OBJECTIVE: To examine the clinical course and causative microorganisms of Bartholin gland abscesses.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
LEVEL OF EVIDENCE: III
Microbiological findings and clinical correlates are important parameters in the treatment of patients with Bartholin abscesses and in the selection of empirical antimicrobial treatment.
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.
Corresponding author: Roy Kessous, MD, Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, Beer Sheva 84101, Israel; e-mail: email@example.com.
Financial Disclosure The authors did not report any potential conflicts of interest.