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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.


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