• Microbiocenosis condition of the reproductive system in women with pelvic inflammation disease

Microbiocenosis condition of the reproductive system in women with pelvic inflammation disease

HEALTH OF WOMAN. 2016.6(112):127–130; doi 10.15574/HW.2016.112.127 
 

Microbiocenosis condition of the reproductive system in women with pelvic inflammation disease 
 

Sytniс P. A.

Odessa national medical University 
 

The aim of the study was to assess the state of microbiocenosis of the reproductive system in women with purulent inflammation of the pelvic organs.


Patients and methods. The survey was conducted during 2012–2015 at the Municipal Clinical Hospital №1 in the city of Odessa (Ukraine). The study involved 27 women with verified purulent inflammation of the pelvic organs. The average age of patients was 41.3±1.2 years. Bacteriological analysis was performed in the clinical laboratory of the Municipal Clinical Hospital №1. The analysis was conducted using classic techniques with the elaboration of antibiotic-gram. The species composition of microorganisms isolated from abscesses, blood, purulent separation, drainage and postoperative wounds was obtained and studied in 27 patients during surgery and daily during the first week hospital stay.


Results. It is shown that among septic diseases of the pelvic organs in patients with purulent dominated tubo-ovarian tumor (9 cases or 33.3%), pyosalpinx with perforations (33.3%). It is found that most often at the time of surgery wounds inoculated Staphylococcus epidermidis (66.7%), Staphylococcus saprophyticus (29.6%), as well as E. coli. (29.6%). Less common are inoculated bacteria like Streptococcus fecalis (14.8%), Enterobacter aeruginosa (3.7%) and Klebsiella pneumoniae (37%). In 40.7% of patients there were microbial associations of different composition, mainly represented by staphylococci and E. coli. It is shown that on the second day of the postoperative period bacteriological crops were negative, indicating the adequacy of the applied antibiotic treatment.


Conclusion. Already on the second day postoperative bacteriological crops were negative, indicating the adequacy of the applied antibiotic. The results allow us to recommend the use of a basic combination therapy protected penicillins, ensuring the elimination of a wide spectrum of pathogens, including anaerobes, and doxycycline that the first two days of hospital stay administered parenterally. After lowering body temperature below 37.5°C and normalization leykohramy a transition to the use of oral antibiotics. We believe that the treatment of PID preference should be given antibiotic combination, while for the diagnosis of chlamydia should use highly specific methods that provide the least amount of false positives (PCR DNA combined with the sowing and the subsequent direct microscopy). What is important is a careful dose and duration of antibiotics and purpose of avoiding situations where patients with PID prescribed instead of causal treatment not justified pathogenetic therapy (immunomodulators, enzymes, adaptogens, etc.).The prospects of further studies related to the assessment of the dynamics of the content of acute-phase proteins in septic diseases of the pelvic organs.


Key words: pelvic inflammation disease, microbiocenosis, diagnostics.


REFERENCES

1. Balakshina NG, Koch LI. 2010. Surgical treatment of complications of purulent inflammatory diseases of the uterus. Bulletin of the Siberian medicine 9;1:70-75.

2. Gusev MV. 2010. Microbiology. M, Academy:464

3. Lapach SN, Chubenko AV, Babich PN. 2000. Statistical methods in biomedical research using Excel. Kiev, MORION:320.

4. Makarenko TA. 2012. The results of organ-preserving treatment of purulent inflammatory diseases of the uterus in women of childbearing age. Endoscopic surgery 18;2:38-42.

5. MOH Ukraine Order from 29.12.2003 No 620 «On approval of clinical protocols for obstetric and gynecological care» Electronic resource. Access mode: http://www.moz.gov.ua/ua/portal/dn_20031229_620.html

6. MOH Ukraine Order from 31.12.2004 No. 676 «On approval of clinical protocols for obstetric and gynecological care». Electronic resource. Access mode: http://www.moz.gov.ua/ua/portal/dn_20041231_676.html

7. MOH Ukraine Order from 08.05.2014 No 310 «On cancelling some orders of the Ministry of Health of Ukraine». Electronic resource. Access mode http://www.moz.gov.ua/ua/portal/dn_20140508_0310.html

8. Podonina NM. 2014. Optimization of tactics of treatment of patients with purulent inflammatory diseases of the uterus. MANEB Observer in the Omsk region 1(4):62-64.

9. Sitnik PA. 2015. Risk factors and clinical features of chronic inflammatory diseases of the uterus in the age aspect. Modern medicine: current issues 48-49:14-18.

10. Strahovetsky VS. 2013. Morphological characteristics of inflammatory diseases of the uterus. Women's Health 4(80):125.

11. Moore MS, Golden MR, Scholes D, Kerani RP. 2016. Assessing Trends in Chlamydia Positivity and Gonorrhea Incidence and Their Associations With the Incidence of Pelvic Inflammatory Disease and Ectopic Pregnancy in Washington State, 1988-2010. Sex Transm Dis. 43(1):2-8. http://dx.doi.org/10.1097/OLQ.0000000000000352; PMid:26656441

12. Bondurri A, Maffioli A, Danelli P. 2015. Pelvic floor dysfunction in inflammatory bowel disease. Minerva Gastroenterol Dietol. 61(4):249-59. PMid:26603727

13. Brunham RC, Gottlieb SL, Paavonen J. 2015. Pelvic inflammatory disease. N Engl J Med. 21;372(21):2039-48

14. Sordia-Hernбndez LH, Serrano Castro LG, Sordia-Piсeyro MO, Morales Martinez A, Sepulveda Orozco MC, Guerrero-Gonzalez G. 2010. Comparative study of the clinical features of patients with a tubo-ovarian abscess and patients with severe pelvic inflammatory disease. Int J Gynaecol Obstet. 132(1):17-9. http://dx.doi.org/10.1016/j.ijgo.2015.06.038; PMid:26431590

15. Crum-Cianflone NF. 2015. Pelvic Inflammatory Disease. N Engl J Med. 373(7):686. http://dx.doi.org/10.1056/NEJMc1507793; PMid:26267641

16. Duarte R, Fuhrich D, Ross JD. 2015. A review of antibiotic therapy for pelvic inflammatory disease. Int J Antimicrob Agents. 46(3):272-7. http://dx.doi.org/10.1016/j.ijantimicag.2015.05.004; PMid:26126798

17. Lachiewicz MP, Moulton LJ, Jaiyeoba O. 2015. Pelvic surgical site infections in gynecologic surgery. Infect Dis Obstet Gynecol. 2015:614-950. http://dx.doi.org/10.1155/2015/614950; PMid:25788822 PMCid:PMC4348594

18. Llata E, Bernstein KT, Kerani RP, Pathela P, Schwebke JR, Schumacher C, Stenger M, Weinstock HS. 2015. Management of Pelvic Inflammatory Disease in Selected U.S. Sexually Transmitted Disease Clinics: Sexually Transmitted Disease Surveillance Network, January 2010-December 2011. Sex Transm Dis. 42(8):429-33. http://dx.doi.org/10.1097/OLQ.0000000000000309; PMid:26165434

19. Yang SF, Wu TF, Tsai HT, Lin LY, Wang PH. 2014. New markers in pelvic inflammatory disease. Clin Chim Acta. 431:118-24. http://dx.doi.org/10.1016/j.cca.2014.02.004; PMid:24525211

20. Pacheco M, Katz AR, Hayes D, Maddock JE. 2016. Physician Survey Assessing Pelvic Inflammatory Disease Knowledge and Attitudes to Identify Diagnosing and Reporting Barriers. Womens Health Issues 26(1):27-33. http://dx.doi.org/10.1016/j.whi.2015.07.013; PMid:26341567