RESUMEN
The prevalence of chlamydial DNA determined by PCR and in-situ hybridisation (ISH) in fresh tissue specimens (endometrium, fallopian tube and ovary) was investigated in 33 women presenting with ectopic pregnancy (EP), 14 women with tubal factor infertility (TFI) and 50 control patients from the UK and the West Indies. In the UK EP group, chlamydial DNA was detected by PCR in 56% of patients; similar results were found in the Trinidad EP group (67%). In the TFI group, chlamydial DNA was detected in (71%) of patients by PCR. The detection of Chlamydia trachomatis DNA by ISH was highest in the TFI group (43%). Women presenting with EP and TFI showed evidence of previous or current genital C. trachomatis infection, underlining the importance of this microorganism in the development of these conditions. Importantly, chlamydial DNA could be detected in DNA preparations from the endometrium, fallopian tube and ovary of EP and TFI patients at the time of surgery.
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Femenino , Research Support, Non-U.S. Gov't , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/microbiología , Chlamydia trachomatis/química , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Genitales Femeninos/microbiología , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/microbiología , Reino Unido/epidemiología , Hibridación in Situ , Infertilidad Femenina/epidemiología , Infertilidad Femenina/microbiología , Reacción en Cadena de la Polimerasa , Embarazo , Embarazo Ectópico/epidemiología , Embarazo Ectópico/microbiología , Prevalencia , Trinidad y Tobago/epidemiologíaRESUMEN
OBJECTIVE: To determine the prevalence of C. trachomatis in ectopic pregnancy by serum IgG and IgM antibody and by chlamydia DNA in endometrial, Fallopian tube and ovarian tissues. DESIGN AND METHODS: A cross-sectional study included 32 women presenting with tubal ectopic pregnancy and 94 fertile controls. Methods employed were ELISA for IgG and IgM and Polymerase Chain Reaction (PCR) and in situ hybridization (ISH) for DNA. RESULTS: Chlamydial IgG and IgM antibody detection was higher in the ectopic than the control groups (IgG, p<0.01; IgM, p<0.01). A similar finding was also noted for chlamydia DNA by PCR (p<0.05). DNA detection was also significantly higher at each site in the upper genital tract (endometrium p<0.01, Fallopian tube p<0.05, ovary p<0.05). CONCLUSION: By antibody detection, this study confirms the role played by genital tract C. trachoma infection and subsequently ectopic pregnancy, but more importantly, identifies chlamydial DNA in upper genital tract tissues. These results support allocation of resources towards screening programmes for C. trachomatis.(Au)