A comparative study of the various organisms causing salpingitis and their potential presence in IUD wearers
Kaufmann, E.
Contraception Fertilite Sexualite 13(2): 475-482
1985
ISSN/ISBN: 0301-861X PMID: 12339972 Document Number: 252739
A prospective study was undertaken to compare the enbdometrial and vaginal bacteria of a continuous series of 283 patients who had IUDs removed between June 1, 1979 and June 1, 1983, by the same clinician. Measures were taken to avoid contamination of the IUD upon removal by the vaginal bacteria, but as a practical matter it was impossible to avoid all contact. The IUDs involved were Multiload copper 250 or 375, Gyne T and T 200, Nova T, and Dimelys. The number of positive cultures from the IUD and the vagina respectively were 1 and 3 of Trichomonas, 82 and 142 Doederlein, 17 and 47 Candida, 131 and 141 white Staphylococcus, 77 an 71 enterococci, 97 and 132 Coli bacilli, 41 abd 54 Lancedfield streptococci, 15 and 58 Hemophilus vaginalis, 13 and 24 Proteus, 1 and 1 Veillonella alcalescens, 3 and 11 Vibrions, 2 and 3 staphylococci dores, 1 and 2 Klebsiella, 1 and 1 Clostridium, 9 and 6 Peptostreptococcus putridus, 1 and 1 Peptococcus prevoti, 6 and 6 Bacteroides fragilis, 2 and 2 Peptococcus intermedius, 0 and 1 Peptococcus aerogenes, and 1 and 1 Citobacter diverous. In almost all cases the concentrartion of bacteria was much greater in the vagina. The rarity of sterile IUDs was not surprising considering the method or removal and the almost inevitable contact with the vagina. The number of organisms declined significantly with parity, but when non-pathogenic bacteria were excluded, the number of sterile IUDs was greatest among nulliparas and primaparas. The Nova T and Dimelys had less contamination by all types of organisms than did the Gravigarde, Multiload copper, or Gyne T. The greatly reduced quantity of bacteria in the uterine cavity relative to the vagina indicates that the cervix is still an effective filter even when it is traversed by the IUD thread.