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pubmed:otherAbstract |
PIP: 33 women with severe infection of the genital tract were studied using fastidious anaerobic techniques. The women, admitted to the Department of Obstetrics and Gynecology at Cook County Hospital were referred to the Infectious Disease Service for the following: pelvic abscesses (13), tubo-ovarian abscesses (3), endometritis following dilatation and currettage (2), sepsis associated with incomplete abortion (7), puerperal sepsis (5), vaginal abscess (1), vulval abscess (1), and Bartholin's gland abscess (1). Anaerobic bacteria was cultivated from all 33 patients. Aerobic bacteria was associated with anaerobes in 21 patients, the most frequent isolate being E. coli, followed by facultative streptococci of the viridans group. 12 patients had only anaerobes present but no patients had aerobes in the absence of anaerobic forms. 12 patients also has positive blood cultures for the same anaerobes isolated from soft tissues. The 3 groups of anaerobes isolated with greatest frequency were bacteroides, peptostreptococci and clostridia. Bacteroides fragilis was the major species recovered in 26 specimens. 6 patients who had failed on conventional antibiotics were treated with clindamycin, a new antibiotic with high activity against anerobes. All patients responded satisfactorily. These bacteriologic and clinical observations suggest that anaerobes play an important and often decisive role in serious pelvic infections.
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