A longitudinal study of Actinomyces israelii in the female genital tract

A prospective longitudinal investigation was performed to study variations in the occurrence of Actinomyces israelii with reference to four microorganisms, staphylococci, E. coli, P. acnes and C. albicans, in the female genital tract. Fifteen healthy women were studied during all phases of the menstrual cycle. Sampling was made from the cervix, vagina and perineal area three times a week during two consecutive menstrual periods and during menstruation from napkins and tampons. Altogether 1108 samples were taken on 349 sampling occasions for different cultural procedures. A. israelii was identified in all women, in varying frequencies (range 4 to 74% of sampling occasions). As a mean, A. israelii was recovered in 24% of the perineal samples, 13% of the vaginal and 6% of the cervical samples. The occurrence of A. israelii was related neither to the recovery of reference microorganisms nor to the phase of the menstrual cycle, the amount of bleeding or discharge, the pH of the vaginal specimens, the contraceptive method used, or to the use of different sanitary products. It is our conclusion that A. israelii appears to be a part of the indigenous genital flora of healthy women.