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Mycoplasma hominis in patients with pelvic inflammatory disease
1Department of Biomedical Sciences, University of Tampere, Finland.
Abstract:
The role of Mycoplasma hominis in pelvic inflammatory disease (PID) was studied among 35 patients with laparoscopically confirmed salpingitis or histopathologically confirmed plasma cell endometritis. M. hominis was isolated from the cervix of 15 patients, from the rectum of 13 patients, and from the endometrium of 5 patients. Only two of these five patients had M. hominis isolated from the endometrium in the absence of Chlamydia trachomatis or Neisseria gonorrheae, the major PID-causing organisms. None of the patients had M. hominis isolated from the fallopian tubes. Of the 35 patients, 7 demonstrated a significant change in enzyme immunoassay antibody levels to M. hominis, suggesting a recent infection with the organism. Six of the seven patients had M. hominis isolated from the cervix, and one had the organism isolated from the endometrium. Compared with patients not having M. hominis isolated from the cervix or endometrium, those who did more frequently had positive serum antibody findings for M. hominis and abnormal gas-liquid chromatographic findings of the vaginal fluid, indicative of bacterial vaginosis.
Insights
Mycoplasma hominis may play a role in pelvic inflammatory disease (PID), particularly when bacterial vaginosis is present. Further research is needed to clarify its specific contribution to PID development.
Area of Science:
- Gynecology
- Microbiology
- Infectious Diseases
Background:
- Pelvic inflammatory disease (PID) is a significant cause of female infertility and chronic pelvic pain.
- The etiology of PID is complex, often involving polymicrobial infections.
- Mycoplasma hominis is a common bacterium found in the female genital tract, but its role in PID is not fully understood.
Purpose of the Study:
- To investigate the association between Mycoplasma hominis and pelvic inflammatory disease (PID).
- To determine the prevalence of M. hominis in patients with confirmed salpingitis or endometritis.
- To explore the relationship between M. hominis, other common pathogens, and bacterial vaginosis in PID patients.
Main Methods:
- Studied 35 patients with laparoscopically confirmed salpingitis or histopathologically confirmed plasma cell endometritis.
- Isolated M. hominis from cervical, rectal, and endometrial samples.
- Assessed antibody levels to M. hominis using enzyme immunoassay.
- Evaluated vaginal fluid for bacterial vaginosis using gas-liquid chromatography.
Main Results:
- M. hominis was isolated from the cervix (15/35) and rectum (13/35), and less frequently from the endometrium (5/35).
- Only two endometrial isolates were found without Chlamydia trachomatis or Neisseria gonorrhoeae.
- Seven patients showed significant antibody level changes, suggesting recent M. hominis infection.
- Patients with cervical or endometrial M. hominis isolates were more likely to have positive M. hominis antibodies and bacterial vaginosis.
Conclusions:
- Mycoplasma hominis may be a co-factor or opportunistic pathogen in PID, especially in the presence of bacterial vaginosis.
- The organism's presence in the cervix and endometrium, along with serological evidence, suggests a potential role in PID pathogenesis.
- Further studies are warranted to elucidate the precise mechanisms by which M. hominis contributes to PID.