Characterization of microorganisms according to vaginal community state types microbiota: an observational study among women across Italy

This manuscript presents an observational analysis of vaginal microbiota profiles in an Italian clinical cohort (n≈203) assessed through a targeted molecular testing workflow (RT-PCR–based panel with a standardized interpretative algorithm). Samples were classified into vaginal Community State Types (CST) and stratified by dysbiosis severity (normal, partial dysbiosis, dysbiosis), enabling a population-level characterization of microbial patterns in real-world diagnostic practice. The study reports the prevalence of key microbial targets across CSTs and dysbiosis strata, explores co-detection patterns through association metrics, and investigates demographic and microbiological correlates of dysbiosis using logistic regression models. Results highlight age-related trends in dysbiosis distribution and identify specific microbial detections and co-detection profiles associated with non-eubiotic states, providing a hypothesis-generating framework for clinical interpretation of molecular panels in women’s health. Limitations include the cross-sectional design and the constrained availability of clinical covariates, which restrict causal inference and motivate future longitudinal and multi-center validation. Overall, the work contributes pragmatic evidence on CST-like profiling and dysbiosis stratification using targeted molecular diagnostics, with potential applications in clinical microbiology and gynecological practice.