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[Microbiologic basis of diagnosis and treatment of pelvic inflammatory disease]

R Quentin1, R Verdon

  • 1Service de bactériologie et hygiène hospitalière, CHRU de Tours, 37044 Tours, France. roland.quentin@dbmail.com

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|November 13, 2012
PubMed

Insights

Pelvic inflammatory disease (PID) is often caused by sexually transmitted infections like gonorrhea and chlamydia, but other bacteria can be involved. Accurate microbiological diagnosis is key for effective antibiotic treatment of PID.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Gynecology

Background:

  • Pelvic inflammatory disease (PID) has diverse etiological agents, with the specific cause remaining unidentified in a significant proportion of cases.
  • Sexually transmitted infections (STIs), particularly Neisseria gonorrhoeae and Chlamydia trachomatis, are primary drivers of PID.
  • Bacterial vaginosis and Trichomonas vaginalis are frequently associated with PID, complicating diagnosis and treatment.

Purpose of the Study:

  • To review the spectrum of microorganisms implicated in pelvic inflammatory disease (PID).
  • To outline current microbiological diagnostic procedures for identifying PID pathogens.
  • To correlate microbiological findings with appropriate antibiotic treatment strategies for PID.

Main Methods:

  • Analysis of microbiological causes of PID, including common STIs and other bacterial pathogens.
  • Review of diagnostic techniques utilizing vaginal fluid, endocervical, and surgical specimens.
  • Application of nucleic acid amplification tests (NAATs) for detecting key pathogens like N. gonorrhoeae and C. trachomatis.

Main Results:

  • Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium are the most frequent microbial causes of PID in the context of STDs.
  • Bacterial vaginosis and Trichomonas vaginalis are common co-infections.
  • In complicated PID or post-procedural cases, vaginal carriage bacteria (Enterobacteriaceae, Staphylococcus, Streptococcus, anaerobes) and Mycoplasma hominis/Ureaplasma urealyticum may be involved.
  • Microbiological diagnosis involves NAATs on various sample types and culture for specific bacteria, including antibiotic susceptibility testing.

Conclusions:

  • Effective PID management requires broad-spectrum antibiotic treatment covering common STIs and anaerobes.
  • Tailoring antibiotic therapy based on microbiological results, including antibiograms, is crucial for complicated cases or when non-STI pathogens are identified.
  • Accurate and timely microbiological diagnosis is essential for optimizing PID treatment outcomes.

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