Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker 3.3)
Index Copernicus  – 161.11; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 3, May-June, p. 427–433

Publication type: original article

Language: English

Incidence of Chlamydial Uterine Cervix Infections in South−West Poland in the Period of 1996–2004

Występowanie zakażeń szyjki macicy wywołanych przez chlamydie w południowo−zachodniej Polsce w latach 1996–2004

Irena Choroszy−Król1,, Marek Murawski2,, Lilla Pawlik1,, Dorota Teryks−Wołyniec1,, Magdalena Frej−Mądrzak1,

1 Department of Microbiology, Silesian Piasts University of Medicine in Wrocław, Poland

2 First Department of Gynecology and Obstetrics, Silesian Piasts University of Medicine in Wrocław, Poland

Abstract

Objectives. Assessment of the incidence of uterine cervix infection caused by Chlamydia trachomatis in southwest Poland in the period of 1996–2004.
Material and Methods. Two methods used for the laboratory diagnosis of the disease were compared. The specificity and sensitivity of the ligase chain reaction (LCR) method versus the direct immunofluorescence (DIF) test were evaluated. The material was cervical smears from 320 patients with different genito−urinary tract diseases. The patients were being treated in gynecological hospital units and outpatient departments (n = 255), private gynecological clinics (n = 45), the Wrocław Health Care Center (n = 12), special−service and police hospital (n = 6), an infectious and invasive diseases hospital (n = 1), and the Tuberculosis Care Center (n = 1). The smears were tested simultaneously by LCR (Chlamydia trachomatis assay, Abbott) and DIF (Chlamyset, Orion Diagnostica), applying monoclonal antibodies labeled with isothiocyanin fluoresceine.
Results. In 1996–1999, the LCR sensitivity in comparison with DIF was 83.3% and specificity 99.6%, whereas the DIF sensitivity in comparison with LCR was 71.4% and specificity 100%. In 2000–2004, positive results were achieved in 109/401 (27.1%) patients. Increasing percentages of infected women were observed in the consecutive years: 21.2%, 25.5%, 28.5%, 29.7%, 31.5%.
Conclusion. The incidence of chlamydial uterine cervix infections in south−west Poland in the period of 1996–2004 is approximately seven times lower than that observed in 1986. The investigations performed in 2000–2004 revealed the presence of Chlamydia trachomatis in 1/3 of women with urogenital tract infections. This situation requires appropriate treatment to avoid remote serious complications.

Streszczenie

Cel pracy. Ocena częstości występowania zakażeń szyjki macicy o etiologii Chlamydia trachomatis w Polsce południowo−zachodniej w latach 1996–2004.
Materiał i metody. Porównano dwie metody badań stosowanych w diagnostyce tego schorzenia. Oceniono swoistość i czułość reakcji łańcuchowej ligazy (LCR) oraz immunofluorescencji bezpośredniej. Materiałem do badań w latach 1996–1999 były rozmazy z kanału szyjki macicy pobrane od 320 pacjentek, a w latach 2000–2004 od 401 pacjentek z różnymi schorzeniami układu moczowo−płciowego. Pacjentki leczono na szpitalnych oddziałach ginekologicznych oraz w przychodniach (n = 255), prywatnych klinikach ginekologicznych (n = 45), we Wrocławskim Centrum Zdrowia (n = 12), szpitalu MSWiA (n = 6) oraz w szpitalu chorób zakaźnych (n = 1), szpitalu gruźliczym (n = 1). Próbki badano jednocześnie techniką LCR (test Chlamydia trachomatis, firmy Abbott) oraz testem immunofluorescencji bezpośredniej DIF (Chlamyset, Orion Diagnostica), wykorzystującym przeciwciała monoklonalne znakowane izotiocyjanianem fluoresceiny.
Wyniki. W latach 1996–1999 czułość metody LCR w porównaniu z DIF wynosiła 83,3%, swoistość – 99,6%, a czułość DIF w porównaniu z LCR wynosiła 71,4%, swoistość – 100%. W latach 2000–2004 wyniki dodatnie uzyskano u 109/401 (27,1%) pacjentek. Procentowy wzrost liczby zakażonych kobiet obserwowany w kolejnych latach wynosił: 21,2; 25,5; 28,5; 29,7 oraz 31,5%.
Wnioski. Częstość występowania chlamydialnych zakażeń szyjki macicy w południowo−zachodniej Polsce w latach 1996–2004 jest około 7 razy niższa od obserwowanej w 1986 r. W badaniach prowadzonych w latach 2000–2004 stwierdzono obecność Chlamydia trachomatis u 1/3 kobiet z zakażeniami układu moczowo−płciowego. W celu uniknięcia poważnych komplikacji w tych schorzeniach należy zastosować odpowiednie leczenie.

Key words

Chlamydia trachomatis, uterine cervix infections, ligase chain reaction method, direct immunofluorescence test

Słowa kluczowe

Chlamydia trachomatis, LCR, DIF, zakażenia szyjki macicy

References (24)

  1. Andrews WW, Lee HH, Roden WJ, Mott W: Detection of genitourinary tract Chlamydia trachomatis infection in pregnant women by Ligase Chain Reaction assay. Obstet Gynecol 1997, 89, 556–560.
  2. Bassiri M., HU HY, Domeika MA, Barczak JD, Svensson LO, Lee HH, Mårdh PA: Detection of Chlamydia trachomatis in urine specimens by ligase chain reaction. J Clin Microbiol 1995, 33, 898–900.
  3. Choroszy−Król I, Ruczkowska J, Pawlik L: Ligase chain reaction (LCR) versus direct immunofluorescence test (DIF) in the diagnosis of Chlamydia trachomatis. Adv Clin Exp Med 1998, 7, 409–414.
  4. Koumans EH, Black CM, Markowitz LE, Unger E, Pierce A, Sawyer MK, Papp JR: Comparison of methods for detection of Chlamydia trachomatis and Neisseria gonorrhoeae using commercially available nucleic acid amplification tests and a liquid pap smear medium. J Clin Microbiol 2003, 41, 1507–1511.
  5. Göessens WHF, Moutom JW, Meijden WJ, Dellen S, Rijsoort−Vos TH, Lemmens N: Comparison of three commercially available amplification assays, AMPCT, LCX, and COBAS AMPLIEOR, for detection of Chlamydia trachomatis in first−void urine. J Clin Microbiol 1997, 35, 2628–2633.
  6. Macmillan S, McKenzie H, Templeton A: Parallel observation of four methods for screening women under 25 years of age for genital infections with Chlamydia trachomatis. Eur J Obstet Gynecol Reprod Biol 2003, 107, 68–73.
  7. Watson EJ, Templeton A, Russel I, Paavonen J, Mardh PA, Stary A, Rederson BS: The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review. J Med Microbiol 2002, 51, 1021–1031.
  8. Carroll KC, Aldeen WE, Morrison M, Anderson R, Lee D, Mottice S: Evaluation of the Abbott LCX ligase chain reaction assay for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine and genital swab specimens from a sexually transmitted disease clinic population. J Clin Microbiol 1998, 36,1630.
  9. Howell MR, Quinn TC, Brathwaite W, Gaydos CA: Screening women for Chlamydia trachomatis in family planning clinics: the cost – effectiveness of DNA amplification assays. Sex Transm Dis 1998, 25, 108– 112.
  10. Clark AM, Steece R, Crouse K, Campbell J, Zanto S, Kartchner D, Mottice S, Pettit D: Multisite pooling study using ligase chain reaction in screening for genital Chlamydia trachomatis infections. Sex Transm Dis 2001, 28, 565–568.
  11. Schachter J, Stamm WE, Quinn TC, Andrews WW, Burczak JD, Lee HH: Ligase Chain Reaction to detect Chlamydia trachomatis of the cervix. J Clin Microbiol 1994, 32, 2540–2543.
  12. Lee HH, Chernesky MA, Schachter J, Burczak JD, Andrews WW, Muldoon S, Leckie G, Stamm WE: Diagnosis of Chlamydia trachomatis genitourinary infection in women by ligase chain reaction assay of urine. Lancet 1995, 345, 213–216.
  13. Loeffelholz MJ, Jirsa SJ, Teske RK, Woods JN: Effect of endocervical specimen adequacy on ligase chain reaction detection of Chlamydia trachomatis. J Clin Microbiol 2001, 39, 3838–3841.
  14. Gaydos CA, Howell MR, Quinn TC, Gaydos JC, McKee KT: Use of ligase chain reaction with urine versus cervical culture for detection of Chlamydia trachomatis in an symptomatic military population of pregnant and nonpregnant females attending papanicolaou smear clinics. J Clin Microbiol 1998, 36, 1300.
  15. Szczurzewski M, Ostaszewska I, Bułhak V: Evaluation of ligase chain reaction (LCR) usefulness in the diagnosis of Chlamydia trachomatis sexually transmitted infections. Przegl Dermatol 1997, 84, 477–480.
  16. Chernesky M, Jang D, Sellors J, Luinstra K, Chong S, Castriciano S, Mahony JB: Urinary inhibitors of polymerase chain reaction and testing of multiple specimens may contribute to lower assay sensitivities for diagnosing Chlamydia trachomatis infected women. Mol Cell Probes 1997, 11, 243–249.
  17. Choroszy−Król I, Ruczkowska J, Kowal A, Pawlik L: Detection of Chlamydia trachomatis in urine specimens by using ligase chain reaction (LCR). Adv Clin Exp Med 2000, 9, 245–250.
  18. Choroszy−Król I, Ruczkowska J: Frequency of Chlamydia trachomatis infection in women in Lower Silesia Region of Poland (1999–2000). Med Wiek Roz 2002, VI, 3 Supl. I, 57–65.
  19. Elias M, Choroszy−Król I, Ruczkowska J, Byczyńska B, Stankiewicz M: Chlamydia trachomatis and concomitant flora in internal−genital organs of asymptomatic women. Gin Pol 1996, 67 (5), 264–269.
  20. Chandeying V, Lamlertkittikul S, Skov S: Acomparison of first−void urine, self−administered low vaginal swab, self−inserted tampon, and endocervical swab using PCR tests for the detection of infection with Chlamydia trachomatis. Sex Health 2004, 1(1), 51–54.
  21. Rice RJ, Bhullar V, Mitchell SH, Bullard J, Knapp JS: Susceptibilities of Chlamydia trachomatis isolates causing uncomplicated female genital tract infections and pelvic inflammatory disease. Antimicrob Agents Chemother 1995, 39, 3, 760–762.
  22. Heinonen PK, Leinonen M: Fecundity and morbidity following acute pelvic inflammatory disease treated with doxycycline and metronidazole. Arch Gynecol Obstet 2003, 268 (4), 284–288
  23. Bevan CD, Ridgway GL, Rothermel CD: Efficacy and safety of azithromycin as monotherapy or combined with metronidazole compared with two standard multidrug regimens for the treatment of acute pelvic inflammatory disease. J Int Med Res 2003, 31(1), 45–54.
  24. Karwan−Płońska A: Chlamydia trachomatis infections. Nowa Med 1995, 2 (8), 23–24.