title: [Longitudinal analysis of vaginal microbiota in women with recurrent vulvovaginal candidiasis].
abstract: OBJECTIVE
  To investigate the vaginal flora in patients with recurrent vulvovaginal candidiasis (RVVC).
  
  
  METHODS
  Vaginal swabs were collected at different time points from 6 RVVC patients and 5 healthy women of child-bearing age. The dynamic changes, microbiota composition, alpha diversity and beta diversity in the two groups were assessed by analyzing the 16S rRNA V4 hypervariable region amplified from the total genomic DNA from the swabs.
  
  
  RESULTS
  Lactobacillus was the predominant species in healthy women with similar proportions of L.iners and L.crispatus; small proportions of Gardnerella, Prevotella and other genus were also detected. In some healthy women, the vaginal flora showed a high relative abundance of anaerobic bacteria such as Gardnerella, Prevotella, Atopobium, Sneathia. Compared with the healthy women, patients with RVVC showed a significantly reduced diversity of vaginal flora, where L.iners was the predominant species and the content of L.crispatus decreased significantly. In healthy women, the vaginal flora fluctuated with the menstrual cycle, and the fluctuation was the most prominent during menstruation; the dominant species either alternated regularly or maintain an absolute superiority in the menstrual cycle. The vaginal flora showed attenuated fluctuation in women with RVVC, were highly conserved within the menstrual cycle, and maintained a similar composition in the episodes and intermittent periods.
  
  
  CONCLUSIONS
  The vaginal flora of RVVC patients do not undergo regular variations with the menstrual cycle and shows a similar composition between the episodes and intermittent periods. Promoting the production of L.iners or inhibiting the colonization of L.crispatus to restore the composition of the vaginal flora may help in the treatment of RVVC.
authors.affiliation: 1Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; 2Department of Obstetrics and Gynecology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, China. E-mail: 13631302429@163.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.forename: Hui-Hua
authors.initials: HH
authors.lastname: Cai
authors.forename: Yan
authors.initials: Y
authors.lastname: He
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Zheng
authors.forename: Ling
authors.initials: L
authors.lastname: Kang
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Zhou
authors.forename: Mu-Biao
authors.initials: MB
authors.lastname: Liu
mesh_terms: D002181:Candidiasis, Vulvovaginal / Q000382:microbiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007778:Lactobacillus / Q000145:classification / Q000302:isolation & purification*; D008137:Longitudinal Studies; D008597:Menstrual Cycle; D064307:Microbiota; D012336:RNA, Ribosomal, 16S / Q000302:isolation & purification; D014621:Vagina / Q000382:microbiology*
chemical_list: D012336:RNA, Ribosomal, 16S