Journal Article

Bacterial Vaginosis and Anaerobic Bacteria Are Associated with Endometritis

Hillier, Sharon L., Ness, Roberta B., Bass, Debra C., Haggerty, Catherine L.

2004

Overview

Background. Chlamydia trachomatis and/or Neisseria gonorrhoeae account for approximately one-third to one-half of pelvic inflammatory disease (PID) cases. Thus, up to 70% of cases have an unknown, nongonococcal/nonchlamydial microbial etiology. Methods. We investigated the associations of N. gonorrhoeae, C. trachomatis, bacterial vaginosis, anaerobic bacteria, facultative bacteria, and lactobacilli with endometritis among 278 women with complete endometrial histology and culture from the PID Evaluation and Clinical Health Study. Results. Women with acute endometritis were less likely to have H2O2-producing Lactobacillus species (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.01–0.8) and more likely to be infected with C. trachomatis (OR, 16.2; 95% CI, 4.6–56.6), N. gonorrhoeae (OR, 11.6; 95% CI, 4.5–29.9), diphtheroids (OR, 5.0; 95% CI, 2.1–12.2), black-pigmented gram-negative rods (OR, 3.1; 95% CI, 1.4–7.0), and anaerobic gram-positive cocci (OR, 2.1; 95% CI, 1.0–4.3) and to have bacterial vaginosis (OR, 2.4; 95% CI, 1.3–4.3). Conclusions. We conclude that bacterial vaginosis—associated organisms are frequent among women with PID. Because these organisms were strongly associated with endometritis, we recommend that all women with PID be treated with regimens that include metronidazole.

• Publisher: The University of Chicago Press,University of Chicago Press
• Subject: Adolescent / Adult / Anaerobic bacteria / Anti-Bacterial Agents - therapeutic use / Antibiotics. Antiinfectious agents. Antiparasitic agents / Antifungal agents / Bacteria, Anaerobic - isolation & purification / Bacterial diseases / Bacterial diseases of the genital system / Bacterial vaginosis / Bacteroides / Biological and medical sciences / Chlamydia trachomatis / Endometritis / Endometritis - complications / Endometritis - microbiology / Endometrium / Epidemiology. Vaccinations / Female / General aspects / Gram positive cocci / Human bacterial diseases / Humans / Infectious diseases / Lactobacillus / Major Articles / Medical sciences / Metronidazole - therapeutic use / Microorganisms / Neisseria gonorrhoeae / Pelvic inflammatory disease / Pharmacology. Drug treatments / Prevotella / Vaginosis, Bacterial - complications / Vaginosis, Bacterial - drug therapy / Vaginosis, Bacterial - microbiology