Chlamydia Trachomatis Infection in Patients With Acute Salpingitis

Mårdh, Per‐Anders; Ripa, Torvald; Svensson, Lovisa; Weström, L

doi:10.1097/00006254-197711000-00024

Cited by 47 publications

(57 citation statements)

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“…The gold standard is culture for chlamydia performed as described by Mardh et al [16] or chlamydia diagnosed by two non-culture tests, now known as the expanded gold standard [17]. The focus of the meta-analysis was to provide an overall summary of diagnostic test accuracy for detection of asymptomatic chlamydia infection.…”

Section: Resultsmentioning

confidence: 99%

The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review

Watson¹,

Templeton²,

Russell

et al. 2002

Journal of Medical Microbiology

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192

114

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Screening women for lower genital tract infection with Chlamydia trachomatis is important in the prevention of pelvic inflammatory disease, ectopic pregnancy and infertility. This systematic review aims to state clearly which of the available diagnostic tests for the detection of C. trachomatis would be most effective in terms of clinical effectiveness. The review included all studies published from 1990 onward that evaluated diagnostic tests in asymptomatic, young, sexually active populations. Medline and Embase were searched electronically and key journals were hand-searched. Further studies were identified through the Internet and contact with experts in the field. All studies were reviewed by two reviewers and were scored by Irwig's assessment criteria. Additional quality assessment criteria included a documented sexual history and recording of previous chlamydial infection. The reviews were subjected to meta-analysis and meta-regression. The 30 studies that were included examined three types of DNAbased test -ligase chain reaction (LCR), PCR and gene probe -as well as enzyme immuno-assay (EIA). The results showed that while specificities were high, sensitivities varied widely across the tests and were also dependent on the specimen tested. Pooled sensitivities for LCR, PCR, gene probe and EIA on urine were 96.5%, 85.6%, 92% and 38%, respectively, while on cervical swabs the corresponding sensitivities of PCR, gene probe and EIA were 88.6%, 84% and 65%. Meta-analysis demonstrated that DNA amplification techniques performed best for both urine and swabs in low prevalence populations. We conclude that nucleic acid amplification tests used on non-invasive samples such as urine are more effective at detecting asymptomatic chlamydial infection than conventional tests, but there are few data to relate a positive result with clinical outcome.

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Section: Resultsmentioning

confidence: 99%

The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review

Watson¹,

Templeton²,

Russell

et al. 2002

Journal of Medical Microbiology

Self Cite

192

114

View full text Add to dashboard Cite

show abstract

“…Although chlamydiae can be isolated from women with cervicitis, and may cause the disease in some (Oriel et al, 1974;Rees et al, 1977), they can also be isolated from apparently healthy women (Oriel et al, 1974). The association between chlamydiae in the cervix and acute pelvic inflamnmatory disease is more obscure, but the direct isolation of chlamydiae from Fallopian tubes of patients with acute salpingitis (Eilard et al, 1976;Mardh et al, 1977) suggests that the organisms are pathogenic in the upper genital tract. To substantiate this, further isolation and serological studies are required.…”

Section: Introductionmentioning

confidence: 99%

Growth and effect of chlamydiae in human and bovine oviduct organ cultures

Hutchinson

Taylor‐Robinson

Dourmashkin

1979

Sexually Transmitted Infections

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SUMMARY Organ cultures of 10 Fallopian tubes were inoculated with a genital strain of Chlamydia trachomatis and seven were infected. Infection was enhanced by centrifuging the organisms on to the tissues, larger numbers of organisms being reisolated from the tissues after this procedure. There was evidence of chlamydial multiplication because the number of organisms which were recovered from the tissues three to five days after inoculation had increased. Recovery was rare, however, after the sixth day, thus suggesting a self-limiting infection. Organ cultures of two bovine oviducts were infected with the bovine abortion strain of Chiamydia psittaci, but in these experiments centrifugation of the inocula did not enhance infection. The organisms were found in both the tissue and medium of cultures up to 18 days after inoculation and in much greater numbers than in the C. trachomatis-infected Fallopian cultures. Chlamydial infection was not entirely host-tissue specific, because C. trachomatis organisms were isolated from bovine oviduct cultures. Inclusions, however, were not detected histologically or electron microscopically in the epithelium of C. trachomatis-infected cultures, but they were detected by these means in C. psittaci-infected bovine cultures. All the elements of the chlamydial growth cycle were seen by electron microscopy, organisms being found in ciliated and possibly non-ciliated cells, and shedding of some infected epithelial cells was observed. No evidence of extensive epithelial cell damage was observed, however, and no loss of ciliary activity was detected in cultures infected with either C. trachormatis or C. psittaci when compared with uninoculated cultures. Thus acute salpingitis, when caused by chlamydial infection, is probably immunologically mediated.

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“…However, the role of Chlamydia trachomatis in PID is being increasingly recognized (5,6), although this organism is difficult to detect in the routine diagnostic laboratory. It may therefore be relevant, when treating patients for serious PID with imipenem, to use an antichlamydial agent such as erythromycin or tetracycline in addition because imipenem does not have significant antichlamydial activity.…”

mentioning

confidence: 99%

Interaction of imipenem with erythromycin and tetracycline assessed by microdilution checkerboard techniques

Gould

Wilson

Milne

et al. 1991

Antimicrob Agents Chemother

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Microdilution methodology was used to study the interaction of imipenem with erythromycin and tetracycline, a combination therapy that might be used for the treatment of serious pelvic inflammatory disease. The combination of imipenem and erythromycin showed no antagonism for Escherichia coli and Haemophilus influenzae but was antagonistic for Staphylococcus aureus, Enterococcusfaecalis, and group B streptococci; the combination of imipenem and tetracycline was antagonistic for all strains except H. influenzae. Correlation between the results of kill curves and the measurement of fractional bactericidal concentration (FBC) indices was good, although FBC indices showed less antagonism than kill curves. Fractional inhibitory concentration indices showed poor correlation, rarely showing antagonism, and indeed showed synergy in three cases. If erythromycin or tetracycline is considered necessary in addition to imipenem in the treatment of pelvic inflammatory disease, it is probably more effective when given after the course of imipenem has been completed.Pelvic inflammatory disease (PID) is often a mixed infection of aerobic and anaerobic bacteria (1) necessitating broad-spectrum antibiotic therapy, and imipenem may be appropriate therapy in serious PID. However, the role of Chlamydia trachomatis in PID is being increasingly recognized (5, 6), although this organism is difficult to detect in the routine diagnostic laboratory. It may therefore be relevant, when treating patients for serious PID with imipenem, to use an antichlamydial agent such as erythromycin or tetracycline in addition because imipenem does not have significant antichlamydial activity. The combination of bacteriostatic agents such as tetracycline and erythromycin with bactericidal agents such as beta-lactams is often antagonistic (4, 9). If this is the case with imipenem, then it would argue against the simultaneous administration of erythromycin or tetracycline, which might be more effective when given subsequently. This study was undertaken to assess the interaction of these three antibiotics.( (190 ,u) was dispensed into each of the wells of 16 microdilution trays. These were covered with cling film until required.After 2, 4, 6, and 24 h of incubation, the contents of each well of the checkerboard were sampled after thorough mixing by suction into the pipette tip and expulsion four times. In addition, at 24 h the microdilution plates were placed on a shaker for 2 min to disperse any pellets that had formed. Colony counts were performed by transferring 10-,ul samples from each well to an Iso-Sensitest agar plate (Oxoid), the surface of which was dried prior to use to prevent coalescence of the drops. Second 10-pI samples were then transferred to the microdilution trays, and six serial 20-fold dilutions were prepared prior to transfer to Iso-Sensitest agar for incubation and counting. In the case of H. influenzae, the Iso-Sensitest agar was supplemented with 5% Fildes enrichment; for group B streptococci, it was supplemented with 5% lysed horse ...

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Chlamydia Trachomatis Infection in Patients With Acute Salpingitis

Cited by 47 publications

References 0 publications

The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review

The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review

Growth and effect of chlamydiae in human and bovine oviduct organ cultures

Interaction of imipenem with erythromycin and tetracycline assessed by microdilution checkerboard techniques

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