Species composition and dynamic changes of vaginal microbiota in patients with recurrent vulvovaginal candidiasis

Abstract

Objective To investigate the species composition and dynamic changes of vaginal microbiota in patients with recurrent vulvovaginal candidiasis （RVVC）. Methods Six patients with confirmed symptomatic RVVC were enrolled in this study. During the onset of RVVC, 1 high vaginal swab sample was collected from each patient on a daily basis to identify the vaginal microbiota. Principal co-ordinate analysis （PCoA）, thermogram analysis and α diversity analysis were adopted to analyze the species composition and dynamic changes of vaginal microbiota in RVVC patients. Results PCoA analysis between groups showed that the species composition of vaginal microbiota in patients with RVVC was similar at the interval between onset, but the species difference was increased at several days before the onset and on the day of onset. Thermogram analysis suggested that the distance between microbiota was large in the onset stage and at the interval between onset of RVVC, and the intermediate difference of microbiota began to converge at several days before the onset stage. The species composition analysis of vaginal microbiota in patients with RVVC showed that Lactobacillus accounted for 64.25%. Bacterial genera with relative abundance between 0.10% and 1.00% included Dialister, Enterobacteriaceae, Finegoldia magna, Atopobium, Aerococcus, Staphylococcus, Anaerococcus and Lactococcus. The genera with relative abundance of >1.00% consisted of Lactobacillus, Prevotella, Streptococcus, Gardnerella and Ureaplasma. The α diversity index evaluation results indicated that the species abundance at the interval between onset of RVVC was similar, which was increased approaching the onset stage, and most returned to a low level of species abundance before the onset. Lactobacillus was the absolute dominant genus during several menstrual cycles of patients receiving follow-up, with small fluctuations. However, there was a transient increase of Prevotella in each group before the onset, and there was also an increase in Gardnerella, which occasionally fluctuated. The proportion of the other genera such as Dialister, Finegoldia magna, Atopobium and Ureaplasma was relatively low,and with few fluctuations. The remaining genera remained at a low level during the menstrual cycle.Conclusions Lactobacillus is the main vaginal microbiota in patients with RVVC. Vaginal microbiota in RVVC patients are relatively stable, with few fluctuations. In clinical treatment,widespread attention should be diverted to the regulation of vaginal microecological environment and restoring the proportion of vaginal microbiota.

Keywords

• |recurrent vulvovaginal candidiasis|vaginal microbiota|species composition|dynamic change