Abstract
Vulvovaginal candidiasis (VVC) is one of the most prevalent vaginal infectious diseases, and there are controversial reports regarding the diversity of the associated vaginal microbiota. We determined the vaginal microbial community in patients with VVC, bacterial vaginosis (BV), and mixed infection of VVC and BV using Illumina sequencing of 16S rRNA tags. Our results revealed for the first time the highly variable patterns of the vaginal microbiome from VVC patients. In general, the alpha-diversity results of species richness and evenness showed the following order: normal control < VVC only < mixed BV and VVC infection < BV only. The beta-diversity comparison of community structures also showed an intermediate composition of VVC between the control and BV samples. A detailed comparison showed that, although the control and BV communities had typical patterns, the vaginal microbiota of VVC is complex. The mixed BV and VVC infection group showed a unique pattern, with a relatively higher abundance of Lactobacillus than the BV group and higher abundance of Prevotella, Gardnerella, and Atopobium than the normal control. In contrast, the VVC-only group could not be described by any single profile, ranging from a community structure similar to the normal control (predominated with Lactobacillus) to BV-like community structures (abundant with Gardnerella and Atopobium). Treatment of VVC resulted in inconsistent changes of the vaginal microbiota, with four BV/VVC samples recovering to a higher Lactobacillus level, whereas many VVC-only patients did not. These results will be useful for future studies on the role of vaginal microbiota in VVC and related infectious diseases.
Highlights
The vaginal microbiota comprises a community of microbes with moderate diversity and plays a mutualistic role in the maintenance of vaginal health
All of the sequences were clustered into operational taxonomic units (OTUs) using TSC, and representative sequences from each operational taxonomy units (OTUs) were used for the taxonomic assignment with Global Alignment for Sequence Taxonomy (GAST), a pipeline with good performance for analyzing V6 tags [22]
Studies involving the longitudinal sampling of healthy women show vaginal microbiome fluctuations from a Lactobacillusdominated status to another structure, most of the snapshot profiles follow the pattern of Lactobacillus predominance [26]
Summary
The vaginal microbiota comprises a community of microbes with moderate diversity and plays a mutualistic role in the maintenance of vaginal health. The recent development of microbial community determination using next-generation sequencing (NGS) techniques has significantly improved the efficiency of studying vaginal microbiota [2,4], allowing the high-throughput analysis of hundreds to thousands of samples with detailed taxonomic and abundance information regarding the microbes present. These improvements provide a better understanding of the normal vaginal microbiota and their longitudinal changes in both healthy women and those with bacterial vaginiasis (BV) [4,5,6,7]. There have been many studies regarding the host immunity and pathogenesis of Candida spp, little attention has been given to the vaginal microbiota, one of the most important aspects of the vaginal environment [10]
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