A specific molecular bacterial vaginosis (BV) subtype, CST-IV-A, has been identified as a significant factor in increasing the risk of acquiring and experiencing reinfections of Chlamydia trachomatis (CT). This discovery stems from a study published in Cell, which examines the link between the cervicovaginal microbiome and CT infections among Black and Hispanic adolescents and young women.
The study conducted by researchers in New York City involved 187 young women diagnosed with Chlamydia trachomatis infections and 373 controls. Using longitudinal samples collected before, during, and after infection, the researchers identified CST-IV-A as a key risk factor. Women with this BV subtype had more than double the likelihood of contracting Chlamydia trachomatis compared to those without it.
According to the study, Chlamydia trachomatis is one of the most common sexually transmitted infections globally, with over 130 million cases reported annually. Among young women, it can lead to severe health complications such as pelvic inflammatory disease (PID), chronic pelvic pain, ectopic pregnancies, and infertility. The risk is even higher for Black and Hispanic women, who experience five times the rate of infection compared to their White counterparts.
The study also found that after treatment with antibiotics, CST-IV-A and other BV subtypes frequently reappeared, increasing the risk of reinfection and complications like miscarriage and PID. According to the researchers, this underscores the role of the microbiome as a therapeutic target.
Lead researcher Dr Robert D. Burk stated, “Our findings reveal that specific bacterial communities are not only linked to the risk of initial Chlamydia trachomatis infection but also reinfection. Understanding these dynamics could pave the way for preventive strategies.”
The researchers employed advanced molecular techniques to analyze bacterial diversity in the cervicovaginal microbiome. A microbial risk score was developed to evaluate the collective impact of multiple bacterial genera. They observed that 10 key bacterial groups, including Candidatus Lachnocurva vaginae and Prevotella, worked together to heighten infection risks.
Beyond identifying risk factors, the study sheds light on disparities in CT infections. Dr Mykhaylo Usyk, one of the authors, noted that limited research focuses on marginalised communities disproportionately affected by Chlamydia trachomatis. “Addressing these disparities requires targeted public health interventions and research efforts,” he emphasised.
The findings offer valuable insights into the importance of effectively managing the female cervicovaginal microbiome. These eperts believe that interventions targeting bacterial vaginosis could notably reduce the burden of Chlamydia trachomatis infections and related health complications for women.
Meanwhile, they advocate for broader awareness and access to screening and treatment in high-risk populations, the researchers suggest further studies to explore therapies that stabilise the microbiome.
