Document Detail


Multiple site sampling does not increase the sensitivity of Chlamydia trachomatis detection in infertility patients.
MedLine Citation:
PMID:  18990379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Persistent Chlamydia trachomatis infections are associated with tubal pathology. We studied whether sampling from multiple sites would increase the identification of the infections. DESIGN: Prospective cohort study. SETTING: Tertiary care facility. PATIENT(S): Two hundred two infertile women. INTERVENTION(S): Smears were taken from the cervix, urethra, high vagina, fimbriae and the Douglas cavity. Blood samples were collected and tubal patency was assessed by pertubation with lipiodol and methylene blue. MAIN OUTCOME MEASURE(S): Detection of C. trachomatis DNA, detection of IgA and IgG antibodies against C. trachomatis, and antibodies against chlamydial heat-shock protein 60, tubal patency. RESULT(S): Chlamydia trachomatis was detected in 2 of 202 patients, for an overall prevalence of 1%. In both patients PCR results were positive in the cervical, vaginal, and urethral specimens. Chlamydia trachomatis IgG, IgA, and chlamydial heat-shock protein 60 IgG were significantly more prevalent in women with distal tubal pathology than in those without (26/40 [65.0%] vs. 16/162 [9.9%], 9/40 [22.5%] vs. 7/162 [4.3%], and 34/40 [85.0%] vs. 34/162 [21.0%]). Bacterial colonization was found in 1 of 202 samples from the Douglas cavity. CONCLUSION(S): Routine DNA testing for C. trachomatis should be confined to cervical sampling. The association between tubal pathology and seropositivity of IgG, IgA, and cHSP60 IgG was confirmed but did not add clinically valuable information during the diagnostic workup of infertility patients.
Authors:
Wolf Dietrich; Martina Rath; Gerold Stanek; Petra Apfalter; Johannes C Huber; Clemens Tempfer
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Publication Detail:
Type:  Journal Article     Date:  2008-11-06
Journal Detail:
Title:  Fertility and sterility     Volume:  93     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-71     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria. wolf.dietrich@meduniwien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Bacterial / blood
Cervix Uteri / microbiology
Chaperonin 60 / immunology
Chlamydia Infections / complications,  diagnosis*,  microbiology
Chlamydia trachomatis / genetics,  immunology,  isolation & purification*
DNA, Bacterial / isolation & purification
Enzyme-Linked Immunosorbent Assay
Fallopian Tube Diseases / microbiology*,  pathology
Fallopian Tubes / microbiology,  pathology
Female
Genitalia, Female / microbiology*,  pathology
Humans
Infertility, Female / microbiology*,  pathology
Laparoscopy
Lipopolysaccharides / immunology
Polymerase Chain Reaction
Predictive Value of Tests
Prevalence
Prospective Studies
Sensitivity and Specificity
Specimen Handling / methods*
Urethra / microbiology
Vagina / microbiology
Vaginal Smears
Young Adult
Chemical
Reg. No./Substance:
0/Antibodies, Bacterial; 0/Chaperonin 60; 0/DNA, Bacterial; 0/Lipopolysaccharides

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