The Role of Polymorphonuclear Leukocyte Counts from Urethra, Cervix, and Vaginal Wet Mount in Diagnosis of Nongonococcal Lower Genital Tract Infection

Infectious Diseases in Obstetrics and Gynecology
Ivana RandjelovicHarald Moi

Abstract

The aim of this study was to evaluate whether the polymorphonuclear leukocyte (PMNL) inflammatory response in women with nongonococcal lower genital tract infection (LGTI) can be used to optimize criteria for syndromic treatment. A cross-sectional study of 375 women attending the STI clinic in Oslo. Urethral, cervical, and vaginal specimens underwent microscopy for PMNLs. Chlamydia trachomatis (Ct) and other STIs were detected in the cervical/vaginal swabs and urine, using nucleic acid amplification test (NAAT). After excluding vulvovaginal candidiasis, genital herpes, and trichomoniasis, we correlated clinical and microscopic signs of inflammation with positive NAAT for Ct, mycoplasma genitalium (Mg), and Ureaplasma urealyticum (Uu) in a subgroup of 293 women. To predict a positive Ct, the combination of high cut-off urethritis (≥10 PMNLs/HPF) and microscopic cervicitis had a high specificity of 0.93, a PPV of 0.37, and a sensitivity of 0.35. LGTI criteria had low predicting values for Mg and Uu. Including microscopic criteria for the diagnosis of LGTI gives better indication for presumptive antibiotic treatment than anamnestic and clinical diagnosis alone.

References

Sep 1, 1992·American Journal of Reproductive Immunology : AJRI·L A ThompsonI D Cooke
Jul 5, 1984·The New England Journal of Medicine·R C BrunhamK K Holmes
May 11, 2000·Infectious Diseases in Obstetrics and Gynecology·J F PeipertD Bass
Jun 1, 2000·Laboratory Investigation; a Journal of Technical Methods and Pathology·V Witko-SarsatL Halbwachs-Mecarelli
Jun 21, 2005·Infectious Disease Clinics of North America·Jeanne M Marrazzo
Nov 8, 2005·Human Reproduction Update·S S Suarez, A A Pacey
Jan 15, 2008·Current Opinion in Infectious Diseases·M Josephine Lusk, Pam Konecny
Oct 10, 2008·Sexually Transmitted Infections·H MoiA Moghaddam
Jul 16, 2014·Scandinavian Journal of Infectious Diseases·Lu LiuYanqun Huang
Apr 23, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Rebecca LisLisa E Manhart
Aug 13, 2015·Sexually Transmitted Diseases·Linda M GorgosJeanne M Marrazzo
Jan 17, 2016·American Journal of Reproductive Immunology : AJRI·Joziani BeghiniAna Katherine Gonçalves
May 6, 2016·International Journal of STD & AIDS·Patrick J HornerHarald Moi
Feb 9, 2017·Sexually Transmitted Diseases·Harald MoiAmir Moghaddam

❮ Previous
Next ❯

Citations

Jul 12, 2021·The American Journal of Emergency Medicine·Johnathan M SheeleLanyu Mi

❮ Previous
Next ❯

Software Mentioned

epiR
logbin
R
mice

Related Concepts

Related Feeds

Candida albicans

Candida albicans is an opportunistic, fungal pathogen of humans that frequently causes superficial infections of oral and vaginal mucosal surfaces of debilitated and susceptible individuals. Discover the latest research on Candida albicans here.