Abstract
Abstracts of the Infectious Diseases Society for Obstetrics and Gynecology: Annual Scientific Meeting and Symposium, August 8–10, 2002
Highlights
Culture is an insensitive technique to identify microbes in small concentrations or microbes that are difficult to isolate by culture
There is a decrease in cervical IL-1b with cure of bacterial vaginosis (BV) in pregnancy, irrespective of whether treatment was systemic or topical. This suggests that the increased levels of cervical IL-1b seen in women with BV are derived from the cervix rather than the upper genital tract, since topical therapy should have no effect on the upper genital tract
Vaginal colonization with an exogenous strain of H2O2-producing Lactobacillus can be achieved in 60% of women with BV after a single course
Summary
Culture is an insensitive technique to identify microbes in small concentrations or microbes that are difficult to isolate by culture. HPV was associated with marijuana use, current douching, sex abuse, greater number of sex partners, greater years of sexual activity, and age difference of sex partner. Conclusion: This analysis suggests that significant benefits of screening and treating for BV are more likely accrue to both fetus/perinate and mother in these settings: (i) prior history of prematurity/LBW; (ii) early pregnancy diagnosis and treatment; (iii) oral (systemic) treatment with antimicrobial matching intrauterine microbes including genital mycoplasmas; (iv) use of macrolide/clindamycin antimicrobials with demonstrated anti-virulence factor and inflammation stabilizing effects as well as intracellular decidual and trophoblast concentration; (v) treatment in populations in which PTB/LBW is more likely to be caused by infection/inflammation; and (vi) when prevention of extreme prematurity/VLBW is a study outcome. Future clinical trials should be designed focusing on: (i) patient selection; (ii) timing of diagnosis and treatment; and (iii) choice of specific antimicrobial regimens likely to show benefit
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