Differences in vaginal microbiome in African American women versus women of European ancestry

Fettweis, Jennifer M.; Brooks, J. Paul; Serrano, Myrna G.; Sheth, Nihar U.; Girerd, Philippe H.; Edwards, D.J.; Strauss, Jerome F.; Jefferson, Kimberly K.; Buck, Gregory A.

doi:10.1099/mic.0.081034-0

Cited by 422 publications

(482 citation statements)

References 54 publications

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“…As in other settings, women with Nugent scores >7 had highly diverse vaginal microbiota. Similar to previous studies in women of African descent, these BVpositive women frequently had vaginal microbiota, dominated by BVAB1, Prevotella, G. vaginalis or L. iners (Fettweis et al 2014). …”

Section: Discussionsupporting

confidence: 85%

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

Lennard

Dabee

Barnabas

et al. 2017

Suid-Afrikaanse Tydskr Natuurwetenskap Tegnol

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Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI) prevalence of 102; 16-22-year-old, HIV-negative South African women from a low-income, highpopulation-density community in Cape Town (CPT). Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV) status was established using Nugent scoring and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV) and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7), 7% as BV-intermediate (Nugent score 3-6) and 38% as BV-negative (Nugent 0-2). Group B Streptococcus (Streptococcus agalactiae), the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and BV may adversely affect reproductive health and place these women at additional risk for HIV acquisition. The high abundance of Prevotella amnii, in particular, may increase HIV risk, given its inflammatory capacity. Laboratorybased testing for STIs (Chlamydia and Gonorrhoeae in particular) appear to be warranted in this community, together with further monitoring or treatment of BV. Hoë voorkomskoers van bakteriële vaginose en Chlamydia in 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Jong Suid-Afrikaanse vroue uit hulpbron-arm gemeenskappe staar verskeie uitdagings in die gesig in terme van hul seksuele en reproduktiewe gesondheid. Hier beskryf ons die voorkoms van vaginale mikrobiota en seksueel oordraagbare infeksies (SOI's) onder 102; 16-22-jarige MIV-negatiewe Suid-Afrikaanse vroue uit 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Vaginale mikrobiota is met behulp van 16S rRNA amplikon volgorde-bepaling geprofileer; bakteriese vaginose (BV) status is met behulp van 'n Nugent-telling vasgestel; en SOI's is deur middel van 'n multipleks polimerase kettingreaksie bepaal. SOI's was algemeen, met 55% van die vroue wat ten minste een SOI gehad het; 41% wat met hoë-risiko menslike papillomavirus (MPV) besmet was, en 'n verdere 28% wat met laerisiko-MPV besmet was; 44% van die vroue was met Chlamydia besmet, waarvan 16% een of meer addisionele SOI gehad het. BV persentasies was ook baie hoog, met 55% van die vroue wat as BV-positief (Nugent-telling ≥7) geklassifiseer is, 7% as BV-intermediêr (Nugent-telling 3-6), en 38% as BVnegatief (Nugent-telling 0-2). Streptococcus (Streptococcus agalactiae), die grootste oorsaak van neonatale sepsis, was teenwoordig in 25% van die BV-positiewe vroue en 28% van die BV-negatiewe vroue, en was dus meer onder BV-negatiewe vroue. Beide Chlamydia-infeksie en BV kan re...

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Section: Discussionsupporting

confidence: 85%

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

Lennard

Dabee

Barnabas

et al. 2017

Suid-Afrikaanse Tydskr Natuurwetenskap Tegnol

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“…PTB-microbiota association. For example, there is evidence that women of black race, a proxy for host genetics and a correlate to social and demographic factors, have a different range of normal vaginal community compositions (15,16).…”

mentioning

confidence: 99%

Replication and refinement of a vaginal microbial signature of preterm birth in two racially distinct cohorts of US women

Callahan

DiGiulio

Goltsman

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

326

482

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Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Previous studies have suggested that the maternal vaginal microbiota contributes to the pathophysiology of PTB, but conflicting results in recent years have raised doubts. We conducted a study of PTB compared with term birth in two cohorts of pregnant women: one predominantly Caucasian (n = 39) at low risk for PTB, the second predominantly African American and at high-risk (n = 96). We profiled the taxonomic composition of 2,179 vaginal swabs collected prospectively and weekly during gestation using 16S rRNA gene sequencing. Previously proposed associations between PTB and lower Lactobacillus and higher Gardnerella abundances replicated in the low-risk cohort, but not in the high-risk cohort. High-resolution bioinformatics enabled taxonomic assignment to the species and subspecies levels, revealing that Lactobacillus crispatus was associated with low risk of PTB in both cohorts, while Lactobacillus iners was not, and that a subspecies clade of Gardnerella vaginalis explained the genus association with PTB. Patterns of cooccurrence between L. crispatus and Gardnerella were highly exclusive, while Gardnerella and L. iners often coexisted at high frequencies. We argue that the vaginal microbiota is better represented by the quantitative frequencies of these key taxa than by classifying communities into five community state types. Our findings extend and corroborate the association between the vaginal microbiota and PTB, demonstrate the benefits of high-resolution statistical bioinformatics in clinical microbiome studies, and suggest that previous conflicting results may reflect the different risk profile of women of black race.pregnancy | prematurity | vaginal microbiota | Lactobacillus | Gardnerella P reterm birth (PTB; delivery at <37 gestational wk) affects ≈12% of US births and is the leading cause of neonatal death and morbidity worldwide. Multiple lines of evidence support a role for the indigenous microbial communities of the mother (the maternal microbiota) in the pathophysiology of PTB. Microbial invasion of the amniotic cavity is one of the most frequent causes of spontaneous PTB (1), and the most common invading taxa are consistent with maternal origin (2-4). Bacterial vaginosis (BV), a condition involving an altered vaginal microbiota, has been consistently identified as a risk factor for PTB (5, 6). Multiple studies have also found chronic periodontitis, another condition associated with an altered microbiota, to be a risk factor for PTB (7,8).High-throughput sequencing methods have facilitated new lines of investigation into the microbial etiology of PTB (9, 10). Amplification and high-throughput sequencing of the 16S rRNA gene (metabarcoding) simultaneously measures the presence and relative abundance of thousands of bacterial taxa (composition), and resolves differences to the level of genus and sometimes species or subspecies. To date, metabarcoding studies of the relationship between the vaginal microbiota and PTB have y...

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“…There are at least five Lactobacillus species that can colonize the vagina: Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus jensenii, Lactobacillus vaginalis and Lactobacillus iners (Antonio et al, 1999;Fettweis et al, 2014;Madhivanan et al, 2015;Wilks et al, 2004). Bacterial vaginosis (BV) is a common clinical condition characterized by a dramatic increase in both bacterial species diversity and overall bacterial burden.…”

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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Differences in vaginal microbiome in African American women versus women of European ancestry

Cited by 422 publications

References 54 publications

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

Replication and refinement of a vaginal microbial signature of preterm birth in two racially distinct cohorts of US women

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

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