Factors shaping vaginal microbiota long-term community dynamics in young adult women

Abstract

The vaginal microbiota is structured into five main community state types (CST) that are known to affect women's health. CST shifts can occur in less than a day, but there is a lack of follow-ups lasting more than a few months; a gap in the knowledge that hampers our understanding of long-term dynamics. Analysing a longitudinal cohort of 125 women followed for a median duration of 10 months, we show that `optimal' (CST I, II, and V) or `sub-optimal' CST III are more stable in time than the `non-optimal' CST IV. We also find that some probabilities of shifting from one CST to another are associated with covariates such reported number of sexual partners or alcohol consumption. Finally, we simulate population-level consequences of variations in behaviours. In addition to providing one of the first insights on vaginal microbiota dynamics over a year, along with a robust methodological analysis, these results open new perspectives to improve our mechanistic understanding of microbial interactions in the vaginal environment and develop new therapeutic strategies.