Bacterial vaginosis and anaerobic bacteria are associated with endometritis.
BACKGROUND
Chlamydia trachomatis and/or Neisseria gonorrhoeae account for approximately one-third to one-half of pelvic inflammatory disease (PID) cases. Thus, up to 70% of cases have an unknown, nongonococcal/nonchlamydial microbial etiology.


METHODS
We investigated the associations of N. gonorrhoeae, C. trachomatis, bacterial vaginosis, anaerobic bacteria, facultative bacteria, and lactobacilli with endometritis among 278 women with complete endometrial histology and culture from the PID Evaluation and Clinical Health Study.


RESULTS
Women with acute endometritis were less likely to have H(2)O(2)-producing Lactobacillus species (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.01-0.8) and more likely to be infected with C. trachomatis (OR, 16.2; 95% CI, 4.6-56.6), N. gonorrhoeae (OR, 11.6; 95% CI, 4.5-29.9), diphtheroids (OR, 5.0; 95% CI, 2.1-12.2), black-pigmented gram-negative rods (OR, 3.1; 95% CI, 1.4-7.0), and anaerobic gram-positive cocci (OR, 2.1; 95% CI, 1.0-4.3) and to have bacterial vaginosis (OR, 2.4; 95% CI, 1.3-4.3).


CONCLUSIONS
We conclude that bacterial vaginosis-associated organisms are frequent among women with PID. Because these organisms were strongly associated with endometritis, we recommend that all women with PID be treated with regimens that include metronidazole.
Haggerty
Catherine L
CL
University of Pittsburgh, 130 DeSoto St., 516 Parran Hall, Pittsburgh, PA 15261, USA. haggerty@pitt.edu
Hillier
Sharon L
SL
Bass
Debra C
DC
Ness
Roberta B
RB
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D004716:Endometritis / Q000150:complications* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D016585:Vaginosis, Bacterial / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D008795:Metronidazole