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Chlamydia trachomatis and spontaneous abortion
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positive patients revealed PCR-negative immediately after the completion of antibiotic treatment. Conclusions: With the above results, the nested PCR is a relatively simple, fast, and practical tool for the detection of C. trachomatis and may be a useful follow-up test for monitoring the treatment effect.
FC4.02.02 CHLAMYDIA TRACHOMATIS AND SPONTANEOUS ABORTION P. Vigil, S. Zacharias, A. Tapia, R. Riquelme, .I. Varleta. CEBRE and Faculty of Biological Sciences, P. Catholic University of Chile, Cruz de1 Sur 177, Las Condes, Santiago, Chile. Objectives: Genital Chlamydia trachomatis (Ct) infection is the most common sexually transmitted asymptomatic disease. It has also been suggested as a dangerous pathogen for pregnancy. The objective of this work is to evaluate the incidence of Ct infection and determine its prevalence and correlation in couples presenting with spontaneous abortions. Study Methods: A total of 961 women and 750 men attending at our reproductive clinic (CEBRE, Santiago, Chile) were studied for the presence of Ct using direct immunofluorescense. The incidence of Ct in the general population, was compared with the incidence in women and couples who had a history of one or more spontaneous first trimester abortions. Results: The general incidence of Ct infection was 11.3% (19411771). In women it was 9.4% (901961) and in men 13.9% (1041750). In women with spontaneous abortion, it was 21% (14166) as compared to 8,9% (23159) for women with a term pregnancy (Chi-square, P
FC2.02.03 THE CONDITION OF MICROBIOCENOSIS OF THE SEXUAL ORGANS IN PATIENTS WITH CHLAMYDIA INFECTION T. V. Sevostvanova, V. K. Chaika, B. A. Iotenko, Done&k State Regional Center of Maternity and Child Protection, Done&k, Ukraine Objectives: To study the condition of microbiocenosis of the sexual organs in women with chlamydia infection. We carried out the study of microbiocenosis of the sexual tracts in 138 patients of the reproductive age, with chlamydia infection. Study Methods: The diseases of the cervix uteri were revealed in 59 patients (pseudoerosion, endocervicitis, leukoplakia, and dysplasia of the epithelium), relapsing candidiasis vulvovaginitis (42 patients); infertility (20); abortions in different terms of pregnancy were noted in the history 7 women. Twenty-eight persons had genital chlamidiosis in their history, and they received specific treatment in special medical institutions. Serological investigations of blood serum for revealing specific chlamydia and herpetic antibodies IgG,M,A were carried out with immunofermental and immunoperoxidatic methods. Bacterioscopy and bacteriology, pH-metry were used. In the study of microbiocenosis of the cervical canal in 109 (78.97)D women with Chlamydia infection the other pathogenic and conditionally- pathogenic micro-organisms (enterococi, colibacillus, ureaplasms) were revealed. The highest percentage of the infection associated with urogenital chlamidiossis is viral (CMV, VPH) and candidosis in 45 (41.2%), virus herpes and chlamydia in 11 (10%). In the investigation of the saprophytic microflora of the urogenital tract in the patients with chlamydia infection it was established the predominance of colibacillus in the discharge from the sexual tracts among examined persons. More seldom protein, staphyloccus aureus and different types of staphylococci were cultured. pH change to alkaline side (pH>4.5) was observed in 42 (30%) cases. Conclusions: The women with different impairments of the reproductive function, the chlamydia infection in 87% of cases associated with other infection. And it is evident that affect on the success in the cure of chlamydia infection.
THURSDAY,
SEPTEMBER 7
FC2.02.04 THE PECULIARITIES OF CURRENT OF GENITAL INFLAMMATORY PROCESS IN SEXUALLY ACTIVE ADOLESCENTS AND WOMEN OF FERTILE AGE A. Rudenko, 0. Romashchenko, A. Romanenko, M. Spivak, L. Yakovenko, E. Shalkovsky. Institute of Urology and Nephrology, Institute of Ped., ObstiGyn, Kiev, Ukraine Objectives: The aim of our study was to carry out the comparative analysis of the current of pelvic inflammatory disease in sexually active adolescents and women of fertile age. Materials and Methods: Blood, scrapes of urethra and cervical channels, fragments of uterine tubes obtained during laparotomy. There were examined two hundred and twelve sexually active adolescents aged from 15 to 18 years who were admitted for conservative treatment and twenty patients -for surgical one, one hundred and twenty eight women aged from 24 to 35 years with chronic genital inflammation, 28 among them were operated in connection with tube infertility. Results: The carried analysis showed the predominance of chlamydia (43,4%), mycoplasma (21,7%), ureaplasma (12,7%), gardnerella (23,1%), trichomonade (13,7%) in etiological spectrum during genital inflammatory disease in sexually active adolescents. These factors in 96,7% of cases were presented in associations. Ureaplasma (22,7%), mycoplasma (16,4%), chlamydia (14,8%), gardnerella (10,4%) were revealed in women of fertile age with chronic genital inflammation in 55,5% of cases in microbial associations. The changes of cytokines status caracterized by oppression of CI- and y-interferon production were determined during immunological study in both groups of patients. The increase of FNP production and disorder in links of local (decrease of SIgA level), cellular and humoral immunity during prolonged inflammation were more expressed in women than in sexually active adolescents. In tissue of uterine tubes of sexually active adolescents and women of fertile age (accordingly) there were found out chlamydia (25,0% and 28,6%), mycoplasma (15,0% and 14,3%), enterobacteria, staphylococcus, streptococcus (30,0% and 21,4%). The significant changes of hystoarchitectonics of tube were determined during chlamydiosis (the expressed destruction of organ) and mycoplasmosis. Resume:Sexually active adolescents represent the high risk group as to reproductive health in the future. The determined disorders of hystoarchitectonics of uterine tubes according to the nature of etyologic factor of inflammation on the background of immune disorders are the basis of development of deep changes of reproductive organs in women of fertile age. This fact leads to the infertility or fetus and newborn pathology.
FC4.02.05 REPRODUCTIVE TRACT INFECTION, SYMmOMS AND SYNDROMIC MANAGEMENT IN RURAL GAMBIAN WOMEN R Bailey’, R Coleman’, B West’, L Morisor?, G Walraven’ 1. Medical Research Council Laboratories, P.O. Box 273, Banjul, The Gambia 2. London School of Hygiene and Tropical Medicine, Keppel Street, London WClE7HT, UK Objectives: Assessment of reproductive tract infections (RTIs), relationship to symptoms and implications for syndromic management in a rural Gambian population. Study methods: Women of reproductive age were questioned about current RTI symptoms, screened for RTIs including bacterial vaginosis (BV), trichomonas(TV), N.gonorrhoeae, Candida, and C.trachomatis, and assessed for depressive symptomatology using the Edinburgh depression scale (EDS) (abstract Coleman et al). The sensitivity, specificity and predictive values of the WHO primary care algorithm for abnormal vaginal discharge (AVD) were examined. Results AVD was reported by 102/1344(8%) of women. BV was found in 36%, Candida in ll%, TV in 6%, and Chlamydia in 1.5% of women screened. TV and EDS>ll, but not BV, Candida or Chlamydia were associated with a complaint of AVD. The WHO primary health AVD algorithm would have treated all 102 women for BV, TV, Candida and cervical infections meaning that 48 proven infections and 60 subjects in whom no infection was demonstrated would have received treatment. Only l/l1 chlamydial infections, 11168 trichomonas infections, and 291380 cases of BV would have been treated. Depressive symptoms (EDS>ll) were not significantly associated with a proven RTI. Use of
positive patients revealed PCR-negative immediately after the completion of antibiotic treatment. Conclusions: With the above results, the nested PCR is a relatively simple, fast, and practical tool for the detection of C. trachomatis and may be a useful follow-up test for monitoring the treatment effect.
FC4.02.02 CHLAMYDIA TRACHOMATIS AND SPONTANEOUS ABORTION P. Vigil, S. Zacharias, A. Tapia, R. Riquelme, .I. Varleta. CEBRE and Faculty of Biological Sciences, P. Catholic University of Chile, Cruz de1 Sur 177, Las Condes, Santiago, Chile. Objectives: Genital Chlamydia trachomatis (Ct) infection is the most common sexually transmitted asymptomatic disease. It has also been suggested as a dangerous pathogen for pregnancy. The objective of this work is to evaluate the incidence of Ct infection and determine its prevalence and correlation in couples presenting with spontaneous abortions. Study Methods: A total of 961 women and 750 men attending at our reproductive clinic (CEBRE, Santiago, Chile) were studied for the presence of Ct using direct immunofluorescense. The incidence of Ct in the general population, was compared with the incidence in women and couples who had a history of one or more spontaneous first trimester abortions. Results: The general incidence of Ct infection was 11.3% (19411771). In women it was 9.4% (901961) and in men 13.9% (1041750). In women with spontaneous abortion, it was 21% (14166) as compared to 8,9% (23159) for women with a term pregnancy (Chi-square, P
FC2.02.03 THE CONDITION OF MICROBIOCENOSIS OF THE SEXUAL ORGANS IN PATIENTS WITH CHLAMYDIA INFECTION T. V. Sevostvanova, V. K. Chaika, B. A. Iotenko, Done&k State Regional Center of Maternity and Child Protection, Done&k, Ukraine Objectives: To study the condition of microbiocenosis of the sexual organs in women with chlamydia infection. We carried out the study of microbiocenosis of the sexual tracts in 138 patients of the reproductive age, with chlamydia infection. Study Methods: The diseases of the cervix uteri were revealed in 59 patients (pseudoerosion, endocervicitis, leukoplakia, and dysplasia of the epithelium), relapsing candidiasis vulvovaginitis (42 patients); infertility (20); abortions in different terms of pregnancy were noted in the history 7 women. Twenty-eight persons had genital chlamidiosis in their history, and they received specific treatment in special medical institutions. Serological investigations of blood serum for revealing specific chlamydia and herpetic antibodies IgG,M,A were carried out with immunofermental and immunoperoxidatic methods. Bacterioscopy and bacteriology, pH-metry were used. In the study of microbiocenosis of the cervical canal in 109 (78.97)D women with Chlamydia infection the other pathogenic and conditionally- pathogenic micro-organisms (enterococi, colibacillus, ureaplasms) were revealed. The highest percentage of the infection associated with urogenital chlamidiossis is viral (CMV, VPH) and candidosis in 45 (41.2%), virus herpes and chlamydia in 11 (10%). In the investigation of the saprophytic microflora of the urogenital tract in the patients with chlamydia infection it was established the predominance of colibacillus in the discharge from the sexual tracts among examined persons. More seldom protein, staphyloccus aureus and different types of staphylococci were cultured. pH change to alkaline side (pH>4.5) was observed in 42 (30%) cases. Conclusions: The women with different impairments of the reproductive function, the chlamydia infection in 87% of cases associated with other infection. And it is evident that affect on the success in the cure of chlamydia infection.
THURSDAY,
SEPTEMBER 7
FC2.02.04 THE PECULIARITIES OF CURRENT OF GENITAL INFLAMMATORY PROCESS IN SEXUALLY ACTIVE ADOLESCENTS AND WOMEN OF FERTILE AGE A. Rudenko, 0. Romashchenko, A. Romanenko, M. Spivak, L. Yakovenko, E. Shalkovsky. Institute of Urology and Nephrology, Institute of Ped., ObstiGyn, Kiev, Ukraine Objectives: The aim of our study was to carry out the comparative analysis of the current of pelvic inflammatory disease in sexually active adolescents and women of fertile age. Materials and Methods: Blood, scrapes of urethra and cervical channels, fragments of uterine tubes obtained during laparotomy. There were examined two hundred and twelve sexually active adolescents aged from 15 to 18 years who were admitted for conservative treatment and twenty patients -for surgical one, one hundred and twenty eight women aged from 24 to 35 years with chronic genital inflammation, 28 among them were operated in connection with tube infertility. Results: The carried analysis showed the predominance of chlamydia (43,4%), mycoplasma (21,7%), ureaplasma (12,7%), gardnerella (23,1%), trichomonade (13,7%) in etiological spectrum during genital inflammatory disease in sexually active adolescents. These factors in 96,7% of cases were presented in associations. Ureaplasma (22,7%), mycoplasma (16,4%), chlamydia (14,8%), gardnerella (10,4%) were revealed in women of fertile age with chronic genital inflammation in 55,5% of cases in microbial associations. The changes of cytokines status caracterized by oppression of CI- and y-interferon production were determined during immunological study in both groups of patients. The increase of FNP production and disorder in links of local (decrease of SIgA level), cellular and humoral immunity during prolonged inflammation were more expressed in women than in sexually active adolescents. In tissue of uterine tubes of sexually active adolescents and women of fertile age (accordingly) there were found out chlamydia (25,0% and 28,6%), mycoplasma (15,0% and 14,3%), enterobacteria, staphylococcus, streptococcus (30,0% and 21,4%). The significant changes of hystoarchitectonics of tube were determined during chlamydiosis (the expressed destruction of organ) and mycoplasmosis. Resume:Sexually active adolescents represent the high risk group as to reproductive health in the future. The determined disorders of hystoarchitectonics of uterine tubes according to the nature of etyologic factor of inflammation on the background of immune disorders are the basis of development of deep changes of reproductive organs in women of fertile age. This fact leads to the infertility or fetus and newborn pathology.
FC4.02.05 REPRODUCTIVE TRACT INFECTION, SYMmOMS AND SYNDROMIC MANAGEMENT IN RURAL GAMBIAN WOMEN R Bailey’, R Coleman’, B West’, L Morisor?, G Walraven’ 1. Medical Research Council Laboratories, P.O. Box 273, Banjul, The Gambia 2. London School of Hygiene and Tropical Medicine, Keppel Street, London WClE7HT, UK Objectives: Assessment of reproductive tract infections (RTIs), relationship to symptoms and implications for syndromic management in a rural Gambian population. Study methods: Women of reproductive age were questioned about current RTI symptoms, screened for RTIs including bacterial vaginosis (BV), trichomonas(TV), N.gonorrhoeae, Candida, and C.trachomatis, and assessed for depressive symptomatology using the Edinburgh depression scale (EDS) (abstract Coleman et al). The sensitivity, specificity and predictive values of the WHO primary care algorithm for abnormal vaginal discharge (AVD) were examined. Results AVD was reported by 102/1344(8%) of women. BV was found in 36%, Candida in ll%, TV in 6%, and Chlamydia in 1.5% of women screened. TV and EDS>ll, but not BV, Candida or Chlamydia were associated with a complaint of AVD. The WHO primary health AVD algorithm would have treated all 102 women for BV, TV, Candida and cervical infections meaning that 48 proven infections and 60 subjects in whom no infection was demonstrated would have received treatment. Only l/l1 chlamydial infections, 11168 trichomonas infections, and 291380 cases of BV would have been treated. Depressive symptoms (EDS>ll) were not significantly associated with a proven RTI. Use of