Introduction
Pelvic inflammatory disease (PID) affects 8% of reproductive-age. However, these pathogens are only detected in a third of PID patients, raising the question whether CT/NG-positive-PIDs differ from CT/NG-negative-PIDs clinically. There is not enough data on the difference in clinical presentation and complications between PID with these sexual transmitted bacteria and PID caused by other organisms.
Our objective was to examine the characteristics of CT and GC infection in comparison with other types of microbial infection among women admitted to our department for Intravenous Antibiotic treatment for clinically diagnosed PID.
Materials & Methods
This retrospective, single-center cohort study compared CT\GC PID patients with non-CT\GC PID patients admitted to The Gynecology department between 2010 and 2016. All patients admitted for PID were taken vaginal, cervical and urinary culture and urine PCR for detection of CT and GC. A random control group of a 100 non-CT\GC PID patients was selected. Pain was measured by VAS scale
Results
A Group of 100 PID patients with positive PCR for CT\GC (83 patients were positive for CT; 17 patients were positive for GC) was identified. The control group included 23% Escherichia coli, 18% other gram-negative bacteria, 25% Streptococcus species, 17% staphylococcus species, 13% enterococcus and 4% other Gram-positive bacteria.
The patients in the study group were 4 years younger in average(p=0.0008), which may explain their lower gravidity and parity. Their BMI was higher(p=0.0001) and they had more cases of recurrent PIDs (0.0001). Their criteria for hospitalization was less likely to be Unresponsiveness to ambulatory antibiotics or admission following IUD insertion but more likely to be general poor condition. Pyosalpinxs was more frequent in the study group. However, there was no statistically significant difference in the number of patients undergoing surgery due to TOA. Days of hospitalization were the same between the groups (p=0.1589). Fever was more prevalent in the control group (58% vs. 34%, p=0.0010). There were no differences in other vital signs. Study group experienced higher pain levels during hospitalization (6.8±2.3 vs. 5.9±3.1, p=0.0207).
CRP was higher in the study group (5.5±5.5 vs. 1.9±4.0, p=0.0001) while no difference was found in WBC (p=0.4529).
Conclusions
Patients with PID who are CT/NG positive are younger, have more recurrent PID, lower gravidity and parity. These patients report more pain and are less likely to have normal US examination. There is no difference in the need of surgery among the groups.