Bhide A, Nama V, Patel S, Kalu E
Department of Gynaecology, Kingston Hospital NHS Trust, Kingston Upon Thames, UK.
J Obstet Gynaecol. 2010;30(7):701-3. doi: 10.3109/01443615.2010.505672.
Bartholin's glands are prone to obstruction at their opening into the vestibule, forming cysts which could be infected to become gland abscess. In our unit, treatment of Bartholin's abscess is usually surgical. In addition to surgical treatment, antimicrobial agents are often administered before microbial culture results are known. In this study, we aimed to determine the most common pathogens in Bartholin's glands abscess in our local population so that empiric antimicrobial therapy, if required, could be correctly directed. Among the 78 cases reviewed, there was positive microbial culture in 73.9%. Bartholin's abscess was commonly caused by opportunistic organisms, either as single agents or polymicrobial infections. Aerobic organisms were the commonest with coliforms being the most common bacteria. No cases of N. gonorrhoea or C. trachomatis were encountered. Flucloxacillin as a single agent was the most frequently prescribed antibiotic. Poly-pharmacy was common practice. It was concluded that whether adjuvant antibiotic therapy is necessary following surgical treatment of Bartholin's abscess is still controversial. Where antibiotics are required, the optimal initial therapy is not known. As poly-microbial infections are common, a broad spectrum agent like co-amoxiclav may be suitable for empirical treatment until culture results are known.
巴氏腺在其开口于前庭处容易发生阻塞，形成囊肿，囊肿可能会感染而变成腺脓肿。在我们科室，巴氏腺脓肿的治疗通常是手术治疗。除手术治疗外，在微生物培养结果出来之前，通常还会使用抗菌药物。在本研究中，我们旨在确定本地人群巴氏腺脓肿中最常见的病原体，以便在需要时能够正确地进行经验性抗菌治疗。在回顾的78例病例中，73.9%的病例微生物培养呈阳性。巴氏腺脓肿通常由机会性微生物引起，可为单一病原体感染或多微生物感染。需氧菌最为常见，大肠菌群是最常见的细菌。未发现淋病奈瑟菌或沙眼衣原体感染病例。氟氯西林作为单一药物是最常用的抗生素。联合用药很常见。得出的结论是，巴氏腺脓肿手术治疗后是否需要辅助抗生素治疗仍存在争议。在需要使用抗生素的情况下，最佳初始治疗方案尚不清楚。由于多微生物感染很常见，在培养结果出来之前，像阿莫西林克拉维酸这样的广谱药物可能适合经验性治疗。
