Characteristics of Women and Their Male Sex Partners Predict Bacterial Vaginosis Among a Prospective Cohort of Kenyan Women With Nonoptimal Vaginal Microbiota.
Characteristics of Women and Their Male Sex Partners Predict Bacterial Vaginosis Among a Prospective Cohort of Kenyan Women With Nonoptimal Vaginal Microbiota.
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DOI：
10.1097/olq.0000000000001259
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发表时间：
2020-12
影响因子：
3.1
通讯作者：
Otieno F
中科院分区：
文献类型：
--
作者：
Mehta SD;Agingu W;Nordgren RK;Green SJ;Bhaumik DK;Bailey RC;Otieno F
在非最佳阴道微生物群落状态类型中，细菌组成随Nugent细菌性阴道病状态而变化，Nugent细菌性阴道病与特定的阴茎分类群相关，控制了阴道群落状态类型、单纯疱疹病毒2型和HIV。文本中提供了补充的数字内容。高达50%的患有非最佳阴道微生物群落类型(CST)的妇女患有细菌性阴道病(BV)。在不理想的CST中，对有和没有BV诊断的妇女有什么区别知之甚少。在阴道CST不理想的女性中，我们确定了与BV相关的女性及其男性性伴侣的特征。在这项前瞻性研究中，252对异性伴侣在基线后1、6和12个月进行了观察。通过高通量16S核糖体RNA基因扩增序列测定宫颈阴道灌洗液和阴茎拭子中的微生物群。非最优CST定义为CST-IV。细菌性阴道病的定义是Nugent评分在7到10之间。广义估计方程分析估计了患有非最佳CST的女性BV的调整后优势比(AORS)。在基线水平，患有非最佳CST的女性的中位年龄为22岁，44%患有BV，16%患有HIV，66%患有II型单纯疱疹病毒(HSV)。男性伴侣的中位年龄为27岁，12%患有HIV，48%患有HSV-2，55%接受过割礼。在非最佳CST中，血链球菌、普雷沃特氏菌、羊普沃特氏菌和梭状芽孢杆菌中，BV相关细菌-2在BV观察中显著丰富。在控制CST、HIV和HSV-2的多变量广义估计方程中，CST-IVA(AOR1.91；P=0.087)、HIV(AOR2.3；P=0.051)、HSV-2(AOR1.75；P=0.065)和男性伴侣阴茎分类群丰富的女性BV增加：Dialister(AOR1.16；P=0.034)、Megasphaera(AOR1.22；P=0.001)和短杆菌(AOR1.13；P=0.019)。这些结果为区分患有BV的女性和非最佳阴道CST的女性提供了洞察力。阻断阴茎和阴道类群的性交换可能有利于预防阴道微生物群的病理状态。
Within nonoptimal vaginal microbial community state type, bacterial composition varied by Nugent bacterial vaginosis status, and Nugent bacterial vaginosis was associated with specific penile taxa, controlling for vaginal community state type, herpes simplex virus 2, and HIV. Supplemental digital content is available in the text. Up to 50% of women with nonoptimal vaginal microbial community state type (CST) have bacterial vaginosis (BV). Little is known about what distinguishes women with and without BV diagnosis within nonoptimal CST. We identified features of women and their male sex partners associated with BV among women with nonoptimal vaginal CST. In this prospective study, 252 heterosexual couples were observed at 1, 6, and 12 months after baseline. Microbiomes were characterized in cervicovaginal lavage and penile meatal swabs through high-throughput 16s ribosomal RNA gene amplicon sequencing. Nonoptimal CST was defined as CST-IV. Bacterial vaginosis was defined as a Nugent score of 7 to 10. Generalized estimating equation analysis estimated adjusted odds ratios (aORs) for BV among women with nonoptimal CST. At baseline, women with nonoptimal CST were a median age of 22 years, 44% had BV, 16% had HIV, and 66% had herpes simplex virus (HSV) type 2. Male partners were a median age of 27 years, 12% had HIV, 48% had HSV-2, and 55% were circumcised. Within nonoptimal CST, Sneathia sanguinegens, Prevotella species, Prevotella amnii, and Clostridiales, BV-associated bacteria-2 were statistically significantly enriched in observations with BV. In multivariable generalized estimating equation controlling for CST, HIV, and HSV-2, BV was increased among women with CST-IVA (aOR, 1.91; P = 0.087), HIV (aOR, 2.30; P = 0.051), HSV-2 (aOR, 1.75; P = 0.065), and enrichment of male partner penile taxa: Dialister (aOR, 1.16; P = 0.034), Megasphaera (aOR, 1.22; P = 0.001), and Brevibacterium (aOR, 1.13; P = 0.019). These results provide insights into factors differentiating women with BV among those with nonoptimal vaginal CST. Interrupting the sexual exchange of penile and vaginal taxa may be beneficial for preventing pathologic state of vaginal microbiome.