The Role of Novel Organisms In Acute Endometritis

盆腔炎是由两种性传播病原体引起的，包括奈瑟菌 淋病和沙眼衣原体，以及厌氧和兼性病原体。 本项目将使用基于培养的方法和基于核酸的技术来表征 从疑似盆腔炎患者的子宫内膜组织中提取微生物 (PLD)。这些数据将提供关于PID病因的新数据，并将为适当的抗菌治疗提供信息 对于PID。我们的初步数据表明，从子宫内膜活检中发现的许多微生物 在我们实验室用培养方法检测的疑似盆腔炎的妇女样本与任何已知的 基于表型特征的分类群。具体地说，我们建议：1)描述 急性盆腔炎队列中250名妇女的700份子宫内膜组织样本中的微生物 和200名妇女参加宫颈炎组(核心B)，2)应用基因测序方法 表征从子宫内膜样本中提取的新生物，以便将这些生物放入 并评估某些生物是否与组织学证据有更强的相关性 子宫内膜炎和急性盆腔炎的体征和症状，3)对所有 从子宫内膜样本中恢复的微生物，以评估目前对妇女的抗生素治疗 4)评估低位子宫内膜新病原体的存在。 使用通过特定核酸从登记时从妇女那里获得的阴道样本的生殖道 从子宫内膜样本中提取的独特生物的核酸开发的探针和5) 对从急性盆腔炎和/或女性患者身上发现的一些新细菌进行全基因组测序 急性子宫内膜炎的组织学证据，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，相关的新生物体的作用和身份 将确定并可能成为改进治疗策略的基础。这个项目将是 得到核心B、项目1和项目4的支持。

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.