Accurate 16S Absolute Quantification Sequencing Revealed Vaginal Microecological Composition and Dynamics During Mixed Vaginitis Treatment With Fufang FuRong Effervescent Suppository

Abstract

BackgroundThe diagnosis and treatment of mixed vaginitis are more complicated than single pathogenic infections, and there may be adverse reactions and several contraindications to conventional antibiotic therapy. Therefore, this study aimed to evaluate the preliminary effects of Fufang Furong Effervescent Suppository for the management of aerobic vaginitis (AV) mixed with bacterial vaginosis (BV) using Accurate 16S absolute quantification sequencing (Accu16S).MethodsIn the present randomized, blind, multi-center clinical trial, women (20 to 55 years) who had received a diagnosis of AV+BV were randomly assigned into clindamycin positive control (n = 41) and Fufang Furong Effervescent Suppository (n = 39) groups. The follow-up occurred in three time periods (V1: -2~0 days; V2: 15-17 days; V3: 40 ± 3 days). At each visit, two vaginal swabs, one for clinical evaluation and one for laboratory examination, were taken from each patient. The Nugent score, Donders’ score, drug-related complications, recurrence rates, and microecological changes of vaginal swabs were assessed in the time three periods.ResultsAt baseline, the two groups were similar in frequency of presentation with vaginal burning, odor, abnormal discharge, and itching. No meaningful differences in Nugent and Donders’ scores were detected between the two groups at stage V2 (Nugent: p = 0.67; Donders’: p = 0.85) and V3 (Nugent: p = 0.97; Donders: p = 0.55). The Furong group presented fewer complications compared to the Clindamycin group. However, this difference was not statistically significant (p = 0.15). Additionally, Accu16S indicated that the total abundance of bacteria in both groups sharply decreased in stage V2, but slightly increased in V3. In stage V3, the absolute abundance of Lactobacillus in the Furong group was considerably higher compared to untreated samples (p < 0.05). On the other hand, no momentous increase was detected in the Clindamycin group (p > 0.05).ConclusionFufang Furong Effervescent Suppository can be as effective as clindamycin cream in the management of AV+BV while may restore the vagina microecosystem better.

Correlation analysis of vaginal microecology and different types of human papillomavirus infection: a study conducted at a hospital in northwest China

“…Because of the high proportion (68.51%) of AV patients combined with the other vaginitis in this study, and mainly combined with BV, we suggest that different pathogens influenced each other, which may have affected the interpretation of their correlation. Increasingly, studies have shown a higher incidence of AV-related mixed vaginitis (30,31), and the relationship between AV itself and HPV infection requires further investigation. Previous studies have shown that the prevalence of HR-HPV is higher in patients with BV (32).…”

“…DNA from cervical cells was extracted for hybridization and color development. A total of 15 high-risk HPV (16, 18,31,33,35,39,45,51,52,53,56,58,59, 66, and 68) and 6 low-risk HPV (6,11,26,73,81, and 82) types can be detected by HPV-DNA detection kit provided by Jiangsu Shuoshi Biotechnology Co., Ltd. The evaluation and diagnosis results were classified into (1) "HPVpositive": one or more of the above-mentioned HPV subtypes were detected and divided into "HPV16/18-positive group" and "HPV other subtype positive group"; and (2) "HPV-negative": none of the above HPV subtypes were detected.…”

Efficacy and mechanism of Baicao Fuyanqing suppository on mixed vaginitis based on 16S rRNA and metabolomics

“…Meng Li et al. investigated the effect of Fufang FuRong Effervescent Suppository on vaginal microecological composition and dynamics in mixed vaginitis(M. Li et al., 2022 ). Similar to BCFYQ , both products are vaginal suppositories derived from traditional Chinese medicine and both contain Sophora flavescens and Stemona japonica .…”