Prevalence of the genital tract bacterial infections after vaginal reconstructive surgery

Due to frequent childbirth, heavy lifting and the structure of the lives of rural women in Shahrekord region, Iran, cystocele and rectocele are of the main medical problems of the women in this area and for its correction, vaginal reconstructive surgery is needed which causes infection. The purpose of this study was to identify the bacteria causing infection after vaginal reconstructive surgery and performing antibiogram to help these patients for faster recovery. Patients enrolled this study were 92 who had undergone previous vaginal reconstructive surgery and now had infection. After examination, the group of patients taking antibiotics (n = 26) were excluded and the remaining 66 completed the study questionnaire. A gynecologist performed sampling; related tests (aerobic and anaerobic culture using an anaerobic culture gas pack jar and type A which provides absolute anaerobic conditions) were performed; antimicrobial susceptibility testing using Disk Diffusion Method was carried out; and the results were recorded. All the positive samples were polymicrobial. Gardnerella vaginalis in 20 cases (31%), peptostreptococci and anaerobic cocci in 9 cases (13.6%), staphylococcus aureus in 8 cases (9.1%), bacteroides and fusobacterium in 7 cases (10.6%), streptococcus group B in 4 cases (6%), yeast cells in 11 cases (16.6%) and Trichomonas vaginalis in wet mount of 4 (6%) existed. Anaerobic bacteria showed 85% sensitivity to clindamycin, 82% to chloramphenicol, 85% sensitivity to ceftizoxime and 45% to penicillin. Facultative anaerobic bacteria showed a sensitivity rate of 90% to ceftizoxime, chloramphenicol and cephalothin. According to our findings, the rate of vaginal bacterial infection in women with vaginal reconstructive surgery has increased; from which, infections with anaerobic bacteria origins have increased dramatically. We recommend antibiotic prophylaxis prior to genital reconstructive surgeries.