Role of bacterial vaginosis-associated microorganisms in endometritis.
OBJECTIVE
Our goal was to define the role of bacterial vaginosis and bacterial vaginosis-associated microorganisms in endometritis.


METHODS
Endometrial biopsies were obtained for histologic and microbiologic study from 178 consecutive women with suspected pelvic inflammatory disease, and 85 of them underwent laparoscopy to diagnose salpingitis.


RESULTS
Histologic endometritis was confirmed in 117 (65%) of the women. Among women who underwent laparoscopy, salpingitis was present in 68% of those with and 23% of those without endometritis. Some but not all bacterial vaginosis-associated microorganisms were linked with endometritis. By logistic regression analysis, after adjustment for bacterial vaginosis and isolation of Neisseria gonorrhoeae and Chlamydia trachomatis, endometritis was associated with endometrial N. gonorrhoeae (odds ratio 5.7, 95% confidence interval 1.8 to 17.5), C. trachomatis (odds ratio 4.8, 95% confidence interval 1.3 to 18.2), anaerobic gram-negative rods (odds ratio 2.6, 95% confidence interval 1.1 to 5.7), and nonwhite race (odds ratio 2.3, 95% confidence interval 1.1 to 4.8).


CONCLUSIONS
The association of anaerobic gram-negative rods with endometritis, after adjustment for bacterial vaginosis, N. gonorrhoeae, and C. trachomatis, supports the role of these microorganisms in the etiology of histologic endometritis among women with clinically suspected pelvic inflammatory disease.
Hillier
S L
SL
Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
Kiviat
N B
NB
Hawes
S E
SE
Hasselquist
M B
MB
Hanssen
P W
PW
Eschenbach
D A
DA
Holmes
K K
KK
D000328:Adult; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D004716:Endometritis / Q000382:microbiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D016017:Odds Ratio; D012044:Regression Analysis; D016585:Vaginosis, Bacterial / Q000382:microbiology*