مطالعه ارتباط بین اندومتریوز، ناباروری و جمعیت باکتریایی رحم زنان مبتلا به اندومتریوز و ناباروری

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی دکتری تخصصی، گروه میکروبیولوژی، دانشکده علوم، کشاورزی و فناوری‌های نوین، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.

2 دانشیار گروه میکروبیولوژی، دانشکده علوم، کشاورزی و فناوری‌های نوین، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.

3 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

4 استادیار گروه زنان و مامایی، دانشکده پزشکی دانشگاه علوم پزشکی شیراز، شیراز، ایران.

10.22038/ijogi.2024.75347.5879

چکیده

مقدمه: اندومتریوز، یک بیماری مزمن ژنیکولوژی است که می­تواند منجر به نازایی شود. با توجه به اینکه رحم استریل نیست، رفلاکس خون قاعدگی به لگن در این بیماران ممکن است آلوده به باکتری و اندوتوکسین باکتری‌ها باشد و به ایجاد و رشد ضایعات اندومتریوز کمک کند. مطالعه حاضر با هدف بررسی ارتباط بین اندومتریوز، ناباروری و باکتری‌های رحم زنان مبتلا به اندومتریوز و نازایی انجام شد.
روش‌کار: این مطالعه مورد- شاهدی از تابستان تا زمستان 1400 بر روی جدایه­ های باکتریایی آندومتر 35 زن مبتلا به اندومتریوز و نازایی و 15 زن سالم در بیمارستان زینبیه شیراز انجام گردید. جدایه­ ها توسط روش بیوشیمیایی و مولکولی شناسایی و آنالیز شدند. جهت بررسی رابطه میکروبیوتای رحم با اندومتریوز و نازایی از نرم‌افزار آماری SPSS (نسخه 21) و آزمون کای دو استفاده شد.
یافته­ها: جدایه­های حاصل از آندومتر رحم زنان بیمار شامل: Enterococcus faecalis(8/31%)، E. coli (2/18%)، Streptococci pyogenes (8/6%)، Klebsiella pneumonia (6/13%)، Klebsiella aerogenes (9/1%)، Staphylococci aureus (5/4%)، Pseudomonas aeruginosa (1/9%)، Staphylococci Epidermidis (8/6%) و در زنان سالم Staphylococci epidermidis (0/30%)،Lactiplantibacillus plantarum (0/45%)، E. coli (0/15%) و Acinetobacter baumannii (0/10%) بود. بر اساس آنالیز آزمون کای دو، بین باکتری­ های پاتوژن و فلور نرمال در گروه­ های مورد مطالعه ارتباط معنی‌داری وجود داشت (05/0>p). همچنین جنس غالب در بین باکتری­ های جدا شده از زنان بیمار و سالم به‌ترتیب E.faecalis (8/31%) وL. plantarum (45%) بود.
نتیجه­ گیری: کاهش گونه‌های لاکتوباسیلوس و افزایش تنوع گونه­ های باکتری‌های بیماری‌زا در رحم زنان مبتلا به اندومتریوز احتمالاً با افزایش استعداد ابتلاء به نازایی مرتبط است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Correlation between endometriosis, infertility and bacterial population of the uterus of women with endometriosis and infertility

نویسندگان [English]

  • Mehdi Dehdashti 1
  • Nima Bahador 2
  • Tahereh Poordast 3
  • Maryam Zolghadr 4
1 Ph.D. student, Department of Microbiology, School of Sciences, Agriculture and New Technologies, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
2 Associate Professor, Department of Microbiology, School of Sciences, Agriculture and New Technologies, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
3 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
4 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
چکیده [English]

Introduction: Endometriosis is a chronic gynecological disease that can lead to infertility. Considering that the uterus is not sterile, the reflux of menstrual blood to the pelvis in these patients may be contaminated with bacteria and bacterial endotoxin, contributing to the development of endometriosis lesions. This study was conducted with aim to investigate the relationship between endometriosis, infertility, and uterine bacteria in women with endometriosis and infertility.
Methods: This case-control study was conducted during summer to autumn of 2021 on the endometrial bacteria of 35 women with endometriosis and infertility, as well as 15 healthy women in Zeinabieh Hospital, Shiraz. Bacterial isolates were identified and analyzed using biochemical and molecular methods. Then, the chi-square test and SPSS (version 21) were utilized to explore the relationship between uterine microbiota and endometriosis and infertility.
Results: The isolates obtained from the uterine endometrium of sick women included Enterococcus faecalis (31.8%), E. coli (18.2%), Streptococci pyogenes (6.8%), Klebsiella pneumonia (13.6%), Klebsiella aerogenes (9.1%), Staphylococci aureus (4.5%), Pseudomonas aeruginosa (9.1%), Staphylococci Epidermidis (6.8%) and in healthy women were Lactiplantibacillus plantarum (45%), E. coli (15%), Acinetobacter baumannii (10%), and Staphylococci epidermidis (30%). According to the results of chi-square test, there was a significant relationship between the type of bacteria (normal flora and pathogenic) and the studied groups (p<0.05). Among the bacteria isolated from sick and healthy women, E. faecalis (31.8%) and L. plantarum (45%) were found to be the dominant genera.
Conclusion: The reduction of Lactobacillus species and the increase in the diversity of pathogenic bacteria species in the uterus are associated with an increased susceptibility to endometriosis and infertility.

کلیدواژه‌ها [English]

  • Bacteria
  • Endometriosis
  • Infertility

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 6
شهریور 1403
صفحه 18-30

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