Diversity of endocervical microbiota associated with genital Chlamydia trachomatis infection and infertility among women visiting obstetrics and gynecology clinics in Malaysia

Abstract

The cervical microbiota constitutes an important protective barrier against the invasion of pathogenic microorganisms. A disruption of microbiota within the cervical milieu has been suggested to be a driving factor of sexually transmitted infections. These include Chlamydia trachomatis which frequently causes serious reproductive sequelae such as infertility in women. In this study, we profiled the cervical microbial composition of a population of 70 reproductive-age Malaysian women; among which 40 (57.1%) were diagnosed with genital C. trachomatis infection, and 30 (42.8%) without C. trachomatis infection. Our findings showed a distinct compositional difference between the cervical microbiota of C. trachomatis-infected subjects and subjects without C. trachomatis infection. Specifically, significant elevations of mostly strict and facultative anaerobes such as Streptococcus, Megasphaera, Prevotella, and Veillonella in the cervical microbiota of C. trachomatis-positive women were detected. The results from the current study highlights an interaction of C. trachomatis with the environmental microbiome in the endocervical region.

Endocervical miRNA Expression Profiles in Women Positive for Chlamydia trachomatis with Clinical Signs and/or Symptoms Are Distinct from Those in Women Positive for Chlamydia trachomatis without Signs and Symptoms

“…It is currently unknown if the CT-infected women have different genetic compositions of chlamydiae. It is also possible that microbiota changes (23)(24)(25) and hormonal changes at the time of infection could dictate the miR expression pattern or result in differences in the development of symptoms. Future studies should include women with signs and symptoms without Chlamydia infection and also coinfection groups (NG/TV/bacterial vaginosis) to determine if miRNA expression patterns are specific to chlamydial infection.…”

The Role of Genital Tract Microbiome in Fertility: A Systematic Review

“…Previously, Hok et al [12] reported similar findings, affirming that Mycobacterium tuberculosis was the only one with a higher occurrence in infertile patients; again, bacterial culturing [14] on cervical swabs, performed for cervicitis, failed to show different cervical flora in infertile women, even though 16% of these women were found positive for Chlamydia trachomatis antibodies on the serum. A further confirmation derived from the study of Cheong et al [36] that assessed the prevalence of the aforementioned pathogen using rRNA metagenomic sequencing on endocervical swabs and found that the large majority of infertile women was infected with Chlamydia trachomatis, in contrast with a lower prevalence of the infection in the fertile group of women (88% vs. 28%) after correction of the results according to demographics parameters. Moreover, many further associated pathogens were isolated more frequently in those women with Chlamydia trachomatis infection.…”

Advantages and Limitations of 16S rRNA Next-Generation Sequencing for Pathogen Identification in the Diagnostic Microbiology Laboratory: Perspectives from a Middle-Income Country

“…Even though the NGS technique was first initiated around 2005, the workflow has been mainly used for research purposes (such as profiling of environmental bacterial communities and gut microbiome profiling) rather than for pathogen identification in the diagnostic microbiology laboratory [ 75 , 76 ], and this is also the case in Malaysia [ 77 , 78 , 79 , 80 ]. Several limitations and challenges towards widespread implementation of the technique for pathogen identification in diagnostic microbiology remain to be overcome, if the platform is to be used in middle-income countries like Malaysia.…”