Open Access Highly Accessed Research article

Quantification of bacterial species of the vaginal microbiome in different groups of women, using nucleic acid amplification tests

Vicky Jespers1*, Joris Menten2, Hilde Smet3, Sabrina Poradosú1, Saïd Abdellati3, Rita Verhelst4, Liselotte Hardy1, Anne Buvé1 and Tania Crucitti3

Author Affiliations

1 Department of Public Health, ITM HIV/AIDS Centre, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium

2 Clinical Trials Unit, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium

3 HIV/STI Reference Laboratory, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium

4 Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium

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BMC Microbiology 2012, 12:83  doi:10.1186/1471-2180-12-83

Published: 30 May 2012



The vaginal microbiome plays an important role in urogenital health. Quantitative real time Polymerase Chain Reaction (qPCR) assays for the most prevalent vaginal Lactobacillus species and bacterial vaginosis species G. vaginalis and A. vaginae exist, but qPCR information regarding variation over time is still very limited. We set up qPCR assays for a selection of seven species and defined the temporal variation over three menstrual cycles in a healthy Caucasian population with a normal Nugent score. We also explored differences in qPCR data between these healthy women and an ‘at risk’ clinic population of Caucasian, African and Asian women with and without bacterial vaginosis (BV), as defined by the Nugent score.


Temporal stability of the Lactobacillus species counts was high with L. crispatus counts of 108 copies/mL and L. vaginalis counts of 106 copies/mL. We identified 2 types of ‘normal flora’ and one ‘BV type flora’ with latent class analysis on the combined data of all women. The first group was particularly common in women with a normal Nugent score and was characterized by a high frequency of L. crispatus, L. iners, L. jensenii, and L. vaginalis and a correspondingly low frequency of L. gasseri and A. vaginae. The second group was characterized by the predominance of L. gasseri and L. vaginalis and was found most commonly in healthy Caucasian women. The third group was commonest in women with a high Nugent score but was also seen in a subset of African and Asian women with a low Nugent score and was characterized by the absence of Lactobacillus species (except for L. iners) but the presence of G. vaginalis and A. vaginae.


We have shown that the quantification of specific bacteria by qPCR contributes to a better description of the non-BV vaginal microbiome, but we also demonstrated that differences in populations such as risk and ethnicity also have to be taken into account. We believe that our selection of indicator organisms represents a feasible strategy for the assessment of the vaginal microbiome and could be useful for monitoring the microbiome in safety trials of vaginal products.