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PubMed1975

Isolation of Chlamydia from women attending a clinic for sexually transmitted disease.

Cervical swabs for Chlamydia culture were collected from 638 unselected women attending a sexually transmitted diseases clinic with a fresh complaint. Chlamydia were isolated from 76 (12 per cent.) of the women. When the results were related to the patients' diagnoses, Chlamydia were present in 44 per cent. of women with gonorrhoea and in 22 per cent. of women who were contacts of men with nonspecific urethritis (women who may be regarded as having non-specific genital infection). Chlamydia were uncommon in women with no evidence of genital infection. Significant correlations were found between the presence of Chlamydia and cervical erosion, cervical cytological inflammatory change, and absence of symptoms. Isolates were obtained more frequently from women with non-specific genital infection who were primary contacts than from women who were secondary contacts. These findings support the concept that Chlamydia are pathogens in the genital tract and are sexually transmitted.

Cervix Uteri↗
PubMed1981

Chlamydia trachomatis and Ureaplasma urealyticum in men attending a sexually transmitted diseases clinic.

Urethral specimens from 480 heterosexual patients were examined for Chlamydia trachomatis. Chlamydia were isolated from 32.7% of men with non-specific urethritis (NSU), from 16.1% of men with gonorrhoea, and from 4.1% of men without urethritis. Chlamydial isolation was not related to duration of symptoms, presence of discharge, or past history of attendance at the clinic. Urine from 176 heterosexual patients was examined for Ureaplasma urealyticum. Ureaplasmas were present in 53.8% of men with NSU, in 28% of men with gonorrhoea, and in 32.9% of men with no urethritis. Detection rates for ureaplasmas in patients with chlamydia-negative and chlamydia-positive NSU were similar, but ureaplasmas were present in significantly greater numbers in patients with chlamydia-negative NSU than in those with chlamydia-positive NSU.

Animals↗
PubMed1994

Chlamydia trachomatis in women: the more you look, the more you find.

OBJECTIVE: To determine the extent to which testing of multiple sites and samples is required to define whether a woman is Chlamydia trachomatis-positive. DESIGN: One-hundred and fifty women attending the Genitourinary Medicine clinic at St Mary's Hospital were enrolled; they had not received antichlamydial antibiotics in the previous three months, were not in a high-risk group for HIV infection, or pregnant, or using an intrauterine contraceptive device. Thirty-two women were re-examined three months after recruitment. METHODS: An urethral specimen was Gram stained (smear) and cultured for gonococci. Another urethral specimen was taken to detect C trachomatis elementary bodies (EBs) by the MicroTrak direct fluorescent antibody (DFA) test (Syva). An endocervical swab specimen was Gram stained (smear) and cultured for gonococci. One of two other endocervical swabs was used for the DFA test and was then placed in medium which was centrifuged in a MicroCentaur at 13,000 rpm for 10 min; the deposit was examined by using the DFA test. The first 15-20 ml of voided urine (first pass urine; FPU) was also centrifuged and the deposit tested similarly. RESULTS: Of 182 cervical smears and/or deposits tested for C trachomatis, 38 were positive; more cervical deposits (37) than smears (26) were positive and, of these, one-fifth of the deposits and one-third of the smears contained fewer than 10 elementary bodies. Of 162 paired urethral smears and FPU deposits available, one or other specimen of 36 pairs was chlamydia-positive, that is 31 smears and 32 deposits; of these, two-fifths of the smears and half of the deposits contained fewer than 10 EBs. Of 150 sets of cervical and urinary tract samples tested, 31 were chlamydia-positive at both sites, six in the cervix alone and four in the urinary tract alone. Of 139 women for whom there were valid first visit sample results, 36 (26%) were chlamydia-positive in the cervix, 34 (25%) in the urinary tract and 41 (29%) had at least one sample from either site positive. Overall, DFA tests of deposits from centrifuged cervical specimens achieved the highest sensitivity (88%) and those of cervical smears the lowest (70%). CONCLUSIONS: Deposits from centrifuged cervical specimens were C trachomatis-positive more often than were cervical smears. Testing deposits from centrifuged urines was as successful as testing urethral smears. One-fifth (cervical deposits) to one-half (urine deposits) of specimens contained fewer than 10 EBs. The urinary tract was chlamydia-positive almost as frequently as the cervix but both sites needed to be tested to define whether a woman was chlamydia-positive.

Cervix Uteri↗
PubMed2000

Assessment of Chlamydia trachomatis prevalence by PCR and LCR in women presenting for termination of pregnancy.

OBJECTIVES: To determine the prevalence of Chlamydia trachomatis in a patient population presenting for legal termination of pregnancy by polymerase chain reaction (PCR) and ligase chain reaction (LCR), from first catch urine and self administered tampons, and comparing with the traditionally collected endocervical swab tested by both PCR and culture. METHODS: Consecutive women attending for legal termination of pregnancy were screened for chlamydia by patient collected first catch urine and tampon, and physician collected endocervical swab. RESULTS: Of 1175 patients with complete samples, there were 33 (2.8%) in whom chlamydia was detected by two or more assays from one or more sample site. Chlamydia was detected equally well by both PCR and LCR in first catch urine (p = 0.25), tampon (p = 0.5), and endocervical swab (p = 0.5). However, both PCR and LCR were significantly better than culture of an endocervical swab (p = 0.0005) for detection of C trachomatis. CONCLUSION: The prevalence of chlamydia in patients presenting for termination of pregnancy was 2.8%. A simple efficient way of performing screening for chlamydia for women presenting for termination of pregnancy is by first catch urine or tampon, which can be tested by the highly sensitive amplification assays, PCR or LCR.

Abortion, Legal↗
PubMed2002

Investigation into the acceptability and effectiveness of a new contact slip in the management of Chlamydia trachomatis at a London genitourinary medicine clinic.

OBJECTIVES: To improve contact tracing for chlamydia. To determine (i) the acceptability to patients of using a contact slip that named chlamydia as the sexually transmissible infection that the contact may have been at risk of acquiring, and (ii) whether an augmented contact slip issued for chlamydia significantly increased the number of sexual partners attending for treatment. METHODS: For a 2 month period, all consecutive heterosexual patients diagnosed with chlamydia at the Mortimer Market Centre (MMC) were offered one or more coded contact slips (CS1) as per clinic protocol. During this time, and for 1 month afterwards, contacts presenting as a result of receiving these contact slips were recorded. This was compared to a subsequent 2 month period during which a contact slip naming chlamydia as the potential infection, with an information leaflet attached (CS2), was issued. Contacts attending as a result of receiving this augmented contact slip were recorded over a similar period. For both cohorts the number of patients refusing either contact slip, and contacts attending other GUM clinics, were recorded. RESULTS: 121 patients were diagnosed with chlamydia and were seen by a health adviser in period one and 130 patients were diagnosed and seen in period two. There was no significant difference detected between the acceptability of CS1 and CS2 (one refusal per cohort). There was a significant increase in the number of sexual contacts attending for treatment after being given CS2 (160 attending of 190 contact slips issued (84%, 95% CI 79 to 89)), compared to CS1 (48 attending of 144 contact slips issued (33%, 95% CI 26 to 43)). CONCLUSIONS: An infection specific contact slip was equally acceptable to patients as the standard contact slip, and it significantly increased the number of sexual contacts attending for treatment.

Adolescent↗
PubMed1992

Specificity of the microimmunofluorescence assay for the serodiagnosis of Chlamydia pneumoniae infections.

Chlamydia pneumoniae infections are mostly confirmed using an indirect microimmunofluorescence test for which potential cross-reactions between antigens from different chlamydial species are not well documented. Using this assay, 928 sera (507 subjects) submitted for Chlamydia pneumoniae serology were tested for specific IgM and IgG to this bacteria using the TW-183 antigen. IgM and IgG reactivities to Chlamydia trachomatis serotypes C, D, E, and L2 and Chlamydia psittaci strain 6BC antigens were also tested. A sample was interpreted as positive only when evenly fluorescent elementary bodies were observed. Twenty-five subjects (4.9%) showed serological evidence of recent Chlamydia pneumoniae infection (IgM positive and (or) IgG seroconversion); 11 of them also showed serological evidence of recent infection with at least one other chlamydial species. Specificity was 50 and 63% for IgM and IgG detection, respectively. These results suggest that mixed or temporally related infections might occur, or, more likely, that some Chlamydia pneumoniae IgM or IgG reactivities might be due to heterotypic antibodies.

Adolescent↗
PubMed2005

The bronchial lavage of pediatric patients with asthma contains infectious Chlamydia.

There has been a worldwide increase in the incidence of asthma, and the disease has greatly impacted the public health care system. Chlamydia pneumoniae has been reported as a possible contributing factor in asthma. The organism has been detected by polymerase chain reaction (PCR) in bronchial tissue, but there has been no direct evidence of viability. To determine the frequency of viable Chlamydia in children, blood and bronchoalveolar lavage were collected from 70 pediatric patients undergoing flexible fiberoptic bronchoscopy. Forty-two of these patients had asthma, whereas the remaining patients had various respiratory disorders. Fifty-four percent (38) of the bronchoalveolar lavage samples were PCR-positive for Chlamydia, and 31% (22) of the PCR-positive samples were positive when cultured on macrophages. Twenty-eight samples (40%) and 14 samples (20%) of the PCR- and culture-positive samples, respectively, were from patients with asthma. Culture of the blood samples revealed that 24 (34.3%) of 70 were positive for Chlamydia compared with 8 (11%) of 70 matched nonrespiratory control subjects (p < 0.01); 17 (24%) of the positive blood cultures from the respiratory group were from patients with asthma. Elevation of total IgE was strongly associated with lavage culture positivity for Chlamydia. We therefore conclude that viable Chlamydia pneumoniae organisms are frequently present in the lung lavage fluid from this cohort of predominantly asthmatic pediatric patients.

Adolescent↗
PubMed2003

Screening for genital chlamydia infection: DNA amplification techniques should be the test of choice.

Our objective was to compare the sensitivities for the detection of Chlamydia trachomatis, of the ligase chain reaction (LCR) on first voided urine (FVU) specimens and enzyme immunoassay (EIA) on pooled endocervical/endourethral swabs from women and endourethral swabs from men. Men and women taking part in the UK chlamydia screening pilot were tested for chlamydia using LCR on a FVU. Patients attending genitourinary medicine clinics also had cervical and/or urethral swabs taken for chlamydia testing by EIA. In women, EIA on pooled swabs detected 575 of the 785 chlamydia positives and in men, EIA detected 209 of 351 positives. The sensitivity of EIA was 73% and 60% in women and men respectively. By using the EIA test, therefore, 27-40% of patients infected with chlamydia will be given a false negative result. We propose that it is unethical to use non-molecular testing in the future.

Adolescent↗
PubMed1998

Clinical study of the effectiveness of a dual amplified immunoassay (IDEIA PCE Chlamydia) for the diagnosis of male urethritis.

A clinical study of patients with male urethritis (n=316) was undertaken to determine the sensitivity potential for a new dual amplified immunoassay (IDEIA PCE Chlamydia). Increased sensitivity (98.8%, 84/85) was obtained for IDEIA PCE Chlamydia compared to a conventional antigen detection test (IDEIA Chlamydia, 81.2%, 69/85) when testing urine samples. In a smaller patient population (n=104) the positivity rate for the first-void urine tested with IDEIA PCE Chlamydia of 30.8% (32/104) was similar to the 27.9% (29/104) obtained from urethral swabs tested with a DNA probe assay (PACE 2). The increased sensitivity of the test was confirmed with a commercial PCR kit (Amplicor) and nested PCR. The IDEIA PCE Chlamydia kit has the sensitivity potential to be a clinically reliable alternative for detecting Chlamydia trachomatis.

Chlamydia Infections↗
PubMed2003

Contemporary approaches to designing and evaluating vaccines against Chlamydia.

The clinically relevant pathologic consequences of primary ocular, genital, or respiratory human infection by members of the genus Chlamydia are conjunctivitis, cervicitis, urethritis and sinusitis. The major complications and sometimes debilitating evolutionary outcomes of these infections include: trichiasis and cicatrizing trachoma, endometritis or pelvic inflammatory disease and involuntary tubal factor infertility and bronchopulmonary pneumonia. These diseases, in addition to other chlamydia-associated chronic syndromes (e.g., artherosclerosis, multiple sclerosis and Alzheimer's disease), pose serious public healthcare and huge budgetary concerns. The current medical opinion is that an efficacious prophylactic vaccine is a sine qua non--to control the morbidity of chiamydial infection in the human population. The research goal for an efficacious human chlamydial vaccine has faced key challenges to define the elements of protective immunity to facilitate vaccine evaluation, the judicious selection of appropriate vaccine candidates that possess stable antigenic and immunologic properties and the development of effective delivery vehicles and adjuvants to boost immune effectors to achieve long-term protective immunity. Progress in the functional immunobiology of Chlamydia has established the essential immunologic paradigms for vaccine selection and evaluation, including the obligatory requirement for a vaccine to induce T-helper Type 1 immune response that controls chlamydiae. Recent advances in chlamydial genomics and proteomics should enhance the identification of likely chlamydial gene products that fulfill the antigenic requirements of putative vaccine candidates. Major inroads are however needed in the construction and development of novel and effective delivery systems, such as vectors and adjuvants. This review summarizes the status of contemporary chlamydial vaccine research and promising trends fueling the growing optimism for an efficacious vaccine. The unified approach to vaccines for the genus Chlamydia is validated by the several conserved genes and common immunogenic proteins among member species and the similarity of immune effectors controlling Chlamydia species in animals and humans.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Evaluation of parameters for laboratory diagnosis of genital female infection by Chlamydia trachomatis].

In order to evaluate the occurrence of Chlamydia trachomatis, we have examined samples of cervical swabs from 189 women (166 of which were symptomatic and the remaining 23 were asymptomatic with regard to chlamydial infection. Two specimens from the endocervical channel were collected and examined by immunofluorescent assay (DIF) and Chlamydia isolation. Detection of IgG and IgA antibodies specific to C. trachomatis was also effected by indirect immunofluorescent assay (IIF), in a cervical secretion sample. We succeeded in isolating chlamydia in 14 (8.4%) symptomatic and 3 (13%) asymptomatic women. The observation that the 152 symptomatic patients with negative results from chlamydia culture presented similar symptoms of disease, indicating that there is no specific symptom for genital infection caused by Chlamydia (p > 0.05). All the 13 (76.5%) positive endocervical specimens, as determined by cell culture and DIF reaction, presented more than 5 epithelial cells in the smears. These cells may represent an interference factor to the positivity of cell culture (p < 0.001). Antibodies of the IgG and/or IgA classes were detected in 11 (64.7%) out of 17 women with positive chlamydia culture, considering as positive the IIF titre of > or = 8. Consequently, this method can not be used as an alternative means of diagnosis, particularly in the earlier stages of chlamydial genital infections, since the presence of the antibodies depends on the phase of the infection and on the individual humoral immune response.

Adult↗
PubMed2002

Clinical management of chlamydia in general practice: a survey of reported practice.

BACKGROUND: Chlamydia trachomatis is the most common curable sexually transmitted infection (STI) in the UK. Prevalence of the infection in different health care settings has been found to be between 2% and 29% and diagnoses of the infection continue to rise significantly. It is estimated, however, that only 10% of all chlamydial infections are seen and treated in genitourinary medicine (GUM) clinics. Few data exist about the actual practice patterns of primary care providers in the management of chlamydia. The management of patients identified with the infection within this setting warrants attention. AIMS: To determine general practitioners' (GPs') and nurses' reported clinical practice in the management of genital chlamydial infection. To design a needs-based education guideline on the management of chlamydia in rural primary care. DESIGN: An anonymous, confidential, self-administered postal questionnaire was sent to all GPs and cervical cytology practice nurses in 84 practices in Dyfed Powys Health Authority (DPHA) area, Wales, UK. RESULTS: Following two mailings of the survey, responses were obtained from 75/84 practices (response rate 89%). A total of 130/307 GPs (response rate 42%) and 72/152 nurses (response rate 47%) in these practices responded. The data demonstrated that few tests for chlamydia are being carried out in general practice: 42% (55/130) of GPs and 54% (37/72) of nurses reported carrying out between one and four tests a month, and 35% (46/130) of GPs and 29% (21/72) of nurses reported performing less than one test a month. Very few positive results are being obtained. The majority of GPs (72%) and nurses (68%) routinely use the appropriate endocervical swab when testing for chlamydia, however 19% of GPs and 20% of nurses are using either an incorrect wooden-stemmed swab or are taking an inappropriate high vaginal swab. CONCLUSIONS: Few chlamydia tests are being performed in primary care in DPHA, Wales. Health professionals in general practice are in need of, and are in favour of, up-to-date training on all aspects of chlamydial identification and management in primary care. Attention needs to be focused upon resources and the paucity of GUM services and their access within the DPHA area.

Chlamydia Infections↗
PubMed2006

Relationship of cervical ectopy to chlamydia infection in young women.

OBJECTIVE: Genital Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection (STI) in the UK. Behaviours including multiple sex partners and inconsistent condom use, and biological factors such as cervical ectopy, may increase susceptibility to STIs. Cervical ectopy is thought to increase risk of chlamydia infection by exposing columnar epithelium to a potential infectious inoculum. This study aimed to determine whether chlamydia was more prevalent in young women with cervical ectopy. METHODS: Clinical notes of women aged 16-24 years attending the Portsmouth Genitourinary Medicine Clinic for an STI screen during the period May-July 2003 were reviewed retrospectively. Information collected included the presence or absence of cervical ectopy, smoking habits, methods of contraception, number of sexual partners in the previous 3 months, and previous STIs. Chlamydia infection was diagnosed by using strand displacement amplification on cervical swabs. RESULTS: A total of 231 women were included in the study. The mean age was 19.8 years. Evidence of cervical ectopy was found in 107 women. Chlamydial infection was detected in 37.4% (40/107) of those women with cervical ectopy and 21.8% (27/124) in those without cervical ectopy. This difference was statistically significant (p = 0.009). The significance remained even when accounting for confounding variables. CONCLUSIONS: Cervical ectopy is a common physiological process in young women. Recognition of cervical ectopy should alert the clinician to the possibility of a genital chlamydia infection. Opportunistic screening for chlamydia in young people should be offered to reduce the prevalence of infection and its sequelae.

Adolescent↗
PubMed1988

Induced abortion: Chlamydia trachomatis and postabortal complications. A cost benefit analysis.

The overall prevalence of Chlamydia trachomatis among 873 abortion-seeking women was 9.3% during 1985. Significantly higher age-specific prevalences of C. trachomatis occurred among younger women (p less than 0.001). None of 17 women treated for C. trachomatis before the abortion was carried out, was readmitted to the hospital. Of 64 Chlamydia-positive women, who commenced treatment within the first 2 weeks after the abortion was carried out, 14.1% were readmitted to the hospital, compared with 5.7% of Chlamydia-negative women (p less than 0.02). Postabortal salpingitis was verified at readmission among 10.9% of Chlamydia-positive women and 3.2% of Chlamydia-negative women (p less than 0.01). An analysis of screening of all abortion-seeking women is estimated to be worthwhile when the prevalence of C. trachomatis exceeds 4.3%. We recommend screening for Chlamydia trachomatis of all abortion-seeking women, 30 years or younger, at the pre-abortion visit, provided that treatment can be completed before the abortion is carried out.

Abortion, Induced↗
PubMed1997

Reduced prevalence of cervical Chlamydia infection among women requesting termination.

BACKGROUND: The prevalence and pattern of Chlamydia trachomatis infection among women requesting induced abortion in the three year period 1992-95 was evaluated and compared to the results of a previous study in 1982-84, where the prevalence of chlamydial infection had been 13.5%. METHODS: A total of 1995 women requested termination, 1855 (93%) of whom were tested for Chlamydia and were included in the study. Two types of tests for chlamydial infection, ELISA and PCR, were used in two consecutive periods. In addition cultures for gonorrhea were done in each case. Information on age, marital status, parity, gestational age and the results of chlamydia and gonorrhea tests of the women and sexual partners were recorded. RESULTS: Chlamydia trachomatis positive women were 149 (8.0%), a significant reduction from the previous 1982-84 study (p<0.001). Women with positive tests were significantly younger (80% < or = 25 years of age; p<0.001) and more frequently single (86.6%; p<0.001), than those with negative tests, as in the previous period. Of the partners, 80.4% were contacted, and 52.1% presented for investigation. Of those tested 42.1% were Chlamydia positive. Four women (0.2%) had Neisseria gonorrhea but none of the partners. CONCLUSIONS: The prevalence of Chlamydia trachomatis is receding among women coming for termination of pregnancy. As treatment before or at operation has repeatedly been shown to be of benefit and since the prevalence is still considerable, continued screening of these women is justified.

Abortion, Legal↗
PubMed2002

A community based study of urogenital chlamydia trachomatis in males aged fifteen years and above, Dembia District, northwest Ethiopia.

Chlamydia trachomatis is one of the most common causes of sexually transmitted diseases in sexually active males and females. Infertility is one of the serious complications of urogenital chlamydial infections. This study was carried out in Chuwahit town and the surrounding village, which is located southwest of Gondar town. The main objective was to estimate the prevalence of urogenital Chlamydia trachomatis among males aged fifteen years and above. The design used was a cross sectional survey. First catch urine was collected from males 15 years and above and interviews were made using a questionnaire. The urine samples were tested with an Enzyme Immuno-Assay (EIA), which is useful in rapid detection of chlamydia antigen. Among 199 males included in the study, thirty-three (16.6%) had laboratory evidence of urogenital Chlamydia trachomatis. The mean (SD) age of the study subjects was 29.3 (+/- 9) years. Students (8 out of 21, 38%) had the highest prevalence of urogenital Chlamydia compared to the other groups (OR = 4.10, 95% CI = 1.12, 14.48). The magnitude of urogenital chlamydia infection in males was high in the study area. Health professionals need to consider genital Chlamydial infections in the management and control of sexually transmitted diseases. Increasing the awareness of students towards urogenital Chlamydial trachomatis and teaching them about the benefits of using condoms is recommended.

Adolescent↗
PubMed1992

The molecular biology and diagnostics of Chlamydia trachomatis.

The rapid development of biotechnological methods provides the potential of dissecting the molecular structure of microorganisms. In this review the molecular biology of chlamydia is described. The genus Chlamydia contains three species C. trachomatis, C. psittaci, and C. pneumonia which all are important human pathogens. Chlamydia is obligate intracellular bacteria with a unique biphasic life cycle. The extracellularly chlamydial elementary bodies (EB) are small, metabolic inactive, infectious particles with a tight outer cell membrane. After internalization into host cells the chlamydial structure changes, they transform to reticulated bodies (RB) which become larger, metabolically active, and start to replicate. Fourtysix hrs post infection RB reorganizes to EB followed by burst of the inclusion. The structure of the EB outer membrane differs from the membrane of gram-negative bacteria since it is highly cross-linked by S-S bridges. There are, however, also similarities to gram-negative cell walls. The chlamydial major outer membrane protein, Omp1, forms pores and is closely associated with lipopolysaccharide, LPS. LPS, however, is more loosely associated with Omp1 than in other gram negative bacteria since incubation of EB with antibodies against LPS will liberate it from the chlamydial surface. Therefore the surface localized LPS may be important for chlamydial survival. OMP1 varies between the different serovar of C. trachomatis. Several very conserved regions are separated by variable domains. The variable domains are very antigenic and are localized at the surface of EB. After chlamydial internalization into the host cell transition to RB starts. Some of the early proteins are DnaK-like and groEL-like heat-shock proteins. The chlamydial DnaK-like protein is very antigenic. Patient serum samples will recognize the chlamydial DnaK-like protein. From the determined DNA sequence the amino acid sequence was determined. It was 57% homologous to the Eschrichia coli DnaK protein. Also the GroEL-like protein is antigenic and very conserved. Factors of importance for pathogenicity of chlamydia have not yet been found. The adhesin(s) is unknown, and no factor of importance for the inhibition of fusion between phagosome and host cell lysosomes has been described. A protein similar to the mip gene product of Legionella pneumofila may be a possible candidate for a pathogenicity factor. Diagnosis of C. trachomatis infections has been done by chlamydia cultivation in tissue culture cells, by immunofluorescence and by ELISA. A new method based on the polymerase chain reaction (PCR) has been developed. As primers sequences from the common plasmid were used. This method has high sensitivity and specificity and does not require live chlamydia.(ABSTRACT TRUNCATED AT 400 WORDS)

Amino Acid Sequence↗
PubMed2001

[Detection of genital tract cytomegalovirus and Chlamydia trachomatis infection in patients with tubal pregnancy].

OBJECTIVE: To investigate the influence of genital tract cytomegalovirus and chlamydia infection on the incidence of tubal pregnancy. METHODS: Ninety-five women with tubal pregnancy (study group) and 42 women with ovarian cysts (control group) were selected for this study. Serum cytomegalovirus (CMV) IgM was identified by enzyme-link-immunosorbent-assay (ELISA). Cervical secretions, endometrium, and salpinx tissue were tested for CMV gH gene and chlamydia heat shock protein (HSP) gene by nest polymerase chain reaction (PCR) and PCR respectively. RESULTS: CMV IgM was positive in 14 (15%) women with tubal pregnancy, and 1 (2%) in the control group. CMV gH gene was detected in 18 women (19%) and chlamydia HSP gene in 25 (26%) of the tubal pregnancy group, and 2 (5%) and 2 (5%) in the control group respectively. There were significant differences between the study and the control group (P < 0.05) with respect to detection of CMV IgM, CMV gH gene and chlamydia HSP gene. CONCLUSIONS: CMVand chlamydia trachomatis genital tract infection were more common in women with tubal pregnancy than that in the control group. Genital CMV and chlamydia trachomatis infection may associate with an increased incidence of tubal pregnancy.

Antibodies, Viral↗