Study design and population
The study was a prospective cohort study, performed at the Soroka
University Medical Center, an 1100-bed tertiary hospital in southern
Israel, and was authorized by the institutional research ethics
committee (0228-17-SOR). All women who planned to undergo elective
salpingectomy at our center were offered the opportunity to participate
in this study. Women receiving immunosuppressive treatments were
excluded from the study, and women with overt, active infections were
excluded from the control group. After obtaining informed consent from
willing participants, a vaginal swab was taken before local cleansing in
the operating room following anesthesia. All women were treated with
prophylactic antibiotics 30-60 minutes before the surgical incision.
Samples were obtained by introducing nylon flocked swab (ESwab, Copan,
Italy) to the vagina up to 5 cm from the introits via a speculum and
rotational swabbing of the vaginal walls for 5-10 seconds. After
performing the salpingectomy procedure, the fallopian tube was
sagittally incised using a strict aseptic technique and a swab was taken
from each of the tube’s lumen at the ampullary region. Samples were
immediately refrigerated and then frozen at -80°C within 24 hours of
sampling until further analysis. Metadata including: age, ethnicity,
menopausal status and prior antibiotic treatments were extracted form
patients’ medical records.