{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T01:12:13Z","timestamp":1790471533222,"version":"4.1.0"},"reference-count":59,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 107-2320-B-016-008-MY3; MOST 108-2221-E-182-043-MY3;MOST 110-2320-B-182A-004"],"award-info":[{"award-number":["MOST 107-2320-B-016-008-MY3; MOST 108-2221-E-182-043-MY3;MOST 110-2320-B-182A-004"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Defense Medical Center, Taiwan","award":["MAB-108-073 and MAB-109-054"],"award-info":[{"award-number":["MAB-108-073 and MAB-109-054"]}]},{"name":"Taipei City Hospital, Renai Branch, Taiwan","award":["TPCH-109-19"],"award-info":[{"award-number":["TPCH-109-19"]}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CORPD2J0051"],"award-info":[{"award-number":["CORPD2J0051"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The three most common sexually transmitted infections (STIs) are Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and Trichomonas vaginalis (TV). The prevalence of these STIs in Taiwan remains largely unknown and the risk of STI acquisition affected by the vaginal microbiota is also elusive. In this study, a total of 327 vaginal swabs collected from women with vaginitis were analyzed to determine the presence of STIs and the associated microorganisms by using the BD Max CT\/GC\/TV molecular assay, microbial cultures, and 16S rRNA sequencing. The prevalence of CT, TV, and GC was 10.8%, 2.2% and 0.6%, respectively. A culture-dependent method identified that Escherichia coli and Streptococcus agalactiae (GBS) were more likely to be associated with CT and TV infections. In CT-positive patients, the vaginal microbiota was dominated by L. iners, and the relative abundance of Gardnerella vaginalis (12.46%) was also higher than that in TV-positive patients and the non-STIs group. However, Lactobacillus spp. was significantly lower in TV-positive patients, while GBS (10.11%), Prevotella bivia (6.19%), Sneathia sanguinegens (12.75%), and Gemella asaccharolytica (5.31%) were significantly enriched. Using an in vitro co-culture assay, we demonstrated that the growth of L. iners was suppressed in the initial interaction with TV, but it may adapt and survive after longer exposure to TV. Additionally, it is noteworthy that TV was able to promote GBS growth. Our study highlights the vaginal microbiota composition associated with the common STIs and the crosstalk between TV and the associated bacteria, paving the way for future development of health interventions targeting the specific vaginal bacterial taxa to reduce the risk of common STIs.<\/jats:p>","DOI":"10.3390\/microorganisms9091864","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T23:05:12Z","timestamp":1630623912000},"page":"1864","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Vaginal Microbiota of the Sexually Transmitted Infections Caused by Chlamydia trachomatis and Trichomonas vaginalis in Women with Vaginitis in Taiwan"],"prefix":"10.3390","volume":"9","author":[{"given":"Shu-Fang","family":"Chiu","sequence":"first","affiliation":[{"name":"Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"Department of Inspection, Taipei City Hospital, Renai Branch, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8728-8881","authenticated-orcid":false,"given":"Po-Jung","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Hung","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Yun","family":"Huang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8488-9614","authenticated-orcid":false,"given":"Lichieh Julie","family":"Chu","sequence":"additional","affiliation":[{"name":"Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan"},{"name":"Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2912-7745","authenticated-orcid":false,"given":"Chi-Ching","family":"Lee","sequence":"additional","affiliation":[{"name":"Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan"},{"name":"Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Chung","family":"Lin","sequence":"additional","affiliation":[{"name":"Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei 114, Taiwan"},{"name":"Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lih-Chyang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mackay Medical College, New Taipei 252, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3205-871X","authenticated-orcid":false,"given":"Wei-Ning","family":"Lin","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei 242, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Huei","family":"Tsao","sequence":"additional","affiliation":[{"name":"Department of Medical Research, National Defense Medical Center, Tri-Service General Hospital, Taipei 114, Taiwan"},{"name":"Department of Microbiology and Immunology, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2779-0116","authenticated-orcid":false,"given":"Petrus","family":"Tang","sequence":"additional","affiliation":[{"name":"Molecular Regulation and Bioinformatics Laboratory, Department of Parasitology, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8720-947X","authenticated-orcid":false,"given":"Yuan-Ming","family":"Yeh","sequence":"additional","affiliation":[{"name":"Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4038-1579","authenticated-orcid":false,"given":"Kuo-Yang","family":"Huang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei 114, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1046\/j.1525-1497.1998.00101.x","article-title":"Evaluation and management of vaginitis","volume":"13","author":"Carr","year":"1998","journal-title":"J. Gen. Intern. Med."},{"key":"ref_2","first-page":"321","article-title":"Vaginitis: Diagnosis and Treatment","volume":"97","author":"Paladine","year":"2018","journal-title":"Am. Fam. Physician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1038\/s41598-020-58862-2","article-title":"Apoptosis of vaginal epithelial cells in clinical samples from women with diagnosed bacterial vaginosis","volume":"10","author":"Roselletti","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/AOG.0000000000002090","article-title":"Clinical Validation of a Test for the Diagnosis of Vaginitis","volume":"130","author":"Gaydos","year":"2017","journal-title":"Obstet. Gynecol."},{"key":"ref_5","unstructured":"Jeanmonod, R., and Jeanmonod, D. (2020). Vaginal Candidiasis (Vulvovaginal Candidiasis). StatPearls, StatPearls Publishing."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s11908-013-0325-5","article-title":"Mixed vaginitis-more than coinfection and with therapeutic implications","volume":"15","author":"Sobel","year":"2013","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"548P","DOI":"10.2471\/BLT.18.228486","article-title":"Chlamydia, gonorrhoea, trichomoniasis and syphilis: Global prevalence and incidence estimates, 2016","volume":"97","author":"Rowley","year":"2019","journal-title":"Bull. World Health Organ."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/OLQ.0000000000001075","article-title":"Sexually Transmitted Infections in Pregnancy and Reproductive Health: Proceedings of the STAR Sexually Transmitted Infection Clinical Trial Group Programmatic Meeting","volume":"47","author":"Wynn","year":"2020","journal-title":"Sex. Transm. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"939","DOI":"10.3201\/eid1806.111590","article-title":"Trichomonas vaginalis antimicrobial drug resistance in 6 US cities, STD Surveillance Network, 2009\u20132010","volume":"18","author":"Kirkcaldy","year":"2012","journal-title":"Emerg. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Unemo, M., Del Rio, C., and Shafer, W.M. (2016). Antimicrobial Resistance Expressed by Neisseria gonorrhoeae: A Major Global Public Health Problem in the 21st Century. Microbiol. Spectr., 4.","DOI":"10.1128\/microbiolspec.EI10-0009-2015"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1086\/428290","article-title":"Evaluation of antimicrobial resistance and treatment failures for Chlamydia trachomatis: A meeting report","volume":"191","author":"Wang","year":"2005","journal-title":"J. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Walker, J., Tabrizi, S.N., Fairley, C.K., Chen, M.Y., Bradshaw, C.S., Twin, J., Taylor, N., Donovan, B., Kaldor, J.M., and McNamee, K. (2012). Chlamydia trachomatis incidence and re-infection among young women--behavioural and microbiological characteristics. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0037778"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1136\/sextrans-2014-051607","article-title":"Frequency and risk factors for incident and redetected Chlamydia trachomatis infection in sexually active, young, multi-ethnic women: A community based cohort study","volume":"90","author":"Aghaizu","year":"2014","journal-title":"Sex. Transm. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1111\/1471-0528.14390","article-title":"Why do lactobacilli dominate the human vaginal microbiota?","volume":"124","author":"Witkin","year":"2017","journal-title":"BJOG"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/2049-2618-2-4","article-title":"The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women","volume":"2","author":"Romero","year":"2014","journal-title":"Microbiome"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/cid\/ciw586","article-title":"The Cervicovaginal Microbiota in Women Notified for Chlamydia trachomatis Infection: A Case-Control Study at the Sexually Transmitted Infection Outpatient Clinic in Amsterdam, The Netherlands","volume":"64","author":"Bruisten","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1097\/OLQ.0b013e3182631c79","article-title":"Association between Trichomonas vaginalis and vaginal bacterial community composition among reproductive-age women","volume":"39","author":"Brotman","year":"2012","journal-title":"Sex. Transm. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1093\/infdis\/jiz354","article-title":"Specific Vaginal Bacteria Are Associated with an Increased Risk of Trichomonas vaginalis Acquisition in Women","volume":"220","author":"Jarrett","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1093\/infdis\/jiw329","article-title":"Desialylation of Neisseria gonorrhoeae Lipooligosaccharide by Cervicovaginal Microbiome Sialidases: The Potential for Enhancing Infectivity in Men","volume":"214","author":"Ketterer","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1128\/JCM.01766-16","article-title":"Combined Testing for Chlamydia, Gonorrhea, and Trichomonas by Use of the BD Max CT\/GC\/TV Assay with Genitourinary Specimen Types","volume":"55","author":"Williams","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"862","DOI":"10.3389\/fmicb.2018.00862","article-title":"Oral Microbiota Community Dynamics Associated with Oral Squamous Cell Carcinoma Staging","volume":"9","author":"Yang","year":"2018","journal-title":"Front. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/nar\/gks808","article-title":"Evaluation of general 16S ribosomal RNA gene PCR primers for classical and next-generation sequencing-based diversity studies","volume":"41","author":"Klindworth","year":"2013","journal-title":"Nucleic Acids Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"10","DOI":"10.14806\/ej.17.1.200","article-title":"Cutadapt removes adapter sequences from high-throughput sequencing reads","volume":"17","author":"Martin","year":"2011","journal-title":"EMBnet J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1038\/nmeth.2604","article-title":"UPARSE: Highly accurate OTU sequences from microbial amplicon reads","volume":"10","author":"Edgar","year":"2013","journal-title":"Nat. Methods"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Edgar, R.C. (2016). SINTAX: A simple non-Bayesian taxonomy classifier for 16S and ITS sequences. biorxiv, 074161.","DOI":"10.1101\/074161"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1186\/s13059-014-0550-8","article-title":"Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2","volume":"15","author":"Love","year":"2014","journal-title":"Genome Biol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1038\/nmeth.f.303","article-title":"QIIME allows analysis of high-throughput community sequencing data","volume":"7","author":"Caporaso","year":"2010","journal-title":"Nat. Methods"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"R60","DOI":"10.1186\/gb-2011-12-6-r60","article-title":"Metagenomic biomarker discovery and explanation","volume":"12","author":"Segata","year":"2011","journal-title":"Genome Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1550-7408.1995.tb01579.x","article-title":"YI-S, a casein-free medium for axenic cultivation of Entamoeba histolytica, related Entamoeba, Giardia intestinalis and Trichomonas vaginalis","volume":"42","author":"Diamond","year":"1995","journal-title":"J. Eukaryot. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e01784-18","DOI":"10.1128\/mBio.01784-18","article-title":"The Protozoan Trichomonas vaginalis Targets Bacteria with Laterally Acquired NlpC\/P60 Peptidoglycan Hydrolases","volume":"9","author":"Pinheiro","year":"2018","journal-title":"mBio"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1186\/2193-1801-2-369","article-title":"Bias problems in culture-independent analysis of environmental bacterial communities: A representative study on hydrocarbonoclastic bacteria","volume":"2","author":"Dashti","year":"2013","journal-title":"SpringerPlus"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1672109","DOI":"10.1155\/2019\/1672109","article-title":"Biofilm in Genital Ecosystem: A Potential Risk Factor for Chlamydia trachomatis Infection","volume":"2019","author":"Filardo","year":"2019","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.ijpharm.2018.09.003","article-title":"Vaginal Bifidobacterium breve for preventing urogenital infections: Development of delayed release mucoadhesive oral tablets","volume":"550","author":"Giordani","year":"2018","journal-title":"Int. J. Pharm."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Chen, K.T., Chen, S.C., Chiang, C.C., Li, L.H., and Tang, L.H. (2007). Chlamydial infection among patients attending STD and genitourinary clinics in Taiwan. BMC Public Health, 7.","DOI":"10.1186\/1471-2458-7-120"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1093\/cid\/ciy504","article-title":"Molecular-based Testing for Sexually Transmitted Infections Using Samples Previously Collected for Vaginitis Diagnosis","volume":"68","author":"Daniel","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.amepre.2016.09.016","article-title":"Association of Bacterial Vaginosis with Chlamydia and Gonorrhea among Women in the U.S. Army","volume":"52","author":"Bautista","year":"2017","journal-title":"Am. J. Prev. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e01548-19","DOI":"10.1128\/mBio.01548-19","article-title":"The Cervicovaginal Microbiota-Host Interaction Modulates Chlamydia trachomatis Infection","volume":"10","author":"Edwards","year":"2019","journal-title":"mBio"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"132ra152","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":"ref_40","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1086\/521307","article-title":"The association between Trichomonas vaginalis infection and level of vaginal lactobacilli, in nonpregnant women","volume":"196","author":"Torok","year":"2007","journal-title":"J. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","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":"ref_42","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1093\/infdis\/145.6.800","article-title":"Maternal carriage and neonatal acquisition of group B streptococci","volume":"145","author":"Gerards","year":"1982","journal-title":"J. Infect. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/j.tim.2017.05.013","article-title":"Perinatal Group B Streptococcal Infections: Virulence Factors, Immunity, and Prevention Strategies","volume":"25","author":"Vornhagen","year":"2017","journal-title":"Trends Microbiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/j.1472-765X.2006.01934.x","article-title":"Influence of probiotic vaginal lactobacilli on in vitro adhesion of urogenital pathogens to vaginal epithelial cells","volume":"43","author":"Zarate","year":"2006","journal-title":"Lett. Appl. Microbiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1111\/jam.12739","article-title":"Preventive effect of Lactobacillus reuteri CRL1324 on Group B Streptococcus vaginal colonization in an experimental mouse model","volume":"118","year":"2015","journal-title":"J. Appl. Microbiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1093\/infdis\/jix395","article-title":"Group B Streptococcus and the Vaginal Microbiota","volume":"216","author":"Rosen","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.immuni.2016.12.013","article-title":"Lactobacillus-Deficient Cervicovaginal Bacterial Communities Are Associated with Increased HIV Acquisition in Young South African Women","volume":"46","author":"Gosmann","year":"2017","journal-title":"Immunity"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1006\/expr.1998.4297","article-title":"Trichomonas vaginalis: In vitro phagocytosis of lactobacilli, vaginal epithelial cells, leukocytes, and erythrocytes","volume":"89","year":"1998","journal-title":"Exp. Parasitol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1128\/CMR.11.2.300","article-title":"Clinical and microbiological aspects of Trichomonas vaginalis","volume":"11","author":"Petrin","year":"1998","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"5074","DOI":"10.1128\/iai.65.12.5074-5081.1997","article-title":"Invasion of brain microvascular endothelial cells by group B streptococci","volume":"65","author":"Nizet","year":"1997","journal-title":"Infect. Immun."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1086\/338475","article-title":"Group B streptococcal beta-hemolysin\/cytolysin promotes invasion of human lung epithelial cells and the release of interleukin-8","volume":"185","author":"Doran","year":"2002","journal-title":"J. Infect. Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3109\/00313029109060813","article-title":"The hemolytic and cytolytic activity of group B streptococcal hemolysin and its possible role in early onset group B streptococcal disease","volume":"23","author":"Tapsall","year":"1991","journal-title":"Pathology"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"3923","DOI":"10.4049\/jimmunol.165.7.3923","article-title":"Group B Streptococcus induces apoptosis in macrophages","volume":"165","author":"Fettucciari","year":"2000","journal-title":"J. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Oliveira, L., Madureira, P., Andrade, E.B., Bouaboud, A., Morello, E., Ferreira, P., Poyart, C., Trieu-Cuot, P., and Dramsi, S. (2012). Group B streptococcus GAPDH is released upon cell lysis, associates with bacterial surface, and induces apoptosis in murine macrophages. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0029963"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"9212","DOI":"10.1038\/s41598-017-07790-9","article-title":"The vaginal microbiome of pregnant women is less rich and diverse, with lower prevalence of Mollicutes, compared to non-pregnant women","volume":"7","author":"Freitas","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.chom.2016.11.010","article-title":"Prevotella as a Hub for Vaginal Microbiota under the Influence of Host Genetics and Their Association with Obesity","volume":"21","author":"Si","year":"2017","journal-title":"Cell Host Microbe"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.contraception.2017.05.017","article-title":"Effects of intrauterine contraception on the vaginal microbiota","volume":"96","author":"Bassis","year":"2017","journal-title":"Contraception"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"622.e1","DOI":"10.1016\/j.ajog.2018.02.017","article-title":"Impact of contraceptive initiation on vaginal microbiota","volume":"218","author":"Achilles","year":"2018","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"218","DOI":"10.2174\/1874285801812010218","article-title":"Contraception: Influence on Vaginal Microbiota and Identification of Vaginal Lactobacilli Using MALDI-TOF MS and 16S rDNA Sequencing","volume":"12","author":"Fosch","year":"2018","journal-title":"Open Microbiol. J."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/9\/9\/1864\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:55:09Z","timestamp":1760165709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/9\/9\/1864"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,2]]},"references-count":59,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["microorganisms9091864"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms9091864","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,2]]}}}