Журнал клинических случаев

Microbiological Examination of Intrauterine Catheters Tips After Operative Hysteroscopy

Abstract

Abdel-Gadir A

Intrauterine catheters have been used widely to prevent intrauterine adhesions and to secure hemostasis after hysteroscopic surgery. The presence of a balloon inside the uterine cavity with the catheter shaft in the vagina may be a risk factor for ascending infections. Urinary bladder infections following catheterization and ureteric stents bacterial colonization have been known for many years. In the current study 57 Foley’s catheter tips were swabbed for microbiological examination after their removal from the uterine cavity 5-7 days after hysteroscopic surgery. Culture for both aerobic and anaerobic bacteria was done as well as sensitivity tests for different antibiotics. 41 cases (71.9%) showed positive bacterial culture; 18 of them proved to be Escherichia coli (43.9%). Other isolated bacteria included Beta hemolytic group B streptococci (10 cases, 24.4%), group D streptococci (5 cases, 12.2%), Klebsiella pneumoniae (3 cases, 7.3%), Pseudomonas aeruginosa and Proteus species (5 cases, 12.2%) and one case of Candida albicans. Resistance to commonly used antibiotics was reported in 39 cultures (95.1%), including all 18 Escherichia coli cases. This small auditing study showed that intrauterine catheters used after hysteroscopic surgery might carry a risk of causing ascending infections. Accordingly, such practice has been halted in our clinic as clinical or even subclinical uterine or tubal infections may reduce the fertility potential of young women who are keen to conceive.