This study investigated the cervicovaginal microbiome's (CVM's) impact on Chlamydia trachomatis (CT) infection among Black and Hispanic adolescent and young adult women. A total of 187 women with incident CT were matched to 373 controls, and the CVM was characterized before, during, and after CT infection. The findings highlight that a specific subtype of bacterial vaginosis (BV), identified from 16S rRNA gene reads using the molBV algorithm and community state type (CST) clustering, is a significant risk factor for CT acquisition. A microbial risk score (MRS) further identified a network of bacterial genera associated with increased CT risk. Post treatment, the CVM associated with CT acquisition re-emerged in a different subset of cases leading to reinfection. Additionally, the analysis showed a connection between post-treatment CVM and the development of pelvic inflammatory disease (PID) and miscarriage, further underscoring the CVM's contributing role to incident CT natural history and highlighting its consideration as a therapeutic target.
Keywords: Chlamydia trachomatis; adolescent and young women; bacterial vaginosis; cervicovaginal; longitudinal cohort analysis; microbial network and CT infection; microbial risk score; microbiome; miscarriage; molBV algorithm; molecular Nugent score; pelvic inflammatory disease; post-treatment CVM changes; prospective cohort study; reinfection and clinical sequelae; risk factors for CT acquisition.
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