One Infection Leads to Another

A recent study sheds light on the cervicovaginal microbiome’s (CVM) influence on the risk and recurrence of Chlamydia trachomatis infection among adolescent and young adult women. Published in Cell, the research identifies specific bacterial communities and microbiome subtypes that increase susceptibility to chlamydia and highlights potential avenues for targeted prevention strategies.

The study population comprised young Black and Hispanic women, who are known to be disproportionately affected by both bacterial vaginosis (BV) and chlamydia. Researchers followed 560 participants, including 187 women with newly diagnosed chlamydia infections and 373 matched controls, analyzing CVM profiles before, during, and after infection.

Using advanced molecular techniques, researchers identified a distinct subtype of BV, termed mBV-A, characterized by the predominance of Candidatus Lachnocurva vaginae. Women with this microbiome profile were 2.5 times more likely to acquire chlamydia than those with Lactobacillus-dominant microbiomes.

Further analysis revealed a network of 10 bacterial genera associated with chlamydia acquisition. These bacteria collectively formed a microbial risk score that was highly predictive of chlamydia risk, offering a more comprehensive understanding than individual bacterial markers.

Post-treatment, the CVM of most participants returned to a baseline state. However, women with persistent BV-like microbiomes, particularly the mBV-A subtype, were at greater risk of chlamydia reinfection.

The study also linked mBV-positive states to other complications, such as pelvic inflammatory disease and miscarriage, emphasizing the CVM’s importance not only in chlamydia infection dynamics but also in broader reproductive health.

Corresponding author Robert Burk said, “These results are particularly significant for communities of color and could lead to a wholly new approach for clinically managing BV and chlamydia. We can now determine which BV cases are most worrisome and should be closely monitored. The findings also suggest that altering the cervicovaginal microbiome could be a strategy for both treating BV and preventing chlamydia.”