Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel.
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel.
J Gynecol Obstet Hum Reprod. 2021 Nov;50(9):102176. doi: 10.1016/j.jogoh.2021.102176. Epub 2021 Jun 1.
Pelvic inflammatory disease (PID) is an infection of the upper genital organs, diagnosed by clinical findings. The nucleic acid amplification test (NAAT) identify sexually transmitted (STD) pathogens from endocervical swabs, via real time PCR. This study explored the prevalence of STD detected by NAAT for women with PID. We also aimed to identify predictive characteristics for positive test.
MATERIAL & METHODS: This retrospective cohort study explored the prevalence of positive NAAT for women with clinically diagnosed PID, 2016-2019, in a secondary referral center. The primary outcome was the prevalence of positive STD tests and specific pathogens. The secondary outcome was predictive clinical and laboratory parameters for positive NAAT.
Among the 610 women in our cohort, 103 had a positive STD PCR, which accounts for 17%. Most of the patients had Urea parvum (39.4%) Mycoplasma hominis (17.2%) or Urea urealyticum (15.7%). Other pathogens with lower incidence were Chlamydia trachomatis (9.8%), Trichomonas vaginalis (3.4%), Mycoplasma genitalium (2.1%) and the lowest rate was for Neisseria gonorrhea (1.5%).
In our population, we found lower prevalence of Chlamydia trachomatis and Neisseria gonorrhea compared to other large populations. This may be due to a high prevalence of married and religious women and also due to administration of a wide range of empirical antibiotic treatment, even for a low suspicion of PID. The study also gives reassurance that our empirical antibiotic protocol is adjusted to the endemic PID pathogens found in our population.
盆腔炎（PID）是一种上生殖道感染，通过临床发现进行诊断。核酸扩增检测（NAAT）通过实时 PCR 从宫颈拭子中识别性传播疾病（STD）病原体。本研究探讨了 PID 患者 NAAT 检测到的 STD 患病率。我们还旨在确定阳性检测的预测特征。
本回顾性队列研究探讨了 2016 年至 2019 年在二级转诊中心临床诊断 PID 的女性中 NAAT 阳性的患病率。主要结局是阳性 STD 检测和特定病原体的患病率。次要结局是阳性 NAAT 的预测临床和实验室参数。
在我们的队列中，610 名女性中有 103 名 STD PCR 阳性，占 17%。大多数患者有脲原体（39.4%）、人型支原体（17.2%）或解脲脲原体（15.7%）。其他发病率较低的病原体是沙眼衣原体（9.8%）、阴道毛滴虫（3.4%）、生殖支原体（2.1%），发病率最低的是淋病奈瑟菌（1.5%）。
在我们的人群中，我们发现沙眼衣原体和淋病奈瑟菌的患病率低于其他大人群。这可能是由于已婚和宗教女性的高患病率，以及广泛使用经验性抗生素治疗，即使 PID 的怀疑程度较低。该研究还证实，我们的经验性抗生素方案适用于我们人群中发现的地方性 PID 病原体。
