Abstract
The aim of this study was to determine the incidence of N. gonorrhoae (NG) and/or C. trachomatis (CT) in acute mucopurulent cervicitis (MPC). The study included 617 non-pregnant women with MPC, who had not been receiving any antimicrobial treatment. The average age of patients was 22.2 years. There were no statistically significant differences according to place of residence, education, and marital status. Samples for laboratory analysis were collected using a routine procedure; NG was identified using the cytochrome oxidase test and Gram staining. CT was isolated on McCoy cell culture and stained with Lugol solution. NG was isolated in three women (0.8%) and CT in 58 women (9.4%). Fifty-six of the CT-positive patients were nullipara and only two were unipara. All NG-positive patients were also nullipara. The mean number of sexual partners was 2.2 in all study subjects, 2.4 in CT-positive subjects, and 2.9 in NG-positive subjects. Vaginal discharge purity according to Schröder was significantly deteriorated in CT-positive patients (p=0.011). When asked about the use of contraceptives, as many as 32.7% patients answered that they did not use any protection, 39% women used the rhythm method and coitus interruptus, 20% were taking oral contraceptives, 6.1% used mechanical devices, and 1.9% used chemical protection. Previous acute and chronic pelvic inflammatory diseases correlated with MPC (p>0.01). Our statistical analysis suggests that chlamydial infection significantly reduces the purity of vaginal discharge, which is more pronounced in nulliparae. Pap smear was not specific enough to demonstrate chlamydial infection. In view of the MPC findings, the prevalence of CT and NG infection is low.
Highlights
The aim of this study was to determine the incidence of N. gonorrhoae (NG) and/or C. trachomatis (CT) in acute mucopurulent cervicitis (MPC)
NG-positive patients had an average of 2.9 partners, while CT-positive subjects had 2.4 patients (Table 1)
This low percentage is perhaps related to the use of the current Croatian “gold standard” - McCoy cell culture for CT isolation - with a sensitivity ranging between 50 % and 90 %, which is considerably lower compared to the methods of nucleic acid amplification with a sensitivity exceeding 95 %
Summary
The aim of this study was to determine the incidence of N. gonorrhoae (NG) and/or C. trachomatis (CT) in acute mucopurulent cervicitis (MPC). Our statistical analysis suggests that chlamydial infection significantly reduces the purity of vaginal discharge, which is more pronounced in nulliparae. As many as 10 % of women with untreated cervicitis caused by CT or NG will develop pelvic inflammatory disease (PID) [7]. The real incidence of MPC is unknown; many studies show it to be quite common among young, sexually active women. The aim of this prospective study was to determine the incidence of gonococcal and chlamydial infection in symptomatic cases of acute MPC diagnosed in a female population of the Bjelovar area, Croatia, and to assess the presence and percentage of gonococcal and chlamydial coinfection
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