Kodimerla, R. | Search bioRxiv

bioRxiv2025

Effect of Azithromycin treatment on the microbial composition, functional dynamics and resistomes of endocervical, vaginal and rectal microbiomes of women in Fiji with Chlamydia trachomatis infection

Antibiotics disrupt mucosal microbial communities, yet the effects on microbiomes with Chlamydia trachomatis (Ct) infection remain poorly understood. Some data exist on vaginal microbiomes pre- and post-treatment, but none are available for the endocervix or rectum that are primary sites of infection. We applied metagenomic shotgun sequencing to vaginal, endocervical and rectal samples from women who, overtime, had Ct persistence, clearance, or no infection to evaluate azithromycin-induced changes in microbial composition, function, and the resistome. Our results show a shift in composition and function that support Ct post-treatment with azithromycin resistance mutations in the Ct rplV gene and significant endocervical enrichment of azithromycin resistance genes in Lactobacillus iners and Gardnerella vaginalis, the strains of which have moderate/high potential for biofilm formation. These findings highlight the unintended ecological consequences of azithromycin, including resistance gene propagation and microbiome shifts that support persistent/recurrent Ct, emphasizing the need for novel treatment and microbiome- preserving strategies.

microbiology↗

bioRxiv2023

The unique microbial diversity, community composition and networks of Pacific Islander endocervical and vaginal microbiomes in the presence or absence of Chlamydia trachomatis infection using metagenomic shotgun sequencing

BackgroundPacific Islanders are a vulnerable population with a high prevalence of Chlamydia trachomatis (Ct) sexually transmitted infections (STIs) and remain underrepresented in research. Here, 258 vaginal and 92 paired endocervical samples from women of diverse ethnicities in Fiji were evaluated using metagenomics to characterize microbial relative abundance, composition and networks including associations with Neisseria gonorrhoeae, human papilloma virus (HPV), Mycoplasma genitalium, Candida and bacterial vaginosis (BV). ResultsPacific Islander ethnicities and age <25 years were significantly associated with Ct infection. Using VALENCIA, a sub-community state type (subCST) classifier, 93 (36.04%) vaginal and 38 (41.30%) endocervical microbiomes did not match reference subCSTs. Four unique subCSTs were developed to better classify Pacific Islander microbiomes: IV-D0, dominated by Gardnerella vaginalis; IV-D1, high/moderate G. vaginalis relative abundance with Prevotella spp.; IV-D2, high/moderate G. vaginalis with Lactobacillus iners; and IV-E, moderate Prevotella spp. Ct positive endocervical and paired vaginal microbiomes were significantly more likely to have differential species relative abundance (81.58%) than Ct negative pairs (35.84%; AOR: 7.93; 95% CI: 2.93-21.93; P<0.0001). A significantly higher alpha diversity was found for iTaukei ethnicity, all subCST-IV types, BV, and Ct for vaginal microbiomes. For endocervical microbiomes, higher diversity was significant for subCST-IV-A, subCST-IV-D1, and subCST-IV-E, and high-risk HPV types. Overall, there was a significantly higher diversity for the endocervix in paired microbiomes. Vaginal microbiomes showed significant divergence in community composition as above and for Candida. Endocervical composition varied significantly by subCST type and Ct status. Gut and BV-associated bacterial clusters were present in Ct positive and negative paired endocervical and vaginal microbiome networks but were smaller with fewer bacterial and no Lactobacillus spp. interactions in Ct-infected endocervical networks where G. vaginalis generated polymicrobial biofilms along with Ct likely influence pathogenicity. ConclusionsFijian endocervical and vaginal microbiomes represent divergent microbial abundance and compositions, especially for Pacific Islander ethnicities, with distinct subCSTs compared to other global populations. The higher microbial diversity of the endocervix with prevalent G. vaginalis, L. iners and Prevotella spp. suggest that these microbiomes/networks may predispose to and/or promote chlamydial and HPV pathogenesis. Prospective studies are needed to further define causal associations to develop successful interventions.

microbiology↗