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Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection

Article Abstract:

Screening women who are at high risk of sexually transmitted diseases and treating them could reduce the incidence of pelvic inflammatory disease. There are an estimated 4 million cases of chlamydial infections in the US each year, making this the most common sexually transmitted disease. This infection can travel up the genital tract, causing pelvic inflammatory disease. Researchers identified 2,607 women in an HMO who had a high risk of chlamydial infections. The risk factors included young age, black race, two or more sex partners in the past and douching. A total of 1,009 were assigned to be screened for chlamydial infections and 1,598 were assigned to usual care. A total of 645 women in the screening group were actually tested for Chlamydia and 44 tested positive. All 44 received treatment for chlamydial infections. After a 12-month follow-up, 9 women in the screening group had developed pelvic inflammatory disease compared to 33 of the women who were not screened. This represents a reduction of 56% in the incidence of pelvic inflammatory disease.

Author: Scholes, Delia, Stamm, Walter E., Holmes, King K., Stergachis, Andy, Heidrich, Fred E., Andrilla, Holly
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
Evaluation, Risk factors, Medical screening, Health screening, Pelvic inflammatory disease

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Increasing Prevalence of Antimicrobial Resistance Among Uropathogens Causing Acute Uncomplicated Cystitis in Women

Article Abstract:

The bacteria that cause cystitis are becoming resistant to many antibiotics. Cystitis is an inflammation or infection of the bladder. Researchers analyzed drug resistance among bacteria isolated from urine specimens collected from 4,342 women with cystitis over a five-year period. The bacteria most commonly isolated from these women were E. coli and Staphylococcus saprophyticus. In more than 20% of the samples, the bacteria were resistant to ampicillin, cephalothin, and sulfamethoxazole. Over the five years, resistance to trimethoprim and co-methoxazole increased. However, the bacteria were still sensitive to nitrofurantoin, gentamicin and ciprofloxacin.

Author: Scholes, Delia, Gupta, Kalpana, Stamm, Walter E.
Publisher: American Medical Association
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1999
Causes of, Statistics, Drug resistance in microorganisms, Microbial drug resistance, Escherichia coli, Cystitis

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Expanding efforts to prevent chlamydial infection

Article Abstract:

New diagnostic tests that use urine samples could revolutionize screening programs for chlamydia infections. Chronic chlamydia infection can cause pelvic inflammatory disease, infertility and ectopic pregnancy. However, it often has no symptoms, leading physicians to propose widespread screening of sexually active men and women. A 1998 study found that 9% of 17- to 25-year-old female Army recruits tested positive for chlamydia. Even when identified, many patients do not comply with treatment. A rapid test that could be done during a clinic visit could improve the treatment of these patients.

Author: Stamm, Walter E.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1998
Editorial

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Subjects list: Diagnosis, Chlamydia infections
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