Abstract
Uterine microbiota have been reported under various conditions and populations; however, it is uncertain the level to which these bacteria are residents that maintain homeostasis, tourists that are readily eliminated or invaders that contribute to human disease. This review provides a historical timeline and summarizes the current status of this topic with the aim of promoting research priorities and discussion on this controversial topic. Discrepancies exist in current reports of uterine microbiota and are critically reviewed and examined. Established and putative routes of bacterial seeding of the human uterus and interactions with distal mucosal sites are discussed. Based upon the current literature, we highlight the need for additional robust clinical and translational studies in this area. In addition, we discuss the necessity for investigating host–microbiota interactions and the physiologic and functional impact of these microbiota on the local endometrial microenvironment as these mechanisms may influence poor reproductive, obstetric, and gynecologic health outcomes and sequelae.
Highlights
For almost a century and based on the work of Henry Tissier in 1900, consensus was that a healthy uterine cavity is sterile (Figure 1) [1]
The purpose of this review is to provide a comprehensive summary of the uterine microbiome literature to date, focusing on detailing studies of “healthy” bacterial residents to bacterial tourists or invaders that are present in particular diseased states
This review mainly focuses on the negative consequences of the presence of uterine microbiota due to inherent difficulties in sampling the uterus in healthy women; clearly the maintenance of homeostasis is important if a “normal” resident microbiome in the uterus is defined
Summary
For almost a century and based on the work of Henry Tissier in 1900, consensus was that a healthy uterine cavity is sterile (Figure 1) [1]. This sterility was hypothesized to be maintained by the cervical plug, which was compared with the “Colossus of Rhodes” in providing an impermeable barrier to bacterial ascension from the vagina [2] This assumption was challenged by multiple reports in the mid to late 1980s, using culture-dependent methods, of uterine-dwelling bacteria even in healthy asymptomatic women (Figure 1) [3,4,5,6]. The current NGS literature on the uterine microbiome has provided provocative glimpses into the putative role of the uterine microbiota in multiple disease states and the potential impact on women’s health It is important, to take into consideration the limitations of the studies to date. Objective: to determine No antibiotic the difference between use within last uterine microbiota
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