Abstract
BackgroundBacterial colonization and associations with bacterial vaginosis (BV) signs and symptoms (Amsel criteria) may vary between populations. We assessed relationships between vaginal bacteria and Amsel criteria among two populations.MethodsKenyan participants from the placebo arm of the Preventing Vaginal Infections (PVI) trial and participants from a Seattle-based cross-sectional BV study were included. Amsel criteria were recorded at study visits, and the vaginal microbiota was characterized using 16S rRNA gene sequencing. Logistic regression models, accounting for repeat visits as appropriate, were fit to evaluate associations between bacterial relative abundance and each Amsel criterion.ResultsAmong 84 PVI participants (496 observations) and 220 Seattle participants, the prevalence of amine odor was 25% and 40%, clue cells 16% and 37%, vaginal discharge 10% and 52%, elevated vaginal pH 69% and 67%, and BV 13% and 44%, respectively. BV-associated bacterium 1 (BVAB1) was positively associated with all Amsel criteria in both populations. Eggerthella type 1, Fannyhessea (Atopobium) vaginae, Gardnerella spp., Sneathia amnii, and Sneathia sanguinegens were positively associated with all Amsel criteria in the Seattle study, and all but discharge in the PVI trial.ConclusionsCore vaginal bacteria are consistently associated with BV signs and symptoms across two distinct populations of women.
Highlights
Bacterial vaginosis (BV) is the most common cause of vaginal discharge worldwide, affecting approximately 26% of reproductive-age women (Peebles et al, 2019)
Eggerthella type 1, Fannyhessea (Atopobium) vaginae, Gardnerella spp., Sneathia amnii, and Sneathia sanguinegens were positively associated with all Amsel criteria in the Seattle study, and all but discharge in the Preventing Vaginal Infections (PVI) trial
Core vaginal bacteria are consistently associated with BV signs and symptoms across two distinct populations of women
Summary
Bacterial vaginosis (BV) is the most common cause of vaginal discharge worldwide, affecting approximately 26% of reproductive-age women (Peebles et al, 2019). BV etiology remains unclear, in part because vaginal microbiota composition varies between individuals diagnosed with BV and over time within individuals (Srinivasan et al, 2010; Gajer et al, 2012; Srinivasan et al, 2012; Ravel et al, 2013; Bautista et al, 2016; Jung et al, 2017; Muzny et al, 2018; Muzny et al, 2019). Clinical BV diagnosis is based on the presence of at least three of four signs/symptoms termed Amsel criteria: amine odor on addition of potassium hydroxide to vaginal fluid; >20% clue cells on vaginal wet prep; thin, gray, homogeneous vaginal discharge; and elevated vaginal pH >4.5 (Amsel et al, 1983). Bacterial colonization and associations with bacterial vaginosis (BV) signs and symptoms (Amsel criteria) may vary between populations. We assessed relationships between vaginal bacteria and Amsel criteria among two populations
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