Risk of Sequelae after Chlamydia trachomatis Genital Infection in Women
Risk of Sequelae after Chlamydia trachomatis Genital Infection in Women
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DOI：
10.1086/652395
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发表时间：
2010-06-15
影响因子：
6.4
通讯作者：
Ness, Roberta B.
中科院分区：
文献类型：
--
作者：
Haggerty, Catherine L.;Gottlieb, Sami L.;Ness, Roberta B.
沙眼衣原体感染是美国最常见的可报告疾病，可导致盆腔炎（PID）、不孕、异位妊娠和慢性盆腔疼痛。虽然C.尽管在许多接受PID诊断的妇女中鉴定出沙眼衣原体，但PID的发病率和时间以及未经治疗的衣原体感染的长期后遗症尚未完全确定。这篇文章检查了作为疾病控制和预防中心衣原体免疫学和控制专家咨询会议的一部分审查的证据，包括24份报告。我们发现没有前瞻性研究直接评估未经治疗的C。沙眼感染几项研究评估了未经治疗的衣原体感染后的PID诊断，但比率差异很大，难以确定总体估计。在高风险环境中，2%-5%未经治疗的妇女在C检测阳性之间的2周内发生POD。并返回治疗。然而，在一般无症状人群中随访较长时间的PID进展率似乎较低。根据最大的研究，在任何原因的症状性PID发生后，高达18%的女性可能会发展为不孕症。在几项研究中，反复衣原体感染与POD和其他生殖后遗症有关，尽管很难确定每次感染的风险是否随着每次复发而增加。本审查批判性地评估这一机构的文献，并提出未来的研究方向。特别是，前瞻性研究评估了C。因此，需要更好的工具来测量盆腔炎和输卵管损伤，并需要对衣原体反复感染的自然史进行研究。
Chlamydia trachomatis infection, the most common reportable disease in the United States, can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. Although C. trachomatis is identified among many women who receive a diagnosis of PID, the incidence and timing of PID and long-term sequelae from an untreated chlamydial infection have not been fully determined. This article examines evidence reviewed as part of the Centers for Disease Control and Prevention Chlamydia Immunology and Control Expert Advisory Meeting; 24 reports were included. We found no prospective studies directly assessing risk of long-term reproductive sequelae, such as infertility, after untreated C. trachomatis infection. Several studies assessed PID diagnosis after untreated chlamydial infection, but rates varied widely, making it difficult to determine an overall estimate. In high-risk settings, 2%-5% of untreated women developed POD within the similar to 2-week period between testing positive for C. trachomatis and returning for treatment. However, the rate of PID progression in the general, asymptomatic population followed up for longer periods appeared to be low. According to the largest studies, after symptomatic PID of any cause has occurred, up to 18% of women may develop infertility. In several studies, repeated chlamydial infection was associated with POD and other reproductive sequelae, although it was difficult to determine whether the risk per infection increased with each recurrent episode. The present review critically evaluates this body of literature and suggests future research directions. Specifically, prospective studies assessing rates of symptomatic PID, subclinical tubal damage, and long-term reproductive sequelae after C. trachomatis infection; better tools to measure PID and tubal damage; and studies on the natural history of repeated chlamydial infections are needed.