[Detection of Legionella pneumophila by nested PCR-RFLP and ELISA on urine specimens of pregnant women with respiratory infections]

Pneumonia during pregnancy can induce serious consequences to the mother and the fetus, therefore its diagnosis and therapy is very important. There are few published articles on Legionella infection prevalence during pregnancy. In patients with Legionellosis, bacterial LPS and DNA are excreted into urine for extended periods, so combination of PCR and ELISA methods would be a good diagnostic tool. This research was done to determine the prevalence of L. pneumophila in pregnant women with respiratory infections. This is a cross-sectional study on 95 pregnant women with respiratory infection carried out during winter to summer 2006. Presence of Legionella infection was con-firmed by nested PCR-RFLP and antigen detection in urine specimens by ELISA method. The data were analyzed by SPSS, version 13, by using independent t tests, Fisher's exact test, ?2, a logistic model and McNemar's test, while considering p<0.05 as significant. The prevalence of infection using PCR was 22.1% [CI=14.1%-30.1%] and by ELISA it was 4.2% [CI=2%-8.2%]; this difference was statistically significant [p<0.005]. The most pre-valent clinical features were Cough [56.8%], headache [54.7%], abdominal pain [38.9%], chills [35.8%], fever [22.1%] and diarrhea [8.4%]. There were significant statistical relationships bet-ween cases with a positive CRP and fever, chills and abdominal pain and previous liver or renal problems [p<0.05, p<0.001]. There were significant relationships between fever and chills with ELISA results [p<0.05] but no relationships with other variables. There was a considerable prevalence of this infection in the studied population [22.1%]. It seems that performing PCR and ELISA tests on urine sample is suitable in detecting Legionella species and it can provide results in a less than a day_ a great help in the diagnosis and treatment of pneumonia especially during pregnancy

prevalence of chlamydia trachomatis infection by molecular analysis of urine samples in women attending OB and GYN clinics in Tehran

Chlamydia trachomatis is a common and curable STI which can be symptomatic or asymptomatic. Nowadays, PCR is a very sensitive diagnostic tool for detecting Chlamydia in urine and can be used in routine screening procedures as a noninvasive test. There are few studies on the prevalence of C. trachomatis in Iranian women and most of them have small sample sizes which are not suitable for epidemiological deductions. The aim of this study was to estimate the prevalence of urogenital C. trachomatis infections by PCR on urine samples of women in their fertility years and to evaluate the necessity of screening for asymptomatic infections in Iranian women. This WHO supported descriptive-analytical and cross-sectional study was performed on 1052, 15-49 year-old women. Participants were selected randomly from attendees of 5 Obstetric-Gynecologic clinics in Tehran during summer and fall of 2003. The research material consisted of a questionnaire and urine samples which were transported to Avesina Research Institute daily to extract their DNA and prepare them for PCR tests. The gathered data were analyzed by SPSS, version 11, and evaluated statistically by t-test, Chi-square, variance analysis and logistic regression, while considering p<0.05 as significant. The mean age of participants was 28.52 +/- 6.36 years. 56.2% of them had high school education, 94.2% were married, 91.8% were housewives, 32.5% were pregnant, 93.8% were sexually active, 99% of them were monogamous and 48.1% were on contraceptive methods. Among sexually active and non-pregnant participants, 10.4% were taking OCPs, 8.7% were using condoms, 16.3% had IUDs and the rest were on other contraceptive methods. In their reproductive history, 39% had vaginal discharges, 12.9% pelvic pains, 1% ectopic pregnancies, 21.2% abortions, 6.5% premature deliveries, 2.7% low birth weight infants and 7.2% were infertile. 129 subjects, [12.3%], had positive PCR tests. Statistically, there was no significant relationship between subjects, reproductive and personal histories of the subjects with the test results. Based on the estimated prevalence, it seems that chlamydial infection is prevalent in the studied population. In populations with prevalences higher than 4%, screening programs are recommended, so that Chlamydia screening can be considered as a part of health care programs in Iran to reduce the burden of the disease

Chlamydia and fertility

Chlamydia trachomatis infection is the most common sexually transmitted disease all around the world. For a long time, Chlamydia trachomatis has been recognized as the common cause of urethritis, cervicitis, and other complications such as pelvic inflammatory disease [PID], ectopic pregnancy, etc. However, today there is more concern on its role in male and female fertility and infertility and many studies have concentrated on this issue all over the world. There is good evidence based on seroepidemiologic studies on relationship between serum Chlamydial antibodies and infertility due to tubal factor in women with or without PID. However, there are many questions about Chlamydia trachomatis and its influence on IVF outcome and the exsisting information is controversial. The impact of Chlamydia trachomatis on male infetility is under investigation and it seems able to cause destruction of different parts of male genital tract in addition to high rate of transmission to women. With regard to these data, it seems that prevention, early diagnosis and treatment of Chlamydial infections are importart and cost effective

[Infections and infertility due to tubal factor]

Tubal factors are most important causes of infertility and are attributed to several etiologies. It seems that infections cause 10% to 70% of tubal factors and are strongly depended on patients age, numbers of infections and geogarphical and regional epidemiology. All types of tubal inflamations can impair fertility such as: acute salpingitis, tubo-ovarian abscess formation, asympothomatic involvement, and chronic salpingitis The most important organisms which parcipitate in acute salpigitis are caused by: Neiserria gonorrhea, Chlamydia trachomatis, anaerobe and gram negative organisms. The World Health Organization [WHO] and The Centre of Disease Control and prevention [CDC] have special attentions on rapid diagnosis and treatment of the disease for preventing further infertility and even fatal results. They suggest different empirical therapy protocols suspecting the most common organisms. Chlamydia trachomatis is the most common organism causing chronic Salpingitis. Mycobacterium tuberculosis and Coccidioies immitis are the next common organisms. With attention to their chronic coarse, epidemiology and patient's signs physician should choose different approaches