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. 2017 Jul 11;12(7):e0181135.
doi: 10.1371/journal.pone.0181135. eCollection 2017.

The Association Between Ethnicity and Vaginal Microbiota Composition in Amsterdam, the Netherlands

Free PMC article

The Association Between Ethnicity and Vaginal Microbiota Composition in Amsterdam, the Netherlands

Hanneke Borgdorff et al. PLoS One. .
Free PMC article


Objective: To evaluate whether ethnicity is independently associated with vaginal microbiota (VMB) composition in women living in Amsterdam, the Netherlands, as has been shown for American women.

Methods: Women (18-34 years, non-pregnant, N = 610) representing the six largest ethnic groups (Dutch, African Surinamese, South-Asian Surinamese, Turkish, Moroccan, and Ghanaian) were sampled from the population-based HELIUS study. Sampling was performed irrespective of health status or healthcare seeking behavior. DNA was extracted from self-sampled vaginal swabs and sequenced by Illumina MiSeq (16S rRNA gene V3-V4 region).

Results: The overall prevalence of VMBs not dominated by lactobacilli was 38.5%: 32.2% had a VMB resembling bacterial vaginosis and another 6.2% had a VMB dominated by Bifidobacteriaceae (not including Gardnerella vaginalis), Corynebacterium, or pathobionts (streptococci, staphylococci, Proteus or Enterobacteriaceae). The most prevalent VMB in ethnically Dutch women was a Lactobacillus crispatus-dominated VMB, in African Surinamese and Ghanaian women a polybacterial G. vaginalis-containing VMB, and in the other ethnic groups a L. iners-dominated VMB. After adjustment for sociodemographic, behavioral and clinical factors, African Surinamese ethnicity (adjusted odds ratio (aOR) 5.1, 95% confidence interval (CI) 2.1-12.0) and Ghanaian ethnicity (aOR 4.8, 95% CI 1.8-12.6) were associated with having a polybacterial G. vaginalis-containing VMB, and African Surinamese ethnicity with a L. iners-dominated VMB (aOR 2.8, 95% CI 1.2-6.2). Shorter steady relationship duration, inconsistent condom use with casual partners, and not using hormonal contraception were also associated with having a polybacterial G. vaginalis-containing VMB, but human papillomavirus infection was not. Other sexually transmitted infections were uncommon.

Conclusions: The overall prevalence of having a VMB not dominated by lactobacilli in this population-based cohort of women aged 18-34 years in Amsterdam was high (38.5%), and women of sub-Saharan African descent were significantly more likely to have a polybacterial G. vaginalis-containing VMB than Dutch women independent of modifiable behaviors.

Conflict of interest statement

Competing Interests: M. F. Schim van der Loeff received HPV research funding from Sanofi Pasteur MSD; he is a co-investigator in a Merck-funded investigator-initiated study on Gardasil; he is an investigator on a Sanofi Pasteur MSD sponsored HPV vaccine trial; he served on a HPV vaccine advisory board of GSK; he received in-kind contribution for another HPV study from Stichting Pathologie Onderzoek en Ontwikkeling (SPOO); and his institution receives HPV research funding from Janssen Infectious Diseases and Vaccines. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The other authors report no competing interests.


Fig 1
Fig 1. Hierarchical clustering of participants by VMB composition.
AV = Atopobium vaginae; BVAB1 = BV-associated bacterium 1; GV = Gardnerella vaginalis; L = Lactobacillus; OTU = operational taxonomic unit; VMB = vaginal microbiota. A. The 20 VMB clusters obtained by hierarchical clustering of 546 vaginal samples. Clustering was based on the relative abundance of 455 OTUs. B. Heatmap showing the relative abundance of the most abundant OTUs using the color key on the left.
Fig 2
Fig 2. Prevalence of VMB groups by ethnic group.
L = Lactobacillus; GV = Gardnerella vaginalis; VMB = vaginal microbiota. *Excluding GV. A. Prevalence of six VMB groups by ethnic group. The error bars show the 95% confidence intervals for the prevalence of the three Lactobacillus-dominated VMB groups combined and the three VMB groups not dominated by lactobacilli combined for each ethnic group. B. The ‘Other VMB’ group was further subdivided into three subgroups: The prevalence of these subgroups is shown by ethnic group.

Comment in

  • Microbiome: Detecting diversity.
    Humphries C. Humphries C. Nature. 2017 Oct 4;550(7674):S12-S14. doi: 10.1038/550S12a. Nature. 2017. PMID: 28976947 No abstract available.

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Grant support

This work was supported by the Aids Fonds Netherlands [grant number 201102;], the Academic Medical Center Amsterdam [institutional funding;], the Public Health Service of Amsterdam [institutional funding;], the Dutch Heart Foundation [grant number 2010T084;], the Netherlands Organization for Health Research and Development (ZonMw) [grant numbers 200500003, 7115 0001, and 204005002;], and the European Union (FP-7) [grant number 278901;]. Some analyses were carried out on the Dutch national e-infrastructure with the support of SURF Foundation []. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.