ArticleFrontiers in cellular and infection microbiology2026
Vaginal microecological diversity and Ureaplasma urealyticum co-infection in high-risk HPV infection: a cross-sectional study.
Article in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Persistent high-risk human papillomavirus (HR-HPV) infection is a key driver of cervical carcinogenesis. Vaginal microecology acts as a host defense barrier, and its dysbiosis may affect HPV clearance. The interplay among microbial diversity, viral load, and sexually transmitted pathogens remains unclear. Methods: This cross-sectional study enrolled 330 women from a gynecological clinic in Shanghai (December 2025 - February 2026). HR-HPV genotyping and viral load were determined by fluorescence quantitative PCR. Vaginal culturable bacteria were identified using MALDI-TOF MS, and culturable bacterial richness (Sobs index) were calculated. Routine vaginal parameters and sexually transmitted pathogens (Chlamydia trachomatis, Neisseria gonorrhoeae, Ureaplasma urealyticum [UU]) were assessed. Microecological characteristics were compared between HR-HPV-positive and -negative groups, with subgroup analyses within the positive group by viral load, genotype, and single/multiple infection. Results: The HR-HPV positivity rate was 43.94% (145/330), with HPV52, HPV53, and HPV16 being predominant, and the highest rate in women >50 years. The HR-HPV-positive group had significantly higher bacterial richness (Sobs index) than the negative group (all P<0.05). Among positive patients, those with high viral load (logarithm >4) had significantly higher Sobs index than those with low viral load (P < 0.05). Proportions of patients with pH>4.5, positive H Conclusion: HR-HPV infection is associated with elevated culturable bacterial richness and dysbiosis; high viral load correlates with more pronounced microbial alterations. UU co-infection is positively associated with HR-HPV. These findings support incorporating vaginal microecological assessment and UU screening into HR-HPV management strategies.
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