Bacterial vaginosis is associated with the microbiome of the penis of the partner

The microbiota of the penis men accurately predicted the frequency of bacterial vaginosis among their female partners, which it has not observed previously. As stated in the study, published in the journal Frontiers in Cellular and Infection Microbiology, the detection of pathogenic bacteria men predicted the development of bacterial vaginosis with a sensitivity of 80 percent and a specificity of 75 percent.

Epidemiological and microbiological data suggest about the role of men in risk of developing bacterial vaginosis and its recurrence. For example, in women whose sexual partners were circumcised men was observed in 40 percent fewer cases of bacterial vaginosis within a year than women who engaged in sex with uncircumcised men. Presumably, the reduction of this number due to the fact that pathogenic bacteria are among uncircumcised men at the inner side of the foreskin, which favors the presence of anaerobic bacteria causing bacterial vaginosis.

Other studies say that among monogamous heterosexual couples vaginal bacterial taxa were highly correlated with taxa penis partner among couples where the woman was suffering from vaginosis, however, the correlation was significantly weaker than in couples where the woman has vaginosis was detected.

In his new work Supriya Mehta (Supriya D. Mehta) from the University of Illinois at Chicago and her colleagues decided to find out how the bacteria isolated from the urethra and coronal sulcus of the glans penis circumcised and uncircumcised men, is able to predict the occurrence of bacterial vaginosis among their sexual partners. The study involved 168 couples in which the woman initially did not suffer from bacterial vaginosis, and a qualitative and quantitative study of the microbiome of the penis of the man was the most complete.

Among the studied pairs, the cumulative frequency of bacterial vaginosis accounted for 31.6 percent, and among women who engaged in sex with circumcised men, the frequency was 27.3 percent, and uncircumcised in is 37.3 (p = 0,12). With more than half (56 percent) of men were circumcised. 21% of men had additional sexual contacts, and only 3 percent of women reported that they had a different sexual partner in the last 6 months. Condom use during last sexual intercourse was not common, reported by 16.7% of men and women.

At the mouth of the urethra men, scientists have identified the ten most important for predicting bacterial vaginosis genera and species of bacteria. In the first three were Parvimonas, Lactobacillus iners and Fastidiosipila. When comparing taxa of bacteria coronal sulcus of the glans by the ability to predict vaginosis, leading was Enhydrobacter, Brevibacterium and Prevotella bivia. In General, these data did not differ from circumcised and uncircumcised men.

For two populations of the microbiome of the penis predictive ability obtained using three different statistical methods were high — 77.5 percent for the mouth of the urethra and 76.8 percent for the coronary sulcus. Using machine learning methods, scientists have found that the overall specificity of predictions is 74.6% and sensitivity 80.7%. While male circumcision was associated with a reduction in the incidence of bacterial vaginosis in previous studies, the classifiers of this study it had a low variable importance ranking for the mouth of the urethra and coronal sulcus.

Since the probable mechanism by which male circumcision protects women from vaginosis is the reduction in the number of anaerobic bacteria in the penis, scientists have suggested that the status of circumcision in itself is not an important predictor, rather, he is the microbial composition of the penis plays a crucial role in predicting vaginosis. One of the theories that could explain the presence of pathogenic bacteria on the penis in circumcised men, suggests the emergence of such bacteria in vagina with frequent sex. However, this hypothesis cannot explain the differential Association between circumcision status and vaginosis observed in this and other studies. An alternative explanation is that the relationship between circumcision status and vaginosis due to the higher bacterial load of the penis in uncircumcised men. The exact reason for this connection is yet to be found.

The results provide empirical support for evaluating the effect of treatment of the male partner at risk for developing vaginosis or recurrence. Any potential treatment — antibiotics or vaginal suppositories with probiotic should be effective to reduce the number of bacteria on the penis. A study of 22 couples in which partners of women with vaginosis symptoms received oral 400 milligrams of metronidazole twice a day and 2 percentage clindamicina cream topically for 7 days showed a decrease in the prevalence and abundance of pathogens in the coronal sulcus after 8 days of treatment, although this was not confirmed within 28 days. It was not associated with re-emergence associated with bacterial vaginosis bacteria in women.

In this connection, it has been hypothesized that the return of the composition of the microbiocenosis of the penis to the original (disease-causing) level may be caused by persisting in the skin of the penis, the urethra or the prostate of bacteria and their re-introduction into the vagina during sex. Needed more extensive long-term studies to understand potential effects of antimicrobial treatment and the circumcision of the microbiome of the penis and relapse of bacterial vaginosis.

In treatment of bacterial vaginosis, there has been a potential shift. Recently, we were toldthat the vaginal lactobacilli of South African women was more resistant to pathogenic bacteria and that, potentially, can be used for correction of the vaginal microbiome.

Vyacheslav Gomenyuk

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