The association between ethnicity and vaginal microbiota composition in Amsterdam, the Netherlands.

Hanneke Borgdorff,Sylvia M Bruisten,Henry J De Vries,Maarten F Schim Van Der Loeff,Marieke B Snijder,Janneke H H M Van De Wijgert,Suzanne E Geerlings,Catharina J Alberts,Maria Prins,Robin Van Houdt,Charlotte Van Der Veer,David N Fredricks

doi:10.1371/journal.pone.0181135

Abstract

ObjectiveTo evaluate whether ethnicity is independently associated with vaginal microbiota (VMB) composition in women living in Amsterdam, the Netherlands, as has been shown for American women.MethodsWomen (18–34 years, non-pregnant, N = 610) representing the six largest ethnic groups (Dutch, African Surinamese, South-Asian Surinamese, Turkish, Moroccan, and Ghanaian) were sampled from the population-based HELIUS study. Sampling was performed irrespective of health status or healthcare seeking behavior. DNA was extracted from self-sampled vaginal swabs and sequenced by Illumina MiSeq (16S rRNA gene V3-V4 region).ResultsThe overall prevalence of VMBs not dominated by lactobacilli was 38.5%: 32.2% had a VMB resembling bacterial vaginosis and another 6.2% had a VMB dominated by Bifidobacteriaceae (not including Gardnerella vaginalis), Corynebacterium, or pathobionts (streptococci, staphylococci, Proteus or Enterobacteriaceae). The most prevalent VMB in ethnically Dutch women was a Lactobacillus crispatus-dominated VMB, in African Surinamese and Ghanaian women a polybacterial G. vaginalis-containing VMB, and in the other ethnic groups a L. iners-dominated VMB. After adjustment for sociodemographic, behavioral and clinical factors, African Surinamese ethnicity (adjusted odds ratio (aOR) 5.1, 95% confidence interval (CI) 2.1–12.0) and Ghanaian ethnicity (aOR 4.8, 95% CI 1.8–12.6) were associated with having a polybacterial G. vaginalis-containing VMB, and African Surinamese ethnicity with a L. iners-dominated VMB (aOR 2.8, 95% CI 1.2–6.2). Shorter steady relationship duration, inconsistent condom use with casual partners, and not using hormonal contraception were also associated with having a polybacterial G. vaginalis-containing VMB, but human papillomavirus infection was not. Other sexually transmitted infections were uncommon.ConclusionsThe overall prevalence of having a VMB not dominated by lactobacilli in this population-based cohort of women aged 18–34 years in Amsterdam was high (38.5%), and women of sub-Saharan African descent were significantly more likely to have a polybacterial G. vaginalis-containing VMB than Dutch women independent of modifiable behaviors.

Highlights

The majority of women of reproductive age have a vaginal microbiota (VMB) dominated by lactobacilli [1]
The overall prevalence of VMBs not dominated by lactobacilli was 38.5%: 32.2% had a VMB resembling bacterial vaginosis and another 6.2% had a VMB dominated by Bifidobacteriaceae, Corynebacterium, or pathobionts
The overall prevalence of having a VMB not dominated by lactobacilli in this populationbased cohort of women aged 18–34 years in Amsterdam was high (38.5%), and women of sub-Saharan African descent were significantly more likely to have a polybacterial G. vaginalis-containing VMB than Dutch women independent of modifiable behaviors

Summary

Introduction

The majority of women of reproductive age have a vaginal microbiota (VMB) dominated by lactobacilli [1]. Other types of VMBs not dominated by lactobacilli, such as VMBs containing a high relative abundance of pathobionts, have been identified but less commonly [1]. An expert consultation organized by the U.S National Institutes of Health (NIH) in 2015 called for more detailed descriptions of the various types of VMBs not dominated by lactobacilli and, eventually, subcategorization into multiple CSTs [6]. This is deemed necessary to improve our understanding of the etiology and pathogenesis of different CSTs and their sequelae, and to develop targeted interventions

Methods

Results

Conclusion