Vaginal and Rectal Clostridial Carriage Among Women of Reproductive Age in the United States

Since 2000, clostridial pelvic infections have claimed the lives of at least 17 young,
previously healthy women. The majority of infections detected by molecular methods were
among women testing positive for Clostridium sordellii only; in 5 cases, deaths were due to
Clostridium perfringens only; and in 3 cases, the women were positive for both. These deaths
occurred among both non-pregnant and recently pregnant women. Clostridium has been isolated
from the vagina in 4-18% of normal, health non-pregnant women, with Clostridium perfringens
the most common isolate. Most studies do not differentiate the small percentage of other
clostridia present in the vaginal microenvironment. The vaginal carriage rate for
Clostridium sordellii remains unknown, but is probably very low, less than 1%.

The correlates of clostridial carriage are unknown, and data on the etiology and lethality
of clostridial infection among women of reproductive age are insufficient to guide possible
courses of safe and effective prevention. In women infected with strains of Clostridium
perfringens and Clostridium sordellii that produce the lethal toxin, it is not clear whether
there is an effective treatment.

Inclusion Criteria:

- Willing and able to provide informed consent

- Between ages 18 and 45

Exclusion Criteria:

-Seeking emergency or oncological care