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New concepts of obstetric and gynecologic infection
Abstract:
Multiple organisms are usually recovered from patients with acute pelvic inflammatory disease (PID). The sexually transmitted organisms Neisseria gonorrhoeae, Chlamydia trachomatis, and genital mycoplasmas frequently initiate infection. Although aerobic and anaerobic bacteria that constitute the normal vaginal flora are frequent secondary invaders following an initial sexually transmitted infection, these bacteria can also primarily cause PID. Early postpartum endometritis, the most common postpartum infection, amniotic fluid infection, and infection following hysterectomy are usually caused by the aerobic and anaerobic bacteria that constitute the normal vaginal flora. Because the organisms that cause the various obstetric-gynecologic infections are often found in combination, it is necessary to begin therapy with broad-spectrum antibiotics. Many of these infections are caused by anaerobic bacteria and it is often necessary to select antibiotics that inhibit anaerobes.
Insights
Pelvic inflammatory disease (PID) and postpartum infections involve multiple organisms, including sexually transmitted and vaginal bacteria. Broad-spectrum antibiotics are crucial for treating these obstetric-gynecologic infections, especially those caused by anaerobic bacteria.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Microbiology
Background:
- Pelvic inflammatory disease (PID) and postpartum infections are often polymicrobial.
- Sexually transmitted organisms like Neisseria gonorrhoeae and Chlamydia trachomatis frequently initiate PID.
- Normal vaginal flora, including aerobic and anaerobic bacteria, can also cause or secondarily infect these conditions.
Purpose of the Study:
- To review the causative organisms of obstetric-gynecologic infections.
- To emphasize the importance of broad-spectrum antibiotic therapy.
Main Methods:
- Literature review of common obstetric-gynecologic infections.
- Analysis of microbial etiology for PID, endometritis, and post-hysterectomy infections.
Main Results:
- Multiple organisms, including Neisseria gonorrhoeae, Chlamydia trachomatis, genital mycoplasmas, and vaginal flora, are implicated in PID.
- Normal vaginal flora are primary causes of postpartum endometritis and post-hysterectomy infections.
- Obstetric-gynecologic infections frequently involve combinations of aerobic and anaerobic bacteria.
Conclusions:
- Effective treatment requires broad-spectrum antibiotics due to polymicrobial nature of infections.
- Antibiotic selection must consider the prevalence of anaerobic bacteria in these infections.