N-199. Vaginal Microbiota of Women with Recurrent Vulvovaginal Candidiasis

X. Zhou1, R. Westman1, R. Hickey1, M. A. Hansmann2, C. Kennedy3, L. J. Forney1;
1Univ. of Idaho, Pullman, WA, 2Procter & Gamble Company, Cincinnati, OH, 3Univ. of Iowa, Iowa City, IA.

Recurrent vulvovaginal candidiasis (RVVC) is an insidious infection that afflicts a large proportion of women of all ages. The high incidence of RVVC and the healthcare costs associated with the treatment of this disease highlight the need for understanding pathogenesis of the infection and the host defense mechanisms responsible for its prevention. In this study, we used cultivation-independent methods to characterize the composition and structure of vaginal microbial communities in 42 women with and without RVVC. The aim was to explore the possible importance of vaginal bacterial communities in reducing the risk of RVVC. The species composition and diversity of microbial communities were evaluated based on profiles of terminal restriction fragment polymorphisms (T-RFLP) of 16S rRNA genes and phylogenetic analysis of cloned 16S rRNA gene sequences from the numerically dominant microbial populations. A likelihood ratio test was conducted to statistically evaluate differences between the microbial community structures of women with and without RVVC. The results showed there were no significant differences between the vaginal microbial communities of women in these two groups (likelihood score 5.948 and a bootstrap-p value of 0.26). Moreover, there were no novel bacteria found in the communities of women with RVVC. The vaginal communities of most women in both groups (38/42; 90%) were dominated by species of Lactobacillus. These were phylogenetic related to L. crispatus, L. iners and L.gasseri. 7% women sampled had communities dominated by Atopobium vaginae, several species of lactobacilli, and various other microbial species in low abundance. The results of this study failed to provide evidence for the existence of altered or unusual vaginal bacterial communities in women with RVVC, compared with women without RVVC. These findings suggest that commensal vaginal bacterial species such as Lactobacillus maybe not a key players in preventing RVVC or modulating fungal virulence. Thus, the use of probiotics containing Lactobacillus spp. to prevent RVVC may not be a beneficial strategy for patients.