Diverse vaginal microbiomes in reproductive-age women with vulvovaginal candidiasis. Diverse vaginal microbiomes in reproductive-age women with vulvovaginal candidiasis

Vulvovaginal candidiasis (VVC) is one of the most prevalent vaginal infectious diseases with controversial reports about the vaginal microbiota diversity. We determined the vaginal microbial community in patients with VVC, bacterial vaginiasis (BV), and mixed infection of VVC and BV using the 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 an increased order from normal control, VVC only, mixed infection of BV and VVC, to BV. The beta-diversity comparison of community structures also showed an intermediate composition of VVC between the control and BV. Detailed comparison showed that while 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 relatively higher abundance of Lactobacillus than the BV group but higher abundance of Prevotella, Gardnerella, and Atopobium than the normal control. The VVC-only group, however, could not be described by any single profile. They spanned 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 showed inconsistent changes of vaginal microbiota, with four BV/VVC samples recovered to a higher Lactobacillus level while many VVC-only patients did not. These results will be useful for future study about the role of vaginal microbiota in VVC and related infectious diseases.

外阴阴道假丝酵母菌病（Vulvovaginal candidiasis, VVC）是最常见的阴道感染性疾病之一，目前针对阴道菌群多样性的相关研究结论尚存争议。本研究通过对16S rRNA标签进行Illumina测序，分析了外阴阴道假丝酵母菌病（VVC）患者、细菌性阴道病（Bacterial Vaginosis, BV）患者以及VVC与BV混合感染患者的阴道微生物群落组成。本研究首次揭示了VVC患者阴道微生物组的高度可变特征。总体而言，在反映物种丰富度与均匀度的α多样性分析中，各组呈现出从正常对照组、仅VVC组、BV与VVC混合感染组到BV组依次升高的趋势。针对群落结构的β多样性比较结果也显示，VVC组的菌群组成介于正常对照组与BV组之间。进一步的细节对比表明，正常对照组与BV组的菌群结构均具有典型特征，而VVC患者的阴道菌群则表现出复杂多样的特点。BV与VVC混合感染组呈现独特的菌群模式：其乳杆菌属（Lactobacillus）丰度显著高于BV组，但普雷沃菌属（Prevotella）、加德纳菌属（Gardnerella）以及阿托波菌属（Atopobium）的丰度均高于正常对照组。而仅VVC组的菌群结构无法通过单一模式进行概括，其菌群谱系跨度广泛，从与正常对照组相似（以乳杆菌属为优势菌）的群落结构，到类似BV的菌群结构（以加德纳菌属和阿托波菌属为优势菌）均有分布。针对VVC的治疗对阴道菌群的调控效果并不一致：4例BV/VVC混合感染样本的阴道菌群恢复至较高的乳杆菌属丰度水平，但多数仅VVC患者的菌群未出现类似改善。本研究结果可为未来探究阴道菌群在VVC及相关感染性疾病中的作用提供重要参考依据。