title: Vaginal microbiome in women from Greenland assessed by microscopy and quantitative PCR.
abstract: BACKGROUND
  Bacterial vaginosis (BV) is a common condition, although its aetiology remains unexplained. The aim of this study was to analyse the composition of vaginal microbiota in women from Greenland to provide a quantitative description and improve the understanding of BV.
  
  
  METHODS
  Self-collected vaginal smears and swabs were obtained from 177 women. The vaginal smears were graded for BV according to Nugent's criteria. The vaginal swab samples were analysed by 19 quantitative PCRs (qPCRs) for selected vaginal bacteria and by PCR for four sexually transmitted infections (STIs).
  
  
  RESULTS
  STIs were common: Mycoplasma genitalium 12%, Chlamydia trachomatis 7%, Neisseria gonorrhoeae 1%, and Trichomonas vaginalis 0.5%. BV was found in 45% of women, but was not associated with individual STIs. Seven of the 19 vaginal bacteria (Atopobium vaginae, Prevotella spp., Gardnerella vaginalis, BVAB2, Eggerthella-like bacterium, Leptotrichia amnionii, and Megasphaera type 1) had areas under the receiver operating characteristic (ROC) curve > 85%, suggesting they are good predictors of BV according to Nugent. Prevotella spp. had the highest odds ratio for BV (OR 437; 95% CI 82-2779) in univariate analysis considering only specimens with a bacterial load above the threshold determined by ROC curve analysis as positive, as well as the highest adjusted odds ratio in multivariate logistic regression analysis (OR 4.4; 95% CI 1.4-13.5). BV could be subdivided into clusters dominated by a single or a few species together.
  
  
  CONCLUSIONS
  BV by Nugent score was highly prevalent. Two of seven key species (Prevotella spp. and A. vaginae) remained significantly associated with BV in a multivariate model after adjusting for other bacterial species. G. vaginalis and Prevotella spp. defined the majority of BV clusters.
authors.forename: Raluca
authors.initials: R
authors.lastname: Datcu
authors.forename: Dionne
authors.initials: D
authors.lastname: Gesink
authors.forename: Gert
authors.initials: G
authors.lastname: Mulvad
authors.forename: Ruth
authors.initials: R
authors.lastname: Montgomery-Andersen
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Rink
authors.forename: Anders
authors.initials: A
authors.lastname: Koch
authors.forename: Peter
authors.initials: P
authors.lastname: Ahrens
authors.affiliation: Microbiology and Infection Control, STI, Research and Development, Statens Serum Institut, Artillerivej 5, DK 2300, Copenhagen S, Denmark. jsj@ssi.dk.
authors.forename: Jørgen Skov
authors.initials: JS
authors.lastname: Jensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D006116:Greenland / Q000453:epidemiology; D006801:Humans; D064307:Microbiota; D008853:Microscopy; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D012372:ROC Curve; D014246:Trichomonas vaginalis / Q000235:genetics / Q000302:isolation & purification; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult