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  • Title: Actinomyces in cervical smears of women using intrauterine contraceptive devices.
    Author: Mali B, Joshi JV, Wagle U, Hazari K, Shah R, Chadha U, Gokral J, Bhave G.
    Journal: Acta Cytol; 1986; 30(4):367-71. PubMed ID: 3526779.
    Abstract:
    Cervical smears from 1,784 women who attended the family planning clinics of the Institute for Research in Reproduction were examined for the presence of Actinomyces-like organisms. Among 815 intrauterine contraceptive device (IUD) users, the repeat smears from 57 women were positive for Actinomyces-like organisms, giving a prevalence rate of 6.99%. Immunofluorescent staining using specific antisera confirmed the presence of A. israelii in all 57 women. Forty IUD users whose smears were positive for Actinomyces-like organisms underwent bacteriologic culture studies; A. israelii was isolated in 23 of these cases. The clinical findings at the time of smear collection in the 57 IUD users were within normal limits. The initial cervical smears of all IUD users and both the initial and repeat smears of all nonusers were negative for Actinomyces-like organisms. The data indicate that prolonged use (greater than 2 years) of an inert or copper intrauterine device promotes the overgrowth of Actinomyces in the vagina and that this can be detected by routine cervical cytology. Cervical smears from 1784 women who attended a family planning clinic in India were examined for the presence of Actinomyces-like organisms. There were 57 (7%) positive smears among the 815 IUD users in this group. Bacteriologic culture studies were carried out in 40 of these women and Actinomyces israelii was isolated in 23 cases. The initial cervical smears of all IUD users and both the initial and repeat smears of all nonusers were negative for Actinomyces. None of the positive smears involved women with less than 1 year of IUD use and only 4 cases were positive with 1-2 years of IUD use. There was no association between the presence of Actinomyces-like organisms and type of IUD, however. The cervical and pelvic examination findings in the 57 women with positive Actinomyces smears were within normal limits at the time of smear collection. These findings suggest that longterm IUD use promotes the outgrowth of Actinomyces in the vagina. Routine cervical cytology and clinical observation are recommended for the early detection of possible pelvic inflammatory disease in these women.
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