Defining a panel of principal bacteria associated with endometritis

The aim of this study is to present a panel that includes the main bacterial genera associated with endometritis. We conducted a search using the terms "endometritis women" OR "female endometritis" OR "pelvic inflammatory disease" AND bacteria* OR "uterine microbiome" in two databases: PubMed and Web of Science, without language or publication year restrictions. The panel is based on an analysis of 40 studies published over the past 38 years. We identified 31 bacterial genera, with the following five being the most frequently cited: Chlamydia and Ureaplasma with 11.03% each, Streptococcus and Mycoplasma with 9.56% each, and Enterococcus with 8.09%. Regarding its etiological aspects, we found that bacterial infection is the most prevalent cause of the disease, occurring because of invasive procedures such as curettage, cesarean section, or insertion of intrauterine devices (IUDs), among others. These events facilitate the entry of pathogenic microorganisms into the uterus, resulting in an inflammatory response and subsequent development of endometritis. The main techniques used to detect these pathogens were microbial culture, Polymerase Chain Reaction (PCR), and Next-Generation Sequencing, with microbial culture being the most employed, followed by PCR or a combination of both techniques. This diversity of techniques has significantly expanded our understanding of the presence and identification of microorganisms associated with the pathophysiology of endometritis. Therefore, it is understood that 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.