Bi Yingying, Wang Yuezhu, Li Wu, Chen Yuhang, Qin Jinlong, Zheng Huajun
Department of Gynaecology, Shanghai Fourth People's Hospital, Shanghai, 200434, China.
Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China.
BMC Microbiol. 2025 Jan 4;25(1):1. doi: 10.1186/s12866-024-03709-3.
Recurrent vaginitis in conjunction with urinary tract infection (RV/UTI) in perimenopausal women is a common clinical condition that impacts both doctors and patients. Its pathogenesis is not completely known, but the urogenital microbiota is thought to be involved. We compared the urogenital and gut microbiotas of perimenopausal women experiencing RV/UTI with those of age-matched controls to provide a new microbiological perspective and scheme for solving clinical problems.
Fifty women of perimenopausal age who were diagnosed with RV/UTI and 50 age-matched healthy controls were enrolled. The urogenital and intestinal microbiota were analyzed via 16S ribosomal RNA gene sequencing by collecting samples from the mouth, anus, urine, cervix, and upper and lower vaginal ends. Among the microbiota of healthy perimenopausal women, the mouth had the highest richness, whereas the anus and mouth had the highest levels of diversity. Compared with those in healthy controls, in the microbiota of patients with RV/UTI, the evenness of the upper vaginal end, anus and cervix significantly increased, whereas the richness and diversity of the cervix significantly decreased. Lactobacillus accounted for 40.65% of the bacteria in the upper vaginal end and 39.85% of the bacteria in the lower vaginal end of healthy women of perimenopausal age, and there were no significant differences in Lactobacillus abundance among the patients with RV/UTI. The relative abundances of 54 genera and 97 species were significantly different between patients and healthy individuals, particularly in the cervix and urine. A total of 147 predicted pathways were significantly different between patients and healthy controls, with the microbiota of the anus exhibiting the greatest number of functional changes, followed by the urine microbiota. A random forest model composed of 16 genera in the lower vaginal end had the highest discriminatory power (AUC 81.48%) to predict RV/UTI.
Our study provides insight into the nature of the urogenital and intestinal microbiota in perimenopausal women, and reveals significant changes in the microbiota in patients with RV/UTI. This information will help characterize the relationship between the urogenital microbiota and RV/UTI, potentially aiding in the development of diagnostic and therapeutic strategies.
围绝经期女性复发性阴道炎合并尿路感染（RV/UTI）是一种常见的临床病症，对医生和患者都会造成影响。其发病机制尚不完全清楚，但认为泌尿生殖道微生物群与之有关。我们比较了患有RV/UTI的围绝经期女性与年龄匹配的对照组的泌尿生殖道和肠道微生物群，以提供解决临床问题的新微生物学视角和方案。
招募了50名被诊断为RV/UTI的围绝经期女性和50名年龄匹配的健康对照者。通过收集口腔、肛门、尿液、宫颈以及阴道上下端的样本，采用16S核糖体RNA基因测序分析泌尿生殖道和肠道微生物群。在健康围绝经期女性的微生物群中，口腔的丰富度最高，而肛门和口腔的多样性水平最高。与健康对照组相比，RV/UTI患者的微生物群中，阴道上端、肛门和宫颈的均匀度显著增加，而宫颈的丰富度和多样性显著降低。围绝经期健康女性阴道上端细菌中乳酸杆菌占40.65%，阴道下端细菌中乳酸杆菌占39.85%，RV/UTI患者之间乳酸杆菌丰度无显著差异。患者与健康个体之间54个属和97个种的相对丰度存在显著差异，尤其是在宫颈和尿液中。患者与健康对照之间共有147条预测途径存在显著差异，肛门微生物群的功能变化数量最多，其次是尿液微生物群。由阴道下端16个属组成的随机森林模型预测RV/UTI的判别能力最高（AUC 81.48%）。
我们的研究深入了解了围绝经期女性泌尿生殖道和肠道微生物群的性质，并揭示了RV/UTI患者微生物群的显著变化。这些信息将有助于描述泌尿生殖道微生物群与RV/UTI之间的关系，可能有助于制定诊断和治疗策略。
