Characterization of vaginal fungal communities in healthy women and women with bacterial vaginosis (BV); a pilot study

The role of the vaginal fungal community, the mycobiota, in women's health is an emerging area of research. Utilization of novel molecular technology enables more in-depth characterization and identification of fungal diversity, and their potential associations to health. The present study is a substudy of a larger observational clinical trial investigating the vaginal microbiota composition before and after antibiotic treatment for Bacterial Vaginosis (BV) infection in comparison to the microbiota of healthy women (Clinicaltrials.gov identifier: NCT03187). Here, we characterized the vaginal mycobiota by sequencing the internal transcribed spacer (ITS) 2 region from vaginal microbial DNA collected from healthy women and women with BV and in relation to their treatment with oral metronidazole. Interestingly, both ascomycetous and basidiomycetous yeasts and filamentous fungi consisting of more than 30 different species were detectable from 21 out of 94 vaginal swab samples. The mycobiota was dominated by Candida species (>60% of relative abundance) and especially with Candida albicans in both study groups. The abundance of C. albicans was inversely correlated with fungal diversity but did not correlate with Nugent scores. Metronidazole did not seem to have a major effect on the relative abundance of C. albicans. The results revealed the diversity of the fungal community within healthy and BV-infected women, which is worth exploring further.

Automated summary

The study characterized the vaginal mycobiota in healthy women and those with BV infection, finding a diverse range of yeast and filamentous fungi species with Candida as the dominant genus. The abundance of C. albicans was inversely correlated with fungal diversity and oral metronidazole treatment did not significantly impact its relative abundance. The results underscore the importance of further exploring the diversity of the fungal community in both healthy and BV-infected women.