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.
