In vitro study of the possible role of the intrauterine contraceptive device tail in ascending infection of the genital tract

Autor: Max Elstein, Watt Pj, B. G. A. Purrier, Sparks Ra
Rok vydání: 1979
Předmět:
Zdroj: British journal of obstetrics and gynaecology. 86(5)
ISSN: 0306-5456
Popis: Potentially pathogenic bacteria colonized the mucus coating the tails of both monofilamentous and multifilamentous intrauterine contraceptive devices (IUCD) in 72 (55 per cent) out of 132 in vitro tests. This suggests that the IUCD tail may be responsible for the passage of vaginal bacteria into the uterus.A detailed analysis was undertaken of the role of the IUD tail in ascending pelvic infections. Findings are reported on a laboratory model designed to establish whether bacteria ascend in the mucus which coats the IUD tail following insertion of the device. Cervical mucus was aspirated from the cervical canal by syringe at the mid-cycle when the mucus was most copious and was either used immediately or stored at +4 degrees Centigrade until required. All samples were cultured and only those yielding small numbers of commensal bacteria were used. The IUD tails studied were the multifilamentous tail of the Dalkon shield, test modified monofilamentous tails measuring 0.25, 0.3 and 0.5 mm in diameter and the monofilamentous tail of the Gravigard (Copper 7). The cervical mucus was introduced into the new 1 ml tuberculin syringe barrels up to the 0.4 ml mark using a double ended needle. The experimental model used was designed to determine if bacteria migrate through the layer of mucus coating the IUD's outer surface. 2 controls were used. 1st, when the IUD tail was omitted from the model, bacteria were found not to migrate above the level of the mucus plug in the syringe. 38 negative control tests were made using different combinations of potentially pathogenic bacteria. In the 2nd control system, the mucus plug was omitted so that the tail of the IUD directly entered the suspension of bacteria in agar. In 22 such tests, bacteria were found not to migrate above the bacterial agar suspension. These controls establish that the recovery of bacteria from the IUD tail above the mucus/air interface represent the migration of bacteria in the mucus film coating the tail. A total of 135 test models was made. Bacteria were cultured from the cervical mucus in 132 of these. In the remaining 3, growth was confined to the length of tail in the agar suspension. In 72 (55%) of the 132 tests which showed bacteria in the cervical mucus, bacteria were cultured from the surface of the tails above the mucus/air interface. No differences were noted between the multifilamentous and monofilamentous tails, but the Gravigard tails yielded significantly fewer cultures from above the mucus/air interface. With all types of tails, bacteria were cultured from as high as 20-30 mm above the mucus/air interface. At a height of 30-40 mm, bacterial growth was recorded on the multifilamentous Dalkon shield, and the 0.3 mm and 0.25 mm monofilamentous nylon tails. There were no differences between the devices with individual bacteria. In sum, the study suggests that the IUD tail may be responsible for the passage of vaginal bacteria into the uterus.
Databáze: OpenAIRE
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