title: Transcervical uterine cultures with a new endometrial suction curette: a comparison of three sampling methods in postpartum endometritis.
abstract: The potential for cervicovaginal contamination has precluded direct sampling of the endometrial cavity and has led to the development of multi-lumen protected catheter systems, among other techniques. The extent of this presumed contamination was examined using three different techniques in 55 postpartum women with the diagnosis of endometritis. Each woman had the endometrium sampled with an unprotected cotton-tipped swab, a double-lumen catheter with brush, and a flexible endometrial suction curette. A statistically larger number of bacterial species was recovered with the cotton swab (2.4) than with the double-lumen catheter (1.3) or the suction curette (1.7) (P less than .001). A difference was also noted between the double-lumen catheter and the suction curette (P = .006); however, this represented less than one-third of a single bacterial species. The larger number of bacterial species recovered by the unprotected methods was found to result not from cervicovaginal contamination, as suspected, but from a significant increase in the recovery of bacteria commonly regarded as potential pathogens, such as Bacteroides bivius, Streptococcus faecalis, Proteus mirabilis, and Bacteroides melaninogenicus.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors.forename: M G
authors.initials: MG
authors.lastname: Martens
authors.forename: S
authors.initials: S
authors.lastname: Faro
authors.forename: H A
authors.initials: HA
authors.lastname: Hammill
authors.forename: G D
authors.initials: GD
authors.lastname: Riddle
authors.forename: D
authors.initials: D
authors.lastname: Smith
mesh_terms: D004107:Dilatation and Curettage / Q000295:instrumentation*; D004716:Endometritis / Q000382:microbiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011645:Puerperal Infection / Q000382:microbiology*; D013048:Specimen Handling / Q000295:instrumentation*; D014599:Uterus / Q000382:microbiology*; D014619:Vacuum Curettage / Q000295:instrumentation*