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. 2021 Nov 4;13:176. doi: 10.1186/s13073-021-00977-w

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 2 — Heatmap showing the vaginal microbiota composition in 103 women before (orange) and after (blue) excisional treatment and in 39 healthy, untreated controls (green) (A) and changes in richness (C) and diversity (D) indices associated with disease status. A Three of the previously described community state types (CSTs) were identified in our cohort. B CST IV was significantly more prevalent in the treatment cohort both before and after treatment compared to 39 untreated controls (p = 0.0081 and 0.0142, respectively, chi-squared test). There was no significant change in the vaginal microbiome composition before and after treatment. C Richness was significantly greater in women planned for excision both before (p = 0.0003, unpaired t test) and after (p = 0.0005, unpaired t test) treatment when compared to healthy untreated controls. D Diversity was also increased in women planned for treatment before (p < 0.0001, unpaired t test) and after (p = 0.0005 unpaired t test) treatment compared to controls. Richness or diversity was no different before and after treatment. CST, community state type; Sobs, species observed; VMB, vaginal microbiota. Dots depict the individual samples; error bars denote mean ± standard deviation, ***p < 0.001; **p < 0.01; *p < 0.05)