Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Bari, IT-70124 Bari, Italy.
Gynecol Obstet Invest. 2009;68(2):108-15. doi: 10.1159/000223819. Epub 2009 Jun 11.
Chronic endometritis (CE) is a subtle pathology causing infertility and abnormal uterine bleeding. We evaluated the reliability of vaginal and cervical cultures for detecting infectious agents at the endometrial level.
In a prospective diagnostic study, 181 women diagnosed with CE and 100 controls underwent vaginal, endocervical and endometrial sampling. Cultures for common bacteria, Neisseria gonorrhoeae, yeast and Ureaplasma urealyticum and PCR for Chlamydia trachomatis were performed.
The prevalent infectious agents at the endometrial level were common bacteria(59.7% of cases); U. urealyticum was detected in 11.0% and C. trachomatis in only 2.8%. The concordance rate between endocervical and endometrial specimens for common bacteria was 48.3%; 100% for C. trachomatis and 58.3% for U. urealyticum. The concordance rate between vaginal and endometrial cultures for common bacteria was 50.2%, only 16.7% for C. trachomatis and 48.8% for U. urealyticum. For common bacteria both vaginal and cervical cultures showed low sensitivities of 0.30 and 0.19, respectively.
Common bacteria and U. urealyticum were the prevalent infectious agents in the uterine cavity of women diagnosed with CE. Both vaginal and endocervical cultures had low concordance with endometrial cultures. Only C. trachomatis test at cervical level had high concordance with endometrial findings.
慢性子宫内膜炎（CE）是一种微妙的病理学，可导致不孕和异常子宫出血。我们评估了阴道和宫颈培养物在检测子宫内膜水平感染因子方面的可靠性。
在一项前瞻性诊断研究中，181 名被诊断为 CE 的患者和 100 名对照者接受了阴道、宫颈和子宫内膜取样。进行了常见细菌、淋病奈瑟菌、酵母和解脲支原体的培养以及沙眼衣原体的 PCR 检测。
子宫内膜水平常见的感染因子有（59.7%的病例）；解脲支原体的检出率为 11.0%，沙眼衣原体仅为 2.8%。宫颈和子宫内膜标本常见细菌的一致性率为 48.3%；沙眼衣原体为 100%，解脲支原体为 58.3%。阴道和子宫内膜培养常见细菌的一致性率为 50.2%，沙眼衣原体仅为 16.7%，解脲支原体为 48.8%。对于常见细菌，阴道和宫颈培养的敏感性均较低，分别为 0.30 和 0.19。
在被诊断为 CE 的女性的子宫腔中，常见细菌和解脲支原体是主要的感染因子。阴道和宫颈培养与子宫内膜培养的一致性较低。只有宫颈水平的沙眼衣原体检测与子宫内膜发现具有较高的一致性。
