Prevalence of Chlamydia trachomatis and Other Bacterial Infections in Pelvic Inflammatory Disease - A Cross Sectional Study

BACKGROUND Pelvic inflammatory disease is a spectrum of diseases affecting the female upper genital tract. It is a poly microbial infection and Chlamydia trachomatis is the most common causative agent. We have undertaken this study with the objective of determining the prevalence of Chlamydia trachomatis infection in pelvic inflammatory disease (PID). METHODS This cross-sectional study consisted of 100 non-pregnant women with clinical features of PID. Endocervical, vaginal swabs and blood samples were collected from them. Polymerase-chain-reaction test (PCR) and enzyme-linked immunosorbent assay (ELISA) for chlamydial detection and Gram’s staining & culture for other pathogens were performed. Chi-square and Fisher’s exact tests were used to study association between the clinical features and Chlamydia trachomatis positivity. RESULTS The prevalence rate of chlamydia was 15.1 %. The other organisms isolated were candida species in 12.9 % and Escherichia coli in 5.3 % of the study population. There was no association between the various demographic variables, menstrual problems, fever, urinary symptoms, history of infertility, abortions, instrumentations and the presence of Chlamydia trachomatis. A significant association was found between the lower abdominal pain which increased during menstruation (P = 0.013) and the two clinical signs, cervical motion tenderness and uterine tenderness (P = 0.001) with the presence of Chlamydia trachomatis and other cervical infections. CONCLUSIONS The prevalence rate of Chlamydia trachomatis in pelvic inflammatory disease was 15 % and other organisms isolated from the cervical swabs were candida species and Escherichia coli. KEY WORDS Pelvic Inflammatory Diseases, Chlamydia trachomatis