scholarly journals Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients

2019 ◽  
Vol 69 (9) ◽  
pp. 1517-1525 ◽  
Author(s):  
Casper D J den Heijer ◽  
Christian J P A Hoebe ◽  
Johanna H M Driessen ◽  
Petra Wolffs ◽  
Ingrid V F van den Broek ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Reproductive Health ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Antibiotic Use ◽  
Female Infertility ◽  
Dependent Manner ◽  
Increased Risk ◽  
Ct Test

Abstract Background We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics. Methods This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models. Results We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status. Conclusions We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

scholarly journals Ten years transmission of the new variant of Chlamydia trachomatis in Sweden: prevalence of infections and associated complications

2017 ◽  
Vol 94 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Jenny Dahlberg ◽  
Ronza Hadad ◽  
Karin Elfving ◽  
Inger Larsson ◽  
Jenny Isaksson ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Complication Rates ◽  
Becton Dickinson ◽  
Specific Pcr ◽  
Single Target ◽  
New Variant ◽  
Low Prevalence

ObjectivesIn 2006, a new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden. It has a deletion in the plasmid resulting in failed detection by the single target systems from Abbott and Roche used at that time, whereas the third system used, from Becton Dickinson (BD), detects nvCT. The proportion of nvCT was initially up to 65% in counties using Abbott/Roche systems. This study analysed the proportion of nvCT from 2007 to 2015 in four selected counties and its impact on chlamydia-associated complications.MethodsC. trachomatis-positive specimens collected from 2007 to 2015 were analysed by a specific PCR to identify nvCT cases. Genotyping was performed by multilocus sequence typing (MLST) and ompA sequencing. Ectopic pregnancy and pelvic inflammatory disease records were extracted from the national registers.ResultsIn total, 5101 C. trachomatis-positive samples were analysed. The nvCT proportion significantly decreased in the two counties using Roche systems, from 56% in 2007 to 6.5% in 2015 (p<0.001). In the two counties using BD systems, a decrease was also seen, from 19% in 2007 to 5.2% in 2015 (p<0.001). Fifteen nvCT cases from 2015 and 102 cases from 2006 to 2009 had identical MLST profiles. Counties using Roche/Abbott systems showed higher mean rates of ectopic pregnancy and pelvic inflammatory disease compared with counties using BD systems.ConclusionsThe nvCT proportion has decreased in all counties and converged to a low prevalence irrespective of previous rates. Genotyping showed that nvCT is clonal and genetically stable. Failing detection only marginally affected complication rates.

scholarly journals Chlamydia in Gynecologic Practice

2005 ◽  
Vol 1 (3) ◽  
pp. 437-446
Author(s):  
Jane Norman
Keyword(s):  
Chlamydia Trachomatis ◽  
Early Detection ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Urine Samples ◽  
Screening Programs ◽  
Screening Strategies

The focus on Chlamydia trachomatis in gynecologic practice 20 years ago was in treating its potential consequences: pelvic inflammatory disease, infertility and ectopic pregnancy. Although these conditions are still important, the current focus of C. trachomatis management for the obstetrician and gynecologist is early detection and treatment. The majority of women with C. trachomatis are asymptomatic, therefore, screening programs are being devised so that C. trachomatis can be treated prior to the occurence of any adverse consequences. Novel tests have allowed the use of urine samples and self-collected vulvovaginal swabs in the detection of C. trachomatis. This article will review the consequences of C. trachomatis infection in women, methods of identification of the organism, the prevalence in various populations, and treatment and screening strategies.

scholarly journals Mycoplasma genitaliumamong Young, Urban Pregnant Women

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Vanessa L. Short ◽  
Jørgen S. Jensen ◽  
Deborah B. Nelson ◽  
Pamela J. Murray ◽  
Roberta B. Ness ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Pregnant Women ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Mycoplasma Genitalium ◽  
Health History ◽  
Increased Risk ◽  
History Of ◽  
The Relationship

Objective. As the consequences ofMycoplasma genitaliumin pregnant women are unknown, we examined the relationship between prenatalM. genitaliuminfection and SAB.Methods. The presence ofM. genitaliumwas determined by PCR in urine from 82 women who subsequently experienced a SAB and 134 women who maintained their pregnancies past 22 weeks gestation. The relationships betweenM. genitaliumand subsequent SAB, demographic, current pregnancy, and reproductive health history characteristics were evaluated.Results. Compared to women withoutM. genitalium, women withM. genitaliumwere more likely to report nulliparity (41.7% versus 17.4%,P=.04), history of pelvic inflammatory disease (27.3% versus 8.8%,P=.08), priorC. trachomatisinfection (63.6% versus 36.9%,P=.11,) and problems getting pregnant (18.2% versus 4.4%,P=.10).M. genitaliumwas not associated with SAB (AOR 0.9, 95% CI 0.2–3.8).Conclusions. Pregnant women who test positive forM. genitaliumdo not have an increased risk of SAB but report a history of reproductive morbidities.

scholarly journals Dynamic laparascopy as a stage of hospital rehabilitation in patients with tubal pregnancy

2005 ◽  
Vol 54 (5S) ◽  
pp. 33-34
Author(s):  
Е. V. Shipitsyna ◽  
А. V. Novikov ◽  
К. V. Shalepo ◽  
V. F. Bezhenar ◽  
А. М. Savicheva
Keyword(s):  
Chlamydia Trachomatis ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Genital Tract ◽  
Tubal Pregnancy ◽  
Tubal Infertility ◽  
Chlamydia Trachomatis Infection ◽  
Hospital Rehabilitation

Objectives: Chlamydia trachomatis infection of the upper genital tract often results in pelvic inflammatory disease (PID), and its sequels include ectopic pregnancy (EP), miscarriage and tubal infertility. This study was aimed to evaluate the rate of C. trachomatis detection as well as anti-C trachomatis antibodies in women with EP.

scholarly journals Relation between Chlamydia trachomatis infection and pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in a Dutch cohort of women previously tested for chlamydia in a chlamydia screening trial

2019 ◽  
pp. sextrans-2018-053778 ◽  
Author(s):  
Bernice M Hoenderboom ◽  
Birgit H B van Benthem ◽  
Jan E A M van Bergen ◽  
Nicole H T M Dukers-Muijrers ◽  
Hannelore M Götz ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Control Strategies ◽  
Incidence Rates ◽  
Chlamydia Screening ◽  
Chlamydia Trachomatis Infection ◽  
Tubal Factor Infertility ◽  
Tubal Factor

ObjectivesA better understanding of Chlamydia trachomatis infection (chlamydia)–related sequelae can provide a framework for effective chlamydia control strategies. The objective of this study was to estimate risks and risk factors of pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility (TFI) with a follow-up time of up until 8 years in women previously tested for chlamydia in the Chlamydia Screening Implementation study (CSI) and participating in the Netherlands Chlamydia Cohort Study (NECCST).MethodsWomen who participated in the CSI 2008–2011 (n=13 498) were invited in 2015–2016 for NECCST. Chlamydia positive was defined as a positive CSI-PCR test, positive chlamydia serology and/or self-reported infection (time dependent). Data on PID, ectopic pregnancy and TFI were collected by self-completed questionnaires. Incidence rates and HRs were compared between chlamydia-positive and chlamydia-negative women corrected for confounders.ResultsOf 5704 women included, 29.5% (95% CI 28.3 to 30.7) were chlamydia positive. The incidence rate of PID was 1.8 per 1000 person-years (py) (1.6 to 2.2) overall, 4.4 per 1000 py (3.3 to 5.7) among chlamydia positives compared with 1.4 per 1000 py (1.1 to 1.7) for chlamydia negatives. For TFI, this was 0.4 per 1000 py (0.3 to 0.5) overall, 1.3 per 1000 py (0.8 to 2.1) and 0.2 per 1000 py (0.1 to 0.4) among chlamydia positives and negatives, respectively. And for ectopic pregnancy, this was 0.6 per 1000 py (0.5 to 0.8) overall, 0.8 per 1000 py (0.4 to 1.5) and 0.6 per 1000 py (0.4 to 0.8) for chlamydia negatives. Among chlamydia-positive women, the strongest risk factor for PID was symptomatic versus asymptomatic infection (adjusted HR 2.88, 1.4 to 4.5) and for TFI age <20 versus >24 years at first infection (HR 4.35, 1.1 to 16.8).ConclusionWe found a considerably higher risk for PID and TFI in chlamydia-positive women, but the incidence for ectopic pregnancy was comparable between chlamydia-positive and chlamydia-negative women. Overall, the incidence rates of sequelae remained low.Trial registrationNTR-5597.

scholarly journals Chlamydia infection as a risk factor in ectopic pregnancy: a case control study

2018 ◽  
Vol 7 (10) ◽  
pp. 4254
Author(s):  
Angela George ◽  
Shaila S.
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Case Control Study ◽  
Case Control ◽  
Chlamydia Infection ◽  
Increased Risk ◽  
History Of ◽  
Ectopic Pregnancies ◽  
Control Study

Background: Chlamydia trachomatis has been linked to 30-50% of all ectopic pregnancies, due to irreversible tissue damage.  Hence it is pertinent to explore the risk factors pertaining to Chlamydia infection and ectopic pregnancies. The aim is to study whether Chlamydia infection is a risk factor for ectopic pregnancy in comparison with early intrauterine pregnancy, and study other risk factors in ectopic pregnancyMethods: Case-control study conducted at Sree Avittom Thirunal Hospital, Thiruvananthapuram over a period of six months taking 43 subjects in each group, i.e., cases and controls. An interview followed by collection of venous blood sample was done, which was subjected to Enzyme linked immunoassay test to detect Immunoglobulin G antibodies to Chlamydia. Comparison of qualitative variables such as age, socioeconomic status, history of infertility, history of pelvic inflammatory disease, previous history of ectopic pregnancy, use of IUCD, history of IVF, use of OCP or progesterone only pills and presence of Chlamydia IgG antibodies - between two groups was analyzed by chi-square test and the strength of association expressed in terms of Odds Rati. A p-value <0.05 was considered statistically significant.Results: Out of 86 samples 54 were positive for Chlamydia infection. Subjects with Chlamydia infection had an increased risk of developing ectopic pregnancy. Among the other risk factorshistory of pelvic inflammatory disease and history of infertility were the most significant with Odds of 3.46 and 3.98 respectively. History of oral contraceptive use also had a significant risk associated with developing ectopic pregnancy. Other factors with significant association included, age more than 25 years, Upper Socioeconomic Class, previous ectopic pregnancy and history of IUCD use for more than 5 years.Conclusions: The increased number of Chlamydia infection and its increased risk for developing irreversible sequels such as ectopic pregnancy, it is pertinent to vigilantly diagnose, treat and prevent vaginal infection and pelvic inflammatory disease.

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