The Role of anaerobic bacteria in female upper genital tract infection and sensitivities to various antibiotics

SUMMARY The present study was carried out to establish the role of anaerobic bacteria in upper genital tract infections of women and to determine the profile of sensitivities to antibiotics so that it can guide to the empirical treatment. Aerobic and anaerobic cultures were done from endoservical specimens of 100 patients with diagnos is of upper genital tract infections according to clinical symptoms and findings and 50 healthy control women. Pathogen microorganisms have been determined in 72 percent of patient 's specimens. Only anaerobic bacteria have been recovered from 20 (27.7 %), only aerobic bacteria from 14 (19.4 %) and both aerobes and anaerobes from 38 (52.7 %) of the 72 specimens. The number of anaerobic bacteria isolated from patients was found to be significantly higher than those from healthy women (p<0.05). This study revealed that anaerobic bacteria play significant role and cause mixed infections in women with upper genital tract infections. The resistance rates of the pigmented Gram negative bacilli were 5 % for both penicillin and cefoxitin while these rates were 69 % for penicillin and 31 % for cefoxitin in the nonpigmented Gram negative bacilli. Resistance to imipenem, clindamycin and metronidazole were not recorded for both pigmented and nonpigmented Gram negative bacilli. For peptostreptococci, the resistance rates were found to be 21 % for metronidazol and 13 % for clindamycin but resistance to imipenem, cefoxitin and penicillin were not recorded. Our results indicate that imipenem may be an advantage for initial empirical treatment in patients suspected upper genital tract infections in our region. Also we can suggest that if Gram negative bacilli were seen on Gram smears without aerobic growth metronidazole, clindamycin or imipenem may be usefull for the empirical treatment. On the other hand penicillin, cefoxitin or imipenem can be effective empirically if Gram positive cocci were seen microscopically without aerobic growth. 71