Microbiology profile in women with pelvic inflammatory disease in relation to IUD use.

I Viberga,V Odlind,G Lazdane,S Olofsson,J Kroica,L Berglund

doi:10.1155/2005/376830

Abstract

To study the microbial characteristics of patients with pelvic inflammatory disease (PID) and the possible impact of an intrauterine device (IUD) on the microbial environment in women presenting with PID. Case-control study, investigating 51 women with acute PID and 50 healthy women. Endocervical specimens for microbiological investigation were obtained at gynaecological examination. IUD users with PID had significantly more Fusobacteria spp. and Peptostreptococcus spp. than non-IUD users with PID. The finding of combinations of several anaerobic or aerobic microbes was associated with a significantly increased risk of PID and with complicated PID. In IUD users, the combinations of several anaerobic/aerobic microbes were associated with an increased risk of PID, irrespective of duration of IUD use. Long-term IUD use appeared to be associated with an increased risk of a PID being complicated. The finding of several anaerobic or aerobic microbes appears to be associated with PID in users of IUD.

Highlights

Pelvic inflammatory disease (PID) is the most common gynaecological infection
The microbiological results are shown for uncomplicated cases compared with complicated cases of PID and results are presented for those groups with regard to intrauterine device (IUD) use or non-IUD use (Table III)
One case of N. gonorrhoeae was found in a woman with PID and three cases of C. trachomatis were detected, all of which were found in the healthy controls

Summary

Introduction

Pelvic inflammatory disease (PID) is the most common gynaecological infection. PID is associated with a high morbidity resulting from an inflammation and damage of the reproductive tract that can lead to sequelae such as tubal factor infertility, ectopic pregnancy and chronic pelvic pain [1,2]. Many studies have been carried out during the last four decades to determine the microbiological aetiology of PID. They demonstrate a direct association between PID and sexually transmitted infections (STI) such as Chlamydia trachomatis and Neisseria gonorrhoeae [1 – 4]. It is well established that the highest PID and STI prevalence is found in sexually active women below 25 and is directly related to the sexual behaviour of both partners [1,2,4 – 6]. Many authors mention the role of facultative and anaerobic pathogens [4,5,7 – 10], as well as Mycoplasma hominis and Ureaplasma urealyticum [11], as aetiological factors in PID

Methods

Results

Conclusion