Διεθνής δημοσίευση της επιστημονικής ομάδας του Locus Medicus
Correlation between hysteroscopic features and specific microbial species in women with chronic endometritis
Από τους:
Vassilis Kapetanios, Maria Lampraki, Georgios Georgoulias, Stavros Kasdaglis, Stylianos Kliafas, Nikolaos Gkavra, Maria Xountasi, Vassilis Tsilivakos, Michail Leventopoulos
Ένα από τα κύρια θέματα που ενδιαφέρουν ιδιαιτέρως το επιστημονικό προσωπικό του Locus Medicus τα τελευταία χρόνια αφορά την ενδομητρίτιδα, τη φλεγμονή δηλαδή του ενδομητρίου η οποία αποτελεί έναν από τους βασικότερους λόγους υπογονιμότητας και αποβολών. Συνδυάζοντας αποτελέσματα εργαστηριακών μικροβιολογικών και μοριακών εξετάσεων ταυτόχρονα με κλινική ενδελεχή παρατήρηση ύστεροσκοπήσεων προέκυψαν αποτελέσματα τα οποία δημοσιεύτηκαν στο περιοδικό Heliyon, Elsevier, impact factor 4, DOI : https://doi.org/10.1016/j.heliyon.2024.e30259, Published : April 26, 2024
Βασικό αποτέλεσμα με κύρια κλινική σημασία αποτέλεσε η στατιστικώς σημαντική συσχέτιση της παρουσίας του Ε-coli με την εστιακή υπερπλασία του ενδομητρίου. Το αποτέλεσμα αυτό τονίζει τη βασική ανάγκη της μικροβιολογικής μελέτης του ενδομητρικού εκπλύματος. Είναι η πρώτη φορά που συσχετίστηκε η ύπαρξη συγκεκριμένης υστεροσκοπικής εικόνας με συγκεκριμ΄΄ενο βακτηριακό παράγοντα
Highlights
- Escherichia coli is associated with focal endometrial hyperplasia.
- A potential pathogenic role for this bacterium in CE complications.
- Hysteroscopy and microbial cultures can be used efficiently to identify CE.
- Targeted antibiotic treatment seems to improve reproductive outcome.
Abstract
Objective and rationale
Chronic endometritis (CE) has recently been associated with unexplained infertility and recurrent miscarriages. The current gold standard for CE detection is histopathological examination. However, office hysteroscopy and endometrial cultures are also significant, due to the possible link between CE and various microorganisms. Bacterial colonization of the endometrium has been associated with reduced success rates of in vitro fertilisation embryo transfer. Few studies have tried to correlate CE hysteroscopy findings with pathogenic microorganisms. This prospective cohort study sought to establish whether hysteroscopic diagnostic lesions correlate with specific microbial species.
Methods
The study encompassed women undergoing diagnostic tests for a range of subfertility health issues. 189 women completed the standard office diagnostic hysteroscopy (DH). 181 had also endometrial samples taken for microbial culture investigation. Correlation analysis (χ2 and Fisher’s exact test) between hysteroscopic findings suggestive of CE and endometrial cultures was carried out. Logistic regression models were also fitted to measure whether a positive endometrial culture could affect CE conditions.
Results
A significant association of E. coli was observed between the hysteroscopically characterized CE + group with focal hyperplasia, when compared to the non–CE group. Logistic regression analysis revealed that women positive for E. coli were 4.423 times more likely to have focal endometrial hyperplasia. No other significant correlations were identified between DH and positive endometrial cultures.
Conclusions
The presence of E. coli in the endometrium was significantly correlated with focal hyperplasia findings from hysteroscopy, emphasizing the importance of microbial cultures in the diagnosis and targeted treatment of CE in women with subfertility.
Keywords
Bacterial culture, Endometritis, Escherichia coli , Hyperplasia, Office hysteroscopy
