Risk of Pelvic Inflammatory Disease in Relation to Chlamydia and Gonorrhea Testing, Repeat Testing, and Positivity: A Population-Based Cohort Study

Liu, Bette; Liu, B; Preen, David B.; Hocking, Jane S; Donovan, Basil; Roberts, C; Ward, James; Mak, Donna B; Guy, Rebecca; Kaldor, John; Pearson, Sallie Anne; Stewart, Louise M.; Wand, Handan; Reekie, Joanne

doi:10.1093/cid/cix769

Cited by 91 publications

(58 citation statements)

References 30 publications

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“…In frequent infections, salpingitis, tubular ovarian abscess, and infertility are also possible, and ectopic pregnancy is an indirect complication of this infection. The tissue damage following chlamydia trachomatis is noteworthy because it happens due to late diagnosis and treatment (6)(7)(8)(9)(10). According to the World Health Organization (WHO) guidelines, only treatment regimens that have more than 95% efficacy are recommended for STIs (40).…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Single-Dose Azithromycin Versus its Combination With Moxifloxacin Based on the Treatment of Chlamydial Cervicitis: A Study Protocol for a Randomized Clinical Trial

Mohammadzadeh

Dolatian

Jorjani

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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Objectives: Chlamydia trachomatis is globally reported as a pathogenic infection and is the most common bacterial cause of sexually transmitted infection (STI) in most countries. In addition, chlamydial cervicitis and the adverse complications of the first line treatment, namely, azithromycin failure are highly prevalent. Thus, the present study will be conducted to determine and compare the effects of single-dose azithromycin and its combination with moxifloxacin based on syndromic and etiologic methods in the diagnosis and treatment of chlamydial cervicitis. Materials and Methods: This is a study protocol for a randomized clinical trial which will be performed at the Women’s Clinics and Health Centers in Amol, Iran during 2018. Further, the study will evaluate women with cervicitis complaints, who have a proven case of chlamydial cervicitis through syndromic or etiologic diagnostic methods and meet the inclusion criteria for the study population. Discussion: To the best of our knowledge, this trial will be the first study to explore the effects of single-dose azithromycin in combination with moxifloxacin in the treatment of chlamydial cervicitis. The results of this trial will further reveal the diagnostic value of syndromic and etiologic methods in the diagnosis of chlamydial cervicitis.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness of Single-Dose Azithromycin Versus its Combination With Moxifloxacin Based on the Treatment of Chlamydial Cervicitis: A Study Protocol for a Randomized Clinical Trial

Mohammadzadeh

Dolatian

Jorjani

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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“…Recently reported cases of ceftriaxone‐resistant Neisseria gonorrhoeae from Australia highlight the significant threat of multidrug‐resistant infection . While chlamydia‐related pelvic inflammatory disease is more common, gonorrhoea‐related disease more often results in hospitalisation . In the context of multidrug resistance, this has serious reproductive health consequences including infertility.…”

Section: Hiv and Sexually Transmitted Infectionsmentioning

confidence: 99%

The Guttmacher– Lancet Commission on sexual and reproductive health and rights: how does Australia measure up?

Bateson

Black

Sawleshwarkar

2019

Medical Journal of Australia

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“…Both CT and NG can cause pelvic inflammatory disease (PID) in women, although data linkage studies suggest that the risk of PID is considerably higher with NG than CT infection [5]. However, there has been much less published research investigating the upper genital tract consequences of NG infection and its role in PID.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with anorectalChlamydia trachomatisorNeisseria gonorrhoeaetest positivity in women: a systematic review and meta-analysis

et al. 2019

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ObjectivesThere has been considerable discussion about anorectal Chlamydia trachomatis (CT) in women, with some calling for anorectal CT screening, but little about anorectal Neisseria gonorrhoeae (NG). Given that urogenital NG is more strongly associated with pelvic inflammatory disease, this is an evidence gap. This systematic review and meta-analysis investigates the associations between anorectal CT in women and CT positivity at other sites (urogenital/oropharyngeal) and with anal intercourse, and compares these with anorectal NG within the same study populations.MethodsElectronic databases were searched for English-language studies published to October 2018 using the following terms: (“Chlamydia” OR “Chlamydia trachomatis”) AND ((“anal” OR “rect*” OR “anorect*”) OR (“extra?genital” OR “multi?site”)). Studies were included if anorectal NG data were available. Random-effects meta-analyses calculated pooled estimates; heterogeneity was investigated using meta-regression.Results25 studies were eligible. Anorectal CT positivity ranged from 0% to 17.5%, with a summary estimate of 8.0% (95% CI 7.0 to 9.1; I2=88.5%). Anorectal NG positivity ranged from 0% to 17.0%, with a summary estimate of 2.1% (95% CI 1.6 to 2.8; I2=92.7%). The association between urogenital and anorectal positivity was stronger for NG than CT (summary prevalence ratio (PR)=89.3 (95% CI 53.1 to 150.3; I2=80.1%), PR=32.2 (95% CI 25.6 to 40.7; I2=70.3%), respectively), and between oropharyngeal and anorectal positivity it was stronger for NG than CT (PR=34.8 (95% CI 10.2 to 118.2; I2=89.9%), PR=8.8 (95% CI 6.8 to 11.5; I2=58.1%), respectively). Anal intercourse was associated with anorectal NG (PR=4.3; 95% CI 2.2 to 8.6; I2=0.0%) but not with anorectal CT (PR=1.0; 95% CI 0.7 to 1.4; I2=0.0%).ConclusionsAnorectal CT is more common than anorectal NG, but anorectal NG is more strongly associated with anal intercourse, urogenital and oropharyngeal NG, suggesting that ongoing discussion about anorectal CT should also include NG. Longitudinal data are required to further understanding of the aetiology of anorectal STIs and assess whether anorectal screening is needed in women.Trial registration numberCRD42df017080188.

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Risk of Pelvic Inflammatory Disease in Relation to Chlamydia and Gonorrhea Testing, Repeat Testing, and Positivity: A Population-Based Cohort Study

Abstract: Gonorrhea infection conferred a substantially higher risk than chlamydia of hospitalization or emergency department presentation for PID. The emergence of gonorrhea antimicrobial resistance may have a serious impact on rates of PID and its associated reproductive health sequelae.

Cited by 91 publications

References 30 publications

The Effectiveness of Single-Dose Azithromycin Versus its Combination With Moxifloxacin Based on the Treatment of Chlamydial Cervicitis: A Study Protocol for a Randomized Clinical Trial

The Effectiveness of Single-Dose Azithromycin Versus its Combination With Moxifloxacin Based on the Treatment of Chlamydial Cervicitis: A Study Protocol for a Randomized Clinical Trial

The Guttmacher– Lancet Commission on sexual and reproductive health and rights: how does Australia measure up?

Factors associated with anorectalChlamydia trachomatisorNeisseria gonorrhoeaetest positivity in women: a systematic review and meta-analysis

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