Detection of chlamydia and other bacteria in cervicitis.

Abstract

Objectives 1.To detect the presence of chlamydia in the cervix of symptomatic and asymptomatic cases of cervicitis 2. To conduct a full bacteriological identification of the microorganisms isolated from the cervix and vagina of the studied women 3. To study the association between chlamydial infection and negative bacterial cultures. 4.To evaluate the findings of wet preparation of vaginal swabs in chlamydia positive and negative cases. 5. To estimate the serum concentration of C-reactive protein (CRP) in chlamydia positive and negative cases.
Materials and methods: This study was conducted during the period from December 2003 up to June 2004. It included a total of 200 women; 120 women were suffering from symptomatic cervicitis and 80 were asymptomatic for any gynaecological problems. Two endocervical and one high vaginal swabs were collected from each patient. One of the two endocervical swabs was used for the detection of chlamydia by immunochromatographic card test and the second one was used for bacterial culture. The high vaginal swab was used for wet preparation, and bacterial culture. The sera of these patients were tested for serum CRP level.
Results: Chlamydia infection was detected in 34 (17%) of the total 200 cases studied. Among the symptomatic group, 19(15.9%) were found to be chlamydia positive, while among the asymptomatic group, 15 (18.7%) were chlamydia positive. The association of chlamydia with negative bacterial culture was found to be significant in symptomatic group of patients (p< 0.001), but not in the asymptomatic group (p>0.100). The wet preparation findings in chlamydia positive cases revealed that the increased numbers of PMN (>10/hpf) were statistically not significant in symptomatic group (p>0.194), but significant in the asymptomatic group (p<0.036). The association of chlamydia positivity with increased serum CRP level (> 6 mg/L ) was also found to be significant in both symptomatic and asymptomatic groups of cases (p <0.001). Also, The presence of clue cells and Trichomonas vaginalis infection increases the possibility of chlamydia infection.
Conclusions: The immunochromatographic card test for chlamydia antigens represents a rapid, informative and not an expensive method for the detection of chlamydia infection. The negative bacterial cultures increase the possibility of chlamydia infection in symptomatic cases, but not in the asymptomatic ones. The CRP level increases significantly in infections caused by chlamydia, but not by other bacteria.