Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Microbiome-X, National Institute of Health Data Science of China, Cheeloo College of Medicine, Shandong University, Jinan, China.
Microbiol Spectr. 2023 Jun 15;11(3):e0315222. doi: 10.1128/spectrum.03152-22. Epub 2023 Mar 30.
Vulvovaginal candidiasis (VVC) can alter the vaginal microbiome composition and structure, and this may be correlated with its variable treatment efficacy. Integrated analysis of the mycobiome and bacteriome in VVC could facilitate accurate diagnosis of infected patients and further decipher the characterized bacteriome in different types of VVC. Our mycobiome analysis determined two common types of VVC, which were clustered into two community state types (CSTs) featured by Candida glabrata (CST I) and Candida albicans (CST II). Subsequently, we compared the vaginal bacteriome in two CSTs of VVC and two other types of reproductive tract infections (RTIs), bacterial vaginosis (BV) and Ureaplasma urealyticum (UU) infection. The vaginal bacteriome in VVC patients was between the healthy and other RTIs (BV and UU) status, it bore the greatest resemblance to that of healthy subjects. While BV and UU patients have the unique vaginal microbiota community structure, which very different with healthy women. Compared with CST II, the vaginal bacteriome of CST I VVC was characterized by a key signature in BV. In comparison, CST II was featured by , the pathogen of UU. The findings of our study highlight the need for co-analysis and simultaneous consideration of vaginal mycobiome and bacteriome in the diagnosis and treatment of VVC to solve common clinical problems, such as unsatisfactory cure rates and recurrent symptoms. Fungi headed by C. albicans play a critical role in VVC but are not sufficient for its occurrence, indicating the involvement of other factors, such as the vaginal bacteriome. We found that different CST correspond to different bacterial composition in patients with VVC, and this could underlie the alteration of vaginal microorganism environment in VVC patients. We believe that this correlation should not be ignored, and it may be related to the unsatisfactory treatment outcomes and high recurrence rate of VVC. Here, we provided evidence for associations between vaginal bacteriome patterns and fungal infection. Screening specific biomarkers for three common RTIs paves a theoretical basis for further development of personalized precision treatment.
外阴阴道假丝酵母菌病（VVC）会改变阴道微生物组的组成和结构，这可能与其治疗效果的差异有关。对假丝酵母菌病患者的真菌组和细菌组进行综合分析，有助于对感染患者进行准确诊断，并进一步阐明不同类型 VVC 中特征性的细菌组。我们的真菌组分析确定了两种常见类型的 VVC，它们聚集为两种以光滑假丝酵母菌（CST I）和白假丝酵母菌（CST II）为特征的群落状态类型（CST）。随后，我们比较了两种 CST 的阴道细菌组与两种其他生殖道感染（RTI），细菌性阴道病（BV）和解脲支原体（UU）感染。VVC 患者的阴道细菌组处于健康和其他 RTI（BV 和 UU）状态之间，与健康受试者最相似。而 BV 和 UU 患者具有独特的阴道微生物群落结构，与健康女性非常不同。与 CST II 相比，CST I VVC 的阴道细菌组的特征是具有 BV 的关键特征签名。相比之下，CST II 的特征是 UU 的病原体。我们的研究结果强调需要对阴道真菌组和细菌组进行联合分析和同时考虑，以解决常见的临床问题，如治疗效果不理想和症状反复出现。以白假丝酵母菌为主的真菌在 VVC 中起关键作用，但不足以引起 VVC，这表明存在其他因素，如阴道细菌组。我们发现，不同 CST 对应的是 VVC 患者中不同的细菌组成，这可能是 VVC 患者阴道微生物环境改变的基础。我们认为这种相关性不容忽视，这可能与 VVC 治疗效果不佳和复发率高有关。在这里，我们提供了阴道细菌组模式与真菌感染之间关联的证据。为三种常见 RTI 筛选特定的生物标志物，为进一步开发个性化精准治疗奠定了理论基础。
