ABSTRACT
Background: Trichomonas vaginalis [T.vaginalis] and Neisseria gonorrhoeae [N.gonorrhoeae] are two most common non-viral sexually transmitted infections in the world. No data are available regarding the epidemiology of genital infections in women of Qom, central Iran
Objective: Epidemiological investigation of sexually transmitted infections in genital specimens of women referred to the referral gynecology hospital in Qom, central Iran
Materials and Methods: Genital swab specimens were collected from women volunteers and used for identification of bacterial and protozoal infections by conventional microbial diagnostics, porA pseudo gene LightCycler[registered sign] real-time PCR [for N.gonorrhoeae] and ITS-PCR [for T.vaginalis]
Results: Of 420 volunteers, 277 [65.9%] had genital signs/symptoms, including 38.3% malodorous discharge, 37.9% dyspareunia, and 54.8% abdominal pain. Totally, 2 isolates of Streptococcus agalactiae were identified. Five specimens [1.2%] in Thayer-Martin culture and 17 [4.1%] in real-time PCR were identified as N.gonorrhoeae. Fifty-four specimens [12.9%] in wet mount, 64 [15.2%] in Dorset's culture, and 81 [19.3%] in ITS-PCR showed positive results for T.vaginalis. Five mixed infections of T.vaginalis+ N.gonorrhoeae were found. The risk of T.vaginalis infection was increased in women with low-birth-weight [p=0.00; OR=43.29], history of abortion [p=0.00; OR=91.84], and premature rupture of membranes [PROM] [p=0.00; OR=21.75]. The probability of finding nuclear leukocytes [p=0.00; OR=43.34] in vaginal smear was higher in T.vaginalis infection
Conclusion: The significant prevalence of trichomoniasis and gonorrhea emphasizes the need for accurate diagnosis and effective surveillance to prevent serious reproductive complications in women
ABSTRACT
Background: Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen worldwide. Early detection and treatment of C.trachomatis genital infection prevent serious reproductive complications
Objective: Performances of enzyme immunoassay [EIA] and major outer membrane protein [MOMP]-polymerase chain reaction [PCR] for diagnosis of genital C.trachomatis infection in women were compared
Materials and Methods: In this cross sectional study a total of 518 women volunteers were included [33.67 +/- 8.3 yrs] who had been referred to Gynecology clinics of Qom province, Iran, were included. Endocervical swab specimens were collected to detect lipopolysaccharide [LPS] antigen in EIA and to amplify MOMP gene of C.trachomatis in PCR. Results were confirmed using ompI nested-PCR. Sensitivity, specificity, positive [PPV] and negative predictive values [NPV] were calculated for performance of the tests. Odds ratios were determined using binary logistic regression analysis
Results: In total, 37 [7.14%] cases were positive by EIA and/or MOMP-PCR. All discrepant results were confirmed by nested-PCR. Sensitivity, specificity, PPV and NPV values of EIA were 59.46%, 100%, 100% and 96.98%, and those of MOMP-PCR were 97.30%, 100%, 100%, 99.79%, respectively. Reproductive complications including 2.7% ectopic pregnancy, 5.4% stillbirth, 5.4% infertility, and 10.8% PROM were recorded. The risk of developing chlamydiosis was increased 4.8-fold in volunteers with cervicitis [p<0.05; OR 4.80; 95% CI 1.25-18.48]
Conclusion: C.trachomatis infection should be regarded in women of reproductive ages especially those with cervicitis. Primary screening of women by using the low cost antigen-EIA is recommended; however, due to the low sensitivity of Ag-EIA, verification of the negative results by a DNA amplification method is needed