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. 2019 Feb 6;19(1):30.
doi: 10.1186/s12905-019-0727-0.

Cervical microbiota in women with cervical intra-epithelial neoplasia, prior to and after local excisional treatment, a Norwegian cohort study

Johanna Wiik  1   2 , Verena Sengpiel  3 , Maria Kyrgiou  4   5 , Staffan Nilsson  6   7 , Anita Mitra  4   5 , Tom Tanbo  8 , Christine Monceyron Jonassen  9 , Tone Møller Tannæs  10 , Katrine Sjøborg  11
Affiliations

Cervical microbiota in women with cervical intra-epithelial neoplasia, prior to and after local excisional treatment, a Norwegian cohort study

Johanna Wiik et al. BMC Womens Health. .

Abstract

Background: Local treatment for cervical intraepithelial neoplasia (CIN) by Loop Electrosurgical Excision Procedure (LEEP) has been correlated with reproductive morbidity, while the cervicovaginal microbiota is also known to affect the risk of preterm delivery. CIN and treatment by LEEP might change the cervical microbiota. The main aim of this study was to describe the cervical microbiota before and after LEEP and assess its associaton with cone depth and HPV persistence. Further, we aimed to compare the microbiota to references with normal cervical cytology.

Methods: Between 2005 and 2007, we prospectively identified 89 women planned for LEEP in a Norwegian hospital and recruited 100 references with a normal cervical cytology. Endocervical swabs were collected prior to treatment and at six (n = 77) and 12 months (n = 72) post LEEP for bacterial culture and PCR, and post LEEP for DNA testing for human papillomavirus (HPV). We compared the cervical microbiota composition before and after treatment and between women planned for LEEP vs references.

Results: There was a reduction in the number of non-Lactobacillus bacterial species six and 12 months after LEEP compared to before treatment and a tendency towards a concomitant increase in Lactobacillus. No association between the detection of cervical bacteria, HPV persistence or cone depth was found. Women planned for LEEP carried significantly more Bacteroides spp., Gardnerella vaginalis, Mycoplasma hominis and Ureaplasma parvum as well as a greater number of bacterial species than the references.

Conclusions: Local excisional treatment appears to alter the cervical microbiota towards a less diverse microbiota. Women with CIN have a more diverse cervical microbiota compared to women with normal cervical cytology.

Keywords: CIN; Cervical Intraepithelial Neoplasia; HPV; Human papillomavirus; LEEP; Lactobacillus; Vaginal microbiota.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Regional Committee for Ethics in Medical Research, East-Region, 2005-04-18, (622–05059). All included women consented to participate after oral and written information.

Consent for publication

Not applicable.

Competing interests

The authors have stated explicitly that there are no competing interest in connection with this article.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of formation of the study groups and follow up
Fig. 2
Fig. 2
Number of non-Lactobacillus bacteria identified in culture or PCR (range: 0–5) for women planned for LEEP as opposed to references. a) All women b) Women aged <46 years
See this image and copyright information in PMC

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