Clinical and microbiological characteristics of bartholin gland abscesses

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. Culturepositive cases were significantly associated with fever (25% compared with 9.3%; P5.043), leukocytosis (50.4% compared with 33.8%; P5.027), and neutrophilia (17.9% compared with 5.9%; P5.021). The odds ratio of having any of these with a positive culture was 2.4 (95% confidence interval 1.3-4.3; P5.003). 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%; P5.033). Three cases of resistance to most beta-lactam antimicrobials (extended-spectrum beta-lactamaseproducing [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.