Actinomyces Colonization in IUD Users

Abstract

The objective of this study is to assess the incidence of Actinomyces colonization in the Papanicolaou smears of IUD users at the Family Planning Research Center, Siriraj Hospital. IUD users who attended the center from January 1997- April 1997, regardless of how long they have been using the IUDs were screened for Actinomyces colonization at the time of enrollment. 342 IUD users with a negative Papanicolaou smear for Actinomyces colonization were included in the study and basic characteristics, type and duration of IUD use were recorded. Papanicolaou smears to detect Actinomyces colonization were repeated again 12 months later. Abnormal signs and symptoms were recorded. The main outcome measurement was a positive papanicolaou smear for actinomyces colonization. The incidence of Actinomyces colonization was 9.9% in IUD users regardless of type of IUDs (N= 34). Inert IUDs produced a significantly higher colonization rate as compared with metallic IUDs, (P<0.05). The colonization rates for Lippes D, Lippes C, ML Cu 250, and Cu T 380 A were 28.6%, 25.0%, 14.1% and 2.1%, respectively. The colonization rates appeared to increase with the duration of IUD use before the study and 62% of them were detected after 48 months of IUD use before the study. Almost all positive smears in IUD users (91.2%) were asymptomatic. The incidence of Actinomyces colonization is related to type and duration of IUD use. For this reason, all patients with IUDs should undergo annual Papanicolaou smears for diagnosis and appropriate treatment including removal IUDs and oral penicillin which were effective in this study.