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O05.4 Association Between Chlamydia Trachomatis Genital Infection and the Vaginal Microbiome
  1. B Ma1,
  2. R M Brotman1,
  3. P Gajer1,
  4. D Fadrosh1,
  5. A Mahurkar1,
  6. O White1,
  7. M Terplan2,
  8. P Bavoil3,
  9. L J Forney4,
  10. J Ravel5
  1. 1University of Maryland School of Medicine Institute for Genome Sciences, Baltimore, MD, United States
  2. 2University of Maryland School of Medicine Department of Obstetrics and Gynecology, Baltimore, MD, United States
  3. 3University of Maryland School of Dentistry, Department of Microbial Pathogenesis, Baltimore, MD, United States
  4. 4University of Idaho, Department of Biological Sciences and the Initiative for Bioinformatics and Evolutionary Studies, Moscow, ID, United States
  5. 5University of Maryland School of Medicine, Institute for Genome Sciences, Baltimore, MD, United States


Background Chlamydia trachomatis (CT) genital infection is one of the most widespread sexually transmitted infections (STIs). It is thought that certain types of vaginal microbiota are better able to prevent STIs, however, very little is known about the relationships between species and genomic composition of the vaginal microbiome and risk of infection. Information about these can be used to advance prevention strategies for STIs. We sought to characterise the vaginal microbiome at the time of diagnosis and after treatment of CT infection.

Methods 101 women with CT genital infection were recruited to a longitudinal study in Baltimore, MD. Participants were treated at diagnosis and returned for clinical visits every 3 months for 9 months, at which times the vaginal microbiota was determined using 16S rRNA analysis. We further applied high-throughput metagenomics to characterise the genomic makeup of the vaginal microbiome.

Results The average age of participants was 19.3 (range 14–28) and 92% were African-American. During CT infection, comprehensive surveys of the vaginal microbiota demonstrated two distinct community state types characterised by: (1) a complex assemblage of strict anaerobes with low proportions of Lactobacillus spp. (60% of samples) or (2) a high relative abundance of Lactobacillus iners-dominated communities (37% of samples) . Metagenomic evaluation suggested unique characteristics of the genomes of the dominant species in these communities (i.e., L. iners, Gardnerella vaginalis). L. iners appeared more genetically diverse than other Lactobacillus species.

Conclusions Complex communities of strict anaerobes with low proportions of Lactobacillus or specific L. iners genome types represented a hallmark of the chlamydia -infected state in this population. Some L. iners may be better suited to adapt to diverse environments while others may be contributing factors to an at-risk microbiome. In the era of personalised medicine, future work will enhance our ability to intervene and establish a protective vaginal microbiome.

  • chlamydia
  • metagenomics
  • vaginal microbiota

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