Complex ecological interactions of Staphylococcus aureus in tampons during menstruation

Area of Science:

• Microbiology
• Gynecology
• Toxicology

Background:

• Menstrual toxic shock syndrome (mTSS) is a severe illness linked to Staphylococcus aureus colonization.
• Tampon use is a risk factor for mTSS in women with vaginal S. aureus.
• The role of the vaginal microbiome in S. aureus colonization during menstruation is not fully understood.

Purpose of the Study:

• To investigate the impact of vaginal microbial community composition on S. aureus colonization of tampons.
• To identify bacterial genera associated with S. aureus presence in menstrual fluid.

Main Methods:

• Analysis of microbiota in menstrual fluids from tampons of 108 healthy women and 7 mTSS cases.
• Utilized culture methods and 16S rRNA gene metabarcoding for microbial analysis.
• Employed between-class analysis to compare microbiota composition.

Main Results:

• Staphylococcus aureus was detected in 40% of healthy volunteers and 100% of mTSS patients.
• Microbiota composition differed based on the presence or absence of S. aureus, with specific genera identified.
• No significant differences in microbiome richness, diversity, or ecological distance were found between groups.

Conclusions:

• The vagina serves as a significant niche for S. aureus in tampon users.
• Tampon microbiota composition influences S. aureus virulence through complex interactions, beyond simple inhibition by lactic acid bacteria.