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. 2022 Jan 28;20:38. doi: 10.1186/s12916-021-02227-7

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© The Author(s) 2022

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 — Heat map of relative abundance data for the top 50 most prevalent vaginal bacterial genera and relationship with different clinical outcomes. Mixed universal primers 28F-YM GAGTTTGATYMTGGCTCAG, 28F-Borrellia GAGTTTGATCCTGGCTTAG, 28F-Chloroflex GAATTTGATCTTGGTTCAG and 28F-Bifdo GGGTTCGATTCTGGCTCAG at a ratio of 4:1:1:1 with 388R reverse primers were used to amplify the V1-V2 region of 16S rRNA followed by sequencing using the Illumina MiSeq platform. The data was processed using the MiSeq SOP Pipeline of the Mothur package and classification used RDP. Ward hierarchical clustering of genus level relative abundance data for the whole cohort of 167 individual samples identified two major vaginal microbiome groups (VMG), characterized by Lactobacillus spp. dominance 75% (125/167) and Lactobacillus spp. depletion 25% (42/167). The mean Lactobacillus content in the Lactobacillus spp. dominated group was 94.2% and in the Lactobacillus spp. deplete group was 18.5%. The Lactobacillus spp. deplete cluster was further divided into Gardnerella dominant and non-Gardnerella (VMG sub-grouping 1), and these clusters could be further divided into Gardnerella dominant, mixed Lactobacillus/Gardnerella, Prevotella or Streptococcus dominated (VMG sub-grouping 2)