Unveiling shifts in cervical microbiota composition among Colombian women in the presence of Trichomonas vaginalis: a longitudinal study

Trichomonas vaginalis is a flagellated protozoan affecting human reproductive health. Although bacterial coinfections have been associated with T. vaginalis infection outcomes, pertinent data are scarce. This study was aimed at assessing vaginal bacterial community changes regarding T. vaginalis outcomes (infection, clearance, persistence) during patients’ follow-up visits. This was a 1-year follow-up study involving Colombian women who provided two cytological scrapings from the cervix (one at baseline and another at follow-up), having an average 12 ± 1 month follow-up interval. T. vaginalis was detected by conventional PCR (Tvk3/7 and BTU9/2 primers). The Illumina Novaseq PE250-platform was used for assessing microbiota composition. This study involved 66 women (132 samples); 68.2% (n = 45) tested negative for T. vaginalis at baseline while 31.8% (n = 21) were initially diagnosed with T. vaginalis infection (99,304 amplicon sequence variants identified/categorised into 62 phyla and 1908 genera). Women who cleared T. vaginalis (n = 10) displayed increased microbial richness, while those having persistence (n = 11) had higher microbial diversity. Significant changes were observed regarding genus relative abundance: Lactobacillus abundance increased in the clearance group (p = 0.002), Prevotella in the persistence group (p = 0.045) and Gardnerella, Megasphaera and Sneathia in the group having acquired T. vaginalis infection (p = 0.045). Regarding relative abundance, logistic regression analysis revealed a positive trend concerning Sneathia increase (adjusted OR 2.23) and reduced Lactobacillus abundance (adjusted OR 0.39) in women with T. vaginalis persistence. DESeq analysis revealed a substantial decrease in the Ornithinimicrobium genus among women without infection during follow-up, while Ruminococcus increased in women having various T. vaginalis outcomes. The results suggested that specific bacterial genera present during T. vaginalis infection may influence its clearance, having potential implications for improving diagnostic and therapeutic strategies for enhancing women’s reproductive health.