Polymicrobial Early Postpartum Endometritis with Facultative andAnaerobic Bacteria, Genital Mycoplasmas, and Chlamydia trachomatis:Treatment with Piperacillin or Cefoxitin

Rosene, Karen; Eschenbach, David A.; Tompkins, Lucy S.; Kenny, George E.; Watkins, Hermien

doi:10.1093/infdis/153.6.1028

Cited by 101 publications

(42 citation statements)

References 24 publications

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“…(118,133,147), intra-amniotic infections (77,149), chorioamnionitis (31,90,122,155), postabortal pelvic inflammatory disease (87), and postpartum endometritis following cesarean section (148). Large studies of postpartum endometritis in women who delivered at hospitals in Houston, Tex., and Seattle, Wash., identified G. vaginalis, often mixed with other bacteria, in endometrial cultures from 25% (136) and 38% (193,241) of infected patients. An important technical feature was the use of an endometrial suction device (136) or a triple-lumen sampling device (193,241) which protects the endometrial specimen from contamination by cervicovaginal flora.…”

Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

“…Large studies of postpartum endometritis in women who delivered at hospitals in Houston, Tex., and Seattle, Wash., identified G. vaginalis, often mixed with other bacteria, in endometrial cultures from 25% (136) and 38% (193,241) of infected patients. An important technical feature was the use of an endometrial suction device (136) or a triple-lumen sampling device (193,241) which protects the endometrial specimen from contamination by cervicovaginal flora. Therefore, the finding that endometrial cultures contained a mixture of bacteria corresponding to those typical of vaginosis could not be attributed to contamination during sampling.…”

Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

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Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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The clinical significance, Gram stain reaction, and genus affiliation of Gardnerella vaginalis have been controversial since Gardner and Dukes described the organism as the cause of "nonspecific vaginitis," a common disease of women which is now called bacterial vaginosis. The organism was named G. vaginalis when taxonomic studies showed that it was unrelated to bacteria in various genera including Haemophilus and Corynebacterium. Electron microscopy and chemical analyses have elucidated the organism's gram-variable reaction. Controversy over the etiology of bacterial vaginosis was largely resolved by (i) studies using improved media and methods for the isolation and identification of bacteria in vaginal fluids and (ii) standardization of criteria for clinical and laboratory diagnosis. Besides G. vaginalis, Mobiluncus spp., Mycoplasma hominis, and certain obligate anaerobes are now acknowledged as participants in bacterial vaginosis. The finding that G. vaginalis, Mobiluncus spp., and M. hominis inhabit the rectum indicates a potential source of autoinfection in addition to sexual transmission. Extravaginal infections with G. vaginalis are increasingly recognized, especially when the toxic anticoagulant polyanetholesulfonate is omitted from blood cultures and when urine cultures are incubated anaerobically for 48 h. The finding that mares harbor G. vaginalis suggests that an equine model can be developed for studies of Gardnerella pathogenesis.

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Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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“…2 The use of gas-liquid chromatography of vaginal secretions to diagnose bacterial vaginosis is also based on this phenomenon. 86,87 The discharge usually contains very few white cells although the presence of greater numbers of white cells does not exclude the diagnosis. A pH less than 4.5, however, is not consistent with a clinical diagnosis of bacterial vaginosis.…”

Section: Diagnosismentioning

confidence: 99%

Evaluation and management of vaginitis

1998

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V aginitis is a common medical problem in women that is associated with substantial discomfort and frequent medical visits. Roughly 5 to 10 million office visits per year are attributed to vaginitis. 1 Research in recent years has increased our understanding of the disease process and its potential sequelae and resulted in improved diagnostic and treatment modalities. 2-6 Nevertheless, adequate diagnosis and treatment of vaginitis in the office setting often is problematic for practitioners. 2,5,7-9 Moreover, the availability of over-the-counter medications for fungal vaginitis has increased the likelihood that women will come to medical attention with partially or inadequately treated infections. 10 We will focus on the common infectious causes of vaginal discharge-yeast infection, bacterial vaginosis, and trichomonas infection, emphasizing new developments in diagnosis, associated complications, and treatment of these infections.The initial evaluation of vaginal discharge requires an understanding of physiologic vaginal discharge and what differentiates it from abnormal, pathologic discharge. Substances from the vulvar, sebaceous, sweat, Bartholin's and Skene's glands, as well as exfoliated cells, cervical mucus, and secretions of the endometrial cavity and fallopian tubes constitute the normal physiologic secretions of the vagina. These secretions pool in the posterior fornix and do not adhere to the vaginal walls. 11 The pH of normal vaginal secretions in women of childbearing age is between 3.8 and 4.5. The presence of sperm, blood, amniotic fluid, or cervical mucus raises the vaginal pH. 11 The amount and fluidity of the discharge can vary over the menstrual cycle. Cervical mucus becomes more fluid around ovulation, and women frequently mistake this change in consistency for an abnormal discharge. Stress increases the rate of vaginal desquamation and thus the amount of discharge, which patients can also mistake for a pathologic discharge. 12 Women generally do not have other symptoms if their discharge is physiologic.In contrast, a pathologic discharge adheres to the vaginal walls and is often accompanied by irritation, pruritus, odor, or urinary symptoms such as dysuria or frequency. 6 The discharge can be thick to watery and frothy, and white to yellow, gray, or green. 11 Causes of an abnormal discharge include infectious causes of vaginitis such as yeast infection, bacterial vaginosis, and trichomonas infection, as well as cervicitis and sexually transmitted diseases such as gonorrhea and chlamydia infection. Noninfectious etiologies include chemical irritants such

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“…These infections are characterized by a fever higher than 38°C, which occurs during the first 10 days after giving birth (except the first 24 hours) and persists for at least 2 days (1). They are microbial infections (2) and originate from Grampositive or Gram-negative bacteria and anaerobes. Factors such as Chlamydia and Neisseria gonorrhoeae rarely lead to an infection immediately after delivery; in fact, Chlamydia usually appears as a delayed infection (3,4).…”

Section: Introductionmentioning

confidence: 99%

Examination of the Association of Meconium-Stained Amniotic Fluid with Postpartum Infection and Fever After C-Section

Azadi¹,

Moshfeghi²,

Bahrami³

et al. 2017

Obstet Gynecol Cancer Res

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Background: Pelvic infections are among the most prevalent and serious postpartum complications. Over the past several decades, these infections, along with preeclampsia and hemorrhage, have constituted the triad of death among mothers. The presence of meconium in the amniotic fluid has been considered as one of the risk factors for postpartum infections. This study aimed to investigate the association of meconium-stained amniotic fluid with postpartum infection and fever. Methods: This prospective cohort study included 200 singleton term pregnant women, referred for childbirth to Imam Khomeini and Razi hospitals of Ahvaz in 2014. The women were assigned to two groups, ie, subjects with meconium-stained amniotic fluid (exposure group) and subjects with clear amniotic fluid (control group). The participants in the two groups were identical in terms of maternal age, gestational age, parity, and duration of ruptured membranes. Pregnant women who had underlying medical problems were excluded from the study. Both groups received intravenous ampicillin half an hour before the surgery until 48 hours after the surgery, based on the protocol introduced by the hospital for women planning cesarean section. The two groups were compared regarding post-C. Section infection. The exposure group consisted of 100 subjects with meconium-stained amniotic fluid, while the control group included 100 subjects with clear amniotic fluid. The participants were observed for maternal prognosis, based on postpartum infections. Results: Both groups underwent C-section. In the exposure and control groups, 14 (14%) and 12 (12%) women had fever after C-section, respectively. Moreover, 6 (6%) and 3 (3%) women in the exposure and control groups had post-C. section wound infections, respectively.

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Polymicrobial Early Postpartum Endometritis with Facultative andAnaerobic Bacteria, Genital Mycoplasmas, and Chlamydia trachomatis:Treatment with Piperacillin or Cefoxitin

Cited by 101 publications

References 24 publications

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Evaluation and management of vaginitis

Examination of the Association of Meconium-Stained Amniotic Fluid with Postpartum Infection and Fever After C-Section

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