[{"data":1,"prerenderedAt":192},["ShallowReactive",2],{"content-route-/en/research/vvc-rvvc-vaginal-microbiome-2024":3},{"state":4,"owner":4,"route":5,"locale":6,"template":7,"content":21,"projection":174,"alternates":183},"target","/en/research/vvc-rvvc-vaginal-microbiome-2024","en-US",{"kind":8,"family":8,"sectionKeys":9},"research-summary",[10,11,12,13,14,15,16,17,18,19,20],"bottom-line","why-source-matters","study-population","tested","results","applicability","limitations","contribution","practical-change","funding-conflicts","source",{"kind":8,"title":22,"description":23,"firstPublished":24,"evidenceAsOf":24,"lastUpdated":24,"changeNote":25,"research":26,"relations":73,"body":77},"Vaginal yeast infection and recurrence: a microbiome study","A small study compared vaginal bacteria and metabolites in VVC, recurrent VVC, and selected healthy controls; its results are associations, not treatment evidence.","2026-10-08","Prepared a contextual summary of a cross-sectional vaginal microbiome study; no map claim or practical action changed.",{"sourceId":27,"studyType":28,"population":29,"sampleScale":30,"contribution":31,"contributionRationale":32,"relatedEvidenceMap":33,"funding":34,"conflicts":35,"paperDate":36,"results":37,"applicability":42,"limitations":50,"practicalChange":72},"liang-vaginal-microbiota-metabolome-vvc-rvvc-2024","Single-centre, cross-sectional case-control multi-omics study","Women ages 18–52 attending one gynecology clinic in Shenzhen, China; the case groups had microscopy-confirmed VVC or RVVC, and controls were screened to be free of several vaginal infections.","The article reports 94 participants recruited and 87 included in analyses, but lists 31 with RVVC, 28 with VVC, and 29 healthy controls (88 total). It accounts for six post-recruitment exclusions: one pregnancy, two VVC cases with BV, two RVVC cases with BV, and one RVVC case with AV; the one-person discrepancy is unexplained.","contextual","The study adds exploratory group comparisons of vaginal bacteria, microbial pathways, and discharge metabolites, but its small single-centre cross-sectional design cannot show cause, predict later recurrence, or establish a treatment target. It does not change current claims or practical guidance.","/en/research/evidence/recurrent-vaginal-yeast-symptoms","Supported by Shenzhen Municipality Science and Technology Planning Project grants JCYJ20190809101409603 and JCYJ20220530160206014; National Natural Science Foundation of China grant 82201793; Shenzhen High-level Hospital Construction Fund grant YBH2019-260; Shenzhen Key Medical Discipline Construction Fund grant SZXK027; Sanming Project of Medicine in Shenzhen grant SZSM202011016; and Peking University Shenzhen Hospital Scientific Research Foundation grants KYQD2022145 and KYQD202211.","The authors declared no conflict of interest.","2024-10-30",[38,39,40,41],"At one sampling visit, the paper lists 31 people with RVVC, 28 with VVC, and 29 selected healthy controls (88 total). It separately reports 87 included in analyses and describes six exclusions among 94 recruits, leaving a one-person discrepancy. Swelling was reported more often in VVC than RVVC; the paper gives no effect estimate or confidence interval in its text.","Lactobacillus made up a mean 69.56% of the bacterial community across groups (73.11% in controls, 66.28% in VVC, and 68.17% in RVVC). BV-associated genera trended higher in both case groups, but the differences were not statistically significant. Lactobacillus iners was higher in RVVC than VVC, with no significant difference from healthy controls reported in the Results text and Fig. 2 caption.","Shannon diversity was lower in controls than in VVC (P=0.0052) and RVVC (P=0.012); VVC and RVVC did not differ (P=0.67). These are between-group measurements, not a validated measure of health or future recurrence.","The authors reported 18,268 LC-MS features as detected and 12,007 and 10,106 as differential in RVVC-versus-control and VVC-versus-control comparisons. L-glutamate was higher in RVVC than VVC, alongside reported microbiome associations. The paper gives no absolute concentration or confidence interval for this finding.",{"appliesTo":43,"doesNotApplyTo":46},[44,45],"Understanding which cross-sectional microbiome and metabolite differences were reported in these selected adult clinic groups.","Seeing an example of a study that used at least four symptomatic episodes per year as its RVVC criterion; this study-specific convention is distinct from current guidance, which the linked map summarizes separately.",[47,48,49],"Establishing that a bacterium, pathway, or metabolite caused VVC or RVVC, or predicting whether an individual will have a future episode.","Choosing antifungal treatment or supporting probiotics, diet changes, or microbiome testing.","Generalizing the results to pregnant people, people with excluded coinfections, or other clinics and populations.",[51,54,57,60,63,66,69],{"finding":52,"limitation":53},"Vaginal bacteria and metabolites differed among groups at the sampling visit.","The study was small, single-centre, and cross-sectional, with no follow-up. It cannot establish which changes came first or whether they caused symptoms; RVVC group membership reflected reported prior episodes, not observed future recurrence.",{"finding":55,"limitation":56},"The article reports 87 included participants but lists group counts totaling 88.","Itemized exclusions account for six of 94 recruits, which also implies 88; the one-person discrepancy is unexplained. This summary retains the reported group counts without deriving a corrected overall total.",{"finding":58,"limitation":59},"The study compared clinic-recruited cases with healthy controls screened to be free of Candida, Trichomonas, aerobic bacteria, and BV.","BV and AV coinfections were excluded from the case groups, and the eligibility criteria excluded several populations, including pregnant and postmenopausal people. This selected comparison does not represent the full range of real-world vaginal symptoms.",{"finding":61,"limitation":62},"The paper reports many relative-abundance, pathway, and LC-MS feature differences.","Most results are not absolute quantities. The main text does not report metabolite-identification standards or a multiple-comparison correction, and it omits several effect sizes and exact P values.",{"finding":64,"limitation":65},"The paper reports a higher L. iners measure in RVVC than VVC.","Results prose and the Fig. 2 caption say the difference was not significant between RVVC and healthy controls, while the Fig. 4 caption describes a difference from both groups. This summary retains the narrower comparison and does not infer a difference from healthy controls.",{"finding":67,"limitation":68},"Group comparisons use significance tests, including Wilcoxon tests.","The Methods section specifies rank-sum tests for continuous variables, while figure captions label group tests as signed-rank; the report does not explain this inconsistency.",{"finding":70,"limitation":71},"The authors propose links among L. iners, L-glutamate, peptidoglycan pathways, and Candida recurrence.","These are hypotheses from observed associations. No intervention, diagnostic threshold, clinical prediction, treatment response, symptom resolution, or safety outcome was tested.","No practical change. This study does not change the evidence map or current guidance and does not support a microbiome test, probiotic, diet, or antifungal treatment recommendation.",[74],{"group":75,"route":33,"label":76},"evidence","Recurrent vaginal yeast symptoms evidence map",{"type":78,"value":79,"toc":170},"minimark",[80,88,94,100,106,118,124,133,139,145,151],[81,82,84],"content-section",{"section-key":10,"title":83},"Bottom line",[85,86,87],"p",{},"This small, single-centre study compared vaginal bacteria and metabolite signals in women with VVC, recurrent VVC, and selected healthy controls. Some measurements differed between groups, but they were observed at one visit. The study cannot show that a bacterium or metabolite caused symptoms or predicted future recurrence, and it does not establish a test or treatment target.",[81,89,91],{"section-key":11,"title":90},"Why this source matters",[85,92,93],{},"The study combines vaginal bacterial sequencing with metabolite measurements from vaginal discharge. It adds biological context to the recurrent vaginal yeast evidence map, while its design leaves the direction and clinical meaning of the observed associations unresolved. Its use of a four-or-more episode definition is a study convention, not a replacement for the recurrence threshold in current guidance.",[81,95,97],{"section-key":12,"title":96},"Study type and population",[85,98,99],{},"Liang and colleagues conducted a cross-sectional case-control study at the gynecology clinic of Peking University Shenzhen Hospital in China. Women ages 18–52 were screened during 2022. The paper lists 31 women with recurrent vulvovaginal candidiasis (RVVC), 28 with vulvovaginal candidiasis (VVC), and 29 healthy controls. It separately reports 87 included in analyses, while those group counts total 88; six post-recruitment exclusions are itemized among 94 recruits, so the one-person discrepancy is unresolved. VVC and RVVC cases were assessed by examination and microscopy; controls were screened to exclude several vaginal infections. The authors used at least four symptomatic episodes in one year for RVVC in the abstract and Methods, while the Introduction says more than three. That is the study's eligibility convention; current guidance uses a separately stated threshold summarized in the linked map.",[81,101,103],{"section-key":13,"title":102},"What was tested",[85,104,105],{},"The study compared group membership with bacteria measured from vaginal-discharge swabs using shotgun metagenomic sequencing and with discharge features measured by liquid chromatography–mass spectrometry. This was not an assigned exposure: participants were sampled once, received no study treatment, and had no follow-up. The study therefore compared features that occurred alongside the groups rather than testing what produced them.",[81,107,109,112,115],{"section-key":14,"title":108},"Results",[85,110,111],{},"The paper lists groups of 31 RVVC, 28 VVC, and 29 healthy participants (88 total), while separately reporting 87 included in analyses and six post-recruitment exclusions among 94 recruits; this leaves a one-person discrepancy. External genital swelling was reported more often in VVC than RVVC; exact counts are shown in the figure, but the text provides no effect estimate or confidence interval.",[85,113,114],{},"Lactobacillus was the most abundant bacterial genus in all groups, averaging 69.56% across the full sample: 73.11% in controls, 66.28% in VVC, and 68.17% in RVVC. Gardnerella, Prevotella, and Atopobium trended higher in the VVC and RVVC groups, but those group differences were not statistically significant. Atopobium vaginae was higher in VVC than healthy controls. Results prose and the Fig. 2 caption report L. iners as higher in RVVC than VVC, but not significantly different from healthy controls. The Fig. 4 caption describes that contrast differently; the discrepancy is addressed below.",[85,116,117],{},"Shannon diversity was lower in healthy controls than in VVC (P=0.0052) and RVVC (P=0.012), while VVC and RVVC did not differ (P=0.67). The study also reported higher carbohydrate and peptidoglycan pathway signals in some case-group comparisons. Its LC-MS analysis labeled 18,268 detected features and called 12,007 RVVC-versus-control and 10,106 VVC-versus-control features differential. L-glutamate was reported higher in RVVC than VVC. These feature-level findings were not reported as absolute concentrations or validated clinical measurements.",[81,119,121],{"section-key":15,"title":120},"Applicability",[85,122,123],{},"These findings describe associations in selected adult patients at one clinic and healthy controls screened to exclude several infections. They do not establish what causes VVC or RVVC, predict an individual's future episodes, or show that changing a microbiome feature would improve health. The study also does not establish a diagnostic threshold or apply directly to pregnant people or people with the excluded coinfections.",[81,125,127,130],{"section-key":16,"title":126},"Limitations",[85,128,129],{},"The study was small and single-centre, measured participants at one visit, and did not follow subsequent recurrence, treatment response, symptom resolution, quality of life, or safety outcomes. The article reports 87 included participants but lists groups totaling 88 and six exclusions among 94 recruits; it does not explain this one-person discrepancy. The healthy group was selected to be pathogen-free, while BV and aerobic-vaginitis coinfections were excluded from the case groups. The findings are mainly relative-abundance and assay-feature comparisons; the article does not report metabolite-identification standards, a multiple-comparison correction, or many effect sizes and exact P values.",[85,131,132],{},"Reporting is inconsistent for some analyses. Results prose and the Fig. 2 caption say L. iners differed between RVVC and VVC but not between RVVC and healthy controls; the Fig. 4 caption says it was higher in RVVC than both groups. The Methods section describes Wilcoxon rank-sum tests for continuous variables, while figure captions call the group tests signed-rank. The report does not resolve these differences, so this summary uses the narrower L. iners comparison. Proposed links between taxa, metabolites, pathways, and recurrence remain hypotheses.",[81,134,136],{"section-key":17,"title":135},"Contribution to the current conclusion",[85,137,138],{},"This is contextual evidence. It adds exploratory observations about vaginal bacterial composition and discharge metabolites in VVC and RVVC, but does not test a cause, prognosis, or treatment. It does not change the map's current conclusions about recurrence, microbiologic confirmation, reassessment, or treatment.",[81,140,142],{"section-key":18,"title":141},"Practical change",[85,143,144],{},"No practical change. The study does not establish a microbiome test or treatment target and does not support changing current clinical guidance.",[81,146,148],{"section-key":19,"title":147},"Funding and conflicts",[85,149,150],{},"The study reported support from Shenzhen Municipality Science and Technology Planning Project grants JCYJ20190809101409603 and JCYJ20220530160206014; the National Natural Science Foundation of China grant 82201793; Shenzhen High-level Hospital Construction Fund grant YBH2019-260; Shenzhen Key Medical Discipline Construction Fund grant SZXK027; Sanming Project of Medicine in Shenzhen grant SZSM202011016; and Peking University Shenzhen Hospital Scientific Research Foundation grants KYQD2022145 and KYQD202211. The authors declared no conflict of interest.",[81,152,154],{"section-key":20,"title":153},"Source",[85,155,156,157,161,162,169],{},"Yiheng Liang and colleagues. ",[158,159,160],"em",{},"Highlight signatures of vaginal microbiota and metabolome contributed to the occurrence and recurrence of vulvovaginal candidiasis."," Microbiology Spectrum. 2024;12(12):e0152124. Published 30 October 2024. ",[163,164,168],"a",{"href":165,"rel":166},"https://pmc.ncbi.nlm.nih.gov/articles/PMC11619578/",[167],"nofollow","Read the original article"," (DOI: 10.1128/spectrum.01521-24; PMID: 39475249).",{"title":171,"searchDepth":172,"depth":172,"links":173},"",2,[],{"sources":175,"claims":181,"safety":182},[176],{"sourceId":27,"title":177,"canonicalId":178,"canonicalUrl":165,"publisher":179,"sourceType":180,"publicationDate":36,"lastChecked":24},"Highlight signatures of vaginal microbiota and metabolome contributed to the occurrence and recurrence of vulvovaginal candidiasis","PMID:39475249; DOI:10.1128/spectrum.01521-24","Microbiology Spectrum","observational-study",[],[],[184,187,190],{"rel":185,"hreflang":6,"href":186},"alternate","https://candipedia.org/en/research/vvc-rvvc-vaginal-microbiome-2024/",{"rel":185,"hreflang":188,"href":189},"pl-PL","https://candipedia.org/pl/research/mikrobiom-pochwy-nawracajaca-grzybica-2024/",{"rel":185,"hreflang":191,"href":186},"x-default",1791487498308]