Antibodies to Chlamydia trachomatis, Mycoplasma hominis, and Neisseria gonorrhoeae in sera from patients with acute salpingitis.

Mårdh, Per‐Anders; Lind, Inga; Svensson, Lovisa; Weström, L; Møller, Birger R.

doi:10.1136/sti.57.2.125

Cited by 37 publications

(7 citation statements)

References 23 publications

(6 reference statements)

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“…Examination of peritoneal fluid at laparoscopy has been shown to be of little use in diagnosing Chlamydia infection as a cause of PID [2,21]. This is confirmed in the present study, where all cultures from peritoneal fluid were negative.…”

Section: Discussionsupporting

confidence: 81%

“…This suggests either technical difficulties in isolation of the Chlamydia organism, or that the tubal occlusion is a host-determined response to past infection, as is suspected for trachoma [5]. However, more recent studies have been able to isolate Chlamydiae from tubal tissue in females with tubal factor infertility in 15%-18% of the cases [12,21].…”

Section: Discussionmentioning

confidence: 99%

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The Role of Chlamydia Trachomatis Infection in Female Infertility

Babay

Al-Meshari

1993

Ann Saudi Med

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The incidence of positive Chlamydia cultures in females undergoing laparoscopy for tubal patency is high. We advocate routine screening for Chlamydia infection in females with infertility. Of seventy-five patients undergoing laparoscopy for infertility, 49 grew Chlamydia on tissue culture of material from the cervix, an incidence of 65.3%. Of these 49 cases, 33 (67.3%) had tubal blockage. In asymptomatic patients, 22 out of 50 had positive cultures from the cervix, an incidence of 44%. Peritoneal fluid culture was negative in all infertile patients. When compared to populations studied elsewhere, the incidence of Chlamydia appears to be high in our population and significantly higher in the infertile patients. In the management of infertility, pelvic inflammatory disease, and neonatal conjunctivitis, Chlamydia should be routinely investigated and treated. Infertility is increasing in many areas of the world, including Saudi Arabia, and poses a major health problem. Tubal occlusion produced by peritubal adhesions, hydrosalpinx formation, and intraluminal adhesions is the underlying pathological abnormality in tubal infertility following acute salpingitis [1]. The risk of infertility following Chlamydia infection is still unknown. Chlamydia trachomatis has been isolated from the fallopian tubes of females with acute pelvic inflammatory disease (PID) [2], Serological studies for Chlamydia have also established a link between infection with Chlamydia and adhesion formation. High serum titers of Chlamydial antibodies have been reported in infertile women with damaged fallopian tubes [3,4]. Between 64% and 91% of infertile females with tubal occlusion had antibodies to Chlamydia, a prevalence two to eight times greater than that found in females with other causes of infertility [5].Chlamydia trachomatis was also found in cultures from the endometrium of infertile females with antiChlamydial antibodies in 26% of cases and from the endocervix in 32% [6]. However, Chlamydia trachomatis was recovered from fallopian tube biopsies in 15% of females undergoing tubal surgery for infertility, and from the endometrium in 80% of them [7].The present study was carried out with the objective to determine the prevalence of Chlamydia trachomatis in the lower genital tract of asymptomatic Saudi patients attending King Khalid University Hospital (KKUH), the prevalence of Chlamydia trachomatis in the genital tract of infertile patients, and to determine the relationship between the organism and tubal infertility. The incidence of Chlamydia trachomatis in the peritoneal fluid of infertile patients was also determined, and the usefulness of analysis of the peritoneal fluid for culture of Chlamydia trachomatis evaluated. Patients and MethodsOver a ten month period between October 1989 and July 1990, 158 consecutive females undergoing evaluation for infertility at KKUH were approached to enroll in this study. All patients were married and all were Saudis. All females were enrolled at their initial visit to the clinic if they were involunta...

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

The Role of Chlamydia Trachomatis Infection in Female Infertility

Babay

Al-Meshari

1993

Ann Saudi Med

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“…Existentambienvarias investigaciones donde relacionan la presencia de altos titulos de anticuerpos anti-C. tradiomatis en pacientes con (EPI) e infertilidad por daño tubárico; en mujeres aparentemente sanas y fértiles los títulos altos de anticuerpos se presentan enun menor porcentaje (3,4,10,11). Esto constituye una línea de trabajo en nuestro medio para determinar el valor diagnóstico de la determinación de anticuerpos cuando se trata de infecciones sistémicas por C. tradiomatis como serían la EPI y las neumonías en niños.…”

Section: Discusionunclassified

Valoración de la determinación de anticuerpos anti-chlamydia trachomatis como método diagnóstico

Vargas¹,

Castañeda²

1992

biomedica

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La determinación de anticuerpos anti-Chlamydia con fines diagnósticos ha sido empleada por varios investigadores con resultados contradictorios. Decidimos por tal motivo valorar dicha prueba, en una población de 52 pacientes con diagnóstico de cervicitls por C. trachomatis y 167 controles. Empleamos la técnica de inmunofluorescencia indirecta y los sueros diluidos al 1:8 y 1:16 en solución salina buffer. En las 52 pacientes diagnosticadas por cultivo detectamos anticuerpos en 20 y en el grupo control en 66, lo cual determinó para la serología cualitativa como método diagnóstico una sensibilidad del 38%, una especificidad del 60%, u n valor predictivo positivo del 23%, un valor predictivo negativo del 76% y una eficencia de la pruebadel 55%. Lo anterior nos indica que la determinación de anticuerpos anti-Chlamydia no debe ser empleada como método diagnóstico para determinar la infección cervical activa por C. trachomatis. INTRODUCCIONLainfecaón porchlamydiatrachomatis es una delas entidades de transmisión sexual más frecuente, como lo indican estudios realizados en diferentes países desarrollados e igualmente en Colombia (1-5); una de sus principales secuelas es la infertilidqd en la mujer, posterior a una enfermedad pélvica infiamatoria (EPI)6,7). Elcultivode C. trachomatis requiere de técnicas especializadas, debido a que es un parásito intracelular obligado (12), por esta razon se han desarrollado en el laboratorio métodos directos e indirectos para su diagnós-tico tales como la inmunofluorescencia directa (IFD) y la prueba inmunoenzimática (ELISA) que detectan antígeno, y la microinmunoflue rescensiaoinmunofluor-aa indirecta (IFI) v . ,, la fijación de complemento para la determinación de anticuerpos (2,8).Nuestra experiencia, en diferentes poblaciones estudiadas, nos ha señalado quelainfecaón por C. h-achomatis, es frecuente(2 1%-47%) (5,9), además hemos comparadoelcultivo con la IFD y ELISA encontrando que son técni-cas que tienen una buena sensibilidad y especificidad para hacer el diagnóstico de esta infección (9).La determinación de anticuerpos contra C. trachomatis ha sido utilizada como mé-todo diagnóstico, pero los resultados han sido contradictorios debido a que existen varios problemas, uno de ellos es el de requerirse dos muestras (fase aguda y fase convaleciente) para poder establecer cambios en los niveles de anticuerpos, los cuales en la mayoría de las veces son difíciles de observar en población sexualmente activa; otra limitante es que los anticuerpos siguen circulando por largos períodos en el suero de los pacientes, por lo tanto al ser determinados no necesariamente indican una infección activa, adicionalmente la seroconversión no ocurre en todos los casos (1,lO).

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“…The relative significance of each of these organisms in development of PID is less than certain [6,9,15,25] and no doubt different in various geographic regions and at various periods of human history. The causal relationship in general between PID, genital bacterial pathogens, and sexual activity has, however, been recognized by members of the medical community for at least 80 years.…”

mentioning

confidence: 97%

“…In recent years other bacteria have been found by various investigators to be associated not only with non-specific or non-gonococcal urethritis and cervicitis, but with PID as well. The organisms that have emerged as the most important in this respect are Chlamydia trachomatis [6][7][8][9] and, to a somewhat lesser extent, Mycoplasma hominis [10][11][12], Bacteroides fragilis [13,14] and ~-hemolytic streptococcus [15].Although the important roles of these organisms in development of PID have been demonstrated only in the past 10-15 years, a critical perusal of the older literature indicates that genital tract infections caused by non-gonorrheal bacteria, particularly Chlamydia, have been known for decades [16][17][18][19]. Experimental work in monkeys by Fritsch et al [16] in 1910 proved that inclusion conjunctivitis, cervicitis, and non-specific urethritis were all characterized by inclusion bodies and caused similar infections; these investigators proposed that these were caused by the same organism.…”

mentioning

confidence: 99%

Pelvic inflammatory disease, intrauterine contraception, and the conduct of epidemiologic studies

Bj¹

1985

Adv Contracept

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Pelvic inflammatory disease (PID) has been described in the medical literature for more than a century as a specific entity. Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma hominis, along with Bacteroides fragilis and other anaerobic bacteria, have been most frequently associated with PID. Factors affecting the occurrence of PID have been extensively studied during the past two decades and include number of sexual partners, age, race, socioeconomic status, education, and contraceptive method. As knowledge concerning factors that contribute to PID increases, epidemiologic studies addressing such issues must become increasingly sophisticated, and the literature needs to be re-evaluated in light of present knowledge. Various risk factors for PID, types of epidemiologic studies, methods for conducting such studies, and data interpretation are reviewed.

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Antibodies to Chlamydia trachomatis, Mycoplasma hominis, and Neisseria gonorrhoeae in sera from patients with acute salpingitis.

Cited by 37 publications

References 23 publications

The Role of Chlamydia Trachomatis Infection in Female Infertility

The Role of Chlamydia Trachomatis Infection in Female Infertility

Valoración de la determinación de anticuerpos anti-chlamydia trachomatis como método diagnóstico

Pelvic inflammatory disease, intrauterine contraception, and the conduct of epidemiologic studies

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