Related Experiment Video
Updated: Feb 6, 2026
Author Spotlight: Enhancing Women's Chronic Pelvic Pain Management Through Acupoint Catgut Embedding
Published on: May 3, 2024
Characterization of pelvic and cervical microbiotas from patients with pelvic inflammatory disease
Yue Wang1, Ye Zhang2,3, Qi Zhang2,3
11Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.
Purpose:
The aims of this work were: (i) to profile and compare pelvic and cervical microbiota from patients with pelvic inflammatory disease (PID); (ii) to test the ascending infection hypothesis that the microbes in the vagina or cervix spread to the upper genital tract and cause PID.
Methodology:
Thirty-eight PID patients and 19 control patients were enrolled in this study and received salpingectomy or salpingo-oophorectomy. Both pelvic and cervical samples were collected during surgery, which were subject to culture diagnosis and next-generation sequencing (NGS)-based 16S rRNA profiling.
Results:
For the PID group, the NGS-based method revealed that half of the pelvic samples were dominated by a single organism while the other half exhibited a polymicrobial infection. The pelvic and cervical microbiota were similar in terms of both taxonomic richness and evenness. Pelvic microbiota was dominated by Acinetobacter, Escherichia, Sneathia and Streptococcus whereas cervical microbiota was dominated by Lactobacillus and Gardnerella. Only six pelvic samples were positive by culture diagnosis, three of which matched the NGS-based results. The PID group was further divided into 23 hydrosalpinx and 15 pyosalpinx samples according to the pelvic mass collected during surgery, the former showing a richer bacterial composition than the latter.
Conclusion:
The NGS-based method provides a more informative profile of pelvic microbiota than the culture method. The pelvic and cervical microbiota from the same patient were inconsistent with each other, and thus therapeutic decisions based on cervical microbiota may lead to antimicrobial misuse.
Insights
Pelvic inflammatory disease (PID) involves distinct microbial communities in the pelvis and cervix. Cervical microbiota analysis alone may lead to incorrect antibiotic treatment for PID.
Area of Science:
- Microbiology
- Gynecology
- Infectious Diseases
Background:
- Pelvic inflammatory disease (PID) is a serious infection of the female reproductive organs.
- The ascending infection hypothesis suggests vaginal or cervical microbes cause PID by spreading to the upper genital tract.
- Understanding the microbial communities involved is crucial for effective diagnosis and treatment.
Purpose of the Study:
- To profile and compare pelvic and cervical microbiota in patients with PID.
- To evaluate the ascending infection hypothesis in the context of PID etiology.
- To assess the utility of cervical microbiota profiling for guiding PID treatment decisions.
Main Methods:
- Enrolled 38 PID patients and 19 controls undergoing salpingectomy or salpingo-oophorectomy.
- Collected pelvic and cervical samples during surgery.
- Utilized culture diagnosis and next-generation sequencing (NGS)-based 16S rRNA profiling.
Main Results:
- NGS revealed half of pelvic samples had single-organism dominance, the other half polymicrobial infections.
- Pelvic microbiota was dominated by Acinetobacter, Escherichia, Sneathia, and Streptococcus.
- Cervical microbiota was dominated by Lactobacillus and Gardnerella; pelvic and cervical microbiota were inconsistent.
- Hydrosalpinx samples showed richer bacterial composition than pyosalpinx samples.
Conclusions:
- NGS-based 16S rRNA profiling offers a more comprehensive view of pelvic microbiota than traditional culture methods.
- Significant inconsistencies exist between pelvic and cervical microbiota in PID patients.
- Relying solely on cervical microbiota for therapeutic decisions in PID risks antimicrobial misuse.
Related Concept Videos
01:26Muscles of the Pelvic Floor and Perineum
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...