title: Uterine cervical non-gonococcal and non-chlamydial bacterial flora and its antibiotic sensitivity in women with pelvic inflammatory disease: did it vary over 20 years?
abstract: BACKGROUND
  Although the presence of bacteria in the cervix is not a sign of disease, the majority of pathogens involved in pelvic inflammatory disease originate from this "normal" flora.
  
  
  OBJECTIVE
  To assess the distribution of cervical nongonococcal and non-chlamydial bacteria in hospitalized women with PID and the bacteria's antibiotic sensitivity.
  
  
  METHODS
  We retrospectively evaluated the cultures obtained from the uterine cervix over a 1 year period (2008) at Wolfson Medical Center, Holon. The distribution of cervical nongonococcal and non-chlamydial bacteria in women with PID and the bacteria's antibiotic sensitivity was compared to that in our previous 1 year study that was performed at Kaplan Medical Center, Rehovot (1988-89).
  
  
  RESULTS
  In 2008, a total of 412 cultures were obtained of which 126 (30.5%) were sterile. The prevalence of negative cultures was similar in 2008 and in 1988, namely, 30.5% and 33.7%, respectively (P = 0.23). PID was finally diagnosed in 116 patients with positive cultures. The most prevalent bacteria in the 2008 study were Enterococcus species and Escherichia coli- 24.0% and 26.4% respectively compared to 18.0% and 38.1% in the 1988 study, with the decrease in E. coli isolates being significant (P = 0.0003). In 2008 the antimicrobial sensitivity for various antibiotics ranged from 44.3% to 100.0% (median 90.2%) while in 1988 it ranged from 2.9% to 80.1% (median 51.9%).
  
  
  CONCLUSIONS
  The cervical bacterial flora in hospitalized women with PID did not vary significantly between 1988 and 2008. However, antimicrobial sensitivity of the isolated bacteria increased dramatically, probably due to a decrease in resistance to antibiotics.
authors.affiliation: Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel. drslurie@hotmail.com
authors.forename: Samuel
authors.initials: S
authors.lastname: Lurie
authors.forename: Halla
authors.initials: H
authors.lastname: Asaala
authors.forename: Orna Schwartz
authors.initials: OS
authors.lastname: Harari
authors.forename: Abraham
authors.initials: A
authors.lastname: Golan
authors.forename: Oscar
authors.initials: O
authors.lastname: Sadan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002584:Cervix Uteri / Q000382:microbiology*; D016983:Enterococcus / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008826:Microbial Sensitivity Tests; D000292:Pelvic Inflammatory Disease / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents