{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:09:43Z","timestamp":1791468583440,"version":"4.3.4"},"reference-count":40,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2012\/16800-3"],"award-info":[{"award-number":["2012\/16800-3"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["1680048"],"award-info":[{"award-number":["1680048"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The protective role of <jats:italic>Lactobacillus iners<\/jats:italic> in the vaginal microbiota has been questioned. Recent studies have shown that <jats:italic>L.\u202finers<\/jats:italic> is the dominating taxon in a large subset of women worldwide. The aim of this study was to identify sociodemographic, behavioural and clinical variables associated with <jats:italic>L.\u202finers<\/jats:italic>-dominated community state type (CST) III in Brazilian women of reproductive age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants and methods<\/jats:title><jats:p>This study leveraged microbiota compositional data generated by sequencing of the V3-V4 16S rRNA gene from vaginal samples collected from 442 participants enrolled in a previous cross-sectional study that included 609\u2009women in five geographical regions of Brazil. A total of 167 (27.4%) participants were excluded from the current study as they did not present a <jats:italic>Lactobacillus<\/jats:italic>-dominated vaginal microbiota. Data on sociodemographic and behavioural characteristics of the study population were obtained through face-to-face interviews. Participants were assigned to two study groups: those with <jats:italic>L.\u202finers<\/jats:italic>-dominated CST III (n=222) and those with three distinct CSTs (I, II or V) dominated by another <jats:italic>Lactobacillus<\/jats:italic> spp. (n=220). Logistic regression analysis using a stepwise method was performed to test association between CST III and participants\u2019 characteristics, considering their OR and 95% CIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the population characteristics assessed, <jats:italic>L.\u202finers<\/jats:italic>-dominated CST III was independently associated with having two or more sexual partners (OR 3.27; 95%\u2009CI 1.50 to 7.11) and microscopic detection of <jats:italic>Candida<\/jats:italic> sp. on vaginal smears (OR 2.24; 95%\u2009CI 1.02 to 4.89). Other characteristics were inversely associated with CST III, including condom use (OR 0.59; 95%\u2009CI 0.38 to 0.91), higher educational level (OR 0.61; 95%\u2009CI 0.41 to 0.91) and diet containing milk\/dairy intake (OR 0.43; 95%\u2009CI 0.20 to 0.90).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unprotected sex practices, number of sexual partners and lower educational levels may be useful for identifying women with <jats:italic>L.\u202finers-<\/jats:italic>dominated microbiota and its suboptimal protective properties. <jats:italic>L.\u202finers<\/jats:italic> microbiota does not seem to provide optimal protection against <jats:italic>Candida<\/jats:italic> sp. colonisation, warranting further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054824","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T17:21:01Z","timestamp":1631121661000},"page":"353-359","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Characteristics associated with <i>Lactobacillus iners<\/i>-dominated vaginal microbiota"],"prefix":"10.1136","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4788-5734","authenticated-orcid":false,"given":"Juliano","family":"Novak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Ravel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina Sanit\u00e1 Tafner","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea da Rocha","family":"Trist\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia Guimaraes","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-1186","authenticated-orcid":false,"given":"Camila","family":"Marconi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"2022072507400902000_98.5.353.1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1002611107"},{"key":"2022072507400902000_98.5.353.2","doi-asserted-by":"publisher","DOI":"10.1186\/2049-2618-1-29"},{"key":"2022072507400902000_98.5.353.3","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3003605"},{"key":"2022072507400902000_98.5.353.4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080074"},{"key":"2022072507400902000_98.5.353.5","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.29.2.297-301.1991"},{"key":"2022072507400902000_98.5.353.6","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2018.0304"},{"key":"2022072507400902000_98.5.353.7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-10"},{"key":"2022072507400902000_98.5.353.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2011.11.005"},{"key":"2022072507400902000_98.5.353.9","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.ijgo.2015.05.016","article-title":"Prevalence of and risk factors for bacterial vaginosis among women of reproductive age attending cervical screening in southeastern Brazil","volume":"131","author":"Marconi","year":"2015","journal-title":"Int J Gynaecol Obstet"},{"key":"2022072507400902000_98.5.353.10","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001932"},{"key":"2022072507400902000_98.5.353.11","doi-asserted-by":"publisher","DOI":"10.1086\/315065"},{"key":"2022072507400902000_98.5.353.12","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-0825-z"},{"key":"2022072507400902000_98.5.353.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-015-0831-1","article-title":"Correlates of the molecular vaginal microbiota composition of African women","volume":"15","author":"Gautam","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2022072507400902000_98.5.353.14","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1097\/OLQ.0000000000001204","article-title":"Characterization of the vaginal microbiome in women of reproductive age from 5 regions in Brazil","volume":"47","author":"Marconi","year":"2020","journal-title":"Sex Transm Dis"},{"key":"2022072507400902000_98.5.353.15","doi-asserted-by":"crossref","first-page":"969","DOI":"10.3390\/microorganisms8070969","article-title":"Is Lactobacillus Gram-Positive? 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