Skip to main content
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1989 Feb 1;140(3):297–301.

Endocervical Chlamydia trachomatis infection in Canadian adolescents.

E G Hughes 1, J Mowatt 1, J E Spence 1
PMCID: PMC1268626  PMID: 2914240

Abstract

The highest prevalence rate of sexually transmitted chlamydial infection is among adolescent girls. To determine the rate among predominantly asymptomatic girls who were seen at a pediatric gynecology unit and to identify those at high risk we screened 541 such patients from Jan. 1 to Dec. 31, 1986, by means of direct fluorescent antibody testing; 422 (78.0%) were asymptomatic. The most common reason for presentation was a request for contraceptive advice (the reason for 59.2% of the patients). Of the 446 patients (82.4%) who were sexually active 66 (14.7%) had evidence of chlamydial infection; none of the 93 sexually inactive patients were infected. Neisseria gonorrhoeae was isolated from eight (1.5%) of the patients. The risk factors that correlated with chlamydial infection were abnormal vaginal discharge, abdominopelvic pain and an abnormal Papanicolaou test result. Because of the high morbidity rate associated with genital chlamydial infection and the high prevalence rate among adolescent girls, most of whom are asymptomatic, all sexually active teenagers should be screened.

Full text

PDF
297

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alexander E. R., Harrison H. R. Role of Chlamydia trachomatis in perinatal infection. Rev Infect Dis. 1983 Jul-Aug;5(4):713–719. doi: 10.1093/clinids/5.4.713. [DOI] [PubMed] [Google Scholar]
  2. Anestad G., Lunde O., Moen M., Dalaker K. Infertility and chlamydial infection. Fertil Steril. 1987 Nov;48(5):787–790. doi: 10.1016/s0015-0282(16)59531-4. [DOI] [PubMed] [Google Scholar]
  3. Baselski V. S., McNeeley S. G., Ryan G., Robison M. A comparison of nonculture-dependent methods for detection of Chlamydia trachomatis infections in pregnant women. Obstet Gynecol. 1987 Jul;70(1):47–52. [PubMed] [Google Scholar]
  4. Bowie W. R., Jones H. Acute pelvic inflammatory disease in outpatients: association with Chlamydia trachomatis and Neisseria gonorrhoeae. Ann Intern Med. 1981 Dec;95(6):685–688. doi: 10.7326/0003-4819-95-6-685. [DOI] [PubMed] [Google Scholar]
  5. Brunham R. C., Binns B., McDowell J., Paraskevas M. Chlamydia trachomatis infection in women with ectopic pregnancy. Obstet Gynecol. 1986 May;67(5):722–726. doi: 10.1097/00006250-198605000-00022. [DOI] [PubMed] [Google Scholar]
  6. Embil J. A., Pereira L. H. Prevalence of Chlamydia trachomatis and genital mycoplasmas in asymptomatic women. Can Med Assoc J. 1985 Jul 1;133(1):34–35. [PMC free article] [PubMed] [Google Scholar]
  7. Fraser J. J., Jr, Rettig P. J., Kaplan D. W. Prevalence of cervical Chlamydia trachomatis and Neisseria gonorrhoeae in female adolescents. Pediatrics. 1983 Mar;71(3):333–336. [PubMed] [Google Scholar]
  8. Gjønnaess H., Dalaker K., Anestad G., Mårdh P. A., Kvile G., Bergan T. Pelvic inflammatory disease: etiologic studies with emphasis on chlamydial infection. Obstet Gynecol. 1982 May;59(5):550–555. [PubMed] [Google Scholar]
  9. Golden N., Hammerschlag M., Neuhoff S., Gleyzer A. Prevalence of Chlamydia trachomatis cervical infection in female adolescents. Am J Dis Child. 1984 Jun;138(6):562–564. doi: 10.1001/archpedi.1984.02140440046010. [DOI] [PubMed] [Google Scholar]
  10. Gump D. W., Gibson M., Ashikaga T. Evidence of prior pelvic inflammatory disease and its relationship to Chlamydia trachomatis antibody and intrauterine contraceptive device use in infertile women. Am J Obstet Gynecol. 1983 May 15;146(2):153–159. doi: 10.1016/0002-9378(83)91044-x. [DOI] [PubMed] [Google Scholar]
  11. Handsfield H. H., Jasman L. L., Roberts P. L., Hanson V. W., Kothenbeutel R. L., Stamm W. E. Criteria for selective screening for Chlamydia trachomatis infection in women attending family planning clinics. JAMA. 1986 Apr 4;255(13):1730–1734. [PubMed] [Google Scholar]
  12. Hawes L. A., Gilbert G. L. Seroepidemiology of Chlamydia trachomatis infection in infertile women in Melbourne. Med J Aust. 1986 Nov 17;145(10):497–499. doi: 10.5694/j.1326-5377.1986.tb139449.x. [DOI] [PubMed] [Google Scholar]
  13. Ingram D. L., Runyan D. K., Collins A. D., White S. T., Durfee M. F., Pearson A. W., Occhiuti A. R. Vaginal Chlamydia trachomatis infection in children with sexual contact. Pediatr Infect Dis. 1984 Mar-Apr;3(2):97–99. doi: 10.1097/00006454-198403000-00002. [DOI] [PubMed] [Google Scholar]
  14. Jones R. B., Mammel J. B., Shepard M. K., Fisher R. R. Recovery of Chlamydia trachomatis from the endometrium of women at risk for chlamydial infection. Am J Obstet Gynecol. 1986 Jul;155(1):35–39. doi: 10.1016/0002-9378(86)90073-6. [DOI] [PubMed] [Google Scholar]
  15. Kiviat N. B., Wølner-Hanssen P., Peterson M., Wasserheit J., Stamm W. E., Eschenbach D. A., Paavonen J., Lingenfelter J., Bell T., Zabriskie V. Localization of Chlamydia trachomatis infection by direct immunofluorescence and culture in pelvic inflammatory disease. Am J Obstet Gynecol. 1986 Apr;154(4):865–873. doi: 10.1016/0002-9378(86)90473-4. [DOI] [PubMed] [Google Scholar]
  16. Levallois P., Rioux J. E., Côté L. Chlamydial infection among females attending an abortion clinic: prevalence and risk factors. CMAJ. 1987 Jul 1;137(1):33–37. [PMC free article] [PubMed] [Google Scholar]
  17. Magnússon S. S., Oskarsson T., Geirsson R. T., Sveinsson B., Steingrímsson O., Thorarinsson H. Lower genital tract infection with Chlamydia trachomatis and Neisseria gonorrhoeae in Icelandic women with salpingitis. Am J Obstet Gynecol. 1986 Sep;155(3):602–607. doi: 10.1016/0002-9378(86)90287-5. [DOI] [PubMed] [Google Scholar]
  18. Martin D. H., Koutsky L., Eschenbach D. A., Daling J. R., Alexander E. R., Benedetti J. K., Holmes K. K. Prematurity and perinatal mortality in pregnancies complicated by maternal Chlamydia trachomatis infections. JAMA. 1982 Mar 19;247(11):1585–1588. [PubMed] [Google Scholar]
  19. Moscicki B., Shafer M. A., Millstein S. G., Irwin C. E., Jr, Schachter J. The use and limitations of endocervical Gram stains and mucopurulent cervicitis as predictors for Chlamydia trachomatis in female adolescents. Am J Obstet Gynecol. 1987 Jul;157(1):65–71. doi: 10.1016/s0002-9378(87)80347-2. [DOI] [PubMed] [Google Scholar]
  20. Møller B. R., Ahrons S., Laurin J., Mårdh P. A. Pelvic infection after elective abortion associated with Chlamydia trachomatis. Obstet Gynecol. 1982 Feb;59(2):210–213. [PubMed] [Google Scholar]
  21. Møller B. R., Allen J., Toft B., Hansen K. B., Taylor-Robinson D. Pelvic inflammatory disease after hysterosalpingography associated with Chlamydia trachomatis and Mycoplasma hominis. Br J Obstet Gynaecol. 1984 Dec;91(12):1181–1187. doi: 10.1111/j.1471-0528.1984.tb04734.x. [DOI] [PubMed] [Google Scholar]
  22. Møller B. R., Sparre Jørgensen A., From E., Stenderup A. Chlamydia, mycoplasmas, ureaplasmas, and yeasts in the lower genital tract of females. Comparison between a group attending a venereal disease clinic and a control group. Acta Obstet Gynecol Scand. 1985;64(2):145–149. doi: 10.3109/00016348509154708. [DOI] [PubMed] [Google Scholar]
  23. Quinn P. A., Petric M., Barkin M., Butany J., Derzko C., Gysler M., Lie K. I., Shewchuck A. B., Shuber J., Ryan E. Prevalence of antibody to Chlamydia trachomatis in spontaneous abortion and infertility. Am J Obstet Gynecol. 1987 Feb;156(2):291–296. doi: 10.1016/0002-9378(87)90270-5. [DOI] [PubMed] [Google Scholar]
  24. Quinn T. C., Gupta P. K., Burkman R. T., Kappus E. W., Barbacci M., Spence M. R. Detection of Chlamydia trachomatis cervical infection: a comparison of Papanicolaou and immunofluorescent staining with cell culture. Am J Obstet Gynecol. 1987 Aug;157(2):394–399. doi: 10.1016/s0002-9378(87)80180-1. [DOI] [PubMed] [Google Scholar]
  25. Shafer M. A., Beck A., Blain B., Dole P., Irwin C. E., Jr, Sweet R., Schachter J. Chlamydia trachomatis: important relationships to race, contraception, lower genital tract infection, and Papanicolaou smear. J Pediatr. 1984 Jan;104(1):141–146. doi: 10.1016/s0022-3476(84)80614-9. [DOI] [PubMed] [Google Scholar]
  26. Shafer M. A., Vaughan E., Lipkin E. S., Moscicki B. A., Schachter J. Evaluation of fluorescein-conjugated monoclonal antibody test to detect Chlamydia trachomatis endocervical infections in adolescent girls. J Pediatr. 1986 May;108(5 Pt 1):779–783. doi: 10.1016/s0022-3476(86)81068-x. [DOI] [PubMed] [Google Scholar]
  27. Stamm W. E., Harrison H. R., Alexander E. R., Cles L. D., Spence M. R., Quinn T. C. Diagnosis of Chlamydia trachomatis infections by direct immunofluorescence staining of genital secretions. A multicenter trial. Ann Intern Med. 1984 Nov;101(5):638–641. doi: 10.7326/0003-4819-101-5-638. [DOI] [PubMed] [Google Scholar]
  28. Svensson L., Mårdh P. A., Ahlgren M., Nordenskjöld F. Ectopic pregnancy and antibodies to Chlamydia trachomatis. Fertil Steril. 1985 Sep;44(3):313–317. [PubMed] [Google Scholar]
  29. THAYER J. D., MARTIN J. E., Jr A SELECTIVE MEDIUM FOR THE CULTIVATION OF N. GONORRHOEAE AND N. MENINGITIDIS. Public Health Rep. 1964 Jan;79:49–57. [PMC free article] [PubMed] [Google Scholar]
  30. Weström L. Effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol. 1975 Mar 1;121(5):707–713. doi: 10.1016/0002-9378(75)90477-9. [DOI] [PubMed] [Google Scholar]
  31. Wiesmeier E., Bruckner D., Black M. Detection of Chlamydia trachomatis infection by direct immunofluorescence staining of genital secretion. Obstet Gynecol. 1987 Mar;69(3 Pt 1):347–349. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES