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Molecular-based Phylogenetic analyses, including the newly-completed Human Microbiomes Project and other next-generation sequencing (NGS) studies have revealed the complexity of the vaginal micro biome in health and disease. The healthy vagina tends to be dominated by hydrogen peroxide and lactic acid producing organisms, the most important of which are Lactobacillus species. The loss of these organisms and the rise of non-resident microorganisms can lead to a diseased state such as bacterial vaginosis (BV or vaginal bacteriosis). The new consensus generated by these studies is that BV is not a single disorder or caused by one etiological agent but rather it is a spectrum of symptoms clinically characterized by vaginal discharge, increased pH and malodor caused by an imbalance in the normal vaginal bacterial flora. NGS techniques allow for the capture of the entire vaginal micro biome in a single assay and create the ability not only to obtain a better understanding of the causes of BV but also lead to a viable clinical method for detecting it. In this study, we use next generation sequencing of 16S rRNA genes to obtain the vaginal micro biome from 270 vaginal swabs. Our analysis includes an in-depth characterization of bacterial communities identified, including quantitation and composition of the communities present in normal and BV samples. Our results show vaginal samples can be broken down into three distinct groups that segregate largely based on degree and type of Lactobacillus content and the presence or absence of G. vaginalis.

Metagenomics Analysis Using Next Generation Sequencing of Vaginal Samples from Community Practices in the US