Bacterial cultures from intrauterine devices removed from patients with pelvic inflammatory disease

Bacterial cultures were obtained from intrauterine devices (IUD) removed from 274 patients admitted to the Department of Obstetrics and Gynecology of the University Central Hospital of Helsinki because of suspected pelvic inflammatory disease (PID), meno-metrorrhagia, pain or other conditions potentially caused by an IUD. A diagnosis of serious PID was made in 42 patients, mild PID in 119 patients, while 113 were found to have no infection. An association between positive cultures of beta-hemolytic streptococci and Escherichia coli and PID was found. Positive cultures of Neisseria gonorrhoeae were significantly correlated with PID. The risk of developing PID was significantly greater during the first month after insertion of the IUD than when more than 30 days had elapsed from insertion of the IUD. The significance of the microbes cultured from removal IUDs as causal agents of pelvic inflammatory disease is discussed.