The aim of this study was to determine the presence of Chlamydia trachomatis (ChT) and Neisseria gonorrhoae (NG) in the genital tract of women with ectopic pregnancy and to compare the positive results with patients' self-reported history of PID. Overall 40 women were eligible for the study. The samples for the ChT and NG Polymerase Chain-reaction (PCR) detection were obtained from the cervix, endometrium and fallopian tube. The results of testing for NG at all sites were negative as were the results from cervical testing for ChT. The prevalence of ChT in the upper genital tract was 12.5%. No statistically significant correlation was found between the positive cases and the previous signs of PID and laparoscopic findings. We found statistically significant relationship between signs of pelvic inflammation in a pacients' history and histopathological findings of tubal inflammation. 12.5% prevalence of ChT confirms the ascending genital infection. There was no association between the positive PCR result and clinical history of pelvic inflammation.IMPACT STATEMENTWhat is already known on this subject? Pelvic inflammatory disease, Chlamydia trachomatis and Neisseria gonorrhoae infections are the main risks for ectopic pregnancy. Clinical history of PID and perioperative adhesions may suggest prior upper genital infection.What do the results of this study add?Chlamydia trachomatis positive PCR result can be found in the upper genital tract without the positivity of cervical smear in women with ectopic pregnancy. Our study is unique in assessing the endometrial biopsy for the presence of Chlamydia trachomatis and Neisseria gonorrhoae.What are the implications of these findings for future clinical practice and/or future clinical research? There is no statistically significant association between positive PCR result and clinical history of PID or pelvic adhesions found during laparoscopy for tubal pregnancy. Therefore there is no need for the preventive antibiotic treatment in patients with these findings.
- MeSH
- Chlamydia trachomatis MeSH
- chlamydiové infekce * komplikace diagnóza epidemiologie MeSH
- lidé MeSH
- mimoděložní těhotenství * diagnóza epidemiologie MeSH
- Neisseria gonorrhoeae MeSH
- pánevní zánět * komplikace MeSH
- polymerázová řetězová reakce MeSH
- těhotenství MeSH
- zánět komplikace MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- azithromycin aplikace a dávkování terapeutické užití MeSH
- ceftriaxon aplikace a dávkování terapeutické užití MeSH
- Chlamydia trachomatis patogenita MeSH
- dítě MeSH
- dospělí MeSH
- faryngitida MeSH
- gonorea * diagnóza farmakoterapie přenos MeSH
- lidé MeSH
- polymerázová řetězová reakce MeSH
- předškolní dítě MeSH
- přenos infekční nemoci MeSH
- sexuálně přenosné nemoci diagnóza farmakoterapie přenos MeSH
- uretritida MeSH
- vaginitida MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
OBJECTIVE: The primary aim of this study was to assess the rate and load of amniotic fluid Chlamydia trachomatis DNA and their associations with intra-amniotic infection and intra-uterine inflammatory complications in women with preterm prelabor rupture of membranes (PPROM). The secondary aim was to assess the short-term morbidity of newborns from PPROM pregnancies complicated by amniotic fluid C. trachomatis DNA. METHODS: A retrospective study of 788 women with singleton pregnancies complicated by PPROM between 24 + 0 and 36 + 6 weeks of gestation was performed. Transabdominal amniocenteses were performed at the time of admission. C. trachomatis DNA in the amniotic fluid was assessed by real-time polymerase chain reaction using a commercial AmpliSens® C. trachomatis/Ureaplasma/Mycoplasma hominis-FRT kit, and the level of Ct DNA was quantified. RESULTS: Amniotic fluid C. trachomatis DNA complicated 2% (16/788) of the PPROM pregnancies and was present in very low loads (median 57 copies DNA/mL). In addition to amniotic fluid C. trachomatis DNA, other bacteria were detected in 62% (10/16) of the C. trachomatis DNA-complicated PPROM pregnancies. Amniotic fluid C. trachomatis DNA was associated with intra-amniotic infection, histologic chorioamnionitis (HCA), and funisitis in 31%, 47%, and 33%, respectively. The presence of C. trachomatis DNA accompanied by Ureaplasma species in the amniotic fluid was associated with a higher rate of HCA than the presence of amniotic fluid C. trachomatis DNA alone. The composite neonatal morbidity in newborns from PPROM pregnancies with amniotic fluid C. trachomatis DNA was 31%. CONCLUSION: The presence of C. trachomatis DNA in the amniotic fluid is a relatively rare condition in PPROM. Amniotic fluid C. trachomatis DNA in PPROM is not related to intensive intra-amniotic and intr-auterine inflammatory responses or adverse short-term neonatal outcomes.
- MeSH
- Chlamydia trachomatis MeSH
- chorioamnionitida * epidemiologie MeSH
- DNA MeSH
- interleukin-6 MeSH
- lidé MeSH
- novorozenec MeSH
- plodová voda MeSH
- předčasný odtok plodové vody * MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Lymphogranuloma venereum (LGV), the invasive infection of the sexually transmissible infection (STI) Chlamydia trachomatis, is caused by strains from the LGV biovar, most commonly represented by ompA-genotypes L2b and L2. We investigated the diversity in LGV samples across an international collection over seven years using typing and genome sequencing. LGV-positive samples (n=321) from eight countries collected between 2011 and 2017 (Spain n=97, Netherlands n=67, Switzerland n=64, Australia n=53, Sweden n=37, Hungary n=31, Czechia n=30, Slovenia n=10) were genotyped for pmpH and ompA variants. All were found to contain the 9 bp insertion in the pmpH gene, previously associated with ompA-genotype L2b. However, analysis of the ompA gene shows ompA-genotype L2b (n=83), ompA-genotype L2 (n=180) and several variants of these (n=52; 12 variant types), as well as other/mixed ompA-genotypes (n=6). To elucidate the genomic diversity, whole genome sequencing (WGS) was performed from selected samples using SureSelect target enrichment, resulting in 42 genomes, covering a diversity of ompA-genotypes and representing most of the countries sampled. A phylogeny of these data clearly shows that these ompA-genotypes derive from an ompA-genotype L2b ancestor, carrying up to eight SNPs per isolate. SNPs within ompA are overrepresented among genomic changes in these samples, each of which results in an amino acid change in the variable domains of OmpA (major outer membrane protein, MOMP). A reversion to ompA-genotype L2 with the L2b genomic backbone is commonly seen. The wide diversity of ompA-genotypes found in these recent LGV samples indicates that this gene is under immunological selection. Our results suggest that the ompA-genotype L2b genomic backbone is the dominant strain circulating and evolving particularly in men who have sex with men (MSM) populations.
- MeSH
- Chlamydia trachomatis klasifikace genetika MeSH
- dospělí MeSH
- fylogeneze MeSH
- genomika * MeSH
- genotyp MeSH
- homosexualita mužská MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymphogranuloma venereum epidemiologie mikrobiologie MeSH
- mladý dospělý MeSH
- molekulární epidemiologie * MeSH
- molekulární evoluce * MeSH
- proteiny vnější bakteriální membrány genetika MeSH
- sekvence nukleotidů MeSH
- sekvenční analýza MeSH
- sekvenování celého genomu MeSH
- senioři MeSH
- sexuálně přenosné nemoci mikrobiologie MeSH
- sexuální a genderové menšiny MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Austrálie MeSH
- Evropa MeSH
BACKGROUND: To determine the association between microbial invasion of the amniotic cavity (MIAC) and the presence of Lactobacillus crispatus- or Lactobacillus iners-dominated cervical microbiota in pregnancies with preterm prelabor rupture of membrane. Next, to assess the relationship between the presence of L. crispatus- or L. iners-dominated cervical microbiota and short-term neonatal morbidity. METHOD: A total of 311 women were included. Cervical samples were obtained using a Dacron polyester swab and amniotic fluid samples were obtained by transabdominal amniocentesis. Bacterial DNA, L. crispatus, and L. iners in the cervical samples were assessed by PCR. Cervical microbiota was assigned as L. crispatus- or L. iners-dominated when the relative abundance of L. crispatus or L. iners was ≥50% of the whole cervical microbiota, respectively. RESULTS: Women with MIAC showed a lower rate of L. crispatus-dominated cervical microbiota (21% vs. 39%; p = 0.003) than those without MIAC. Lactobacillus crispatus-dominated cervical microbiota was associated with a lower rate of early-onset sepsis (0% vs. 5%; p = 0.02). CONCLUSIONS: The presence of L. crispatus-dominated cervical microbiota in women with preterm prelabor rupture of membrane was associated with a lower risk of intra-amniotic complications and subsequent development of early-onset sepsis of newborns.
- MeSH
- amniocentéza metody MeSH
- cervix uteri mikrobiologie MeSH
- Chlamydia trachomatis MeSH
- chorioamnionitida mikrobiologie MeSH
- Lactobacillus crispatus * MeSH
- Lactobacillus * MeSH
- lidé MeSH
- mikrobiota MeSH
- Mycoplasma hominis MeSH
- novorozenec MeSH
- plodová voda mikrobiologie MeSH
- předčasná porodní činnost MeSH
- předčasný odtok plodové vody mikrobiologie MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Ureaplasma MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- adrenarche MeSH
- Chlamydia trachomatis patogenita MeSH
- chování mladistvých MeSH
- gonorea MeSH
- kouření MeSH
- lidé MeSH
- mladiství * MeSH
- Papillomaviridae patogenita MeSH
- pití alkoholu MeSH
- pohlavní dimorfismus MeSH
- poruchy spojené s užíváním psychoaktivních látek prevence a kontrola MeSH
- průzkumy a dotazníky MeSH
- psychotropní léky klasifikace škodlivé účinky MeSH
- puberta fyziologie psychologie MeSH
- sexuálně přenosné nemoci epidemiologie klasifikace MeSH
- syfilis epidemiologie MeSH
- věkové faktory MeSH
- vývoj mladistvých fyziologie MeSH
- Check Tag
- lidé MeSH
- mladiství * MeSH
- MeSH
- Chlamydia trachomatis patogenita MeSH
- chlamydiové infekce * diagnóza terapie MeSH
- imunoterapie MeSH
- kyselina askorbová aplikace a dávkování terapeutické užití MeSH
- lidé středního věku MeSH
- virus Epsteinův-Barrové patogenita MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
