The vaginal microbiome and sexually transmitted infections are interlinked: Consequences for treatment and prevention

Abstract

In a Perspective for our Collection on STI research, Janneke van de Wijgert discusses the latest on how the vaginal microbiota predisposes women to acquisition of STIs and discusses future potential for clinical intervention.

Fig 1. Visualization of interrelationships among various urogenital conditions involving micro-organisms.

Green colors indicate desirable conditions, and red colors indicate undesirable conditions. In both cases, the darker the color, the more desirable or undesirable the condition, respectively. The size of the circles is relative to the size of the respective epidemics, but only very roughly. The STI circle does not include viral STIs. The circles on the far left and far right appear as if they do not overlap because the image is two dimensional, but they do overlap somewhat. It is important to note that few studies on the associations between urogenital conditions and host responses or adverse outcomes (which determine whether a condition is desirable or undesirable) have been holistic. For example, many studies only employ 16S ribosomal RNA sequencing of the vaginal microbiota, but this does not cover fungi, protozoa, and viruses and does not reliably identify Chlamydia trachomatis and Neisseria gonorrhoeae. Abbreviations: GBS, Group B streptococcus; STI, sexually transmitted infection. * Complications include HIV acquisition, pelvic inflammatory disease, adverse pregnancy outcomes, and maternal and neonatal infections.