Cervicovaginal Microbiota Predicts Neisseria gonorrhoeae Clinical Presentation

infection of the female lower genital tract can present with a spectrum of phenotypes ranging from asymptomatic carriage to symptomatic cervical inflammation, or cervicitis. The factors that contribute to the development of asymptomatic or symptomatic infections are largely uncharacterized. We conducted a pilot study to assess differences in the cervicovaginal microbial community of patients presenting with symptomatic vs. asymptomatic infections to a sexually transmitted infections (STI) clinic. DNA was isolated from cervicovaginal swab specimens from women who tested positive for infection using a clinical diagnostic nucleic acid amplification test. We performed deep sequencing of 16S ribosomal RNA gene amplicons, followed by microbiome analyses with QIIME, and species-specific real-time PCR to assess the composition of microbial communities cohabitating the lower genital tract with the infecting . Specimens collected from asymptomatic individuals with infection and no co-infection with and/or carried dominant microbial communities more frequently than symptomatic patients without co-infection. When compared to asymptomatic individuals, symptomatic women had microbial communities characterized by more diverse and heterogenous bacterial taxa, typically associated with bacterial vaginosis (BV) [ , , , and Bacterial Vaginosis-Associated Bacterium-1 (BVAB1)/" "]. Both symptomatic and asymptomatic patients with additional STI co-infection displayed a BV-like microbial community. These findings suggest that dominant vaginal microbial community may protect individuals from developing symptoms during lower genital tract infection with .