Dados do Trabalho

Title

DEVELOPMENT OF A COMPREHENSIVE PANEL INCLUDING THE PRIMARY BACTERIA LINKED TO ENDOMETRITIS

Objective

This study aims to present a panel that includes the main genera of bacteria commonly associated with endometritis.

Methods

To characterize the microbiota associated with endometritis, we conducted a comprehensive search in two databases: PubMed and Web of Science, without restricting the language and year of publication. The search was performed using the following parameters: “endometritis women” OR “endometritis female” OR "pelvic inflammatory disease" AND bacteria* OR “uterine microbiome”. We excluded reviews, meta-analyses, book chapters, studies conducted in animal models, and publications that did not report original clinical data or did not mention "endometritis" in the title or abstract.

Results

The panel is based on an analysis of 39 studies published over the past 38 years. We have identified 31 bacterial genera, with the following five being the most frequently observed: Chlamydia and Ureaplasma with 11.03% each, Streptococcus and Mycoplasma with 9.56% each, and Enterococcus with 8.09%. Additionally, we discuss the etiological aspects of endometritis and the main techniques used for detecting these pathogens. Regarding its etiological aspects, we found that bacterial infection is the most prevalent cause of the disease, occurring as a result of predisposing factors such as invasive procedures like uterine curettage, cesarean section, or insertion of intrauterine devices (IUDs), preterm birth, premature rupture of membranes, postpartum infection, and miscarriage, among others. These events can facilitate the entry of pathogenic microorganisms into the uterus, resulting in an inflammatory response and subsequent development of endometritis. It is important to note that the etiology of endometritis may vary in different population groups and clinical contexts. The main techniques used for detecting these pathogens associated with endometritis were microbial culture, Polymerase Chain Reaction (PCR), and Next-Generation Sequencing, were microbial culture has been the most employed, followed by PCR, or a combination of both techniques. Considering the articles that composed this review, one study employed a sequencing approach, enabling a more comprehensive analysis of microbial diversity. This diversity of techniques has greatly expanded our understanding of the presence and identification of microorganisms associated with the pathophysiology of endometritis.

Conclusion

These findings serve as a foundation for further investigations of microorganisms related to endometritis, and such analyses will help to clarify the relationship between endometritis and the bacteria that cause it. This, in turn, will improve our understanding of the epidemiology of the condition and enhance the accuracy of its diagnosis and treatment recommendations.

Keywords

uterus; inflammation; endometrium; microbiome.