Cohen I
Department of Reproductive Biology, MacDonald Hospital for Women, Case Western University School of Medicine, Cleveland, Ohio.
Clin Ther. 1992 Mar-Apr;14(2):185-91.
In this retrospective study, the efficacy of screening for and treating cervical Chlamydia trachomatis infection was evaluated in a pregnant population at increased risk for chlamydial infection. Over a 2 1/2-year period, 5.75% (338) of the 5,875 women tested were found to be infected with this organism. Of the 323 women patients available for follow-up, 76% (244) were successfully treated and 24% (79) remained infected throughout their pregnancies. Forty (12%) patients became infected during pregnancy, while 26 (8%) were reinfected during pregnancy, despite treatment with erythromycin. Twenty-seven (8%) patients had their first antenatal visit and cervical swab less than a week before delivery. The gestational age at which the first cervical chlamydial swab was obtained was significantly more advanced in patients who remained infected (30.23 +/- 6.2 weeks) than those who were successfully treated (22.15 +/- 7.66 weeks; P = 0.00001). The data suggest that in a pregnant population considered to be at increased risk for C trachomatis infection: (1) there is a subgroup of patients with a high risk of remaining infected or becoming reinfected with C trachomatis during pregnancy despite treatment with erythromycin and (2) repeated prenatal testing and treatment of those infected is necessary to detect and eradicate maternal chlamydial infection.
在这项回顾性研究中，对衣原体感染风险增加的孕妇群体进行了宫颈沙眼衣原体感染筛查及治疗的疗效评估。在2年半的时间里，5875名接受检测的女性中有5.75%（338人）被发现感染了该病原体。在可供随访的323名女性患者中，76%（244人）得到成功治疗，24%（79人）在整个孕期持续感染。40名（12%）患者在孕期感染，26名（8%）患者尽管接受了红霉素治疗，但在孕期再次感染。27名（8%）患者在分娩前不到一周进行了首次产前检查并采集了宫颈拭子。持续感染的患者首次采集宫颈衣原体拭子的孕周（30.23±6.2周）显著晚于成功治疗的患者（22.15±7.66周；P = 0.00001）。数据表明，在被认为衣原体感染风险增加的孕妇群体中：（1）有一部分患者即使接受了红霉素治疗，在孕期仍有很高的持续感染或再次感染沙眼衣原体的风险；（2）对感染者进行反复的产前检测和治疗对于检测和根除母体衣原体感染是必要的。
