Vaginal microbiome and sexually-transmitted pathogens in Chinese reproductive-age women: a multicentre cross-sectional and longitudinal cohort study

Sexually transmitted infections (STIs) are associated with vaginal dysbiosis, and co-infections are common but understudied. In this study, 6217 reproductive-age women are recruited from 38 study centres across China at baseline and 2738 participants are followed up at 6 months. We profile the vaginal microbiota by 16S rRNA gene sequencing in conjunction with measurement of nine common STIs. The primary outcome of this study is STI status, and secondary outcome is the risk of cervical lesions. Mycoplasmas hominis (MH) far exceeds other STIs in the association with vaginal microbiota, whereases previously reported associations between Human papillomavirus (HPV) and vaginal dysbiosis might be confounded by the co-infected MH in this study. Both MH infection and increased bacterial diversity are independently associated with increased risk of cervical lesion in HPV-negative women (Shannon, OR (odds ratio) = 1.71, 95% CI (confidence interval) = 1.23-2.36; MH, OR = 2.42 95% CI = 1.36-4.30). These associations are also identified in longitudinal analyses (Shannon, HR (hazard ratio) = 1.72, 95% CI = 1.04-2.86; MH, HR = 2.37, 95% CI = 0.98-5.72). Our findings highlight the importance of considering MH status when studying vaginal microbiota in cervical lesions, and suggest the need for further investigation of microbiota-associated mechanisms in HPV-negative cervical lesions. (ClinicalTrials.gov. NCT04694495).

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Publication Details

Journal
Nature Communications
Published
2025-11-14
DOI
https://doi.org/10.1038/s41467-025-64917-7
Citations
2
Primary Topic
Reproductive tract infections research
Type
article
Field-Weighted Citation Impact
2.37

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article

Vaginal microbiome and sexually-transmitted pathogens in Chinese reproductive-age women: a multicentre cross-sectional and longitudinal cohort study

Bin Huang, Lu Fan, Xiaojuan Gao, Xia He et al.
2 citations
Nature Communications
Reproductive tract infections research
2.37
article

Vaginal microbiome and sexually-transmitted pathogens in Chinese reproductive-age women: a multicentre cross-sectional and longitudinal cohort study

Bin Huang, Lu Fan, Xiaojuan Gao, Xia He, Lianhua Wei, Kaifeng Wu, Changzhong Li, Xianjin Wu, Ping Zhan, Zhiyu Pang, Zhijuan Liu, Yonghao Wu, Peng Liang, Jinxia Ou, Pengming Sun, Rongdan Chen, Wenjun Zhu, Yufeng Xiong, Cancan Qi, Yingxiu Chen, Yi Hou, Qiming Liu, Chao-xin Jiang, Muxuan Chen, Haitao Yu, Baoqing Sun, Jing Zhao, Jing Sha, M. Li, Guijie Zhang, Ming Li, Bo Wang, Hong Chen, Xuefeng Wang, Yan He, Xiaoyan Li, Jinbo Liu, Meiling Luo, Zuyi Zhou, Liangzhi Cai, Shuyi Han, Hui Chen, Han Yan, Weiguang Luo, Yingxuan Zhang, Guanghui Chen, Wei Qing, Fen Lin, Xue Guo, Hongwei Zhou, Yanan Zhang, Bingbing Xiao, Kewei Zhao, Shuhua Li, Ruizhe Wang
article en
2 citations

Abstract

Sexually transmitted infections (STIs) are associated with vaginal dysbiosis, and co-infections are common but understudied. In this study, 6217 reproductive-age women are recruited from 38 study centres across China at baseline and 2738 participants are followed up at 6 months. We profile the vaginal microbiota by 16S rRNA gene sequencing in conjunction with measurement of nine common STIs. The primary outcome of this study is STI status, and secondary outcome is the risk of cervical lesions. Mycoplasmas hominis (MH) far exceeds other STIs in the association with vaginal microbiota, whereases previously reported associations between Human papillomavirus (HPV) and vaginal dysbiosis might be confounded by the co-infected MH in this study. Both MH infection and increased bacterial diversity are independently associated with increased risk of cervical lesion in HPV-negative women (Shannon, OR (odds ratio) = 1.71, 95% CI (confidence interval) = 1.23-2.36; MH, OR = 2.42 95% CI = 1.36-4.30). These associations are also identified in longitudinal analyses (Shannon, HR (hazard ratio) = 1.72, 95% CI = 1.04-2.86; MH, HR = 2.37, 95% CI = 0.98-5.72). Our findings highlight the importance of considering MH status when studying vaginal microbiota in cervical lesions, and suggest the need for further investigation of microbiota-associated mechanisms in HPV-negative cervical lesions. (ClinicalTrials.gov. NCT04694495).

Nature CommunicationsVol. 16(1)
Guangzhou University of Chinese Medicine (CN), University of Science and Technology of China (CN), Guiyang Medical University (CN), Sun Yat-sen University (CN), Guangxi Medical University (CN), Changzhi Medical College (CN), Peking University (CN), Affiliated Hospital of Southwest Medical University (CN), Third Affiliated Hospital of Southern Medical University (CN), Mudanjiang Medical University (CN), People 's Hospital of Jilin Province (CN), The Seventh Affiliated Hospital of Sun Yat-sen University (CN), Nanfang Hospital (CN), Zhuhai People's Hospital (CN), Foshan Hospital of TCM (CN), First Affiliated Hospital of Guangzhou University of Chinese Medicine (CN), Jinan Central Hospital (CN), Affiliated Hospital of Guizhou Medical University (CN), Gansu Provincial Hospital (CN), Shandong Provincial Hospital (CN), First People’s Hospital of Zunyi (CN), Zhujiang Hospital (CN), First Affiliated Hospital of GuangXi Medical University (CN), Fuzhou Maternity and Child Health Care Hospital (CN), Hainan General Hospital (CN), The First Affiliated Hospital, Sun Yat-sen University (CN), Weihai Maternal and Child Health Hospital (CN), The First People’s Hospital of Lianyungang (CN), The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (CN), Chaozhou Central Hospital (CN), Peking University First Hospital (CN), Henan Provincial People's Hospital (CN), Tibet Autonomous Region People's Hospital (CN), Huizhou Central People's Hospital (CN), First Hospital of China Medical University (CN), Southern Medical University Shenzhen Hospital (CN), Xian Yang Central Hospital (CN), Shenzhen Luohu People's Hospital (CN), Inner Mongolia Maternal and Child Health (CN), Guangdong Provincial Center for Disease Control and Prevention (CN), Guangdong Provincial People's Hospital (CN), Shandong First Medical University (CN), First Hospital of Lanzhou University (CN), Hefei First People's Hospital (CN), Dazhou Central Hospital (CN), Southern Medical University (CN), Lanzhou University (CN), Qiqihar Medical University (CN), China Medical University (CN), Guangzhou Medical University (CN)
National Natural Science Foundation of China, Basic and Applied Basic Research Foundation of Guangdong Province
Openalex Percentile: Top 9%
Reproductive tract infections research
2.37
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