Abstract
Background
Recurrent vaginitis in conjunction with urinary tract infection (RV/UTI) in perimenopausal women is a common clinical condition that plagues doctors and patients. Its pathogenesis is not completely known, but the urogenital microbiota is thought to be involved. We compared the urogenital and gut microbiota of perimenopausal women experiencing RV/UTI with those of age-matched controls in an attempt to provide a new microbiological perspective and scheme for solving clinical problems.
Results
Fifty women of perimenopausal age who were diagnosed with RV/UTI and 50 age-matched healthy controls were enrolled. The urogenital and intestinal microbiota were analyzed using 16S ribosomal RNA gene sequencing by collecting samples from the mouth, anus, urine, cervix, and upper and lower vaginal ends.In the microbiota of healthy perimenopausal women, the mouth site showed the highest richness, while the anus and mouth had the highest diversity. Compared with those in healthy controls, in the microbiota of patients with RV/UTI, the evenness of the upper vaginal ends, anus and cervix significantly increased, while the richness and diversity of the cervix significantly decreased. Lactobacillus accounted for 40.65% of the bacteria in the upper vaginal ends and 39.85% of the bacteria in the lower vaginal ends of healthy women of perimenopausal age, and there were no significant differences in Lactobacillus abundance among the patients with RV/UTI. The relative abundance of 54 genera and 97 species showed significant difference between patients and healthy samples, particularly in the cervix and urine. A total of 147 predicted pathways showed significant differences between patients and healthy controls, with the microbiota of the anus exhibited the greatest number of functional changes, followed by that of the urine microbiota. A random forest model composed of eight genera in the upper vaginal ends showed the highest discriminatory power (AUC 99.38%) to predict RV/UTI.
Conclusions
Our study provides insight into the nature of the urogenital and intestinal microbiota in perimenopausal women, and revealed significant changes of microbiota in the patients with RV/UTI. This will help characterize the relationship between the urogenital microbiota and RV/UTI, potentially aiding in diagnostic and therapeutic strategy development.