Objectives
In women with signs and symptoms of PID, the detection of Gardnerella vaginalis and Atopobium vaginae in the endometrium is associated with histologic evidence of endometritis. The aim of this study was to evaluate whether these organisms were associated with histologic endometritis among women without signs and symptoms of PID.
Methods
Women aged 15-30 diagnosed with mucopurulent cervicitis, endocervical C. trachomatis (CT), or having a sexual partner infected with N. gonorrhoeae (GC), CT, or non-gonococcal urethritis were enrolled. None of the women met the CDC definition of PID. An endometrial biopsy was obtained from women using a Pipelle. Histologic H & E and MPG stained endometrium was assessed for endometritis defined as at least 1 plasma cell per 100X field with or without neutrophils. Endometrial tissue was tested for GC, CT, and M. genitalium by NAAT and additional tissue was cultured for aerobic and anaerobic bacteria. Bacteria were identified by extracting the DNA from each isolate and using DNA based tests, and sequencing of the 16S rRNA gene. The G. vaginalis were designated to clades using amplified ribosomal DNA restriction analysis. Vaginal flora was assessed by Gram stain Nugent score. Differences in bacterial prevalence were evaluated by Fisher’s exact test.
Methods
Women aged 15-30 diagnosed with mucopurulent cervicitis, endocervical C. trachomatis (CT), or having a sexual partner infected with N. gonorrhoeae (GC), CT, or non-gonococcal urethritis were enrolled. None of the women met the CDC definition of PID. An endometrial biopsy was obtained from women using a Pipelle. Histologic H & E and MPG stained endometrium was assessed for endometritis defined as at least 1 plasma cell per 100X field with or without neutrophils. Endometrial tissue was tested for GC, CT, and M. genitalium by NAAT and additional tissue was cultured for aerobic and anaerobic bacteria. Bacteria were identified by extracting the DNA from each isolate and using DNA based tests, and sequencing of the 16S rRNA gene. The G. vaginalis were designated to clades using amplified ribosomal DNA restriction analysis. Vaginal flora was assessed by Gram stain Nugent score. Differences in bacterial prevalence were evaluated by Fisher’s exact test.
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