Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States.
Sequencing Core, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.
Front Cell Infect Microbiol. 2020 Aug 4;10:433. doi: 10.3389/fcimb.2020.00433. eCollection 2020.
We determined the predictive accuracy of penile bacteria for incident BV in female sex partners. In this prospective cohort, we enrolled Kenyan men aged 18-35 and their female sex partners aged 16 and older. We assessed BV at baseline, 1, 6, and 12 months. Incident BV was defined as a Nugent score of 7-10 at a follow-up visit, following a Nugent score of 0-6 at baseline. Amplification of the V3-V4 region of the bacterial 16S rRNA gene was performed on meatal and glans/coronal sulcus swab samples. Majority vote classifier combined the decisions of three machine learning classification algorithms (Random Forest, Support Vector Machine, K Nearest Neighbor). We report the estimate cross-validation predictive accuracy for incident BV based on baseline penile taxa. The incidence of BV was 31% among 168 couples in which the woman did not have BV at baseline: 37.3% if the man was uncircumcised vs. 26.3% if the man was circumcised. Incident BV occurred at 1 month ( = 23), 6 months ( = 20), 12 months ( = 9). The predictive capacity of meatal taxa was high: sensitivity (80.7%), specificity (74.6%), accuracy (77.5%), area under the curve (88.8%). Variable importance ranking identified meatal taxa that in the vagina are associated with BV: , and were among the top 10 most predictive taxa. The accuracy of glans/coronal sulcus taxa to predict incident BV was comparable to meatal taxa accuracy, but with greater variability. Baseline penile microbiota accurately predicted BV incidence in women who did not have BV at baseline, with more than half of incident infections observed at 6- to 12- months after penile microbiome assessment. These results suggest interventions to manipulate the penile microbiome may reduce BV incidence in sex partners, and that potential treatment (antibiotic or live biotherapeutic) will need to be effective in reducing or altering bacteria at both the glans/coronal sulcus and urethral sites (as represented by the meatus). The temporal association clarifies that concordance of penile microbiome with the vaginal microbiome of sex partners is not merely reflecting the vaginal microbiome, but can contribute to it.
我们确定了阴茎细菌对女性性伴侣细菌性阴道病(BV)发病的预测准确性。在这项前瞻性队列研究中,我们招募了年龄在 18-35 岁的肯尼亚男性及其年龄在 16 岁及以上的女性性伴侣。我们在基线、1、6 和 12 个月时评估了 BV。在随访时,Nugent 评分为 7-10 时定义为新发 BV,而基线时 Nugent 评分为 0-6。对尿道口和龟头/冠状沟拭子样本的细菌 16S rRNA 基因的 V3-V4 区进行扩增。多数投票分类器结合了三种机器学习分类算法(随机森林、支持向量机、K 最近邻)的决策。我们报告了基于基线阴茎分类群的新发 BV 的估计交叉验证预测准确性。在基线时女性没有 BV 的 168 对夫妇中,BV 的发生率为 31%:未行包皮环切术的男性中为 37.3%,而行包皮环切术的男性中为 26.3%。1 个月( = 23)、6 个月( = 20)、12 个月( = 9)时发生新发 BV。尿道口分类群的预测能力较高:敏感性(80.7%)、特异性(74.6%)、准确性(77.5%)、曲线下面积(88.8%)。变量重要性排序确定了与 BV 相关的阴道尿道口分类群: 、 和 是前 10 个最具预测性的分类群之一。龟头/冠状沟分类群预测新发 BV 的准确性与尿道口分类群的准确性相当,但变异性更大。基线阴茎微生物组准确预测了基线时没有 BV 的女性的 BV 发病率,在阴茎微生物组评估后 6 至 12 个月时观察到超过一半的新发感染。这些结果表明,干预阴茎微生物组可能会降低性伴侣的 BV 发病率,而潜在的治疗(抗生素或活体生物治疗)需要在龟头/冠状沟和尿道部位(代表尿道口)有效减少或改变细菌。时间关联阐明了阴茎微生物组与性伴侣阴道微生物组的一致性不仅仅是反映阴道微生物组,而是可以促成其变化。