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Open AccessCase Report

Taxonomical and Functional Assessment of the Endometrial Microbiota in A Context of Recurrent Reproductive Failure: A Case Report

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Igenomix Foundation - Instituto de Investigación Sanitaria Hospital Clínico (INCLIVA), 46980 Valencia, Spain
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Department of Pediatrics, Obstetrics and Gynecology, School of Medicine, University of Valencia, 46010 Valencia, Spain
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Bioinformatics Department, Igenomix R&D, 46980 Valencia, Spain
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Research Department, Igenomix R&D, 46980 Valencia, Spain
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Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA
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BIDMC, Harvard University, Boston, MA 02138, USA
*
Authors to whom correspondence should be addressed.
Pathogens 2019, 8(4), 205; https://doi.org/10.3390/pathogens8040205
Received: 8 October 2019 / Revised: 22 October 2019 / Accepted: 22 October 2019 / Published: 24 October 2019
(This article belongs to the Section Human Pathogens)
Investigation of the microbial community in the female reproductive tract has revealed that the replacement of a community dominated by Lactobacillus with pathogenic bacteria may be associated with implantation failure or early spontaneous abortion in patients undergoing assisted reproductive technology (ART) treatment. Herein we describe taxonomically and functionally the endometrial microbiome of an infertile patient with repeated reproductive failures (involving an ectopic pregnancy and two clinical miscarriages). The microbiological follow-up is presented over 18-month in which the microbiota was evaluated in six endometrial fluid samples. The microbial profile of 16S rRNA gene sequencing showed a persistent infection with Gardnerella and other bacterial taxa such as Atopobium and Bifidobacterium. In addition, taxonomic and functional analysis by whole metagenome sequencing in the endometrial fluid sample collected before one clinical miscarriage suggested the presence of multiple Gardnerella vaginalis clades with a greater abundance of clade 4, usually associated with metronidazole resistance. These results revealed a persistent G. vaginalis endometrial colonization presenting genetic features consistent with antimicrobial resistance, biofilm formation, and other virulence factors, which could be related to the reproductive failure observed. View Full-Text
Keywords: reproductive failure; clinical miscarriage; ectopic pregnancy; endometrial microbiota; Gardnerella vaginalis; 16S rRNA gene sequencing; whole metagenome sequencing; metronidazole resistance; biofilm formation reproductive failure; clinical miscarriage; ectopic pregnancy; endometrial microbiota; Gardnerella vaginalis; 16S rRNA gene sequencing; whole metagenome sequencing; metronidazole resistance; biofilm formation
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Garcia-Grau, I.; Perez-Villaroya, D.; Bau, D.; Gonzalez-Monfort, M.; Vilella, F.; Moreno, I.; Simon, C. Taxonomical and Functional Assessment of the Endometrial Microbiota in A Context of Recurrent Reproductive Failure: A Case Report. Pathogens 2019, 8, 205.

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