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Vaginal flora and pelvic inflammatory disease

S Faro1, M Martens, M Maccato

  • 1Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City 66160.

American Journal of Obstetrics and Gynecology
|August 1, 1993
PubMed
Summary

This study found that acute pelvic inflammatory disease (PID) in women with purulent discharge does not align with the typical bacterial vaginosis profile. The dominant bacteria in PID were not the anaerobic species characteristic of bacterial vaginosis.

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Area of Science:

  • Gynecology
  • Infectious Diseases
  • Microbiology

Background:

  • Pelvic inflammatory disease (PID) is a serious infection.
  • Bacterial vaginosis (BV) is a common vaginal condition.
  • The relationship between PID and BV requires further investigation.

Purpose of the Study:

  • To evaluate the coexistence of bacterial vaginosis (BV) in patients with acute pelvic inflammatory disease (PID).
  • To characterize the vaginal and endocervical flora in patients with acute PID.

Main Methods:

  • Microbiologic criteria were used to assess bacterial vaginosis due to purulent discharge obscuring microscopic evaluation.
  • Vaginal, endocervical, and endometrial specimens were collected from 41 patients with acute PID.
  • Bacterial isolates were identified and quantified.

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Main Results:

  • Vaginal bacterial flora in PID patients were inconsistent with BV, dominated by Lactobacillus and gram-positive bacteria.
  • Neisseria gonorrhoeae was the most frequent isolate from the endocervix (20 patients) and endometrium (11 patients).
  • Chlamydia trachomatis was isolated from 11 patients in the endocervix.
  • Anaerobic bacteria were not dominant in any sampled site.

Conclusions:

  • The endogenous bacterial flora in acute PID is not consistent with the microbiologic definition of bacterial vaginosis.
  • Neisseria gonorrhoeae is a predominant pathogen in acute PID, more frequent than Chlamydia trachomatis in the endocervix and endometrium.