[Cervico-vaginal pathogens and contraception: microbiological observations]

Abstract

The authors relate the results about 172 vaginal and cervical swabs, in women with or without oral/local (IUD) contraception, with or without vaginosis/vaginitis. Gardnerella vaginalis was always prevalent; the authors observed an high correlation between cervical IUD and vaginal Gardnerella, more than IUD and cervical Chlamydia trachomatis. Bacterial associations in Gardnerella vaginalis (Mobiluncus, obligate anaerobes) are related; incidence of Candida and Trichomonas vaginalis are reported; correlation between these microbial agents and contraception are discussed.

PIP: During 1986, 172 female patients aged 17-71 were examined to assess the relationship of contraceptives and pathogens. 18 women used oral contraceptives (OCs), 24 used IUDs, 52 had cervico-vaginal infections, and 78 were healthy and asymptomatic without risk factors (OC use, IUDs, or pregnancies). The ELISA immunoenzymatic system and the immunofluorescence method were utilized. In 50 controls (64% of 78 cases) lactobacillus bacillus was detected in the specimens taken by swabs in 28 cases (36%) other microorganisms were found: Gardnerella vaginalis in 6 cases, 3 different streptococci in 10 cases, staphylococcus and Escherichia coli in 2 cases each, and candida in 10 cases. Among 23 sick women, there were 4 cases of chlamydia, and, in a subgroup of 19 women G. vaginalis was observed in 12 cases (63%) and candida in 4 cases (21%). Another 29 women of the 52 with infections presented 20 cases (69%) of G. vaginalis, 4 cases of mobiluncus, 4 cases of trichomonas vaginalis, and 3 cases of candida. Among the 52 infected women, the most frequent agent was G. vaginalis (67%), followed by mobiluncus (19%), candida (13.5%), trichomonas (13.5%), and chlamydia (17%). Among 24 IUD users, the incidence of pathogens was: lactobacillus 100% of chlamydia in 3 cases, and G. vaginalis in 2 cases. Among 18 OC users, chlamydia was frequent, followed by G. vaginalis, trichomonas, and candida. The association of IUD use to Gardrerella was 70%, IUDs to Chlamydia was 33%, OC use to Gardnerella 33%, and OCs to candida 11%. These results indicate that periodic examinations prior to and after insertion of an IUD are useful to detect pathogens in the cervico- vaginal environment, prevent their spreads and avert infection.