Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, and Public Health Services, Ministry of Health, Jerusalem, Israel.
Obstet Gynecol. 2013 Oct;122(4):794-799. doi: 10.1097/AOG.0b013e3182a5f0de.
To examine the clinical course and causative microorganisms of Bartholin gland abscesses.
This was a retrospective study of all patients treated for Bartholin gland abscesses between the years 2006 and 2011 at the Soroka University Medical Center, a regional medical center in southern Israel.
During the study period, 219 women were admitted as a result of an abscess of the Bartholin gland, 63% of which were primary abscesses and 37% recurrent abscesses (occurrence of a second clinical event). Pus cultures were positive in 126 (61.8%) of cases. Escherichia coli was the single most frequent pathogen found (43.7%) and 10 cases (7.9%) were polymicrobial. Culture-positive cases were significantly associated with fever (25% compared with 9.3%; P=.043), leukocytosis (50.4% compared with 33.8%; P=.027), and neutrophilia (17.9% compared with 5.9%; P=.021). The odds ratio of having any of these with a positive culture was 2.4 (95% confidence interval 1.3-4.3; P=.003). In the recurrent group, 81% recurred ipsilaterally and the mean time for recurrence was 32 ± 50 months. Infection with E coli was significantly more common in recurrent infection compared with primary infections (56.8% compared with 37%; P=.033). Three cases of resistance to most beta-lactam antimicrobials (extended-spectrum beta-lactamase-producing [E coli] strains) were identified.
A substantial proportion of patients with Bartholin gland abscess are culture-positive with E coli being the single most common pathogen. Microbiological findings coupled with their clinical correlates are important parameters in the management of patients with a Bartholin gland abscess and in the selection of empirical antimicrobial treatment during the primary diagnosis.
: III.
探讨巴氏腺脓肿的临床病程和病原体。
本研究为 2006 年至 2011 年间在以色列南部地区索罗卡大学医学中心接受巴氏腺脓肿治疗的所有患者进行的回顾性研究。
研究期间，219 名女性因巴氏腺脓肿入院，其中 63%为原发性脓肿，37%为复发性脓肿（发生第二次临床事件）。126 例（61.8%）的脓液培养呈阳性。大肠杆菌是最常见的病原体（43.7%），10 例（7.9%）为混合感染。阳性培养与发热（25%比 9.3%；P=.043）、白细胞增多（50.4%比 33.8%；P=.027）和中性粒细胞增多（17.9%比 5.9%；P=.021）显著相关。阳性培养的这些因素的比值比为 2.4（95%置信区间 1.3-4.3；P=.003）。在复发性组中，81%在同侧复发，复发的平均时间为 32±50 个月。与原发性感染相比，复发性感染中大肠杆菌感染更为常见（56.8%比 37%；P=.033）。发现 3 例对大多数β-内酰胺类抗菌药物（产超广谱β-内酰胺酶[大肠杆菌]株）耐药。
巴氏腺脓肿患者中有相当一部分培养呈阳性，大肠杆菌是最常见的病原体。微生物学发现及其临床相关性是巴氏腺脓肿患者管理的重要参数，也是原发性诊断中经验性抗菌治疗选择的重要参数。
III。
