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  • Title: Actinomyces in the vaginas of women with and without intrauterine contraceptive devices.
    Author: Curtis EM, Pine L.
    Journal: Am J Obstet Gynecol; 1981 Aug 15; 140(8):880-4. PubMed ID: 7023240.
    Abstract:
    Either Actinomyces israeli, A. naeslundii, or Arachnia propionica was found, by immunofluorescence studies, in cervicovaginal mucus from 36% of 50 women. One or more of these organisms were found in a surprising 27% of those with neither intrauterine contraceptive devices (IUDs) nor intravaginal foreign bodies. The only common finding was abundant vaginal mucus, and no clinical features were more serious than vaginal itching, odor, or vague discomfort. Among those women who harbored actinomycetes, the average duration of continuous IUD use was 5.3 years; the comparable figure for those with no infection was 2.1 years. This study compares the presence of Actinomyces in the vaginas of women with and without IUDs. Mucus samples were collected from the external cervical os of 50 randomly selected women. The smears were air-dried, heat-fixed, and stained directly with fluorescent antibody conjugates for A. israelii, A. naeslundii, and Arachnia propionica (Actinomyces species with clinical significance in human beings). A fluorescent microscope with oil immersion magnification of about 400x was used, and identification of the specific organisms depended upon both cellular morphologic features and the brilliant greenish yellow fluorescence of the cell membrane. Either 1 of 3 A. species was positively identified in 18 of 50 patients (36%). 1 or more species were found in 8 of 30 patients with no internal devices (27%). Of 18 IUD wearers, 8 were positive for Actinomyces (44%). 1 patient with a retained vaginal tampon and another 1 with a pessary also had positive smears. A. israelii and Arachnia propionica were the most commonly identified species. If the organism was found, average duration of continuous IUD use was 5.3 years (range, 1 to 15 years). Where these organisms do not exist, average continuous use was 2.1 years. Age of patients positive for Actinomyces ranged from 18 to 52 years. These findings do not show the true incidence of these organisms in either the general population or IUD wearers. However, they suggest the presence of such organisms in asymptomatic women, with or without intravaginal devices. Papanicolaou staining is not sufficient in identifying the presence of the organisms. Further studies must be done. The immunofluorescence technique is a simple, rapid and universally available technique for identifying the organism. Further studies should be done to determine whether these organisms lie dormant until some pathogens or trauma precipitate disease. Also, the disease actinomycosis should be carefully distinguished from the mere presence of Actinomycetaceae in the vagina.
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