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Significance of isolating non‐tuberculous mycobacterial organisms in infertile women with tubal disease: an observational study
Author(s) -
Radha Bai Prabhu T,
Pandiyan N,
Sujatha N,
Jawahar MS
Publication year - 2019
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.15814
Subject(s) - infertility , chlamydia trachomatis , tuberculosis , chlamydia , mycobacterium tuberculosis , medicine , gynecology , pelvic inflammatory disease , hysterosalpingography , neisseria gonorrhoeae , disease , hydrosalpinx , female infertility , biology , immunology , microbiology and biotechnology , pathology , pregnancy , genetics
Objectives To explore whether non‐tuberculous mycobacteria ( NTM ) are associated with tubal disease leading to infertility. Design Prospective observational study. Setting Teaching hospital. Population Women with tubal factor infertility. Methods In all, 173 infertile women with tubal disease were investigated for genital tuberculosis, Chlamydia trachomatis and Neisseria gonorrhoeae using polymerase chain reaction, culture and histopathological examination. On culture, NTM were grown in 23.7% of endometrial samples. The mycolic characteristics of these organisms were analysed. Main outcome measure Whether NTM are associated with tubal disease leading to infertility. Results The organisms identified in association with tubal disease were Mycobacterium tuberculosis in 30%, gonococci in 1.7%, Chlamydia in 7.5% and NTM in 23.7% of cases. Mycobacterium chelonae was the predominant organism identified by high‐performance liquid chromatography. In ten women, for whom there was laparoscopic evidence of tubal disease, the only organism that was grown was NTM , and the tests for other organisms were negative. Tests for possible environment (theatre, instruments) contamination was reported negative. Conclusion While evaluating infertile women for tubal disease, culture studies revealed a high prevalence of NTM in the endometrium. In the absence of M. tuberculosis , gonococci and Chlamydia infection, the presence of NTM suggests the possibility that these organisms may be responsible for tubal damage leading to infertility. Tweetable abstract On evaluating the causes of tubal disease, NTM were associated with tubal disease.