Features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis

ObjectiveTo investigate the features of vaginal bacteria community in women with recurrent vulvovaginal candidiasis (RVVC) and its etiological risk in vaginal health.MethodsTotally 237 reproductive-aged women with RVVC in an acute episode were studied. Whereas 230 healthy reproductive-aged women were enrolled as the control. The vaginal pH was evaluated, while vaginal secretions were sampled for Gram's staining and oilmicroscopy. By Nugent score system, the composition of vaginal communities was determined, and other micro-ecological features were approached. To describe other features of vaginal microbiota, the community's bacteria density, species diversity and predominant species were evaluated at 1 000 × magnification.ResultsThe vaginal pH (4.53 ± 0.30) and Nugent score (4.31 ± 0.73) in RVVC group were significantly increased compared with vaginal pH (4.11 ± 0.30) and Nugent score (1.32 ± 1.29) in control group (P<0.05, respectively). The density of Lactobacillus in RVVC group was significantly lower than that in control group (P<0.05), while the densities of Gardnerella vaginalis, Gram-positive cocci and other species were significantly higher respectively than those in control group (P<0.05). Species diversity of women with RVVC significantly exceeded that of control group (P<0.05). More than half of vaginal communities in RVVC group lost Lactobacillus-dominating and were predominated by other bacteria such as Gardnerella vaginalis and Gram-positive cocci. The prevalence of Gardnerella vaginalis-dominating and Gram-positive cocci-dominating communities in RVVC group (37.55% and 19.83%) were significantly higher than those in control group (1.30% and 1.73%) (P<0.05).ConclusionThe significant changes in vaginal bacterial community were observed in RVVC women. Such variations in community might relate to vaginal biological barrier compromising and increase the risk to the recurrence of VVC. It is still controversial whether probiotics can prevent recurrences of VVC, and more randomized, double-blind, placebo-controlled trials with a larger sample size should be carried out, so as to clarify its effects for the prophylaxis of RVVC.