Related Experiment Videos
Etiology of acute pelvic inflammatory disease proven by laparoscopy
1Department of Obstetrics and Gynecology, E. Wolfson Hospital, Holon, Israel.
Background:
Only a few studies have investigated the etiology of acute pelvic inflammatory disease (PID) in laparoscopy-proven cases using pelvic samples for culture. Most of these studies were conducted in North America and Scandinavia.
Goal Of The Study:
To study the microbial etiology of laparoscopy-proven acute pelvic inflammatory disease in Israeli women.
Study Design:
A prospective survey of women admitted to a hospital for treatment of acute pelvic inflammatory disease. All diagnoses were laparoscopy confirmed. Specimens for culture were obtained from the pelvic cavity via the laparoscope, and two serum samples were sent for serologic studies.
Results:
Forty patients were studied. Their mean age was 34.4 years of age, and 27.5% had a history of PID. Chlamydia trachomatis infection was diagnosed in 14 (35%) patients (group A). Facultative and/or anaerobic bacteria were isolated from pelvic specimens of 7 (17.5%) patients (group B), one of these patients also had positive chlamydial serology. Mycoplasma hominis was cultured from a pelvic specimen of one woman, and herpes simplex virus grew from a pelvic sample of another patient in whom C. trachomatis was also found. In 19 (47.5%) women, the microbial etiology could not be determined (group C). In no case was Neisseria gonorrhoeae isolated. Stage I (mild) PID was diagnosed most often in group A (75% vs. 14% in group B [P < 0.02]), whereas the opposite was true for stage III (severe) PID (71.4% in group B vs 25% in group A [P = 0.07]). Tubal abscess was mainly diagnosed in group B patients (57% vs 16.6% in group A [P = 0.09]).
Conclusion:
In Israel, C. trachomatis is the most common cause of PID, while gonococci are rarely involved in this infection.
Insights
Chlamydia trachomatis is the leading cause of acute pelvic inflammatory disease (PID) in Israeli women, with Neisseria gonorrhoeae rarely implicated. This study highlights regional differences in PID etiology.
Area of Science:
- Gynecology
- Infectious Diseases
- Microbiology
Background:
- Limited research exists on the microbial causes of acute pelvic inflammatory disease (PID) using laparoscopy-proven cases and pelvic samples.
- Existing studies on PID etiology are predominantly from North America and Scandinavia.
Purpose of the Study:
- To investigate the microbial etiology of laparoscopy-confirmed acute pelvic inflammatory disease (PID) specifically in Israeli women.
- To identify the causative agents responsible for PID in this distinct geographic population.
Main Methods:
- A prospective study involving women hospitalized for acute pelvic inflammatory disease (PID).
- Laparoscopic confirmation of all PID diagnoses.
- Collection of pelvic cavity specimens via laparoscopy for microbial culture and serologic testing.
Main Results:
- Chlamydia trachomatis was identified in 35% of patients, associated with milder PID stages.
- Facultative and/or anaerobic bacteria were isolated in 17.5% of cases, linked to more severe PID and tubal abscesses.
- Neisseria gonorrhoeae was not detected in any patient; microbial etiology remained undetermined in 47.5% of cases.
Conclusions:
- Chlamydia trachomatis is the predominant pathogen causing acute pelvic inflammatory disease (PID) in Israel.
- Neisseria gonorrhoeae appears to play a minimal role in PID etiology within the studied Israeli population.
- Findings suggest significant geographic variations in the microbial causes of PID.