[Chlamydia trachomatis infection in women and the use of oral contraceptives]

Abstract

We determined the prevalence of genital Chlamydia trachomatis infection in women who visited a clinic for sexually transmitted diseases (STD) and the influence of the number of partners and the use of oral contraceptives (OC), with special attention to the recognition of pelvic inflammatory disease (PID) and to the results of therapy. Of 217 women, with a mean age of 26 years (range 14-56), who visited the STD clinic of the University Hospital of Groningen from July 1985 until November 1987, anamnestic data were collected as well as the results of swabs from cervix and urethra taken for culture and direct immunofluorescence test of C. trachomatis and for gonococcal culture. The influence of the number of partners (1 versus greater than 1) and OC on the prevalence of C. trachomatis infection was evaluated by logistic regression analysis. PID was excluded in coöperation with the department of gynaecology. C. trachomatis-infected women were treated by doxycycline orally (day 1 2 x 100 mg, day 2-7 1 x 100 mg) according to the dosage scheme advised by the Dutch Health Council in 1986. A control culture was taken 2-3 weeks after treatment. C. trachomatis was detected in 72/217 (33%) women by culture and (or) direct IF test and in 22/41 (54%) women with gonorrhoea. In connection with the number of partners in the year preceding the examination, the following prevalences were found: 18/74 (24%) (1 partner), 43/108 (40%) (2-5 partners) and 10/27 (greater than 5 partners).(ABSTRACT TRUNCATED AT 250 WORDS)

PIP: The authors determined the prevalence of genital Chlamydia trachomatis infection in women who visited a clinic for sexually transmitted diseases (STDS) and the influences of the number of partners and of the use of oral contraceptives (OCs), with special attention paid to the recognition of pelvic inflammatory disease (PID) and to the results of therapy. Of 217 women with a mean age of 26 years (range 14-56), who visited the STD clinic of the University Hospital of Groningen from July 1985-November 1987, anamnestic data were collected as well as the results from swabs of the cervix and urethra taken for culture and direct immunofluorescence (IF) test of C. trachomatis and for gonococcal culture. The influence of the number of partners (1 vs 1) and OCs on the prevalence of C. trachomatis infection was evaluated by logistic regression analysis. PID was excluded in cooperation with the department of gynecology. C. trachomatis-infected women were treated by doxycycline orally (day 1, 2x 100 mg, days 2-7, 1x 100 mg) according to the dosage scheme advised by the Dutch Health Council in 1986. A control culture was taken 2-3 weeks after treatment. C. trachomatis was detected in 72/217 (33%) of the women by culture and/or direct IF test and in 22/41 (54%) women with gonorrhea. In connection with the number of partners in the year preceding the examination, the following prevalences were found: 18/74 (24%, 1 partner), 43/108 (40%, 2-5 partners), and 10/27 (5 partners). The prevalence among OC-using women was significantly higher (p0.05) than in non-OC using women: 44.101 (44%) vs 21/93 (23%). This was also true when OC users were compared to sterilized women (9/47, 19%), regardless of number of partners and age. Active PID was found in 2 women, both infected. After treatment with positive C. trachomatis cultures, control cultures were negative in 39/40 (98%). A relatively high prevalence of genital C. trachomatis infection is found in women visiting STD clinics, as well as in women with only 1 partner during the year preceding the examination. This study supports the hypothesis of OC use being a risk factor. How OC use influences PID risk is not fully understood. Within the framework of reliable contraception and prevention of STD complications, the combination of OC + a barrier method should be advised to women without a steady partner. Further study is necessary to determine whether preventive antibiotic treatment of asymptomatic adolescents with anamnestic risk factors for C. trachomatis infection is indicated at the start of a new relationship. (author's modified)