Impact of Mycoplasma Infection on the Reproductive Tract Microbiota in Patients with Chronic Endometritis
10.3969/j.issn.1671-7414.2025.06.026
- VernacularTitle:慢性子宫内膜炎患者支原体感染对生殖道菌群的影响
- Author:
Li YIN
1
;
Xiang SHI
;
Yanqiu LIU
Author Information
1. 成都市双流区第一人民医院 妇产科,成都 610000
- Publication Type:Journal Article
- Keywords:
Mycoplasma infection;
endometritis;
reproductive tract flora
- From:
Journal of Modern Laboratory Medicine
2025;40(6):142-148
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of Mycoplasma infection(MP)on the reproductive tract microbiota of patients with endometritis.Methods A retrospective analysis was conducted on the clinical data of patients with endometritis who was visited in the First People's Hospital of Shuangliu District from April 2023 to April 2024.Based on inclusion and exclusion criteria,a total of 60 subjects were ultimately included in each of the MP-positive and MP-negative groups.Univariate analysis was used to compare the differences in inflammation,immunity,endometrial morphology,and disease severity between the two groups.The Illumina Nova sequencing platform was used to sequence and analyze the reproductive tract secretions of 120 subjects.The detected microbial flora was subdivided into different taxonomic levels including kingdom,phylum,class,order,family,genus and species.Mothur software was employed to calculate the Shannon diversity index and Simpson diversity index to evaluate species richness.The Wilcoxon rank-sum test was used to compare the abundance of colonies between the two groups.Using R software(v4.0.1),evaluated the differences in gene ontology(GO)annotations and metabolic pathways of Kyoto encyclopedia of genes and genomes(KEGG)pathways between different groups.Results Compared with the MP-negative group,the MP-positive group exhibited statistically significant differences in levels of inflammatory and immune indicators,as well as in the proportions of congestion and edema,atypical blood vessels,varying thicknesses,and severe disease severity(t/χ2=3.043～26.830,all P<0.05).The reproductive tract flora of the two groups was divided into four phyla:Proteobacteria,Actinobacteria,Firmicutes and Bacteroidetes.The abundance of Proteobacteria(47.95%vs 33.32%),Bacteroidetes(9.48%vs 3.41%)and Actinobacteria(4.11%vs 2.04%)increased,while the abundance of Firmicutes(38.46%vs 61.23%)decreased in the MP-positive group compared to the MP-negative group,and the differences were statistically significant(χ2=10.126～12.745,all P<0.05).A comparison of the α-diversity analysis results of the reproductive tract microbiota between the two patient groups revealed that the Shannon index and Simpson index in the MP-positive group were 4.81±0.14 and 1.68±0.07,respectively,while those in the MP-negative group were 4.07±0.18 and 1.42±0.04,respectively.The Shannon index and Simpson index in the MP-positive group were both significantly higher than those in the MP-negative group,and the differences were statistically significant(t=9.342,9.583,all P<0.001).Compared with the MP-negative group,the abundance of Streptococcus[proportion difference(PD):5.26,95%CI:2.63～6.27],Escherichia(PD:2.71,95%CI:1.34～4.58),Staphylococcus(PD:4.00,95%CI:2.06～6.14),Enterococcus(PD:4.10,95%CI:1.02～4.58),Mycoplasma(PD:6.05,95%CI:3.08～8.79),Pseudomonas(PD:2.97,95%CI:1.28～4.06)and Gardnerella(PD:6.07,95%CI:2.59～8.75)increased in the MP-positive group,while the abundance of Lactobacillus(PD:-19.22,95%CI:-21.97～-10.39)and Bifidobacterium(PD:-16.91,95%CI:-24.06～-10.57,)decreased,and the differences were statistically significant(t=3.857～11.306,all P<0.05).Analysis of metabolic pathways in the two patient groups revealed that,within the MP-positive chronic endometritis(CE)cohort,functional gene categories with significantly increased relative enrichment included ATP-binding function,DNA repair processes,inosine monophosphate biosynthetic processes,fatty acid biosynthetic processes,arginine biosynthetic processes,and peptidase activity.Analysis of signaling pathways in both patient groups found that ABC transporter complexes,aminoacyl-tRNA biosynthesis,unsaturated fatty acid biosynthesis,phenylalanine metabolism,tyrosine metabolism,tryptophan metabolism,and insulin signaling pathways were notably active in MP-positive CE patients.Conclusion Compared to MP-negative CE patients,MP-positive patients exhibited more pronounced inflammatory and immune responses,as well as a higher proportion of endometrial morphological abnormalities and severe disease severity.The reproductive tract microbiota diversity increased in MP-positive CE patients,with Streptococcus becoming the dominant genus and a decreasing trend in the relative abundance of Lactobacillus.
