Studies on uterine tract infections and the IUCD with special reference to actinomycetes

Abstract

Since the advent of the plastic IUCD, an increasing number of patients with clinical pelvic actinomycosis have been reported in the literature and in a very much larger number of women, actinomycetes have been identified in cervical smears, either by Papanicolaou stain or specific immunofluorescence. After a 3-year study, we have concluded that actinomycetes can readily be cultured wherl the growth of more rapidly growing anaerobes is inhibited by metronidazole and anaerobic culture is continued for up to 14 days. We consider that actinomycetes form part of a polymicrobial anaerobic infestation developing in the presence of a foreign body. The organisms are found almost exclusively in women who have used all-plastic IUCDs for a long term and, from a continuing study. it is apparent that most disappear rapidly when the plastic device is removed or replaced by a copper device. Significant symptomatic evidence of infection is found in a small proportion of patients who are actinomycete-positive.

The Importance of the Removal of the Intrauterine Device in Genital Colonization by <i>Actinomyces</i>

“…In view of the essential role played by the removal of the IUD from the uterine cavity in the disappearance of genital colonization by Actinomyces, in our opinion, and as reported by authors such as Duguid et al [14], Arroyo and Quinn [18], Leslie and Garland [13], Antolín et al [16], Tendolkar et al [17], Ló pez-Olmos et al [12], Fiorino [10], Chardonnens et al [11], Rodriguez Costa et al [15], Schlaen et al [4], Fresnadillo et al [2], IUD removal, by itself, could be sufficient as an effective treatment for this process, eliminating the need to associate antibiotics.…”

Intrauterine contraceptive device‐related actinomycosis infection presenting as an incarcerated inguinal hernia

“…Fiorino evaluated 92 patients having pelvic actinomycoses and concluded that on an average these patients had IUCD in situ for approximately 8 years 8 . There are studies that suggest that a plastic IUCD device is more prone to actinomyces infections and that these infections can be eradicated if this device is removed or replaced by a copper device 9 …”

Anaerobes in Surgical Infections in Kuwait: A Multicenter Study on 379 Patients

“…was re covered from 2 patients with perianal infec tions, and from lUCDs removed from 3 pa tients with pelvic inflammatory disease. Pel vic actinomycosis as a complication in IUCD usage is well documented [15,16].…”