Запальні захворювання органів малого таза на тлі використання внутрішньоматкової спіралі: мікробіологічний профіль та клінічне значення

Intrauterine devices (IUDs) are widely used long-acting method of reversible contraception which has a high efficacy and safety. Around the world, about 22.8% of women use IUDs for birth control. However, the use of these devices is highly associated with an increased risk of pelvic inflammatory diseases, potentially leading to significant health complications.The objective: to identify the prevalence of bacterial microorganisms in endocervical swabs from women using IUDs and assess the antibiotic sensitivity profiles of these isolates.Materials and methods. This research is a cross-sectional study starting from June 2022 and ending in June 2024. Both written and verbal consents of 162 women aged 18–48 years who used IUDs as a contraceptive method and attended the private gynecology clinic and Al-Zahrawi hospital in Mosul city, Iraq were provided. Endocervical vaginal swabs were taken and diagnosed by Gram staining method, biochemical testing, and the VITEK 2 system for bacterial identification. Antibiotic sensitivity was assessed using automated methods.Results. Among the 162 participants, 90 (55.56%) women had negative culture results, while 72 (44.44%) patients had positive results. Escherichia coli was the predominant microorganism (17.28%), followed by Klebsiella spp. (6.79%) and Staphylococcus aureus (7.41%). Antibiotic sensitivity test has revealed that meropenem, imipenem, levofloxacin, and colistin were the most effective medications, showing 100% sensitivity. Other antibiotics, including amikacin and ampicillin, displayed high resistance rates (66.67% and 70.83%, respectively). Clinical features like dyspareunia, vaginal discharge, and pelvic pain were significantly associated with positive cultures (p < 0.05).Conclusions. The study highlights a substantial prevalence of bacterial infections among women who use IUDs, with Escherichia coli as the leading pathogen. Carbapenems (imipenem and meropenem) showed the highest efficacy, suggesting their suitability for treating such infections. Regular monitoring and appropriate antibiotic treatment are recommended to manage IUD-associated infections effectively.