The Microbiome Composition of a Man's Penis Predicts Incident Bacterial Vaginosis in His Female Sex Partner With High Accuracy
The Microbiome Composition of a Man's Penis Predicts Incident Bacterial Vaginosis in His Female Sex Partner With High Accuracy
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DOI：
10.3389/fcimb.2020.00433
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发表时间：
2020-08-04
影响因子：
5.7
通讯作者：
Bailey, Robert C.
中科院分区：
文献类型：
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作者：
Mehta, Supriya D.;Zhao, Dan;Bailey, Robert C.
背景：我们确定了阴茎细菌对女性性伴侣细菌性感染的预测准确性。在这个前瞻性队列中，我们招募了18-35岁的肯尼亚男性及其16岁及以上的女性性伴侣。我们在基线、1、6和12个月时评估BV。事件BV定义为随访时纽金特评分为7-10分，基线时纽金特评分为0-6分。在金属和龟头/冠状沟拭子样本上扩增细菌16S rRNA基因V3-V4区。多数投票分类器结合了三种机器学习分类算法（随机森林、支持向量机、K近邻）的决策。我们报告了基于基线阴茎分类群的事件BV估计交叉验证预测精度。结果：168对夫妻中女性基线时未患细菌性阴道炎的发生率为31%，男性未行包皮环切的为37.3%，男性行包皮环切的为26.3%。BV事件发生于1个月（n= 23）、6个月（n= 20）、12个月（n= 9）。金属分类群的预测能力高：敏感性（80.7%）、特异性（74.6%）、准确性（77.5%）、曲线下面积（88.8%）。对阴道内与细菌性阴道炎相关的金属类群进行变量重要性排序：细小单胞菌、乳杆菌、crispatus、Dialister、Sneathia sanguinegens和gardnerella vaginalis均在预测细菌性阴道炎的前10位。龟头/冠状沟分类群预测BV事件的准确性与金属分类群的准确性相当，但差异较大。结论：基线阴茎微生物群准确地预测了基线时没有BV的女性的BV发病率，在阴茎微生物群评估后6至12个月观察到超过一半的感染事件。这些结果表明，控制阴茎微生物组的干预措施可能会降低性伴侣的细菌性阴道炎发病率，潜在的治疗方法（抗生素或活体生物疗法）将需要有效地减少或改变龟头/冠状沟和尿道部位（以阴道为代表）的细菌。时间关联澄清了阴茎微生物组与性伴侣阴道微生物组的一致性不仅反映了阴道微生物组，而且可以促进阴道微生物组。
Background:We determined the predictive accuracy of penile bacteria for incident BV in female sex partners. In this prospective cohort, we enrolled Kenyan men aged 18-35 and their female sex partners aged 16 and older. We assessed BV at baseline, 1, 6, and 12 months. Incident BV was defined as a Nugent score of 7-10 at a follow-up visit, following a Nugent score of 0-6 at baseline. Amplification of the V3-V4 region of the bacterial 16S rRNA gene was performed on meatal and glans/coronal sulcus swab samples. Majority vote classifier combined the decisions of three machine learning classification algorithms (Random Forest, Support Vector Machine, K Nearest Neighbor). We report the estimate cross-validation predictive accuracy for incident BV based on baseline penile taxa. Results:The incidence of BV was 31% among 168 couples in which the woman did not have BV at baseline: 37.3% if the man was uncircumcised vs. 26.3% if the man was circumcised. Incident BV occurred at 1 month (n= 23), 6 months (n= 20), 12 months (n= 9). The predictive capacity of meatal taxa was high: sensitivity (80.7%), specificity (74.6%), accuracy (77.5%), area under the curve (88.8%). Variable importance ranking identified meatal taxa that in the vagina are associated with BV:Parvimonas, Lactobacillus iners, L. crispatus, Dialister, Sneathia sanguinegens, andGardnerella vaginaliswere among the top 10 most predictive taxa. The accuracy of glans/coronal sulcus taxa to predict incident BV was comparable to meatal taxa accuracy, but with greater variability. Conclusions:Baseline penile microbiota accurately predicted BV incidence in women who did not have BV at baseline, with more than half of incident infections observed at 6- to 12- months after penile microbiome assessment. These results suggest interventions to manipulate the penile microbiome may reduce BV incidence in sex partners, and that potential treatment (antibiotic or live biotherapeutic) will need to be effective in reducing or altering bacteria at both the glans/coronal sulcus and urethral sites (as represented by the meatus). The temporal association clarifies that concordance of penile microbiome with the vaginal microbiome of sex partners is not merely reflecting the vaginal microbiome, but can contribute to it.