Microbiological study of removed intrauterine devices

Intrauterine devices [IUDs] are highly [effective, long-term methods of contraception. Although evidence of a direct association between IUD use and pelvic inflammatory disease [PID] is scarce, concerns about PID related to IUDs use has limited their use throughout the world. In this study, 200 participants were chose from among women who requested an IUD as a means of contraception. The IUDs were removed 36 months later or in case of PID. No PID cases were recorded during the follow-up period. Prior to IUD insertion, 121 women [60.5%] had symptoms and/or signs of lower genital tract infection, whereas during the follow-up period 179 women [89.5%] had symptoms and/or signs of lower genital tract infection. Vaginal and endocervical specimens prior to insertion of IUD and during follow up period were collected from all participants and specimens from removed IUD. The Papanicolaou smears were negative for Actionmyces throughout the study period. Following IUD removal, 189 LUD cultures [94.5%] were positive. The bacterial flora of the removed IUDs consisted of common aerobic and anaerobic microorganisms that do not account for PID. The most common microorganisms identified were Staphylococcus coagulase negative [67%], Eschericia coli [57%], and Enterococcus faecalis [47%]. IUDs are a very effective and safe method of contraception if potential recipients are selected carefully. Culture of the removed IUDs and therapeutic management of women with positive cultures are not recommended when women are asymptomatic for PID

Mycoplasma hominis and ureaplasma urealyticum vaginosis in pregnant women

The main feature of BV is a change in vaginal flora from predominant Lactobacilli to overgrowth of other microorganisms like; Mycoplasma hominis [M. hominis] and Ureaplasma urealyticum [U. urealyticum]. M. hominis and U. urealyticum vaginosis has been associated with abortion, intraamniotic infection, premature rupture of membranes [PROM] and intrapartum fever in pregnant women. This study was carried out on 100 pregnant women complaining of abnormal vaginal discharge in addition, 50 normal healthy pregnant women were included as a control. Vaginal specimens were collected from all studied women. The incidence of BV among pregnant women was [39%] whereas none of the controls has BV. There was positive correlation between the number of pregnancy but not its duration. M. hominis was detected in BV cases [38.5%] and U. urealyticum in [46.2%]. As regarding the susceptibility, M. hominis was more sensitive to norfioxacin and tetracycline [100% for each] and also, U. urealyticum isolates were more sensitive to norfioxacin and tetracycline [94.4, 88.9%] respectively, but they were resistant to Amoxicillin and Amoxacillin/Culvunate

Chlamydia trachomatis in women with intermenstrual bleeding using different methods of contraception

Intermenstrual bleeding is a troublesome complaint in women using the oral contraceptives [OCs] or intrauterine devices [IUDs]. Traditionally, this bleeding was attributed to insufficient hormonal support in case of oral contraceptive or to local mechanical irritation in the case of IUDs. The endometritis may be the cause causing this bleeding. In this study 150 women were included. They were divided into five groups each consists of 30 women. The first group was women who are using IUDs for more than 3 months with complaining of intermenstrual bleeding in the previous 3 cycles at least, for which no probable cause could be detected. The second group was women who are using the same IUDs for more than 3 months without complaining of intermenstrual bleeding. The third group was women who were are using OCs for more than 3 months and having imtermenstrual bleeding in the previous 3 cycles at least, for which a probable cause could not be demonstrated. The fourth group was women who are using the same OCs for more than 3 months without complaining of intermenstrual bleeding. The last group was women who are not using a method of contraception in the previous 3 months considered as a control group. Endocervical and endometrial specimens were collected from studied women for detection of chlamydia trachomatis antigen by direct immunofluorescence [DIF] method. A significant increase in the incidence of detection of C. trachomatis from IUDs user 17/30 [56.7%] from Ocs user 9/30 [30%] with intermenstrual bleeding [p < 0.05]. Also, there is increase in the incidence of C. trachomatis from IUDs user 7/30 [23.3%] from Ocs user, 3/30 [10%] without intermenstrual bleeding but non-significant [p >0.05] We concluded that C. trachomatis could be the aetiological agent of intermenstrual bleeding in women using IUDs or Ocs