A study on the possible association of dysfunctional uterine bleeding with bacterial vaginosis, mycoplasma, ureaplasma, and Gardnerella vaginalis

Bhattacharjee, Baibaswata; Ghosh, A K; Murray, A.

doi:10.1136/sti.76.5.407

Cited by 3 publications

(3 citation statements)

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“…Approaches where the uterine cavity can be sampled directly clearly are a superior method to the study goal, though also a major constraint to the study of various patient sets, as only in highly selected patients the uterus is removed or opened during surgery. In addition, in our setting, hysterectomy in otherwise healthy, premenopausal women in the absence of oncological conditions, severe comorbidity, or perioperative antibiotic treatment is an uncommon indication, and mostly performed because of dysfunctional uterine bleeding and/or benign uterine wall tumours, potentially altering the intra-uterine environment and affecting uterine bacterial colonisation as previously documented ( Kristiansen et al, 1987 ; Larsson et al, 1990 ; Møller et al, 1995 ; Bhattacharjee et al, 2000 ). Accordingly, we did opt for a transcervical approach with the Tao Brush™ IUMC Endometrial Sampler (Cook OB-GYN, Bloomington, Ind., USA), a device that appeared suitable, albeit undoubtedly imperfect, as further specified.…”

Section: Methodsmentioning

confidence: 88%

Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene

Verstraelen

Vílchez-Vargas

Desimpel

et al. 2016

PeerJ

236

132

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Background. It is widely assumed that the uterine cavity in non-pregnant women is physiologically sterile, also as a premise to the long-held view that human infants develop in a sterile uterine environment, though likely reflecting under-appraisal of the extent of the human bacterial metacommunity. In an exploratory study, we aimed to investigate the putative presence of a uterine microbiome in a selected series of non-pregnant women through deep sequencing of the V1-2 hypervariable region of the 16S ribosomal RNA (rRNA) gene.Methods. Nineteen women with various reproductive conditions, including subfertility, scheduled for hysteroscopy and not showing uterine anomalies were recruited. Subjects were highly diverse with regard to demographic and medical history and included nulliparous and parous women. Endometrial tissue and mucus harvesting was performed by use of a transcervical device designed to obtain endometrial biopsy, while avoiding cervicovaginal contamination. Bacteria were targeted by use of a barcoded Illumina MiSeq paired-end sequencing method targeting the 16S rRNA gene V1-2 region, yielding an average of 41,194 reads per sample after quality filtering. Taxonomic annotation was pursued by comparison with sequences available through the Ribosomal Database Project and the NCBI database.Results. Out of 183 unique 16S rRNA gene amplicon sequences, 15 phylotypes were present in all samples. In some 90% of the women included, community architecture was fairly similar inasmuch B. xylanisolvens, B. thetaiotaomicron, B. fragilis and an undetermined Pelomonas taxon constituted over one third of the endometrial bacterial community. On the singular phylotype level, six women showed predominance of L. crispatus or L. iners in the presence of the Bacteroides core. Two endometrial communities were highly dissimilar, largely lacking the Bacteroides core, one dominated by L. crispatus and another consisting of a highly diverse community, including Prevotella spp., Atopobium vaginae, and Mobiluncus curtisii.Discussion. Our findings are, albeit not necessarily generalizable, consistent with the presence of a unique microbiota dominated by Bacteroides residing on the endometrium of the human non-pregnant uterus. The transcervical sampling approach may be influenced to an unknown extent by endocervical microbiota, which remain uncharacterised, and therefore warrants further validation. Nonetheless, consistent with our understanding of the human microbiome, the uterine microbiota are likely to have a previously unrecognized role in uterine physiology and human reproduction. Further study is therefore warranted to document community ecology and dynamics of the uterine microbiota, as well as the role of the uterine microbiome in health and disease.

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Section: Methodsmentioning

confidence: 88%

Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene

Verstraelen

Vílchez-Vargas

Desimpel

et al. 2016

PeerJ

236

132

View full text Add to dashboard Cite

show abstract

“…Manuscript to be reviewed sets, as only in highly selected patients the uterus is removed or opened during surgery. In addition, in our setting, hysterectomy in otherwise healthy, premenopausal women in the absence of oncological conditions, severe comorbidity, or perioperative antibiotic treatment is an uncommon indication, and mostly performed because of dysfunctional uterine bleeding and/or benign uterine wall tumours, potentially altering the intra-uterine environment and affecting uterine bacterial colonisation as previously documented (Kristiansen et al, 1987;Larsson et al, 1990;Møller et al, 1995;Bhattacharjee et al, 2000). Accordingly, we did opt for a transcervical approach with the Tao Brush™ IUMC Endometrial Sampler (Cook OB-GYN, Bloomington, Ind., USA), a device that appeared suitable, albeit undoubtedly imperfect, as further specified.…”

Section: Endometrial Sampling Approachmentioning

confidence: 87%

Peer Review #1 of "Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene (v0.2)"

2016

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Background. It is widely assumed that the uterine cavity in non-pregnant women is physiologically sterile, also as a premise to the long-held view that human infants develop in a sterile uterine environment, though likely reflecting under-appraisal of the extent of the human bacterial metacommunity. In an exploratory study, we aimed to investigate the putative presence of a uterine microbiome in a selected series of non-pregnant women through deep sequencing of the V1-2 hypervariable region of the 16S ribosomal RNA (rRNA) gene. Methods. Nineteen women with various reproductive conditions, including subfertility, scheduled for hysteroscopy and not showing uterine anomalies were recruited. Subjects were highly diverse with regard to demographic and medical history and included nulliparous and parous women. Endometrial tissue and mucus harvesting was performed by use of a transcervical device designed to obtain endometrial biopsy, while avoiding cervicovaginal contamination. Bacteria were targeted by use of a barcoded Illumina MiSeq paired-end sequencing method targeting the 16S rRNA gene V1-2 region, yielding an average of 41,194 reads per sample after quality filtering. Taxonomic annotation was pursued by comparison with sequences available through the Ribosomal Database Project and the NCBI database. Results. Out of 183 unique 16S rRNA gene amplicon sequences, 15 phylotypes were present in all samples. In some 90% of the women included, community architecture was fairly similar in as much B. xylanisolvens, B. thetaiotaomicron, B. fragilis and an undetermined Pelomonas taxon constituted over one third of the endometrial bacterial community. On the singular phylotype level, six women showed predominance of L. crispatus or L. iners in the presence of the Bacteroides core. Two endometrial communities were highly dissimilar, largely lacking the Bacteroides core, one dominated by L. crispatus and another consisting of a highly diverse community, including Prevotella spp., Atopobium vaginae, and Mobiluncus curtisii. Discussion. Our findings are, albeit not necessarily generalizable, consistent with the presence of a unique microbiota dominated by Bacteroides residing on the endometrium of the human non-pregnant uterus. The transcervical sampling approach may be influenced to an unknown extent by

show abstract

“…Approaches were the uterine cavity can be sampled directly, clearly are a superior method to the study goal, though also a major constraint to the study of various patient sets, as only in highly selected patients the uterus is removed or opened during surgery. In addition, in our setting, hysterectomy in otherwise healthy, premenopausal women in the absence of oncological conditions, severe comorbidity, or perioperative antibiotic treatment is an uncommon indication, and mostly performed because of dysfunctional uterine bleeding and/or benign uterine wall tumours, potentially altering the intra-uterine environment and affecting uterine bacterial colonisation as previously documented (Kristiansen et al, 1987;Larsson et al, 1990;Møller et al, 1995;Bhattacharjee et al, 2000). Accordingly, we did opt for a transcervical approach with the Tao Brush™ IUMC Endometrial Sampler (Cook OB-GYN, Bloomington, Ind., USA), a device that appeared suitable, albeit undoubtedly imperfect, as further specified.…”

Section: Endometrial Sampling Approachmentioning

confidence: 87%

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Supplemental Information 2: Figure S1. Rarefaction Curves Illustrating Sampling Depth

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A study on the possible association of dysfunctional uterine bleeding with bacterial vaginosis, mycoplasma, ureaplasma, and Gardnerella vaginalis

Cited by 3 publications

References 1 publication

Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene

Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene

Peer Review #1 of "Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene (v0.2)"

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