Variation of the Vaginal Lactobacillus Microbiome in Cytolytic Vaginosis

OBJECTIVE: This pilot study aimed to evaluate whether different microbial compositions cause symptoms in patients with Lactobacillus overgrowth and to investigate the variation in Lactobacillus microbiome in cytolytic vaginosis (CV). MATERIALS AND METHODS: Lactobacillus species were identified from the vaginal fluid of 70 healthy women and 79 patients with CV using molecular analysis of the 16S rRNA gene. χ and Fisher exact tests were used to compare the isolated rates of Lactobacillus species between the 2 groups. The capabilities of dominant Lactobacillus strain to produce acid in the 2 groups were analyzed by repeated measures analysis of variance. RESULTS: The isolation of 2 or more Lactobacillus species per vaginal sampling was significantly less common in the CV group (1.3%) compared with the healthy control (HC) group 12.2% (p = .013). Significant differences in Lactobacillus species were observed between the 2 groups (p < .001). Lactobacillus crispatus was more often found in the CV group (88.7%) than in the HC group (56.4%, p < .001). Compared with that in the HC group, the dominant L. crispatus strain in the CV group tended to produce more acid. CONCLUSIONS: The CV group carried a less diverse Lactobacillus species, vaginally. Lactobacillus crispatus was common to both CV and HC groups but demonstrated enhanced acid-producing capability in the CV group. The pathogenesis of CV may be based, in part, on an overgrowth of L. crispatus with enhanced acid-producing capability.