What are Clostridial bacteria that cause infections after induced abortions?
Clostridium sordellii (also called Paeniclostridium sordellii) and Clostridium perfringens are anaerobic spore-forming bacteria that can cause life-threatening infections after induced abortions.
- C. sordellii can cause fatal toxic shock syndrome (TSS) and C. perfringens causes a gangrenous infection called necrotizing fasciitis.
- C. sordellii and other Clostridium species have been found in the normal vaginal flora in 8%-18% of women.
- Lethal and hemorrhagic toxins are responsible for the virulence of C. sordellii. Lethal toxin is responsible for most fatal cases but is variably expressed by different C. strains and its effects are altered by environmental conditions.
- Situations which create an environment hospitable to these infections include uterine tissue injured by surgical instruments/trauma, non-viable decidual tissue, other retained pregnancy tissue, or clotted blood. All of these are found in induced abortion, specifically mifepristone and misoprostol-induced (including when an abortion is started with mifepristone and completed surgically)