Cyclic changes in cervical microflora and their effect on infections following hysterectomy

In a prospective study the cyclic changes in the cervical microflora and the endometrial histology were correlated with the incidence of postoperative infections in 99 women undergoing elective abdominal hysterectomy. Escherichia coli and Bacteroides fragilis were isolated more frequently during the proliferative phase than during the secretory phase and, correspondingly, postoperative infections were more frequent when operated during the proliferative phase than during the secretory phase. Moderate to severe infections occurred in 31.6% of the patients operated during the proliferative phase in contrast to 18% during the secretory phase. This suggests increased host susceptibility to infection during the proliferative phase.