Gynuity Health Projects

Programs

Vaginal and Rectal Carriage of Clostridium Sordellii & Perfringens

Clostridia bacteria, C. sordellii and C. perfringens specifically, have been identified recently as serious pathogens among women of reproductive age. Since 2000, clostridial pelvic infections have claimed the lives of at least 17 young, previously healthy women. While extremely rare, such infections are nonetheless alarming, because they strike healthy women and also, because of their rapid, fatal course, and absence of traditional signs of infection. The most publicized of the Clostridia cases have followed medical abortions; however, available clinical and epidemiological research does not show a specific causal pathway linking use of mifepristone or misoprostol to development of clostridial infection.

Since clostridial infection cases are so rare, Gynuity has embarked on a project on the prevalence of the bacteria to add depth and precision to the very fragmented literature on this topic. We conducted a large, multi-site study of over 5,000 women in the U.S. from 2008-2013. Through screening women at various time points in their reproductive lives and collecting information on their background characteristics and behavior, we are able to describe:

  • The prevalence of C. sordellii and C. perfringens in the vagina and rectum among women of reproductive age
  • The duration of presence of these bacteria in women
  • Potential correlates of positive cultures: background characteristics, behavioral practices, medical conditions, etc.
  • Changes in prevalence following medical and surgical abortion
  • The different strains of the bacteria collected in the study and whether the strains differ in terms of potential lethality

Enrollment in this study concluded in mid-2013, and findings will be disseminated in 2014.