Rudolph P. Galask

Aerobic and anaerobic flora of the cervix during pregnancy and the puerperium.

Comparison of species of bacteria isolated from patients with endometritis with species isolated from normal pregnant and nonpregnant women suggests that bacteria causing infections are indigenous to the genital tract. However, complete studies of the flora of pregnant women, especially anaerobic flora, are lacking. Aerobic and anaerobic cultures of the endocervix were obtained from women in all trimesters of pregnancy and at three days and six weeks post partum. The incidence of occurrence of each species of bacteria and the average number of different species per culture were determined for each period. The most prevalent organisms in each period were aerobic gram-positive rods and cocci and anaerobic gram-positive cocci. The average number of species of aerobic bacteria per culture remained approximately the same in each culture period. The average number of anaerobic species per culture decreased as pregnancy progressed, peaked on the third postpartum day, and at six weeks post partum returned to a level similar to that of the first trimester.

Bacterial attachment to the chorioamniotic membranes.

Intra-amniotic infections are believed to result from bacteria of cervical and vaginal origin which gain access to the amniotic sac. The logical sequence in this process would be bacterial attachment to the maternal surface, followed by migration through the chorioamniotic membranes to the fetal surface. Fresh sterile chorioamniotic membranes were interposed between two arms of specially constructed incubation vessels. Bacteria (Escherichia coli, group B streptococci, or Neisseria gonorrhoeae) were inoculated into the arm (containing a basal salt medium) contiguous with the maternal surface. The arm contiguous with the fetal surface of the membrane contained pseudoamniotic fluid. At intervals up to 24 hours after inoculation, the membranes were removed, washed, fixed in glutaraldehyde, and examined by means of scanning and transmission electron microscopes. The ability of group B streptococci and E. coli to attach to and invade the chorioamniotic membranes was demonstrated by this technique. It appeared that group B streptococci had a greater capacity to attach and invade than did E. coli, whereas N. gonorrhoeae predictably failed to attach.

Vaginal microbial flora: practical and theoretic relevance.

&NA; The bacterial flora of the female reproductive tract is a focal point for the study of infectious disease in obstetrics and gynecology, as it is recognized that many pelvic infections involve bacteria resident on the cervical‐vaginal epithelium. The vaginal flora contains a large variety of bacterial species, including aerobic and anaerobic organisms, as revealed by modern microbiologic methods. Recent studies have indicated that certain organisms commonly involved in pelvic infections, particularly those following genital tract surgery, namely Escherichia coli and Bacteroides fragilis, appear to be underrepresented in relationship to the infectious complications they cause. A possible explanation of this phenomenon has been suggested based on the finding that traumatic events in the reproductive tract, including parturition, surgery, and invasive malignancy, result in increased colonization by organisms commonly involved in pelvic infections. Other changes in the flora related to the hosts hormonal milieu were identified and are generally less profound than those related to trauma. We have reviewed some of the newer aspects of our understanding of the genital flora, such as quantitation of the vaginal flora, which should continue to improve our understanding of the role of the genital tract flora in disease states.

Bacterial flora of the cervix from 100 prehysterectomy patients

Although anaerobic bacteria are being reported more frequently as causes of pelvic infections, few investigators have carefully studied these organisms in the normal female genital flora. This study describes the aerobic and anaerobic flora of 100 women prior to their undergoing hysterectomy. Anaerobic organisms were isolated from 86 per cent of the cultures in combination with aerobic organisms. Of the anaerobes the gram-positive cocci were the most common isolates (154 isolates in 74 cultures). The anerobic gram-positive rods (41 isolates in 38 cultures) were second, followed by the anerobic gram-negative rods (32 isolates in 29 cultures) and the anerobic gram-negative cocci (16 isolates in 15 cultures). The gram-positive cocci were most prevalent aerobic organisms isolated (149 isolates in 85 cultures).

Vaginal Microbial Flora: Composition and Influences of Host Physiology

Abstract The normal bacterial flora of the female genital tract is composed of various aerobic and anaerobic bacteria. Because the normal flora may be a source of disease-causing organisms or may i...

Bacterial growth inhibition by amniotic fluid: VI. Evidence for a zinc-peptide antibacterial system

The zinc bacterial inhibitory activity of amniotic fluid is dependent on the presence of a second, organic component contained in amniotic fluid. The second component is heat stable, resists proteolytic digestion, and is present in amniotic fluid throughout pregnancy. Further, the component may be a peptide with a molecular weight of less than 5,000 daltons. Phosphate reversal of amniotic fluid inhibitory activity may result from interference with the organic component rather than zinc.

The effect of antibiotic prophylaxis on patients undergoing total abdominal hysterectomy

A prospective, double-blind study was conducted to evaluate the effect of cephalosporins on morbidity of women undergoing total abdominal hysterectomy. Each patient received a 5 day course of active drug or placebo beginning the night before surgery. Microbiologic studies, including culture and antibiotic sensitivities, were done on each patient pre- and postoperatively. Of the 46 women who received placebo, eighteen (39 per cent) were classified as morbid. Causes of morbidity included operative bed, wound, respiratory, or urinary tract infections. E. coli was the organism most frequently isolated. Of the 47 women who received cephalosporin prophylaxis, seven (15 per cent) were classified as morbid. The causes of the morbidity were often poorly defined, and cephalosporin-resistant organisms were recovered more often from these women than from those on placebo. There was no significant difference in length of hospital stay between women who received prophylaxis and those who did not.

Vaginal colonization by bacteria and yeast

A number of different factors have been found to influence the microflora of the vagina. Studies showing an increased rate of colonization associated with pregnancy, menses, oral contraceptive use, and estrogen replacement therapy illustrate the influence of hormones, glycogen content, and pH on vaginal colonization. The microorganisms found in the vagina may also be dependent on the existence of specific attachment sites, which may differ in the various areas of the vagina. Vaginal colonization appears to be altered in patients with diabetes mellitus, those receiving steroid therapy, and immunosuppressed individuals. Surgical manipulation of the vagina and the use of broad-spectrum antibiotics may also contribute to the growth of organisms in the vaginal tract.

Bacterial inhibition by amniotic fluid

Abstract Amniotic fluid is inhibitory for a number of bacteria. Its action is primarily bacteriostatic and may be related in part to inadequate nutritional factors. However, supplementation of amniotic fluid with casein hydrolysate still resulted in a prolongation of the lag phase of growth.

The effect of antibiotic prophylaxis on patients undergoing vaginal operations

Abstract A prospective, double-blind study was conducted to evaluate the effect of cephalosporins on morbidity in women undergoing vaginal hysterectomy. Each patient received a five-day course of an active drug or a placebo beginning the night before operation. Microbiological studies, including culture and antibiotic sensitivities, were done on each patient pre- and post-operatively. Of 23 women who received the placebo, 11 (48 per cent) were classified as morbid. They had either an operative bed infection or a urinary tract infection. Only a small number of cephalosporin-resistant organisms were involved in these infections. Of the 25 women who received the cephalosporins, none (0 per cent) was classified as morbid. A small increase in the number of cephalosporin-resistant organisms (most notably Pseudomonas aeruginosa ) was found postoperatively. Four patients were readmitted with pelvic infections after their original discharge. Microbiological data and a discussion of these infections are presented.