Bacterial community structure shapes the vaginal resistome during pregnancy

Abstract Maternal-fetal infections are a leading cause of morbidity and mortality, often requiring complex antibiotic treatments due to increasing antibiotic resistance. However, the determinants of resistance in the vaginal microbiome (VMB) remain underexplored. We characterized a cohort of 1547 pregnant women and show that the VMB harbors a wide range of antibiotic resistance genes (ARGs). Genes conferring resistance to Macrolide-Lincosamide-Streptogramin (MLS) and tetracycline antibiotic classes were the most abundant, whereas those from ß-lactam class were the most diverse. ARG diversity was found to be primarily shaped by microbial community state types (CSTs), with CST I ( Lactobacillus crispatus-dominated community ) showing the lowest and CST IV ( anaerobic species-dominated community ) the highest diversity. Co-abundance patterns further revealed modular structures linking specific taxa (e.g., Gardnerella , Prevotella , and Enterobacterales ) to distinct ARGs and mobile genetic element profiles. A novel method incorporating predicted ARGs phenotypes, which we call the Phenotypic Resistance Diversity Index (PRDI), uncovered a resistome signature linked to adverse pregnancy outcomes, including increased microbial diversity and expanded predicted antibiotic resistance breadth in preterm premature rupture of membranes. Overall, our study establishes the VMB as a structured and dynamic reservoir of ARGs, contributing to the broader human resistome, opening new perspectives for advancing maternal and neonatal care.

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Publication Details

Journal
npj Biofilms and Microbiomes
Published
2026-09-05
DOI
https://doi.org/10.1038/s41522-026-01144-y
Primary Topic
Reproductive tract infections research
Type
article
Field-Weighted Citation Impact
0.00

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article

Bacterial community structure shapes the vaginal resistome during pregnancy

Luce Landraud, V. Tessier, Dominique Luton, Pierre‐Yves Ancel et al.
npj Biofilms and Microbiomes
Reproductive tract infections research
article

Bacterial community structure shapes the vaginal resistome during pregnancy

Luce Landraud, V. Tessier, Dominique Luton, Pierre‐Yves Ancel, Hendy Abdoul, Claire Poyart, Jessica Rousseau, Kenzo-Hugo Hillion, Laurent Mandelbrot, Frédéric Batteux, Sean Kennedy, Olivier Clermont, Nathalie Grall, Céline Plainvert, Asmaa Tazi, Luc Desfrère, François Goffinet, Christophe Pannetier, Nassim Boutouchent, Agnes Baud, Hélène Jabbarian, Laura Lesimple, Sinthiya Sivanesan, Laurence Lecomte, Lahçene Allal, Pierre-Henri Jarreau, Céline Méhats
article en

Abstract

Abstract Maternal-fetal infections are a leading cause of morbidity and mortality, often requiring complex antibiotic treatments due to increasing antibiotic resistance. However, the determinants of resistance in the vaginal microbiome (VMB) remain underexplored. We characterized a cohort of 1547 pregnant women and show that the VMB harbors a wide range of antibiotic resistance genes (ARGs). Genes conferring resistance to Macrolide-Lincosamide-Streptogramin (MLS) and tetracycline antibiotic classes were the most abundant, whereas those from ß-lactam class were the most diverse. ARG diversity was found to be primarily shaped by microbial community state types (CSTs), with CST I ( Lactobacillus crispatus-dominated community ) showing the lowest and CST IV ( anaerobic species-dominated community ) the highest diversity. Co-abundance patterns further revealed modular structures linking specific taxa (e.g., Gardnerella , Prevotella , and Enterobacterales ) to distinct ARGs and mobile genetic element profiles. A novel method incorporating predicted ARGs phenotypes, which we call the Phenotypic Resistance Diversity Index (PRDI), uncovered a resistome signature linked to adverse pregnancy outcomes, including increased microbial diversity and expanded predicted antibiotic resistance breadth in preterm premature rupture of membranes. Overall, our study establishes the VMB as a structured and dynamic reservoir of ARGs, contributing to the broader human resistome, opening new perspectives for advancing maternal and neonatal care.

npj Biofilms and Microbiomes
Université Claude Bernard Lyon 1 (FR), Centre National de la Recherche Scientifique (FR), Inserm (FR), Institut Pasteur (FR), Université Paris Cité (FR), Sorbonne Université (FR), Hôpital Louis-Mourier (FR), Université Sorbonne Paris Nord (FR), Sorbonne Paris Cité (FR), Hôpital Cochin (FR), Assistance Publique – Hôpitaux de Paris (FR), Maternité Port Royal (FR), Normandie Université (FR), Institut Cochin (FR), Réseau pour la Transition Énergétique (FR), Hôpital Bichat-Claude-Bernard (FR), Impact (CA), Infection, Anti-microbiens, Modélisation, Evolution (FR), Université de Rouen Normandie (FR)
Bpifrance
Good health and well-being
Openalex Percentile: Top 12%
Reproductive tract infections research
DOIOpen Access PDFOpenAlex
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