PEACH study examines the causes of upper genital tract infection in women with pelvic inflammatory disease

2001 ◽  
Keyword(s):  
Tract Infection ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Genital Tract ◽  
Genital Tract Infection ◽  
Upper Genital Tract Infection

scholarly journals Mycoplasma genitalium: An Emerging Cause of Pelvic Inflammatory Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Catherine L. Haggerty ◽  
Brandie D. Taylor
Keyword(s):  
Tract Infection ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Genital Tract ◽  
Mycoplasma Genitalium ◽  
Genital Tract Infection ◽  
Cross Sectional ◽  
Increased Risk ◽  
Upper Genital Tract Infection

Mycoplasma genitaliumis a sexually transmitted pathogen that is increasingly identified among women with pelvic inflammatory disease (PID). AlthoughChlamydia trachomatisandNeisseria gonorrhoeaefrequently cause PID, up to 70% of cases have an unidentified etiology. This paper summarizes evidence linkingM. genitaliumto PID and its long-term reproductive sequelae. Several PCR studies have demonstrated thatM. genitaliumis associated with PID, independent of gonococcal and chlamydial infection. Most have been cross-sectional, although one prospective investigation suggested thatM. genitaliumwas associated with over a thirteenfold risk of endometritis. Further, a nested case-control posttermination study demonstrated a sixfold increased risk of PID amongM. genitaliumpositive patients. Whether or notM. genitaliumupper genital tract infection results in long-term reproductive morbidity is unclear, although tubal factor infertility patients have been found to have elevatedM. genitaliumantibodies. Several lines of evidence suggest thatM. genitaliumis likely resistant to many frequently used PID treatment regimens. Correspondingly,M. genitaliumhas been associated with treatment failure following cefoxitin and doxycycline treatment for clinically suspected PID. Collectively, strong evidence suggests thatM. genitaliumis associated with PID. Further study ofM. genitaliumupper genital tract infection diagnosis, treatment and long-term sequelae is warranted.

scholarly journals The Role ofChlamydia trachomatisPolymorphic Membrane Proteins in Inflammation and Sequelae among Women with Pelvic Inflammatory Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Brandie D. Taylor ◽  
Toni Darville ◽  
Chun Tan ◽  
Patrik M. Bavoil ◽  
Roberta B. Ness ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Membrane Proteins ◽  
Tract Infection ◽  
Inflammatory Disease ◽  
Genital Tract ◽  
Genital Tract Infection ◽  
Increased Risk ◽  
Pilot Sample ◽  
Upper Genital Tract Infection ◽  
Antibody Levels

Chlamydia trachomatispolymorphic membrane proteins (Pmps) may increase genital tract inflammation and play a role in virulence. Antibody levels for PmpA, PmpD, and PmpI, measured in densitometric units, were assessed among a pilot sample of 40C. trachomatis-infected women with mild-to-moderate clinical PID. Women who expressed antibodies to PmpA were less likely to achieve pregnancy (40.0% versus 85.7%; ) and less likely to have a live birth (0.0% versus 80.0%; ) compared to women who did not express antibody to PmpA. Women who expressed antibodies to PmpI were more likely to have upper genital tract infection (61.5% versus 20.0%; ). However, seropositivity to PmpI and PmpD did not modify the risk of reproductive sequelae or inflammation. Seropositivity to chlamydial PmpA may represent a biomarker of increased risk of sequelae secondary to infection withC. trachomatis.

scholarly journals Association of Lower Genital Tract Inflammation With Objective Evidence of Endometritis

2000 ◽  
Vol 8 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Jeffrey F. Peipert ◽  
Roberta B. Ness ◽  
David E. Soper ◽  
Debra Bass
Keyword(s):  
Tract Infection ◽  
Blood Cells ◽  
Genital Tract ◽  
White Blood Cells ◽  
Genital Tract Infection ◽  
Lower Genital Tract ◽  
Objective Evidence ◽  
Group 2 ◽  
Upper Genital Tract Infection ◽  
Group 1

The purpose of this report is to evaluate the association between lower genital tract inflammation and objectively diagnosed endometritis. We analyzed the first 157 patients enrolled in the PEACH study, a multicenter randomized clinical trial designed to compare the effectiveness of outpatient and inpatient therapy for PID. Women less than 38 years of age, who presented with a history of pelvic discomfort for 30 days or less and who were found to have pelvic organ tenderness (uterine or adnexal tenderness) on bimanual examination, were initially invited to participate. After recruitment of the first 58 patients (group 1) we added the presence of leukorrhea, mucopurulent cervicitis, or untreated positive test forN. gonorrhoeaeorC. trachomatisto the inclusion criteria (group 2, N = 99). We compared rates of endometritis in the two groups and calculated the sensitivity, specificity, and predicted values of the presence of white blood cells in the vaginal wet preparation. The rate of upper genital tract infection in group 1 was 46.5% (27/58) compared to 49.5% (49/99) in group 2. Microbiologic evidence of eitherN. gonorrhoeaeorC. trachomatisincreased from 22.4% in group 1 to 38.3% in group 2. The presence of Vaginal white blood cells or mueopus has a high sensitivity (88.9%), but a low specificity (19.4%) for the diagnosis of upper genital-tract infection. Assessment of the lower genital tract for evidence of infection or inflammation is a valuable component of the diagnostic evaluation of pelvic inflammatory disease. The presence of either mucopus or vaginal white blood cells is a highly sensitive test for endometritis in patients with pelvic pain and tenderness. Infect. Dis. Obstet. Gynecol. 8:83–87, 2000.

scholarly journals Circulating pathogen-specific plasmablasts in female patients with upper genital tract infection

2018 ◽  
Vol 126 ◽  
pp. 69-75
Author(s):  
Nina V. Palkola ◽  
Sari H. Pakkanen ◽  
Oskari Heikinheimo ◽  
Jussi M. Kantele ◽  
Anu Kantele
Keyword(s):  
Tract Infection ◽  
Genital Tract ◽  
Genital Tract Infection ◽  
Female Patients ◽  
Upper Genital Tract Infection

Endometrial Histopathology in Patients with Culture-proved Upper Genital Tract Infection and Laparoscopically Diagnosed Acute Salpingitis

1990 ◽  
Vol 14 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Nancy B. Kiviat ◽  
Pål Wølner-Hanssen ◽  
David A. Eschenbach ◽  
Judith N. Wasserheit ◽  
Jorma A. Paavonen ◽  
...  
Keyword(s):  
Tract Infection ◽  
Genital Tract ◽  
Genital Tract Infection ◽  
Upper Genital Tract Infection
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