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Bacteria Linked to RU-486 Deaths a `Really Rare' Human Pathogen

Posted on: Wednesday, 17 May 2006, 00:02 CDT

CHICAGO _ Public hearings after deaths associated with the abortion pill have turned the cold eye of science to Clostridium sordelli, a rare bacterium.

Since 2000, C. sordelli has been linked to four medical abortion deaths in California and one in Canada. Although none of the women showed signs of an infection, they died within days of sepsis, an overwhelming bacterial infection of the bloodstream. Various species of Clostridium bacteria are found naturally in the vaginas of an estimated 4 percent to 18 percent of all women. Medical experts say C. sordellii accounts for perhaps 1 percent of those bacteria.

"It's a rare _ really rare _ human pathogen," said Dr. David L. Pitrak, chief of infectious diseases at the University of Chicago. "I've never had a patient who had a clinical infection with this."

Scientists have identified nearly 100 species in the Clostridium group of bacteria, though only 25 to 30 commonly cause human disease.

Clostridia grow in low-oxygen, form spores, and are widely found in dust, soil, vegetation and the gastro-intestinal tracts of humans and animals.

The most frequent human infections come from food poisoning and wound contamination. Serious clostridial diseases, including gangrene and tetanus, can be fatal.

All four U.S. women and the Canadian had taken mifepristone (RU 486) followed by misoprostol, for medical abortions. Women typically are given 200 milligrams of mifepristone orally, then instructed by their abortion provider to take 800 milligrams of misoprostol vaginally at home two days later.

Mifepristone blocks a hormone required to sustain a pregnancy. When followed by misoprostol, which produces contractions, a fetus is expelled.

All five women inserted misoprostol into the vagina, a method not endorsed by the FDA, which urges it be swallowed.

But the vaginal method has been shown to be more effective than oral administration for the termination of pregnancy from day 49 to day 63, and vaginal insertion after 200 mg. of mifepristone has been recommended by the World Health Organization.

"I don't think anybody knows the complete story yet," Pitrak said. "Why is this particular bug the agent? Other organisms could be introduced that make toxins, too.

"The surprising thing to me is that the deaths have occurred in women who received the vaginal application in the second part of the abortion. That may well be the key to all this.

"But I don't know how they will find out. It's very hard to study something like this when it occurs so rarely."

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(c) 2006, Chicago Tribune.

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Source: Chicago Tribune

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