Bacterial Vaginosis Is a Strong Predictor ofNeisseria gonorrhoeaeandChlamydiatrachomatisInfection

Wiesenfeld, Harold C.; Hillier, Sharon L.; Krohn, Marijane A.; Landers, Daniel V.; Sweet, Richard L.

doi:10.1086/367658

Cited by 473 publications

(346 citation statements)

References 17 publications

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“…Current epidemiological evidence using the above-mentioned diagnostic methods also suggests that any deviation from a lactobacilli-dominated cervicovaginal microbiome increases women's susceptibility to HIV and, in HIVpositive women, genital HIV shedding (Sha et al, 2005;van de Wijgert et al, 2008;Hayes et al, 2010). Furthermore, relationships between BV by Nugent scoring and herpes simplex virus type 2 (HSV-2; Cherpes et al, 2003), Neisseria gonorrhoeae, Chlamydia trachomatis (Wiesenfeld et al, 2003) and Trichomonas vaginalis (Rathod et al, 2011) have been described.…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women

Tsivtsivadze²,

et al. 2014

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Cervicovaginal microbiota not dominated by lactobacilli may facilitate transmission of HIV and other sexually transmitted infections (STIs), as well as miscarriages, preterm births and sepsis in pregnant women. However, little is known about the exact nature of the microbiological changes that cause these adverse outcomes. In this study, cervical samples of 174 Rwandan female sex workers were analyzed cross-sectionally using a phylogenetic microarray. Furthermore, HIV-1 RNA concentrations were measured in cervicovaginal lavages of 58 HIV-positive women among them. We identified six microbiome clusters, representing a gradient from low semi-quantitative abundance and diversity dominated by Lactobacillus crispatus (cluster R-I, with R denoting 'Rwanda') and L. iners (R-II) to intermediate (R-V) and high abundance and diversity (R-III, R-IV and R-VI) dominated by a mixture of anaerobes, including Gardnerella, Atopobium and Prevotella species. Women in cluster R-I were less likely to have HIV (P ¼ 0.03), herpes simplex virus type 2 (HSV-2; Po0.01), and high-risk human papillomavirus (HPV; Po0.01) and had no bacterial STIs (P ¼ 0.15). Statistically significant trends in prevalence of viral STIs were found from low prevalence in cluster R-I, to higher prevalence in clusters R-II and R-V, and highest prevalence in clusters R-III/R-IV/R-VI. Furthermore, only 10% of HIV-positive women in clusters R-I/R-II, compared with 40% in cluster R-V, and 42% in clusters R-III/ R-IV/R-VI had detectable cervicovaginal HIV-1 RNA (P trend ¼ 0.03). We conclude that L. crispatusdominated, and to a lesser extent L. iners-dominated, cervicovaginal microbiota are associated with a lower prevalence of HIV/STIs and a lower likelihood of genital HIV-1 RNA shedding.

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Section: Introductionmentioning

confidence: 99%

Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women

Tsivtsivadze²,

et al. 2014

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“…Bacteria that predominate the vaginal microbiota during BV include Gram-positive and Gram-negative anaerobes such as Gardnerella vaginalis, Prevotella, Bacteroides and Porphyromonas species, as well as Mycoplasma hominis, Mobiluncus species, BV-associated bacteria BVAB1-3 and Atopobium vaginae (Fredricks et al, 2005;Hill, 1993;Hillier et al, 1993;Srinivasan et al, 2012;Thorsen et al, 1998;Zhou et al, 2004). Women with BV are at increased risk for preterm birth, acquisition of sexually transmitted infections, including HIV, and pelvic inflammatory disease (Cherpes et al, 2003;Hillier et al, 1995;Martin et al, 1999;Ness et al, 2004;Sobel, 2000;Wiesenfeld et al, 2003). Despite the clinical significance and high prevalence of BV, the basis for the reduction in the prevalence of lactobacilli and the increase in the prevalence of such anaerobes remain obscure.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Lactobacillus crispatus isolates from Lactobacillus-dominated vaginal microbiomes with isolates from microbiomes containing bacterial vaginosis-associated bacteria

et al. 2016

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Vaginal lactobacilli can inhibit colonization by and growth of other bacteria, thereby preventing development of bacterial vaginosis (BV). Amongst the lactobacilli, Lactobacillus crispatus appears to be particularly effective at inhibiting growth of BV-associated bacteria. Nonetheless, some women who are colonized with this species can still develop clinical BV. Therefore, we sought to determine whether strains of L. crispatus that colonize women with lactobacillidominated vaginal microbiomes are distinct from strains that colonize women who develop BV. The genomes of L. crispatus isolates from four women with lactobacilli-dominated vaginal microbiomes (,1 % 16S rRNA reads above threshold from genera other than Lactobacillus) and four women with microbiomes containing BV-associated bacteria (.12 % 16S rRNA reads from bacterial taxa associated with BV) were sequenced and compared. Lactic acid production by the different strains was quantified. Phage induction in the strains was also analysed. There was considerable genetic diversity between strains, and several genes were exclusive to either the strains from Lactobacillus-dominated microbiomes or those containing BV-associated bacteria. Overall, strains from microbiomes dominated by lactobacilli did not differ from strains from microbiomes containing BV-associated bacteria with respect to lactic acid production. All of the strains contained multiple phage, but there was no clear distinction between the presence or absence of BV-associated bacteria with respect to phage-induced lysis. Genes found to be exclusive to the Lactobacillus-dominated versus BV-associated bacteria-containing microbiomes could play a role in the maintenance of vaginal health and the development of BV, respectively.

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“…This microbially mediated vaginal acidity provides an important barrier that restricts the colonization of potential pathogens (Boskey et al, 1999). Perturbations to the composition of the human vaginal microbiome are often associated with diseased states, including bacterial vaginosis (BV) (Fredricks et al, 2005;Oakley et al, 2008;Marrazzo et al, 2010;Srinivasan et al, 2010), susceptibility to sexually transmitted infectious diseases (Sewankambo et al, 1997;Wiesenfeld et al, 2003), tubal infertility (Wiesenfeld et al, 2012;van Oostrum et al, 2013) and adverse pregnancy outcomes (White et al, 2011;Ganu et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance

et al. 2014

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Bacterial communities colonizing the reproductive tracts of primates (including humans) impact the health, survival and fitness of the host, and thereby the evolution of the host species. Despite their importance, we currently have a poor understanding of primate microbiomes. The composition and structure of microbial communities vary considerably depending on the host and environmental factors. We conducted comparative analyses of the primate vaginal microbiome using pyrosequencing of the 16S rRNA genes of a phylogenetically broad range of primates to test for factors affecting the diversity of primate vaginal ecosystems. The nine primate species included: humans (Homo sapiens), yellow baboons (Papio cynocephalus), olive baboons (Papio anubis), lemurs (Propithecus diadema), howler monkeys (Alouatta pigra), red colobus (Piliocolobus rufomitratus), vervets (Chlorocebus aethiops), mangabeys (Cercocebus atys) and chimpanzees (Pan troglodytes). Our results indicated that all primates exhibited host-specific vaginal microbiota and that humans were distinct from other primates in both microbiome composition and diversity. In contrast to the gut microbiome, the vaginal microbiome showed limited congruence with host phylogeny, and neither captivity nor diet elicited substantial effects on the vaginal microbiomes of primates. Permutational multivariate analysis of variance and Wilcoxon tests revealed correlations among vaginal microbiota and host species-specific socioecological factors, particularly related to sexuality, including: female promiscuity, baculum length, gestation time, mating group size and neonatal birth weight. The proportion of unclassified taxa observed in nonhuman primate samples increased with phylogenetic distance from humans, indicative of the existence of previously unrecognized microbial taxa. These findings contribute to our understanding of host-microbe variation and coevolution, microbial biogeography, and disease risk, and have important implications for the use of animal models in studies of human sexual and reproductive diseases.

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Bacterial Vaginosis Is a Strong Predictor ofNeisseria gonorrhoeaeandChlamydiatrachomatisInfection

Cited by 473 publications

References 17 publications

Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women

Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women

Comparison of Lactobacillus crispatus isolates from Lactobacillus-dominated vaginal microbiomes with isolates from microbiomes containing bacterial vaginosis-associated bacteria

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance

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