The Role of Novel Organisms In Acute Endometritis

盆腔炎（PID）是由性传播病原体引起的，包括奈瑟氏菌 淋病和沙眼衣原体，以及厌氧和兼性病原体。 该项目将使用基于培养的方法和基于核酸的技术来表征 从疑似盆腔炎妇女子宫内膜组织中回收的微生物 这些数据将提供关于PID病因学的新数据，并将告知适当的抗微生物治疗。 因为PID我们的初步数据表明，许多从子宫内膜活检中回收的微生物 在我们的实验室中使用培养方法的疑似PID的妇女样本不符合任何已知的 基于表型特征的分类。具体而言，我们建议：1）描述 急性PID队列中250名妇女的700份子宫内膜组织样本中的微生物 和200名参加宫颈炎队列的妇女（核心B），2）应用基因测序方法， 表征从子宫内膜样品中回收的新生物体，以便将这些生物体置于 分类组，并评估是否有些生物体与组织学证据更密切相关 急性PID的体征和症状，3）对所有患者进行抗菌药物敏感性测试 从子宫内膜样本中回收的微生物，以评估目前对妇女的抗生素治疗 急性PID是适当的，4）评估新的子宫内膜病原体的存在下， 使用通过特异性核酸检测从入组时的女性获得的阴道样品， 从子宫内膜样品中回收的独特生物体的核酸开发的探针，和5） 对从患有急性PID的女性中回收的一些新细菌进行全基因组测序，和/或 急性胰腺炎的组织学证据，以确定其身份和正确的分类位置， 这些有机体。在拟议的研究结束时，与之相关的新生物的作用和身份 将确定患有PID的患者，并可能形成改进治疗策略的基础。该项目将 由核心B、项目1和项目4支持。

Pelvic inflammatory disease (PID) is caused by both sexually transmitted pathogens, including Neiserria gonorrhoeae and Chlamydia trachomatis, and anaerobic and facultative pathogens.The broad, long term goal of this project is to use both culture-based methods and nucleic acid-based technology to characterize the microorganisms recovered from the endometrial tissues of women with suspected pelvic inflammatory disease (PlD).These data will provide novel data on the etiology of PID and will inform appropriate antimicrobic therapy for PID. Our preliminary data suggests that many of the microorganisms recovered from the endometrial biopsy samples of women with suspected PID using culture methodology in our laboratory do not fit any known taxonomic group based on phenotypic characteristics. Specifically, we propose to: 1) describe the microorganisms in 700 endometrial tissue samples obtained from 250 women enrolled in the acute PID cohort and 200 women enrolled in the cervicitis cohort (Core B), 2) apply genetic sequencing methodology to characterize the novel organisms recovered from the endometrial samples in order to place these organisms into taxonomic groups and to assess whether some organisms are more strongly associated with histologic evidence of endometritis and the signs and symptoms of acute PID, 3) perform antimicrobic susceptibility testing of all organisms recovered from the endometrial samples in order to assess current antibiotic treatments for women with acute PID are appropriate, 4) assess the presence of novel endometrial pathogens in the lower reproductive tract using vaginal samples obtained from women at enrollment through specific nucleic acid probes developed from nucleic acid of unique organisms recovered from the endometrial samples and 5) perform full genomic sequencing of some of the novel bacteria recovered from women with acute PID and/or histologic evidence of acute endometritis in order to establish the identity and correct taxonomic placement of these organisms. At the conclusion of the proposed studies, the role and identity of novel organisms associated with PID will be identified and may form the basis for improved treatment strategies. This project will be supported by Core B, Project 1 and Project 4.