Chronic endometritis: correlation among hysteroscopic, histologic, and bacteriologic findings in a prospective trial with 2190 consecutive office hysteroscopies.
OBJECTIVE
To evaluate the type and etiopathogenic role of infectious agents detected in endometrial cultures obtained from women with chronic endometritis (CE).


METHODS
Prospective controlled study.


METHODS
University hospital.


METHODS
2190 women undergoing hysteroscopy for different indications.


METHODS
Vaginal and endometrial samples were collected from 438 women with a CE diagnosis at hysteroscopy and 100 women with no signs of CE (controls).


METHODS
Histology and cultures for common bacteria, Neisseria gonorrhoeae and Mycoplasma, and molecular biology testing for Chlamydia were performed.


RESULTS
We compared results of vaginal and intrauterine cultures obtained from women with and without CE. Histologic results were positive in 388 of these cases (88.6%), and at least one microorganism was found in 320 endometrial samples (73.1%). In the control group, histologic results and endometrial culture were positive in only 6% and 5% of cases, respectively. The most frequent infectious agents detected at the endometrial level were common bacteria (58% of cases). Ureaplasma urealyticum was detected in 10% and Chlamydia in only 2.7% of positive endometrial cultures. In only 143 (32.6%) cases were the same infectious agent isolated in endometrial and vaginal cultures.


CONCLUSIONS
More than 70% of CE cases resulted from nongonococcal, nonchlamydial infections. Common bacteria and Mycoplasma were the most frequent etiologic agents. Vaginal cultures have low concordance with endometrial cultures.
Cicinelli
Ettore
E
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Bari, Bari, Italy. cicinelli@gynecology1.uniba.it
De Ziegler
Dominique
D
Nicoletti
Roberto
R
Colafiglio
Giuseppe
G
Saliani
Nicola
N
Resta
Leonardo
L
Rizzi
Donatella
D
De Vito
Danila
D
D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D016022:Case-Control Studies; D002689:Chlamydia / Q000302:isolation & purification; D002908:Chronic Disease; D004715:Endometriosis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D016984:Enterococcus faecium; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D009174:Mycoplasma / Q000302:isolation & purification; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D009819:Office Visits; D011446:Prospective Studies; D013210:Staphylococcus / Q000302:isolation & purification; D013302:Streptomyces / Q000302:isolation & purification; D014509:Ureaplasma / Q000302:isolation & purification; D014599:Uterus / Q000382:microbiology* / Q000473:pathology; D014621:Vagina / Q000382:microbiology*