil. (.) 10% olive oil in water and (#) 30% olive oil in water.

Figure 6 shows transfer efficacy to and survival rate on skin of Lactobacillus plan- tarum 931 suspended in olive oil on hygiene tissues used on five different subjects.

Figure 7 shows transfer efficacy to and survival rate on skin of Lactobacillus plan- tarum 931 suspended in paraffin oil on hygiene tissues used on five different sub- jects.

Figure 8 shows transfer efficacy to and survival rate on skin of Lactobacillus plan- tarum 931 suspended in Milli Q water on hygiene tissues used on five different subjects.

Figure 9 shows transfer to and survival of Lactobacillus plantarum 931 suspended in olive oil in the urethra after application via a tissue sheet used in the urogenital area on four different subjects.

Figure 10 shows transfer to and survival of Lactobacillus plantarum 931 suspended in olive oil in the perineum after application via a tissue sheet used in the urogenital area on four different subjects.

Figure 11 shows the growth rate of Lactobacillus plantarum 931 cells after storage in olive oil on a tissue sheet (A and o) as compared to the growth rate of freshly in- oculated L. plantarum 931 cells from an overnight culture (-).

Definitions By"hygiene tissue"is meant any device for wiping skin, for instance, a washcloth, patch, towelette, napkin, wetwipe, and the like.

By"matrix"is meant any natural or synthetic fiber, such as felt, batting, rayon, cel- lulose, regenerated cellulose, polyester, polyolefin fibers, textile and the like, or foam.

Preferred"lactic acid producing bacterial strain"for the object of the present in- vention include bacteria from the genera Lactobacillus, Lactococcus and Pediococ- cus. Preferably the selected bacterium used is from the species Lactococcus lactis, Lactobacillus acidophilus, Lactobacillus curvatus or Lactobacillus plantarum. Even more preferably the lactic acid producing bacterium is Lactobacillus plantarum 931 (deposition No. (DSM): 11918).

By lipid is meant a water-insoluble organic molecule with a fatty character. Suitable lipids for the present invention include petroleum-derived lipids, synthetic lipids, and animal-and plant-derived lipids.

By"additional component"is meant agents commonly added to skin caring prod- ucts, such as caring agents, water absorbent agents, pH buffering agents (weak or- ganic or inorganic acids, such as lactic acid, ascorbic acid, citric acid or boric acid), perfume, antioxidants, hydrocortisone, other anti-inflammatory steroids, etc. Further details on suitable agents commonly added to skin caring products are given in Harry's Cosmeticology 8th ed. , Ed by MM Rieger, Chemical Publishing Co. , Inc., New York, 2000.

By"moisture impervious packing unit"is meant a packing unit having a highest water vapor transmission rate of 6 g/m2/calendar day in accordance with ASTME 398-83.

Detailed description of the invention

The hygiene tissue provided in the present invention is intended to be used for cleaning and simultaneously reestablishing and maintaining a healthy microbial flora on the skin and in the urogenital area. The hygiene tissue provided can be composed of a matrix comprising any natural or synthetic fiber, such as felt, batting, rayon, cellulose, regenerated cellulose, polyester, polyolefin fibers, textile and the like, or foam, or combinations thereof. The water content of the matrix of the hy- giene tissue is preferably 10% or less (by weight), more preferably 5% or less (by weight) and most preferably 1% or less (by weight). The hygiene tissue is impreg- nated with a suspension of a lactic acid producing bacterium in a lipid. The lipid en- capsulates the bacteria and thereby acts to protect the bacteria from moisture, which enhances bacterial survival during manufacturing and storage. Exposure to moisture during manufacturing and storage of products that comprise lactic acid producing bacteria, causes reactivation of the bacteria, which subsequently leads to their death.

Therefore, by protecting the bacteria from moisture, their survival is enhanced and the durability of the product extended. The inventors also found that encapsulating the bacteria in lipid resulted in enhanced transfer rates to and survival of the bacteria on the skin after their delivery to it (see Example 3 below). This can be an effect of the lipid creating a micromilieu, that is beneficial for retaining bacterial viability and that enhances growth of the added bacteria on the skin. Also, the lipid has more ad- hesive properties than, for example, water, thereby resulting in a higher amount of bacteria actually being transferred to the skin. In addition to its bacterial survival enhancing properties, the lipid also serves as a skin treatment agent that cleans the skin without causing drying out. Once the bacteria have been delivered to the skin, the moist on the skin reactivates the bacteria, thereby allowing them to perform their

intended action, i. e. competitively exclude and prevent colonization of pathogenic microbial species. Optionally, additional substances, including water absorbent agents (such as inorganic salts, e. g. calcium chloride), tensides (non-ionic, ampho- teric and anionic surfactants), pH buffering agents (weak organic or inorganic acids, such as lactic acid, ascorbic acid, citric acid or boric acid), perfume, antioxidants, hydrocortisone and other anti-inflammatory steroids, can also be added to the lipid- bacterial suspension, or directly to the hygiene tissue.

The amount of lipid suspension of lactic acid producing bacteria on the tissue is 0.5- 95% by weight.

The number of probiotic bacteria on the hygiene tissue is preferably 104_101 1 colony forming units (CFU) and more preferably 10'-10"CFU. The preparation of lactic acid producing bacteria are preferably provided in a dried form, preferably as a freeze-dried powder. The bacteria can also be provided in microincapsulated forms.

Preferably the water activity of the bacterial preparation is 0.30 or less, more pref- erably 0.25 or less, most preferably 0.20 or less.

In one preferred embodiment the probiotic lactic acid producing bacterial strain with antagonistic effect is selected from the genera Pediococcus, Lactobacillus or Lacto- coccus including combinations thereof. The lactic acid producing bacterial strain is preferably isolated from the skin or urogenital area of a healthy person.

In another preferred embodiment the probiotic bacterial strain with antagonistic ef- fect is at least a Lactobacillus plantarum strain.

In an even more preferred embodiment the probiotic bacterial strain with antagonis- tic effect is at least Lactobacillus plantarum 931 (deposition No. (DSM): 11918).

Suitable lipids for the present invention support survival of the stored cells of so that the maximum decrease in number of culturable cells is 3 log units after 12 months storage. Suitable lipids for the present invention preferably have a water content of 5% or less (by weight), preferably 3% or less (by weight), most preferably 1% or less (by weight).

More preferably, suitable lipids support survival of the stored cells of so that the maximum decrease in number of culturable cells is 2 log units after 12 months stor- age.

Most preferably, suitable lipids support survival of the stored cells of so that the maximum decrease in number of culturable cells is 1 log unit after 12 months stor- age.

Suitable lipids enable transfer of bacteria to the skin of more 105 or more culturable cells per cm2.

More preferably, suitable lipids enable transfer of bacteria to the skin of 106 or more culturable cells per cm2.

Most preferably, suitable lipids enable transfer of bacteria to the skin of 107 or more culturable cells per cm2.

Suitable lipids are also characterized by supporting survival of the bacterial cells on the skin so that 102 or more culturable cells per cm2 can be recovered 12 hours after delivery by use of the hygiene tissue.

More preferably, suitable lipids support survival of the bacterial cells on the skin so that 103 or more culturable cells per cm2 can be recovered 12 hours after delivery by use of the hygiene tissue.

Most preferably, suitable lipids support survival of the bacterial cells on the skin so that 104 or more culturable cells per cm2 can be recovered 12 hours after delivery by use of the hygiene tissue.

Suitable lipids for the present invention include petroleum-derived lipids, such as paraffinum liquidum (mineral oils, paraffin oils, and vaseline oils), petrolatum (vaseline and petroleum jelly), cera microcrystallina, ozokerite, ceresine and paraf- fins. Alternatively, synthetic lipids, such as Dimethicone, Cyclomethicone and sili- cone esters, such as cetearyl methicone can be used. A third alternative is to use animal-or plant-derived lipids, which usually are triglycerides. The naturally ani- mal-or plant-derived lipids are often mixtures of mono-, di-and triglycerides and free fatty acids. The lipids may be purified, hydrogenated, refined, modified and used alone or in different mixtures. Examples of suitable, original animal-derived lipids include bees'waxes, emu oil, lactis lipida, lanolin, shark liver oil and tallow.

Examples of suitable plant-derived original lipids include apricot kernel oil, arachis oil, avocado oil/wax, bayberry wax, black currant seed oil, borage seed oil, brazil nut oil, camelia sinensis oil, candelilla wax, canola oil, carnauba wax, castor oil, co- coa butter, coconut oil, corn oil, cotton seed oil, dog rose seed oil, evening primrose seed oil, grape seed oil, illipe butter, jasmine wax, jojoba wax, lavender wax, linseed oil, mango seed oil, olive oil, orange wax, palm oil, palm kernel oil, peanut oil, rice wax, safflower oil, sesame seed oil, shea butter, soybean oil, sunflower seed wax, sweet almond oil and wheat germ oil. The lipids can be used alone or in mixtures comprising at least two lipids.

Preferably a liquid lipid is used in the present invention.

More preferred lipids include olive oil, canola oil, coconut oil, palm kernel oil, pea- nut oil, soy bean oil, Dimethicone, paraffin oil, and petrolatum. These lipids are specially preferred since they provide high survival of lactic acid bacteria and high

transfer rates of the bacteria to the skin and urogenital area. In addition these lipids have positive effects in the skin; they have a soothing effect, show skin protective properties and are non-toxic and non-allergenic. The preferred lipids are all of non- animal origin.

In order to protect the probiotic bacteria from moisture during storage and transpor- tation, the hygiene tissue is preferably provided individually packed in a moisture impervious packing unit. The packing unit can be constructed in several different ways. Importantly, the material used should not have a vapor permeability exceed- ing 6g/m2/calendar day in accordance with ASTME 398-83 at 37. 8°C and 90% rela- tive humidity. Suitable materials to be used to obtain an impervious packing unit in- clude polyethylene, polypropylene, polyester, polyamide, polyvinylalcohol and similar polymers, aluminum foil, aluminum oxide, silicon oxide, and the like. In or- der to produce packing material that has good wear strength and can readily be sealed, a less expensive material may be used as outer protective wear layers and/or as inner sealing layers. For instance, the packing unit can comprise an inner material that enables a good seal to be obtained, e. g. polyethylene, polypropylene, butyl ac- rylate, vinyl acetate or wax, an intermediate material that consists of a moisture im- pervious material, and a stronger outer barrier material, e. g. polyethylene or poly- propylene. After placement of the hygiene tissue comprising the lipid suspension containing the lactic acid producing bacteria, all openings of the packing unit have to be tightly sealed. It is important that the seals do not have a moisture permeability exceeding that of the packing material itself. Further details on the design of suitable impervious packing units are given in WOOO/76878, which hereby is incorporated as reference.

Example 1 Survival of Lactobacillus plantarum 931 in olive oil on hygiene tissues A preparation of freeze dried L. plantarum 931 cells in skimmilk was grounded until a powder of fine grains was formed. 10 g of the L. plantarum 93 1 powder was added to 120 ml olive oil (Filippo BERIO extra virgin olive oil) and shaken until a homogenous solution was formed. An additional aliquot of 80 ml of olive oil was added and the resulting 200 ml solution was vortexed for ca 2 min. The bacterial suspension was kept at room temperature for 3 hours, with mixing twice an hour.

Tissue sheets (Spun Lace Dupont and SCA Absbond) were cut to 6x4 cm squares and placed in sterile stainless steel trays. On each tissue sheet, 2 ml of bacterial sus- pension was dropped over the tissue to cover it. The tissue sheet was folded in the middle, then from the long side to the middle again and packed in foil bags, which edges were welded. Samples were removed for determination of initial bacterial concentration and the remaining bags were stored at room temperature for viability studies.

As a comparison to storage of L. plantarum 931 cells in olive oil, L. plantarum 931 cells were stored in suspensions of water and olive oil on hygiene tissues. These were prepared by mixing vigorously 2.5 g of freeze dried L. plantarum 931 cells (prepared as described above) with 45 ml of Milli Q water and 5 ml olive oil (Filippo BERIO, Italy) or 35 ml Milli Q water and 15 ml olive oil to prepare suspen- sions with approximately 10 or 30% oil, respectively. The bacterial oil-water sus- pensions were applied to tissue sheets (Spun Lace Dupont) for bacterial survival studies. On each tissue sheet (6x7 cm), 1 ml of bacterial suspension was dropped to cover the tissue. The tissue sheet was folded in the middle, then from the long side to the middle again and packed in foil bags, which edges were welded. Samples were removed for determination of initial bacterial concentration and the remaining bags were stored at room temperature in the dark for viability studies.

To test the viability of the L. plantarum 931 cells after storage for different time pe- riods on a tissue sheet, the tissue sheet was transferred to a Stomacher bag and 10 ml of 0.9% NaCI was spread over the tissue sheet. The bag was run for 3 min on high effect in Stomacher. The contents of the bag was then transferred to test tubes, di- luted in 0.9% NaCI when necessary, and immediately plated onto Rogosa plates.

The number of colonies was counted after 2 days of incubation at 37°C in 5% C02 in air. Two tissue sheets were analyzed at each sampling date.

The survival of L. plantarum 931 in olive oil on hygiene tissues for a total time pe- riod of one year and three months is shown in Fig. 1. The survival of the L. plan- tarum 931 cells stored under these conditions was very high for both tissue sheets variants tested. In comparison, storage of oil-water suspensions (10 and 30% olive oil in water) of the bacteria on a tissue sheet (Fig. 2) resulted in a rapid decrease in viability with a drop of more than 103 orders of magnitude over just a three months time period studied.

Example 2 Survival of L. plantarum 931 in lipids with different chemical compositions 497 mg of a powder of L. plantarum 931 in skim milk, prepared as described in Ex- ample 1, was mixed with 5 ml of olive oil (Filippo BERIO extra virgin olive oil, Filippo BERIO, Italy) or rapeseed oil (Felix AB, Sweden). The pH of the oils was ca 5. The rapeseed oil also contained, in addition to rapeseed oil, citric acid and vi- tamin A and D. The suspensions were vortexed for 1 min and allowed to rest for 1 min. This was repeated four more times. The bacterial suspensions were kept for 4 hours at room temperature with mixing twice an hour. The suspensions were then divided into 1 ml aliquots and stored in sterile brown glass vials. The initial concen- trations of bacteria in the suspensions were determined. The vials were stored in a dark place at room temperature and normal air humidity varying from 30-60%.

In addition to the experiment described above, to further compare the survival of L. plantarum 931 in lipids with different compositions, 2 g of freeze-dried L. plan- tarum 931 cells in skimmilk (2x10'° colony forming units/g) were mixed with either 40 ml or 40 g of the different lipid compositions, depending on the lipid consis- tency. The tested lipids were: white vaseline (petrolatum, Apoteket AB, Umea, Sweden), paraffin (paraffinum liquidum, Apoteket AB, Gothenburg, Sweden), glyc- erol ("glycerin", maximum water content 0.5%, Apoteket AB, Gothenburg, Swe- den), olive oil ("Olea Europea", cold pressed, Apoteket AB, Gothenburg, Sweden), dimethiconum (Dimethicone, 350 cSt. , Dow Corning 200/350 S fluid, Kebo Lab, Sweden), and Akoline MCM (mono-diglyceride of medium chain fatty acids; pri- marly caprylic and capric acids, , Karlshamns AB, Sweden), Akomed R (cap- rylic/capric triglyceride from coconut and/or palm kernel oils, deodorized, Karl- shamns AB, Sweden), and Akorex L (canola oil, partially hydrogenated, deodorized, Karlshamns AB, Sweden). The samples were stored in sterile, brown, glass vials at room temperature in the dark at normal air humidity (varying from 30-60% relative humidity). To establish the number of viable L. plantarum 931 cells after different storage times, 1 g of the samples was transferred to a stomacher bag and 9 ml of 0.9% NaCl was added. The bag was then run at high effect in Stomacher for 3 min.

The contents of the bag was transferred to test tubes, diluted when necessary in NaCI and cultured on MRS-plates at 37°C in 5% CO2in air for 2 days.

As a comparison to storage of L. plantarum 931 cells in different lipids, L. plan- tarum 931 cells were also stored in suspensions of water and olive oil. These were prepared by mixing vigorously 2.5 g of freeze dried L. plantarum 931 cells (pre- pared as described above) with 45 ml of Milli Q water and 5 ml olive oil (Filippo BERIO, Italy) or 35 ml Milli Q water and 15 ml olive oil to prepare suspensions with approximately 10 or 30% oil, respectively. The samples were stored in sterile plastic vials at room temperature at normal air humidity (varying from 30-60% rela- tive humidity). To test survival after different time intervals, samples were removed

from the vials, diluted in 0.9% NaCI and incubated at 37°C in 5% CO2in air for 2 days.

Figure 3 shows an extraordinarily high level of survival of the L. plantarum 931 cells in olive and rapeseed oil over the more than one year time period studied. Stor- age in vaseline, paraffin, Dimeticonum, Akoline MCM, Akomed R, and Akorex L also resulted in a high survival over extended time periods (Fig. 4). However, stor- age in the more hydrophilic glycerol resulted in a pronounced decrease in survival over time (Fig. 4). Also, the Akoline MCM, known to have bacteriostatic properties, could not support survival of the cells (Fig. 4). In addition, it can be seen that stor- age in the more hydrophilic environment provided in the oil-water suspensions (Fig.

5) results in a very rapid initial decrease in viability by more than 102 orders of magnitude over the first month of storage. During the next two months studied, the decrease in survival rates flattened out, but still the decrease in survival is much higher than what is observed when the bacterial cells were stored in a lipid.

Example 3 Study on transfer efficacy to and survival rates on skin of L. plantarum 931 sus- pended in olive oil, paraffin oil or Milli Q water 2.00 g of freeze-dried L. plantarum 931 were added to a sterile glass vial and 40 ml of olive oil, paraffin oil or Milli Q water were added. The suspensions were shaken until homogenous solutions formed and were left at room temperature for four hours. Tissue sheets with L. plantarum 931 were prepared by cutting tissue sheets to 7x8 cm pieces and dropping 2 ml of the different bacterial suspensions, prepared as described above, to cover the tissue. The tissue sheets were folded in the middle, then from the long side to the middle again and packed in foil bags which edges were welded. Samples were removed for determination of initial bacterial concen- trations and the remaining bags were stored at room temperature for viability stud- ies. Two of the prepared tissue sheets with L. plantarum 931 for each preparation

were used in the bend of the arm on five subjects (i. e. one tissue was used for three subjects and the other one for two). Before the test, samples were taken to assure that no L. plantarum 931 cells were initially present on the skin. On each subject, in one bend of the arm a tissue sheet with L. plantarum 931 in Milli Q water was streaked and a tissue sheet with L. plantarum 931 in olive oil was similarly used in the other. The skin was then sampled for presence of L. plantarum 931 cells at 0,4, 6 and 24 hours after streaking. The sampling procedure was as follows: a sterile stick provided with a cotton wool top was dipped in 0.9% NaCI and rolled 4 times over an area of 1 cm2 at the site of application of the bacteria. The stick was then dipped in 1 ml of 0.9% NaCI and mixed. The samples were diluted in 0. 9% NaCI and immediately plated onto Rogosa plates. The plates were incubated at 37°C in 5% C02 in air for 2 days. After 24 hours the bend of the arm, where L. plantarum 931 cells in Milli Q water were applied, was rinsed with Sumabac (Diversey Lever, Huddinge, Sweden) and a tissue sheet with L. plantarum 931 cells in paraffin oil was streaked in that bend of the arm, which, as previously, was sampled at 0,4, 6 and 24 hours after streaking to assess the amount of L. plantarum 931 cells on the skin.

As shown in Fig. 6-8 the amount of L. plantarum 931 cells transferred to the skin was usually more than 10 times higher when the bacteria were suspended in olive (Fig. 6) or paraffin oil (Fig. 7) compared to when they were suspended in Milli Q water (Fig. 8). Suspending the bacteria in lipid instead of water therefore was demo- strated to enhance the transfer rate of the bacteria to the skin. Also, once the L. plantarum 931 cells were on the skin, the lipid also enhanced bacterial survival, since the initial drop in bacterial counts was slower and the final level of bacteria on the skin after 24 hours was much higher after use of a tissue where the bacteria were suspended in olive or paraffin oil (Fig. 6 and 7), compared to what was found when water was used as suspending agent (Fig. 8).

Example 4 Transfer of L. plantarum 931 suspended in olive oil applied to a tissue sheet used in the urogenital area A bacterial suspension was prepared by adding 5.051 g of a powder of L. plantarum 931 (prepared as described in Example 1) to 100 ml olive oil (Filippo BERIO extra virgin olive oil). The powder was first added to 75 ml of olive oil and shaken to form a homogenous solution before addition of another 25 ml, followed by vortex- ing for 2 min. The bacterial suspension was kept at room temperature for 2 hours, with mixing twice an hour. A tissue sheet was prepared and inoculated with the bacteria as described in Example 1. 4 girls were treated with the tissue sheet in the urogenital area. Samples were collected from the urethra and perineum, using sterile cotton sticks, before using the tissue sheet, to ensure that no lactobacilli were ini- tially present. Thereafter samples were collected immediately after treatment, and after 2,4, 6, and 17 hours, to monitor transfer and survival of the lactobacilli by dipping a sterile stick provided with a cotton wool top in MRS-broth and rolling it three times over an area of 1 cm2 at the site of application of the bacteria. The stick was then put in one ml MRS-broth. In the same way a stick was rolled over the ure- tra over an area of'/4 cm2 and was the put in another tube of MRS-broth. The sam- ples were plated onto Rogosa plates containing 128 pg/ml vancomycin. The plates were incubated at 37°C in 5% C02 in air for two days.

The girls were not allowed to take a bath or shower during the study, but were not given instructions in any other respect. The results shown in Fig. 9 and 10 demon- strate that there was a high level of transfer of L. plantarum 931 to the urethra (Fig.

9) and perineum (Fig. 10) and that a surprisingly high amount of bacteria remained in these areas during the time period studied.

Example 5 Viability of L. plantarum 931 after storage in olive oil on a hygiene tissue Growth of L. plantarum 931 suspended in olive oil on tissue sheets that had been stored for 6 days was compared to growth of L. plantarum 931 that were not sus- pended and stored in olive oil. The tissue sheets were wetted with 10 ml 0.9% NaCI and run in Stomacher for 3 minutes on high effect. The solution was then transferred to test tubes and 10 pI were inoculated into 10 ml MRS broth. The bacterial con- centration was followed during growth at 37°C in 5% C02 in air by quantifying the number of colony forming units (CFU) and the optical density (OD) at 0,2, 4,6, 8, 10,12 and 24 hours. Duplicate samples were taken for the analysis. The results shown in Fig. 11 demonstrate that the capability of growth of the L. plantarum 931 cells had been suspended and stored in olive oil on a tissue sheet is just as good as growth of cells from an overnight culture of L. plantarum 931. Accordingly, the L. plantarum 931 cells were not negatively affected by the storage in olive oil.