Unique Vaginal Microbiota That Includes an Unknown Mycoplasma-Like Organism Is Associated With Trichomonas vaginalis Infection

Martín, David H.; Zozaya, Marcela; Lillis, Rebecca A.; Myers, Leann; Nsuami, Malanda; Ferris, Michael J.

doi:10.1093/infdis/jit100

Cited by 80 publications

(71 citation statements)

References 45 publications

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“…We also detected sequence variants corresponding to Trichomonas-associated Candidatus Mycoplasma girerdii (25)(26)(27), and Trichomonas was indeed present in all samples with frequency >10 −3.5 . No STI organism was significantly associated with PTB (Fig.…”

Section: Resultsmentioning

confidence: 71%

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.

327

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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Section: Resultsmentioning

confidence: 71%

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.

327

482

View full text Add to dashboard Cite

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“…JX508800) is 99% identical to our infant-derived OTU (Fig. S4); this clone was isolated from a vaginal swab from a Trichomonas vaginalis -infected patient (37). Finally, we amplified and cloned near-full-length 16S rRNA gene sequences from baby 3’s DOL 18 saliva (see Materials and Methods).…”

Section: Resultsmentioning

confidence: 73%

“…S4 in the supplemental material). Intriguingly, a recent study found high abundances of this uncultivated Mycoplasma in the vaginal microbiota of Trichomonas vaginalis -infected women (detected in 19/30 T. vaginalis -infected and 1/29 uninfected individuals) (37), again raising the possibility that this organism too was transferred from mother to infant at delivery. Further investigation into the diversity, distribution, and clinical significance of this novel, uncultivated Mycoplasma in human hosts is warranted, particularly in pregnant women and premature infants.…”

Section: Discussionmentioning

confidence: 99%

Microbiome Assembly across Multiple Body Sites in Low-Birthweight Infants

Costello

Carlisle

Bik

et al. 2013

mBio

142

162

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The purpose of this study was to evaluate the composition and richness of bacterial communities associated with low-birthweight (LBW) infants in relation to host body site, individual, and age. Bacterial 16S rRNA genes from saliva samples, skin swabs, and stool samples collected on postnatal days 8, 10, 12, 15, 18, and 21 from six LBW (five premature) infants were amplified, pyrosequenced, and analyzed within a comparative framework that included analogous data from normal-birthweight (NBW) infants and healthy adults. We found that body site was the primary determinant of bacterial community composition in the LBW infants. However, site specificity depended on postnatal age: saliva and stool compositions diverged over time but were not significantly different until the babies were 15 days old. This divergence was primarily driven by progressive temporal turnover in the distal gut, which proceeded at a rate similar to that of age-matched NBW infants. Neonatal skin was the most adult-like in microbiota composition, while saliva and stool remained the least so. Compositional variation among infants was marked and depended on body site and age. Only the smallest, most premature infant received antibiotics during the study period; this heralded a coexpansion of Pseudomonas aeruginosa and a novel Mycoplasma sp. in the oral cavity of this vaginally delivered, intubated patient. We conclude that concurrent molecular surveillance of multiple body sites in LBW neonates reveals a delayed compositional differentiation of the oral cavity and distal gut microbiota and, in the case of one infant, an abundant, uncultivated oral Mycoplasma sp., recently detected in human vaginal samples.

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“…and Gardnerella spp. [111], suggesting that T. vaginalis directly influences or is influenced by the microbial environment and confirming the potential importance of interactions between T. vaginalis and vaginal microbiota.…”

Section: Management and Treatmentmentioning

confidence: 83%

Epidemiology and Treatment of Trichomoniasis

Kissinger

2015

Curr Infect Dis Rep

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Trichomonas vaginalis is the most common nonviral sexually transmitted infection (STI) in the world. It was once thought to be a nuisance STI, but it is now being recognized as an important source of reproductive morbidity and a facilitator of HIV transmission and acquisition, and thus it is an important public health problem. The prevalence of T. vaginalis varies greatly by geography and risk group, but is more common among persons of African descent and appears to increase with age, though this may be a screening phenomenon. Wet mount and culture are simple diagnostics, but have lower sensitivity than nucleic acid amplification techniques presently approved for women only. Single dose (2 g) metronidazole (MTZ) for both the index patient and their sexual partners is the preferred treatment. High rates of retest positivity are found after single-dose treatment which are likely due to clinical resistance rather than re-infection and/or drug resistance.

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Unique Vaginal Microbiota That Includes an Unknown Mycoplasma-Like Organism Is Associated With Trichomonas vaginalis Infection

Abstract: T. vaginalis may alter the vaginal microbiota in a manner that is favorable to its survival and/or transmissibility. An unknown Mycoplasma species plays a role in some of these transformations. In other cases, these changes may result in a heightened host inflammatory response.

Cited by 80 publications

References 45 publications

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

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

Microbiome Assembly across Multiple Body Sites in Low-Birthweight Infants

Epidemiology and Treatment of Trichomoniasis

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