NONCLOSTRIDIAL ANAEROBIC BACTERIA IN SEPTIC ABORTION

To clarify the role of various bacterial species in septic abortion, a series of patients were carefully studied bacteriologically, using quantitative aerobic and anaerobic technics. Bacteremia was demonstrated in thirty-four of the fifty-six patients whose blood was cultured on admission. Two or three bacterial species were recovered from half of the positive blood cultures. Thirty-four isolates were strictly anaerobic, thirteen were microaerophilic and only twelve were aerobic. From sixty-nine uterine exudates, anaerobic and microaerophilic species were isolated in abundance eighty-one times, whereas aerobic species were isolated in abundance only twenty-one times. These findings establish nonclostridial anaerobic and microaerophilic bacteria (principally anaerobic streptococci and Bacteroides species) as the major invasive pathogens in this mixed infection. Although the blood stream invasion is often transient, these organisms can cause extrauterine complications such as pelvic abscess, suppurative thrombophlebitis and metastatic infection of the lung, liver, brain and heart valves. Early treatment with penicillin and tetracycline should prevent such complications in the great majority of patients. Aerobic negative rods (principally Escherichia coli) are frequently present in uterine exudates but usually in small numbers. They are, nevertheless, the most common cause of bacteremic shock, and kanamycin is recommended as the third drug in routine initial antibiotic coverage. © 1969.