Association Between Trichomonas vaginalis and Vaginal... : Sexually Transmitted Diseases (original) (raw)

Original Study

Association Between Trichomonas vaginalis and Vaginal Bacterial Community Composition Among Reproductive-Age Women

Brotman, Rebecca M. PhD, MPH*†; Bradford, L. Latey BS*; Conrad, Melissa MSc‡; Gajer, Pawel PhD*; Ault, Kevin MD§¶; Peralta, Ligia MD∥; Forney, Larry J. PhD**††; Carlton, Jane M. PhD‡; Abdo, Zaid PhD††‡‡§§; Ravel, Jacques PhD*¶¶

From the *Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD; †Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD; ‡Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY; §Department of Gynecology and Obstetrics and the Emory Vaccine Center, Emory University, Atlanta, GA; ¶Hubert Department of Global Health, Rollins School of Public Health, Emory University Atlanta, GA; ∥Department of Pediatrics, Adolescent and Young Adult Medicine, University of Mary land School of Medicine, Baltimore, MD; **Department of Biological Sciences, University of Idaho, Moscow, ID; ††Institute for Bioinformatics and Evolutionary Studies (IBEST), University of Idaho, Moscow, ID; Departments of ‡‡Mathematics and §§Statistics, University of Idaho, Moscow, ID; and ¶¶Department of Microbiology and Immunology University of Maryland School of Medicine, Baltimore, MD

The authors thank Bishoy Michael, Hongqui Yang, Joyce Sakamoto, Grace Maldarelli, Sergio Mojica, Stacey McCulle and Sara Koenig (all at University of Maryland, Institute for Genome Sciences) for technical help, as well as Dr. Charlotte Gaydos (Johns Hopkins School of Medicine) for providing the DNA of Trichomonas vaginalis that was used as positive control in the PCR assays. The authors also thank Dr. Khalil Ghanem (Johns Hopkins School of Medicine) for insightful comments in the review of the manuscript.

Supported by National Institutes of Health grants U01-AI070921 (Ravel), K01-AI080974 (Brotman), UH2-AI083264 (Ravel and Forney) and R21AI083954 (Carlton). The study was also supported in part by NIH grants UL1-RR025008, KL2-RR025009 and TL1-RR025010 (Ault).

Presented in part as a poster at the International Human Microbiome Congress, March 9–11, 2011, Vancouver Canada and as an oral presentation at the International Society for Sexually Transmitted Disease Research, 19th Biennial Congress, July 11–13, 2011, Quebec City.

The authors report no conflict of interest.

Correspondence: Rebecca M. Brotman, PhD, MPH, Department of Epidemiology and Public Health, Institute for Genome Sciences, University ofMaryland School of Medicine, 801 West Baltimore St., Rm No. 633, Baltimore, MD 21201. E-mail: [email protected]. or Jacques Ravel, PhD, Department of Microbiology and Immunology, Institute for Genome Sciences, University of Maryland School of Medicine, 801 West Baltimore St., Rm No. 611, Baltimore, MD 21201. E-mail: [email protected].

Received for publication February 21, 2012, and accepted June 5, 2012.

Objectives

Some vaginal bacterial communities are thought to prevent infection by sexually transmitted organisms. Prior work demonstrated that the vaginal microbiota of reproductive-age women cluster into 5 types of bacterial communities; 4 dominated by Lactobacillus species (L. iners, L. crispatus, L. gasseri, L. jensenii) and 1 (termed community state type (CST) IV) lacking significant numbers of lactobacilli and characterized by higher proportions of Atopobium, Prevotella, Parvimonas, Sneathia, Gardnerella, Mobiluncus, and other taxa. We sought to evaluate the relationship between vaginal bacterial composition and Trichomonas vaginalis.

Methods

Self-collected vaginal swabs were obtained cross-sectionally from 394 women equally representing 4 ethnic/racial groups. T. vaginalis screening was performed using PCR targeting the 18S rRNA and β-tubulin genes. Vaginal bacterial composition was characterized by pyrosequencing of barcoded 16S rRNA genes. A panel of 11 microsatellite markers was used to genotype T. vaginalis. The association between vaginal microbiota and T. vaginalis was evaluated by exact logistic regression.

Results

T. vaginalis was detected in 2.8% of participants (11/394). Of the 11 _T. vaginalis-_positive cases, 8 (72%) were categorized as CST-IV, 2 (18%) as communities dominated by L. iners, and 1 (9%) as _L. crispatus_-dominated (P = 0.05). CST-IV microbiota were associated with an 8-fold increased odds of detecting T. vaginalis compared with women in the _L. crispatus_-dominated state (OR: 8.26, 95% CI: 1.07–372.65). Seven of the 11 T. vaginalis isolates were assigned to 2 genotypes.

Conclusion

T. vaginalis was associated with vaginal microbiota consisting of low proportions of lactobacilli and high proportions of Mycoplasma, Parvimonas, Sneathia, and other anaerobes.