Impact of diverging anaerobic technology on cul-de-sac isolates from patients with...

The probability of obtaining accurate identification of bacteria present in the cul-de-sac in cases of polymicrobial bacterial endometritis-salpingitis-peritonitis (ESP) was analyzed on the basis of a comparison of bacteriologic data derived from the hospital laboratory and those engendered by a research anaerobic laboratory. Two sets of paired cul-de-sac specimens from 20 cases of ESP were analyzed at two different laboratories whose anaerobic technology differed from that of the reference laboratory. At University Hospital (Jacksonville, Florida), 22 of 36 (61%) aerobic bacterial isolates were correctly identified, in contrast to only eight of 52 (15.4%) anaerobic isolates. The clinical facility of the University of Florida College of Medicine (Gainesville, Florida) identified 28 of 32 (86.5%) aerobic and 16 of 34 (47.9%) anaerobic isolates. The probability of accurately delineating the anaerobic bacteria present in polymicrobial peritonitis which may develop in patients with acute salpingitis was directly related to the degree of sophistication in anaerobiology. Since most institutions cannot provide sophisticated anaerobiology, the authors contend that therapy cannot be contingent upon microbiologic data and that the clinician must rely primarily on clinical and biophysical parameters to monitor the effectiveness of therapy.