Cervicovaginal microbiota in Chlamydia trachomatis and other preventable sexually transmitted infections of public health importance: a systematic umbrella review.

A dysbiotic cervicovaginal microbiota, characterized by the overgrowth of anaerobic bacteria, leads to bacterial vaginosis, known to increase the risk of acquiring sexually transmitted infections. The present umbrella review aims to summarize evidence from systematic reviews and meta-analyses on how cervicovaginal microbiota changes in relation to preventable sexually transmitted infections of public health importance, namely Chlamydia trachomatis, Neisseria gonorrhoeae, and human papillomavirus. The databases PubMed, Scopus, and Web of Science were searched with the following strategy: ((chlamydia trachomatis) OR (treponema pallidum) OR (HPV) OR (neisseria gonorrhoeae)) AND (((microbio*) OR (metagen*)) AND (genital)); a total of 12 studies were included. Overall, this umbrella review highlighted that a highly diverse cervicovaginal microbiota has been associated with C. trachomatis infection and can be considered a risk factor in pre-cancerous lesions/cervical cancer related to high-risk HPV infections, whereas the role of cervicovaginal microbiota in N. gonorrhoeae infection is still unclear. In conclusion, specific microbial profiles associated with a high risk for each sexually transmitted pathogen have not yet been identified, and, in the future, more advanced multi-omics approaches will be helpful to clearly describe the etiopathogenetic relationships between resident microorganisms and genital conditions.