{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T05:41:03Z","timestamp":1792388463710,"version":"4.4.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic endometritis (CE), a persistent inflammatory condition of the endometrial lining, is clinically linked with adverse reproductive outcomes. It is currently hypothesized to be associated with infection, and is often treated with broad-spectrum antibiotics. However, the specific microbial alterations remain poorly defined due to heterogeneous findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Web of Science, Medline, Embase, Cochrane Library, and Scopus were searched for studies published up to July 2025. Studies were included if they compared CE patients to non-CE controls and analyzed vaginal or endometrial microbiota. Standardized mean difference (SMD) for alpha-diversity, odds ratio (OR) for microbial detection rates, with 95% confidence intervals (CIs) were calculated. Qualitative syntheses of beta-diversity and microbial abundance profiles were also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Twenty-two studies (n = 1274 CE patients, n = 1109 controls) were included. Alpha-diversity indices showed no significant differences for both vaginal and endometrial microbiota. However, a subgroup analysis revealed a significant upregulation in endometrial Chao1 indices in 16S V4 sequencing studies (SMD\u00a0=\u00a00.38, 95% CI: 0.06 to 0.70,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00). Beta-diversity findings were inconsistent, though three endometrial studies reported significant intergroup differences. Qualitative synthesis revealed a decrease in\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      and an increase in opportunistic pathogens, including\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      and\n                      <jats:italic>Sphingomonas<\/jats:italic>\n                      . Pooled analysis of microbial detection rates showed significantly higher prevalence for\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      (OR\u00a0=\u00a04.93, 95% CI: 2.13 to 11.39,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a048%) and\n                      <jats:italic>Ureaplasma<\/jats:italic>\n                      (OR\u00a0=\u00a06.30, 95% CI: 2.53 to 15.68,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00%) in CE patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CE is associated with dysbiosis of the vaginal and endometrial microbiota, characterized by a shift from beneficial commensals to pathogenic microbes. This dysbiosis may contribute to an altered the intrauterine immune microenvironment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      PROSPERO\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251115587<\/jats:ext-link>\n                      , identifier CRD420251115587.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1754297","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T06:41:20Z","timestamp":1771569680000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Vaginal and endometrial microbiota dysbiosis in patients with chronic endometritis: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Ruiying","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Bo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education","place":["Chengdu, China"]},{"name":"Key Laboratory of Chronobiology of National Health Commission of Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"75","DOI":"10.3390\/sci6040075","article-title":"Microbiota status and endometrial cancer: A narrative review about possible correlations in affected versus healthy patients","volume":"6","author":"Aquino","year":"2024","journal-title":"Sci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1093\/humupd\/dmy012","article-title":"How uterine microbiota might be responsible for a receptive, fertile endometrium","volume":"24","author":"Benner","year":"2018","journal-title":"Hum. 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