Special Precautions/Comments:

Interferences:  Antibiotics may affect growth of certain bacteria.

Method:  Culture on selective media for the presence of Actinomyces species, specifically Actinomyces israelii . Cultures require a minimum 7 days incubation. Isolates of clinical interest will be identified by MALDI-ToF MS. Calibration: N/A.  EQA scheme: NEQAS EQA scheme. IQC: Regular resubmission of anonymised patient samples.

Interpretation: Where Actinomyces species are isolated (positive), identification will be confirmed by MALDI-ToF MS. Negative cultures will be reported as Actinomyces species not isolated. Please note, susceptibility testing is not routinely offered for Actinomyces species. Clinical comment will be provided where appropriate.

Additional Information:

Background information: Intrauterine devices (IUDs) offer a means of long-acting, reversible contraception. There are two types available in the UK: levonorgestrel intrauterine devices (LNG-IUDs) and copper intrauterine devices (Cu-IUDs). For both devices, the risk of pelvic infection appears to increase in the first 3 weeks after IUD insertion. However, the overall risk is very low (less than 1%). Also, IUD insertion can cause symptoms that could be suggestive of infection, such as pelvic pain and altered discharge, but these are normal side effects (generally short lived) and care should be taken to not over diagnose. Therefore, microbiological examination of removed devices is rarely needed. Pelvic actinomycosis is a very rare, chronic, bacterial pelvic infection that is associated with long-term IUD use.