You are here

Article Text

Article menu

Download PDFPDF

Oral Presentations
O05 – FEMALE GENITAL INFECTIONS, IMMUNOLOGY AND MICROBIOME
Monday, July 15, 2019 4:15 PM – 5:45 PM
O05.4 The effect of the combined oral contraceptive pill on the vaginal microbiota of women treated for bacterial vaginosis
Free
  1. Larissa Ratten1,
  2. Catriona Bradshaw2,
  3. Erica Plumer2,
  4. Christopher Fairley2,
  5. Gerald Murray3,
  6. Suzanne Garland3,
  7. Jennifer Danielewski3,
  8. Gilda Tachedjian4,
  9. Eric Chow2,
  10. Lenka Vodstrcil2
  1. 1Monash University, Central Clinical School, Clayton, Australia
  2. 2Monash University, Central Clinical School, Carlton, Australia
  3. 3The Royal Women’s Hospital, Centre for Women’s Infectious Disease Research, Parkville, Australia
  4. 4The Burnet Institute, Melbourne, Australia

Abstract

Background Bacterial Vaginosis (BV) is considered to be a dysbiosis of the vaginal microbiota (VM); it causes vaginal symptoms, increases risk for STI/HIV acquisition and negatively impacts obstetric outcomes. We analysed the VM of women from an open-label trial of women randomized to the combined-oral contraceptive pill (COCP) or current non-hormonal contraceptive practices after antibiotic treatment for BV. Our aim was to determine if COCP-exposure was associated with an optimal VM dominated by Lactobacillus spp. following antibiotic treatment.

Methods Women (N=92) returned vaginal swabs and questionnaires monthly for 6 months or until BV recurrence. Specimens (N=449) underwent VM analysis by 16S rRNA gene V3V4 amplicon sequencing. Alpha diversity was calculated using the Shannon diversity index. Associations between behavioural factors and diversity were investigated using generalized estimating equations population-averaged models and multinomial regression was used to assess factors associated with composition.

Results Specimens were grouped into five VM types: Lactobacillus iners dominated, L. crispatus dominated, mixed Lactobacillus spp., Gardnerella vaginalis dominated and mixed highly diverse taxa. COCP-exposure was associated with a decrease in VM diversity (Shannon; adjusted coefficient=-0.55, 95%CI:-0.75, 0.36,p<0.001). Women with COCP-exposure were also more likely to have VM dominated by either L. iners (adjusted relative risk ratio [RRR]=4.40, 95%CI: 1.90,10.18,p=0.001) or L. crispatus (adjRRR=3.12, 95%CI:1.24,7.81,p=0.015) than one dominated by G. vaginalis. Conversely, women who reported an ongoing regular sex partner (RSP) were more likely to have a VM dominated by G. vaginalis (adjRRR=2.56, 95%CI:0.80,8.22,p=0.144) or mixed diverse taxa (adjRRR=2.01, 95%CI:0.81,4.99,p=0.129) than by L. crispatus, although this was not significant.

Conclusion COCP-exposure is associated with higher relative abundance of Lactobacillus spp. and an increased likelihood of developing a VM dominated by L. crispatus or L. iners following antibiotic treatment. Conversely, re-exposure to an RSP increased the likelihood of a VM that was abundant in BV-associated bacteria including G. vaginalis. These findings have important implications for the development of BV treatment and prevention strategies.

Disclosure No significant relationships.

  • microbiome

https://doi.org/10.1136/sextrans-2019-sti.131

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.