The colonization of IUDs with Actinomyces and other bacteriae

The colonization of IUDs with Actinomyces and other bacteriae

I. Gönenç, Z. Vural, G. Köse, N. Aka, G. Dönmezdemir

Department of Obstetrics and Gynecology, Haydarpasa Numune Training and

Research Hospital, Istanbul, Turkey

Aims: In a study carried out prospectively in the Family Planning Unit

of Haydarpasa Numune Training and Research Hospital in Istanbul, Turkey, we

aimed to investigate the range and frequency of bacterial colonization of the

removed IUDs especially by Actinomyces.

Materials and Methods: 135 randomly chosen women among IUD users and

who applied to our family planning unit with a request of removal of their IUDs

consisted the material of our study. The IUDs were placed in Triptic Soy Broth

and in anaerobic media containing SPS, immediately after the IUD strings were

trimmed. Vaginal swabs were obtained for Gram staining. All remarkable findings

were recorded after regular gynecological examinations. Two passages were made

from each culture medium for microscopic examination and sheep blood media. All

aerobic and anaerobic cultures were evaluated after relevant incubation periods.

Results: The shortest IUD wearing time was one month while the longest

one was 15 years (5.1+3.5 years). The most common clinical findings

presented were menorrhagia (25.9%) and pelvic pain (16.3%). Mann-Whitney U, x2,

Fisher’s exact x2 and Spearman’s correlation tests were used for

statistical evaluations. In Gram stains at 100 magnification, the presence of >15

PNL was evaluated as occurrence of infection (n=81, 60%). On the Gram stains 26

of the women (19.3%) had clue cells, 6 women (4.4%) had both PNL and yeast cells.

There was no correlation between the duration IUD wear and existence of

infection (p>0.05). The microorganisms identified after the incubation

periods were Staphylococcus coagulase negative (35.6%), Lactobacilli (17.7%),

Enterococcus spp. (14.8%), Eschericia coli (13.3%) Streptococcus spp. (8.9%),

Gardnerella vaginalis (7.4%), Candida albicans (5.9%), Peptococcus spp. (2.2%),

Mobilincus spp. (1.5%), Pseudomonas spp. (1.5%) and Actinomyces spp. (1.5%).

There was a significantly high statistical relationship between Actinomyces

colonization and the use of IUD exceeding 10 years (p<0.01).

Conclusion: The rate of Actinomyces colonization in our study is

similar to current literature. We conclude that IUDs should not be used beyond

expiry dates since we found a correlation with long-term IUD use (approximately

13 years) and Actinomyces colonization.

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