Mycobiome Study Reveals Different Pathogens of Vulvovaginal Candidiasis Shape Characteristic Vaginal Bacteriome Original paper
Researched by:
-
Dr. Umar
ID
Dr. Umar
Read MoreClinical Pharmacist and Clinical Pharmacy Master’s candidate focused on antibiotic stewardship, AI-driven pharmacy practice, and research that strengthens safe and effective medication use. Experience spans digital health research with Bloomsbury Health (London), pharmacovigilance in patient support programs, and behavioral approaches to mental health care. Published work includes studies on antibiotic use and awareness, AI applications in medicine, postpartum depression management, and patient safety reporting. Developer of an AI-based clinical decision support system designed to enhance antimicrobial stewardship and optimize therapeutic outcomes.
-
Dr. Umar
Read More
Researched by:
-
Dr. Umar
ID
Dr. Umar
Read More
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
Location
China
Sample Site
Vagina
Species
Homo sapiens
What was studied?
This original research examined vulvovaginal candidiasis mycobiome signatures by integrating fungal (mycobiome) and bacterial (bacteriome) profiling to determine how different Candida pathogens shape distinct vaginal microbial states. Using ITS sequencing for fungi and 16S rRNA sequencing for bacteria, the investigators defined two mycobiome-driven community state types (CSTs): CST I, dominated by Candida glabrata, and CST II, dominated by Candida albicans. The study evaluated how these CSTs correspond to characteristic bacterial patterns and compared them with the microbiota of women with bacterial vaginosis (BV), Ureaplasma urealyticum infection (UU), and healthy controls. The overarching aim was to identify microbial signatures that could refine diagnostic accuracy and inform clinical management, particularly for recurrent or treatment-resistant.
Who was studied?
A total of 161 women were recruited at a clinical center in China: 44 with VVC, 37 with BV, 33 with UU, and 47 healthy controls. All participants were examined by gynecologists, screened using clinical criteria (Amsel, Nugent scoring, microscopy), and excluded for confounding factors such as recent antibiotic use, pregnancy, diabetes, menstruation, or concurrent infections. VVC cases were identified by symptoms plus Candida detection using microscopy and culture, with species differentiation captured through next-generation sequencing. This design ensured a broad representation of common reproductive tract infections and provided a comparative microbial landscape.
Most important findings
The study identified two dominant VVC fungal CSTs with distinct bacterial associations. CST I (C. glabrata) showed enrichment of Prevotella, a genus strongly associated with BV and higher vaginal pH, while CST II (C. albicans) showed increased Ureaplasma, characteristic of UU infections. These CST-specific bacterial patterns (seen in heatmaps and LEfSe plots) demonstrated that different Candida pathogens create unique interkingdom microbial structures. Across groups, VVC microbiomes were more similar to healthy controls than to BV or UU. Healthy women exhibited high Lactobacillus abundance and low diversity, whereas BV samples were dominated by Prevotella, Sneathia, Atopobium, and other anaerobes. UU samples showed elevated Streptococcus, Anaerococcus, and Veillonella. VVC samples retained relatively high Lactobacillus (~80%), indicating that fungal infection perturbs, but does not collapse, the lactobacilli-dominant structure.
A summarized comparison appears below:
| Group | Dominant Features | Key Microbial Signatures |
|---|---|---|
| Healthy | High Lactobacillus, low diversity | Acidic pH, stable microbiome |
| BV | High diversity, anaerobes | Prevotella, Sneathia, Atopobium |
| UU | Mixed anaerobes | Streptococcus, Veillonella, Ureaplasma |
| VVC CST I | C. glabrata + BV-like bacteria | Prevotella ↑ |
| VVC CST II | C. albicans + UU-like bacteria | Ureaplasma ↑ |
Key implications
This study’s integration of mycobiome and bacteriome profiling reveals that VVC is not a uniform condition but consists of distinct pathogen-specific microbial ecosystems. The identification of CST-specific bacterial partners suggests that mixed infections are common and may contribute to treatment failures, particularly when C. glabrata co-occurs with BV-associated anaerobes. The findings reinforce the need for diagnostic approaches that assess both fungal and bacterial communities and support the development of microbiome-informed precision therapies.
Citation
Zhao C, Li Y, Chen B, et al. Mycobiome study reveals different pathogens of vulvovaginal candidiasis shape characteristic vaginal bacteriome.Microbiol Spectr. 2023;11(3):e03152-22. doi:10.1128/spectrum.03152-22
Vulvovaginal Candidiasis (VVC)
Vulvovaginal candidiasis (VVC) is a common fungal infection caused by Candida albicans. Disruptions in the vaginal microbiome and immune responses contribute to its development. Effective treatment involves both antifungal therapy and strategies to restore microbiome balance, preventing recurrent infections and addressing emerging antifungal resistance.
Bacterial Vaginosis
Bacterial vaginosis (BV) is caused by an imbalance in the vaginal microbiota, where the typically dominant Lactobacillus species are significantly reduced, leading to an overgrowth of anaerobic and facultative bacteria.