ROLE OF BACTERIAL VAGINOSIS-ASSOCIATED MICROORGANISMS IN ENDOMETRITIS

OBJECTIVE: Our goal was to define the role of bacterial vaginosis and bacterial vaginosis-associated microorganisms in endometritis. STUDY D ESIGN: Endometrial biopsies were obtained for histologic and microbiol ogic study from 178 consecutive women with suspected pelvic inflammato ry disease, and 85 of them underwent laparoscopy to diagnose salpingit is. RESULTS: Histologic endometritis was confirmed in 117 (65%) of the women. Among women who underwent laparoscopy, salpingitis was present in 68% of those with and 23% of those without endometritis. Some but not all bacterial vaginosis-associated microorganisms were linked with endometritis. By logistic regression analysis, after adjustment for b acterial vaginosis and isolation of Neisseria gonorrhoeae and Chlamydi a trachomatis, endometritis was associated with endometrial N. gonorrh oeae (odds ratio 5.7, 95% confidence interval 1.8 to 17.5), C. trachom atis (odds ratio 4.8, 95% confidence interval 1.3 to 18.2), anaerobic gram-negative rods (odds ratio 2.6, 95% confidence interval 1.1 to 5.7 ), and nonwhite race (odds ratio 2.3, 95% confidence interval 1.1 to 4 .8). CONCLUSIONS: The association of anaerobic gram-negative rods with endometritis, after adjustment for bacterial vaginosis, N. gonorrhoea e, and C. trachomatis, supports the role of these microorganisms in th e etiology of histologic endometritis among women with clinically susp ected pelvic inflammatory disease.