Comparison of the penile microbiome in infant male circumcision: Mogen clamp versus ShangringResearch in context
Juan E. Salazar,
Daniel E. Park,
Nahid Punjani,
Tony Pham,
Maliha Aziz,
Godfrey Kigozi,
Ronald H. Gray,
Stephen D. Kiboneka,
Marc Goldstein,
Philip S. Li,
Richard Lee,
Cindy M. Liu
Affiliations
Juan E. Salazar
Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
Daniel E. Park
Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
Nahid Punjani
Department of Urology, Weill Cornell Medicine of Cornell University, New York-Presbyterian Hospital, New York, NY, USA
Tony Pham
Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
Maliha Aziz
Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA
Godfrey Kigozi
Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
Ronald H. Gray
Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, USA
Stephen D. Kiboneka
Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe, Uganda
Marc Goldstein
Department of Urology, Weill Cornell Medicine of Cornell University, New York-Presbyterian Hospital, New York, NY, USA
Philip S. Li
Department of Urology, Weill Cornell Medicine of Cornell University, New York-Presbyterian Hospital, New York, NY, USA
Richard Lee
Department of Urology, Weill Cornell Medicine of Cornell University, New York-Presbyterian Hospital, New York, NY, USA
Cindy M. Liu
Antibiotic Resistance Action Center, Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA; Corresponding author. George Washington University, Science and Engineering Hall, 800 22nd St NW, Washington, DC, 20052, United States.
Summary: Background: This study aimed to characterise the infant penile (coronal sulcus) microbiome and the effects of early infant male circumcision (EIMC), following a standard surgical method (Mogen Clamp) and a non-surgical alternative (ShangRing). Methods: We collected coronal sulcus swabs at baseline and on days 7 and 14 post-circumcision from infants assigned to receive EIMC by Mogen Clamp (n = 15) or ShangRing (n = 15), in a randomised trial in Rakai and Kakuuto, Uganda. We used 16S rRNA gene-based sequencing and broad-coverage qPCR to characterise the infant penile microbiome and assess the effects of EIMC in both study arms. Findings: Prior to EIMC, the infant penile microbiome had a mixture of facultative and strict anaerobes. In both study arms, EIMC caused penile microbiome proportional abundance changes characterised by decreases in penile anaerobes [ShangRing Prevotella: −15.0%, (SD = 19.1); Mogen clamp Prevotella: −3.6% (11.2); ShangRing Veillonella: −11.3% (17.2); Mogen clamp Veillonella: −2.6% (11.8)] and increases in skin-associated facultative anaerobes [ShangRing Corynebacterium: 24.9%, (22.4); Mogen clamp Corynebacterium: 4.7% (21.3); ShangRing Staphylococcus: 21.1% (20.5); Mogen clamp Staphylococcus: 18.1% (20.1)]. Clostridium tetani was not detected during the study. Interpretation: Mogen Clamp and ShangRing EIMC both changed the composition of the infant penile microbiome by reducing the proportional abundances of anaerobes and uropathogens, which is consistent with medical male circumcision findings in adults. C. tetani was not increased by either EIMC method. Funding: Bill and Melinda Gates Foundation.
