Effect of male circumcision using shangring and mogen clamp on the infant penile microbiome. Infant Penile Microbiome

Background: Medical male circumcision has been shown to reduce risk of urinary tract complications in infants and infectious disease, such as HIV, in men. Though the mechanisms are unclear, they may be mediated by reducing uropathogens in infants and penile anaerobes in men. However, the effect of early infant male circumcision on infant penile microbiome is unknown.Methods: Infants were assigned to receive surgical circumcision using Mogen Clamp (control) or device male circumcision using ShangRing (intervention) in a randomized trial in Rakai and Kakuuto, Uganda. We collected coronal sulcus swabs at baseline and at days 7 and 14 post-circumcision from 15 participants per arm. We analyzed the penile microbiome using 16S rRNA gene-based sequencing and quantitative PCR to determine the impact of circumcision method on penile bacteria abundance.Results: At baseline, infants in both arms had similar microbiome profiles. Post-circumcision, infants from both arms showed significant changes in penile microbiome characterized by significant decreases in multiple penile anaerobes and uropathogens and significant increases in skin-associated facultative anaerobes and gram-positive anaerobic cocci. Clostridium tetani was not detected.