{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:52:14Z","timestamp":1791827534245,"version":"4.3.4"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["AI061628, AI099106, HHSN266200400073C"],"award-info":[{"award-number":["AI061628, AI099106, HHSN266200400073C"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000051","name":"National Human Genome Research Institute","doi-asserted-by":"publisher","award":["HG005966-01"],"award-info":[{"award-number":["HG005966-01"]}],"id":[{"id":"10.13039\/100000051","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HD882, AI07140"],"award-info":[{"award-number":["HD882, AI07140"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Bacterial colonization and associations with bacterial vaginosis (BV) signs and symptoms (Amsel criteria) may vary between populations. We assessed relationships between vaginal bacteria and Amsel criteria among two populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Kenyan participants from the placebo arm of the Preventing Vaginal Infections (PVI) trial and participants from a Seattle-based cross-sectional BV study were included. Amsel criteria were recorded at study visits, and the vaginal microbiota was characterized using 16S rRNA gene sequencing. Logistic regression models, accounting for repeat visits as appropriate, were fit to evaluate associations between bacterial relative abundance and each Amsel criterion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 84 PVI participants (496 observations) and 220 Seattle participants, the prevalence of amine odor was 25% and 40%, clue cells 16% and 37%, vaginal discharge 10% and 52%, elevated vaginal pH 69% and 67%, and BV 13% and 44%, respectively. BV-associated bacterium 1 (BVAB1) was positively associated with all Amsel criteria in both populations. <jats:italic>Eggerthella<\/jats:italic> type 1, <jats:italic>Fannyhessea<\/jats:italic> (<jats:italic>Atopobium) vaginae<\/jats:italic>, <jats:italic>Gardnerella<\/jats:italic> spp., <jats:italic>Sneathia amnii<\/jats:italic>, and <jats:italic>Sneathia sanguinegens<\/jats:italic> were positively associated with all Amsel criteria in the Seattle study, and all but discharge in the PVI trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Core vaginal bacteria are consistently associated with BV signs and symptoms across two distinct populations of women.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2022.801770","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T07:24:24Z","timestamp":1646378664000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":21,"title":["Associations Between Vaginal Bacteria and Bacterial Vaginosis Signs and Symptoms: A Comparative Study of Kenyan and American Women"],"prefix":"10.3389","volume":"12","author":[{"given":"Kayla A.","family":"Carter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer E.","family":"Balkus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omu","family":"Anzala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Kimani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah G.","family":"Hoffman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina L.","family":"Fiedler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vernon","family":"Mochache","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Fredricks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Scott","family":"McClelland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujatha","family":"Srinivasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/0002-9343(83)91112-9","article-title":"Nonspecific Vaginitis: Diagnostic Criteria and Microbial and Epidemiologic Associations","volume":"74","author":"Amsel","year":"1983","journal-title":"Am. J. Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1932","DOI":"10.1093\/infdis\/jiw043","article-title":"Periodic Presumptive Treatment for Vaginal Infections May Reduce the Incidence of Sexually Transmitted Bacterial Infections","volume":"213","author":"Balkus","year":"2016","journal-title":"J. Infect. Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1093\/infdis\/jiw622","article-title":"Impact of Periodic Presumptive Treatment for Bacterial Vaginosis on the Vaginal Microbiome Among Women Participating in the Preventing Vaginal Infections Trial","volume":"215","author":"Balkus","year":"2016","journal-title":"J. Infect. Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s40779-016-0074-5","article-title":"Bacterial Vaginosis: A Synthesis of the Literature on Etiology, Prevalence, Risk Factors, and Relationship With Chlamydia and Gonorrhea Infections","volume":"3","author":"Bautista","year":"2016","journal-title":"Mil Med. Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.ajog.2018.10.014","article-title":"Diversity of Vaginal Microbiota in Sub-Saharan Africa and its Effects on HIV Transmission and Prevention","volume":"220","author":"Bayigga","year":"2019","journal-title":"Am. J. Obstet. Gynecol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e96844","DOI":"10.1371\/journal.pone.0096844","article-title":"Comparison of Lower Genital Tract Microbiota in HIV-Infected and Uninfected Women From Rwanda and the US","volume":"9","author":"Benning","year":"2014","journal-title":"PloS One"},{"key":"B7","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1128\/jcm.30.3.663-666.1992","article-title":"Sialidases (Neuraminidases) in Bacterial Vaginosis and Bacterial Vaginosis-Associated Microflora","volume":"30","author":"Briselden","year":"1992","journal-title":"J. Clin. Microbiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1093\/infdis\/jiu330","article-title":"Interplay Between the Temporal Dynamics of the Vaginal Microbiota and Human Papillomavirus Detection","volume":"210","author":"Brotman","year":"2014","journal-title":"J. Infect. Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"9966","DOI":"10.1073\/pnas.1705899114","article-title":"Replication and Refinement of a Vaginal Microbial Signature of Preterm Birth in Two Racially Distinct Cohorts of US Women","volume":"114","author":"Callahan","year":"2017","journal-title":"Proc. Natl. Acad. Sci."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00083","article-title":"Gardnerella Vaginalis Enhances Atopobium Vaginae Viability in an In Vitro Model","volume":"10","author":"Castro","year":"2020","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/2049-2618-2-15","article-title":"Unifying the Analysis of High-Throughput Sequencing Datasets: Characterizing RNA-Seq, 16S rRNA Gene Sequencing and Selective Growth Experiments by Compositional Data Analysis","volume":"2","author":"Fernandes","year":"2014","journal-title":"Microbiome"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1056\/NEJMoa043802","article-title":"Molecular Identification of Bacteria Associated With Bacterial Vaginosis","volume":"353","author":"Fredricks","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"132ra52","DOI":"10.1126\/scitranslmed.3003605","article-title":"Temporal Dynamics of the Human Vaginal Microbiota","volume":"4","author":"Gajer","year":"2012","journal-title":"Sci. Transl. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e0136658","DOI":"10.1371\/journal.pone.0136658","article-title":"Unravelling the Bacterial Vaginosis-Associated Biofilm: A Multiplex Gardnerella Vaginalis and Atopobium Vaginae Fluorescence In Situ Hybridization Assay Using Peptide Nucleic Acid Probes","volume":"10","author":"Hardy","year":"2015","journal-title":"PloS One"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e109670","DOI":"10.1371\/journal.pone.0109670","article-title":"Prevalence and Correlates of Bacterial Vaginosis in Different Sub-Populations of Women in Sub-Saharan Africa: A Cross-Sectional Study","volume":"9","author":"Jespers","year":"2014","journal-title":"PloS One"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1111\/j.1365-2672.2006.03147.x","article-title":"Species Diversity and Relative Abundance of Vaginal Lactic Acid Bacteria From Women in Uganda and Korea","volume":"102","author":"Jin","year":"2007","journal-title":"J. Appl. Microbiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1080\/1040841X.2017.1291579","article-title":"Etiology of Bacterial Vaginosis and Polymicrobial Biofilm Formation","volume":"43","author":"Jung","year":"2017","journal-title":"Crit. Rev. Microbiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e63514","DOI":"10.1371\/journal.pone.0063514","article-title":"Association of the Vaginal Microbiota With Human Papillomavirus Infection in a Korean Twin Cohort","volume":"8","author":"Lee","year":"2013","journal-title":"PloS One"},{"key":"B19","doi-asserted-by":"publisher","first-page":"27663","DOI":"10.3402\/mehd.v26.27663","article-title":"Analysis of Composition of Microbiomes: A Novel Method for Studying Microbial Composition","volume":"26","author":"Mandal","year":"2015","journal-title":"Microb. Ecol. Health Dis."},{"key":"B20","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1136\/sextrans-2012-050616","article-title":"Do Atopobium Vaginae, Megasphaera Sp. And Leptotrichia Sp. Change the Local Innate Immune Response and Sialidase Activity in Bacterial Vaginosis","volume":"89","author":"Marconi","year":"2013","journal-title":"Sex Transm. Infect."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1093\/infdis\/jiu818","article-title":"Randomized Trial of Periodic Presumptive Treatment With High-Dose Intravaginal Metronidazole and Miconazole to Prevent Vaginal Infections in HIV-Negative Women","volume":"211","author":"McClelland","year":"2015","journal-title":"J. Infect. Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1016\/S1473-3099(18)30058-6","article-title":"Evaluation of the Association Between the Concentrations of Key Vaginal Bacteria and the Increased Risk of HIV Acquisition in African Women From Five Cohorts: A Nested Case-Control Study","volume":"18","author":"McClelland","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"B23","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1093\/infdis\/jiy243","article-title":"Identification of Key Bacteria Involved in the Induction of Incident Bacterial Vaginosis: A Prospective Study","volume":"218","author":"Muzny","year":"2018","journal-title":"J. Infect. Dis."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1093\/infdis\/jiz342","article-title":"An Updated Conceptual Model on the Pathogenesis of Bacterial Vaginosis","volume":"220","author":"Muzny","year":"2019","journal-title":"J. Infect. Dis."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2015.00253","article-title":"Vaginal Biogenic Amines: Biomarkers of Bacterial Vaginosis or Precursors to Vaginal Dysbiosis","volume":"6","author":"Nelson","year":"2015","journal-title":"Front. Physiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of Diagnosing Bacterial Vaginosis is Improved by a Standardized Method of Gram Stain Interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J. Clin. Microbiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/00007435-200303000-00016","article-title":"Glycosidase and Proteinase Activity of Anaerobic Gram-Negative Bacteria Isolated From Women With Bacterial Vaginosis","volume":"30","author":"Olmsted","year":"2003","journal-title":"Sex Transm. Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1097\/OLQ.0000000000000972","article-title":"High Global Burden and Costs of Bacterial Vaginosis: A Systematic Review and Meta-Analysis","volume":"46","author":"Peebles","year":"2019","journal-title":"Sex Transm. Dis."},{"key":"B29","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/2049-2618-1-29","article-title":"Daily Temporal Dynamics of Vaginal Microbiota Before, During and After Episodes of Bacterial Vaginosis","volume":"1","author":"Ravel","year":"2013","journal-title":"Microbiome"},{"key":"B30","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1146\/annurev.med.51.1.349","article-title":"Bacterial Vaginosis","volume":"51","author":"Sobel","year":"2000","journal-title":"Annu. Rev. Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1086\/591942","article-title":"Comparison of the Diversity of the Vaginal Microbiota in HIV-Infected and -Uninfected Women With and Without Bacterial Vaginosis","volume":"198","author":"Spear","year":"2008","journal-title":"J. Infect. Dis."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e37818","DOI":"10.1371\/journal.pone.0037818","article-title":"Bacterial Communities in Women With Bacterial Vaginosis: High Resolution Phylogenetic Analyses Reveal Relationships of Microbiota to Clinical Criteria","volume":"7","author":"Srinivasan","year":"2012","journal-title":"PloS One"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e10197","DOI":"10.1371\/journal.pone.0010197","article-title":"Temporal Variability of Human Vaginal Bacteria and Relationship With Bacterial Vaginosis","volume":"5","author":"Srinivasan","year":"2010","journal-title":"PloS One"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e00204","DOI":"10.1128\/mBio.00204-15","article-title":"Metabolic Signatures of Bacterial Vaginosis","volume":"6","author":"Srinivasan","year":"2015","journal-title":"MBio"},{"key":"B35","doi-asserted-by":"publisher","first-page":"97.e1","DOI":"10.1016\/j.ajog.2007.06.039","article-title":"An Adherent Gardnerella Vaginalis Biofilm Persists on the Vaginal Epithelium After Standard Therapy With Oral Metronidazole","volume":"198","author":"Swidsinski","year":"2008","journal-title":"Am.\u00a0J. Obstet. Gynecol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1097\/OLQ.0b013e3181f0bdd0","article-title":"The Short-Term Variability of Bacterial Vaginosis Diagnosed by Nugent Gram Stain Criteria Among Sexually Active Women in Rakai, Uganda","volume":"38","author":"Thoma","year":"2011","journal-title":"Sex Transm. Dis."},{"key":"B37","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1099\/ijsem.0.003200","article-title":"Emended Description of Gardnerella Vaginalis and Description of Gardnerella Leopoldii Sp. Nov., Gardnerella Piotii Sp. Nov. And Gardnerella Swidsinskii Sp. Nov., With Delineation of 13 Genomic Species Within the Genus Gardnerella","volume":"69","author":"Vaneechoutte","year":"2019","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1097\/QCO.0b013e32835c20cd","article-title":"The Biofilm in Bacterial Vaginosis: Implications for Epidemiology, Diagnosis and Treatment","volume":"26","author":"Verstraelen","year":"2013","journal-title":"Curr. Opin. Infect. Dis."},{"key":"B39","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40168-017-0237-y","article-title":"Normalization and Microbial Differential Abundance Strategies Depend Upon Data Characteristics","volume":"5","author":"Weiss","year":"2017","journal-title":"Microbiome"},{"key":"B40","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1016\/s0029-7844(03)00858-5","article-title":"Bacterial Vaginosis in Sexually Experienced and Non-Sexually Experienced Young Women Entering the Military","volume":"102","author":"Yen","year":"2003","journal-title":"Obstet. Gynecol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"e56111","DOI":"10.1371\/journal.pone.0056111","article-title":"A Multi-Omic Systems-Based Approach Reveals Metabolic Markers of Bacterial Vaginosis and Insight Into the Disease","volume":"8","author":"Yeoman","year":"2013","journal-title":"PloS One"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e12411","DOI":"10.1371\/journal.pone.0012411","article-title":"Comparative Genomics of Gardnerella Vaginalis Strains Reveals Substantial Differences in Metabolic and Virulence Potential","volume":"5","author":"Yeoman","year":"2010","journal-title":"PloS One"},{"key":"B43","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/j.1467-9868.2005.00503.x","article-title":"Regularization and Variable Selection via the Elastic Net","volume":"67","author":"Zou","year":"2005","journal-title":"J. R. Stat. Soc. Ser. B. Stat. Methodol."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.801770\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T07:24:28Z","timestamp":1646378668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.801770\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,4]]},"references-count":43,"alternative-id":["10.3389\/fcimb.2022.801770"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2022.801770","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,4]]},"article-number":"801770"}}