Vaginal and rectal clostridial colonization among women of reproductive age in the United States

Shannon, Chevis N.; Veatch, Maggie; Chong, Erica; Agnew, Kathy; Nucatola, Deborah; Newhall, E.; Sheehan, K.L.; Winikoff, Beverly

doi:10.1016/j.contraception.2010.04.141

Cited by 5 publications

(4 citation statements)

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“…It is postulated that vaginal carriage is due to transfer from anorectal flora. A recent pilot study of prevalence of rectal and vaginal colonization with C. sordellii and C. perfringens in over 500 women of reproductive age found a prevalence congruent with the limited estimates published in the literature: rectal colonization by C. perfringens was 10.2%, and by C. sordellii was 2.8%; vaginal colonization by C. perfringens was 1.5%, and no women screened positive vaginally for C. sordellii [5].…”

Section: Introductionmentioning

confidence: 71%

Gynecologic Clostridial Toxic Shock in Women of Reproductive Age

Zane¹,

Guarner

2011

Curr Infect Dis Rep

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Clostridial toxic shock, caused by Clostridium sordellii or Clostridium perfringens, is a rare and largely fatal syndrome among reproductive-aged women with genital tract infection, and may occur following various pregnancy outcomes or without pregnancy. Clinicians should be aware of common clinical features of this very rapidly-progressing syndrome including abdominal pain, tachycardia, hypotension, third-space fluid accumulations, hemoconcentration, and marked leukemoid response, often with lack of fever. In this review, we summarize known cases through mid-2011 and information on clinical presentation, diagnosis, treatment, and results of recent investigations regarding pathogenesis, including germination, toxins, and host response that may have important implications for development of preventive or therapeutic interventions.

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Section: Introductionmentioning

confidence: 71%

Gynecologic Clostridial Toxic Shock in Women of Reproductive Age

Zane¹,

Guarner

2011

Curr Infect Dis Rep

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“…Cultures of the cervix or fetus or placenta are required in septic abortion with the main aim of determining the aetiology of the causes of infection and antibiotic-resistant bacteria. However, in practice, this is difficult to do in limited health facilities [18,19] . Most women with severe infections will die from complications of a septic abortion.…”

Section: Resultsmentioning

confidence: 99%

Double trouble: A combination from abortus provocation and septic shock how to care on limiting facility

Firmansyah¹,

Hendsun²,

Singgih³

2021

Int. J. Clin. Obstet. Gynaecol.

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Septic abortion is an infection in the product of conception of pregnancy that can be maintained with a mortality rate of up to 1 in 4 cases. Risk factor of septic abortion is terminating of pregnancy by an incompetent person, the environment or using an instrument that is not sterile or related. One case of septic abortion has been reported which has massive bleeding and infection for less than 17 days. Gynecological examination results found conception or placenta. Comprehensive treatment is a key for save the patients in limited health facilities. Treatment includes administration of RL fluids, dopamine, evacuation of residual conception, and use of broad-spectrum antibiotics. The patient's condition improved after 2 hours of intensive treatment in a limited facility.

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“…26 C sordellii are infrequently found in the vagina (less than 0.5%) and rectum (approximately 2%) of reproductive-aged women. 25 Detailed autopsy examination of those women with a C sordellii septic abortion probably reflects the usual situation for all of these toxin producers; C sordellii antigen was found only in the necrotic endometrium and myometrium (the placenta has been previously removed) but antigen was not present in the lung, kidney, heart, or liver. 22 Thus, it appears that these toxin producers can cause death from the release of potent toxins that cause distant vascular damage and organ failure without actual bacterial spread to these organs.…”

Section: Microbesmentioning

confidence: 97%

“…25 However, C perfringens is isolated from up to 5% of all septic abortions 18 and an especially high number of women who die. 24 C perfringens appears more common in unsafe septic abortion where delay in the removal of dead tissue allows proliferation of these slow-growing bacteria in an anaerobic tissue environment.…”

Section: Microbesmentioning

confidence: 99%

Treating Spontaneous and Induced Septic Abortions

Eschenbach

2015

Obstetrics &Amp; Gynecology

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Worldwide, abortion accounts for approximately 14% of pregnancy-related deaths, and septic abortion is a major cause of the deaths from abortion. Today, septic abortion is an uncommon event in the United States. The most critical treatment of septic abortion remains the prompt removal of infected tissue. Antibiotic administration and fluid resuscitation provide necessary secondary levels of treatment. Most young physicians have never treated septic abortion. Many obstetrician-gynecologists experience, or plan to experience, global health activities and will likely care for women with septic abortion. Thus, updated knowledge of the pathophysiology, clinical presentation, microbes, and proper treatment is needed to optimally treat this emergency condition when it exists. The pathophysiology of septic abortion involves infection of the placenta, especially the maternal villous space that leads to a high frequency of bacteremia. Symptoms and signs range from mild to severe. The microbes involved are usually common vaginal bacteria, including anaerobes, but occasionally potentially very serious and lethal infection is caused by bacteria that produce toxins. The primary treatment is early curettage to remove infected and devitalized tissue even in the face of continued fetal heart tones. Important secondary treatments are the administration of fluids and antibiotics. Updated references of sepsis and septic shock are reviewed.

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Vaginal and rectal clostridial colonization among women of reproductive age in the United States

Cited by 5 publications

References 0 publications

Gynecologic Clostridial Toxic Shock in Women of Reproductive Age

Gynecologic Clostridial Toxic Shock in Women of Reproductive Age

Double trouble: A combination from abortus provocation and septic shock how to care on limiting facility

Treating Spontaneous and Induced Septic Abortions

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