女性性器内の無芽胞嫌気性菌に関する研究

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タイトル別名
  • Non Sporeforming Anaerobic Bacteria in Obstetrical and Gynecological Field (Report II) The Anaerobic Bacteria in Puerperas
  • 女性性器内の無芽胞嫌気性菌に関する研究-2-産褥における女性性器内の無芽胞嫌気性菌
  • ジョセイ セイキナイ ノ ム ガホウ ケンキセイキン ニカンスルケンキュウ 2
  • 第二報産褥における女性性器内の無芽胞嫌気性菌

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The anaerobic bacteria of the uterus and vagina in puerperas, both afebrile and febrile, were investigated during the period from January 1973 to December 1976.<BR>The anaerobic bacteria were isolated at a rate of 35.4%(from the uterus) and 20.8%(from the vagina) in 48 afebrile puerperas, at a rate of 76.5%(from the uterus) and 44.1%(from the vagina) in 34 febrile puerperas (puerperal infection). Two significant characteristics were found from this study. The one is that the anaerobic bacteria were found more frequently in the uterus than in the vagina, in both afebrile and febrile puerperas. This was a striking contrast to widely known theory that the aerobes in puerperas were greater in number in the vagina than in the uterus. The other was that the rate of occurrence of the anaerobic bacteria in the uterus of the afebrile puerperas was high but still less than that in febrile puerperas.<BR>Among 34 febrile puerperas 26 showed uterine anaerobes and in 13 cases the same types of bacteria were found also in the vagina. These findings contrasted well with those in afebrile puerperas, in which the uterine anaerobes were rarely found in vagina at the same time. Since both the vaginal and uterine bacteria in puerperal infections are almost always the same, it is sufficient to investigate only the vaginal bacteria in order to make the diagnosis.<BR>Of the 26 patients found to have uterine anaerobes, 9 had also aerobes. When these 9 patients' symptoms were gradually relieved by therapy, the anaerobic bacteria gradually disappeared and were replaced by aerobes after a short time. It is said that many anaerobic infections are mixed infection involving aerobic bacteria. But the result of this study on postpartum was in sharp contrast to this concept.<BR>Uterine anaerobes were found very frequently after intrauterine manipulations (e.g. vacuum extraction, forceps delivery, breech delivery, metreurysis, manual removal of placenta). In addition to these manipulations, some patients suffered premature or early rupture of membranes, prolonged labor, lacelations of the perineum or cervix. In these cases the detection rate of anaerobes in uterus was even higher.<BR>In puerperas who were anemic during pregnancy and/or who have suffered serious hemorrhage during labor (more than 500 ml), puerperal infections often occurred especially when the anaerobic bacteria already existed in the uterus or invaded externally into the uterus. Therefore, anemia prepartum and postpartum may be an important factor to decrease the host defences and to make favorable conditions for infections.<BR>In many textbooks, a temperature of 38.0°C or higher is regarded as one of the important criteria for diagnosing the puerperal infection, however, it has been proposed recently that 37.5°C or higher be accepted as a clinical criterion because of the increase of anaerobic infections. I am of the same opinion according to the results of this study.

収録刊行物

  • 感染症学雑誌

    感染症学雑誌 54 (4), 188-199, 1980

    一般社団法人 日本感染症学会

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