Purulent pelvic collections in HIV infected female patients: bacterial flora and antibiotic sensitivity

Abstract

Purulent pelvic collections are common pathologies observed in contemporary gynaecological practice. They may originate from chronic pelvic inflammatory disease, from abortions or following normal deliveries. This study was designed to compare the bacterial flora in purulent pelvic collections obtained from HIV infected and noninfected female patients treated over a period of two years. Samples of pus were collected from both groups during laparotomy that was carried out by the same trained surgeon and sent for culture and sensitivity tests at the “Centre Pasteur” laboratory in Yaounde, Cameroon. There were 2016 admissions into the gynaecological wards during the study period and 113 (5.60%) were patients with purulent pelvic collections of whom 39 (34.50%) were tested positive for HIV. The collections in HIV positive patients were mainly chronic (tubo-ovarian abscesses, 53.83% and pyosalpinges, 2.207%). On the other hand acute pelvic collections (post partum 32.43%, post-abortum 46.65%) were predominant in women who were tested negative. Bacteroides spp and Staphylococcus aureus were the dominant bacteria isolated from HIV infected samples as against Escherichia coli and Streptococcus spp found in HIV noninfected samples. All the bacteria isolated were sensitive to chloramphenicol. HIV infected group of patients had longer periods of hospitalization. Routine counseling and testing of patients with purulent pelvic collections should be incorporated in their work-up packages before surgery and short courses of chloramphenicol therapy should be administered.

Clinics in Mother and Child Health Vol. 2(2) 2005: 375-378