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.
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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.
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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.
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