Culturomics Approaches Expand the Diagnostic Accuracy for Sexually Transmitted Infections

Abstract

Sexually transmitted infections (STIs) are a major health concern with clinical manifestations being acknowledged to cause severe reproductive impairment. Research in infectious diseases has been centered around the known major pathogens for decades. However, we have just begun to understand that the microbiota of the female genital tract is of particular importance for disease initiation, infection progression, and pathological outcome. Thus, we are now aware that many poorly described, partially not yet known, or cultured bacteria may pave the way for an infection and/or contribute to disease severity. While sequencing-based methods are an important step in diagnosing STIs, culture-based methods are still the gold-standard method in diagnostic routine, providing the opportunity to distinguish phenotypic traits of bacteria. However, current diagnostic culture routines suffer from several limitations reducing the content of information about vaginal microbiota. A detailed characterization of microbiota-associated factors is needed to assess the impact of single-bacterial isolates from the vaginal community on vaginal health and the containment of STIs. Here we provide current concepts to enable modern culture routines and create new ideas to improve diagnostic approaches with a conjunct usage of bioinformatics. We aim to enable scientists and physicians alike to overcome long-accepted limitations in culturing bacteria of interest to the human health. Eventually, this may improve the quality of culture-based diagnostics, facilitate a research interface, and lead to a broader understanding of the role of vaginal microbiota in reproductive health and STIs.

Emerging Presence of Culturable Microorganisms in Clinical Samples of the Genitourinary System: Systematic Review and Experience in Specialized Care of a Regional Hospital

“…Bacterial infections of the genitourinary tract are frequently empirically treated with generic antibiotics because routine laboratory procedures are unable to provide a diagnosis. However, advances in the diagnostic procedures available to clinical microbiology laboratories (e.g., mass spectrometry—MALDI-TOF, media enrichment and molecular techniques) have improved identification of the microorganisms responsible for these infections, allowing specifically targeted treatments to be applied in a larger proportion of cases [ 8 ].…”

Sorangicin A Is Active against Chlamydia in Cell Culture, Explanted Fallopian Tubes, and Topical In Vivo Treatment

“…To analyze whether the growth pattern of lactobacilli would be altered upon SorA application, six patient-derived vaginal isolates from our STI culturomics facility [16] were selected: L. gasseri, L. fermentum, L. jensenii, L. mucosae, L. reuteri, and L. rhamnosus. Culture purity was confirmed via MALDI-TOF (matrix assisted laser desorption/ionization time of flight) (Bruker Corporation, Billercia, USA) and a pre-culture inoculated in 10 mL brain heart infusion media (Thermo Fischer, Waltham, MA, USA) under anaerobic conditions (Whitely H35 HEPA, Don Whitley Scientific, Bingley, UK).…”

Vaginal Microbiome in Reproductive Medicine

“…In addition to being more readily available and more affordable—factors not to be underestimated—culture techniques have the critical advantage of revealing more phenotypical traits, which are of interest to clinical decision-making. However, due to numerous limitations inherent in the cultivation process, a large amount of information on different microbial communities in the genital tract, such as their interdependencies, is bound to remain elusive [ 14 ].…”