Evaluation of Cervical Microbial Flora in Patients with Pelvic Inflammatory Disease
Study Objective: To evaluate the cervical microbial flora in patients with pelvic inflammatory disease (PID). Materials and Methods: Overall, 501 patients, aged 18 to 35, were examined in the study. These women presented to ob/gyns with abnormal vaginal discharge, aching lower abdominal and lumbar pain, and infertility. PID was diagnosed and confirmed by physical examination, laboratory investigations (bacterioscopy, bacteriologic examination, PCR diagnostic tests, and blood tests), pelvic sonography, computed tomography, laparoscopy, and morphology. The control group consisted of 84 women, aged 20 to 35, who had come to the clinic for a gynecological check-up and to ask for recommendations about contraceptive methods. Results: Microbial contamination and/or true colonization of the cervical canal with pathogenic and potential pathogenic microorganisms was found to be significantly more pronounced in patients with PID than in women in the control group. Mixed flora (bacteria, viruses, and fungi) were present in the cervical canal in 63.47 ± 2.15% of patients. In patients with PID, the presence of mixed flora in the cervical canal is associated with a high risk of further development of inflammation into the endometrium, fallopian tubes, and peritoneum. Conclusion: In patients who have been treated for PID, it is necessary to evaluate the microbial flora of the cervical canal in an outpatient setting, and to assess the degree of microbial contamination and/or true colonization. This will help, to a certain degree, to assess the effectiveness of the previous treatment and to estimate the risk of PID recurrence.