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Factors related to genital Chlamydia trachomatis and its diagnosis by culture in a sexually transmitted disease clinic.

Abstract The authors cultured 2,320 patients who attended the Denver Metro Health Clinic for Sexually Transmitted Diseases from September 1981 to June 1983 to determine clinical and epidemiologic factors associated with genital chlamydial infection. Among consecutive heterosexual men with urethral discharge, 226 of 849 (27%) had positive urethral cultures, with rates significantly lower among those with profuse (18%) or purulent (19%) discharges, and higher (37%) among those with symptoms for more than seven days. In a subgroup of men without gonococci, those who had polymorphonuclear leukocytes on smear had higher isolation rates (33%) than those who did not (3%). Among consecutive female patients, 172 of 1,031 (17%) had positive cervical cultures, with rates significantly lower in those who were white (13%), married (7%), or using a diaphragm (0 of 77), and higher in those who were positive for Neisseria gonorrhoeae (38%). There was a marginally significant increased rate of chlamydial isolation among oral contraceptive users only for women aged 20 years or younger. Younger age was significantly associated with chlamydial isolation in both men and women after controlling for sexual activity and other factors. Various patient characteristics can be combined to define subgroups of men and women, with rates of isolation ranging from under 4% to over 60%. These results can be useful in deciding whom to test and whom to treat presumptively in a public health setting.
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Authors

Mayor MeshTerms
Keywords

Age Factors

Bacterial And Fungal Diseases

Chlamydia

Comparative Studies

Diseases

Epidemiologic Methods

Gonorrhea

Infections

Northern America

Prevalence

Risk Factors

Sex Factors

Sexually Transmitted Diseases

Signs And Symptoms

Americas

Barrier Methods

Biology

Contraception

Demographic Factors

Developed Countries

Developing Countries

Family Planning

Measurement

North America

Population

Population Characteristics

Reproductive Tract Infections

Research Methodology

Studies

United States

Vaginal Diaphragm

Journal Title american journal of epidemiology
Publication Year Start




PMID- 3394697
OWN - NLM
STAT- MEDLINE
DA  - 19880818
DCOM- 19880818
LR  - 20041117
IS  - 0002-9262 (Print)
IS  - 0002-9262 (Linking)
VI  - 128
IP  - 2
DP  - 1988 Aug
TI  - Factors related to genital Chlamydia trachomatis and its diagnosis by culture in 
      a sexually transmitted disease clinic.
PG  - 298-308
AB  - The authors cultured 2,320 patients who attended the Denver Metro Health Clinic
      for Sexually Transmitted Diseases from September 1981 to June 1983 to determine
      clinical and epidemiologic factors associated with genital chlamydial infection. 
      Among consecutive heterosexual men with urethral discharge, 226 of 849 (27%) had 
      positive urethral cultures, with rates significantly lower among those with
      profuse (18%) or purulent (19%) discharges, and higher (37%) among those with
      symptoms for more than seven days. In a subgroup of men without gonococci, those 
      who had polymorphonuclear leukocytes on smear had higher isolation rates (33%)
      than those who did not (3%). Among consecutive female patients, 172 of 1,031
      (17%) had positive cervical cultures, with rates significantly lower in those who
      were white (13%), married (7%), or using a diaphragm (0 of 77), and higher in
      those who were positive for Neisseria gonorrhoeae (38%). There was a marginally
      significant increased rate of chlamydial isolation among oral contraceptive users
      only for women aged 20 years or younger. Younger age was significantly associated
      with chlamydial isolation in both men and women after controlling for sexual
      activity and other factors. Various patient characteristics can be combined to
      define subgroups of men and women, with rates of isolation ranging from under 4% 
      to over 60%. These results can be useful in deciding whom to test and whom to
      treat presumptively in a public health setting.
FAU - Magder, L S
AU  - Magder LS
AD  - Division of Sexually Transmitted Diseases, Centers for Disease Control, Atlanta, 
      GA.
FAU - Harrison, H R
AU  - Harrison HR
FAU - Ehret, J M
AU  - Ehret JM
FAU - Anderson, T S
AU  - Anderson TS
FAU - Judson, F N
AU  - Judson FN
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Epidemiol
JT  - American journal of epidemiology
JID - 7910653
SB  - IM
SB  - J
MH  - Adult
MH  - Age Factors
MH  - Chlamydia Infections/*diagnosis/microbiology
MH  - Chlamydia trachomatis/*isolation & purification
MH  - Continental Population Groups
MH  - Contraception
MH  - Female
MH  - Genital Diseases, Female/diagnosis/microbiology
MH  - Genital Diseases, Male/diagnosis/microbiology
MH  - Humans
MH  - Male
MH  - Risk Factors
MH  - Sexually Transmitted Diseases/*diagnosis/microbiology
MH  - Urethra/microbiology
MH  - Vagina/microbiology
OID - PIP: 054325
OID - POP: 00181138
OAB - PIP: To increase knowledge of the prevalence of genital chlamydia trachomatis
      infection and the associated epidemiologic and clinical factors, cultures were
      obtained from 2320 patients at a Denver clinic for sexually transmitted diseases.
      Specific subsamples examined included 96 consecutive male clinic attendees with
      no urethral discharge on examination, 1193 consecutive male attendees with
      urethral discharge, and 1031 consecutive female attendees. Only 4 (4%) of the men
      attending the clinic who did not have a discharge on examination were positive
      for chlamydial infection compared with 275 (23%) of men with a discharge. Of the 
      men with discharge, the isolation rate of chlamydia was 27% among heterosexuals
      but only 14% among homosexuals and bisexuals. Of the female attendees cultured,
      172 (17%) had positive cervical findings. Younger age was associated with
      chlamydial infection in both men and women even after controlling for sexual
      activity. In a subgroup of men without gonococci, those who had polymorphonuclear
      leukocytes on smear had higher isolation rates (33%) than those who did not (3%).
      Among women, chlamydia rates were significantly lower for whites (13%), married
      women (7%), and diaphragm users (0%). There was a marginally significant
      increased rate of chlamydial isolation among oral contraceptive users only for
      women aged 20 years or below. Significantly fewer (18%) men with profuse
      discharge were positive for chlamydial infection compared with men with a scant
      or moderate discharge (27% and 31%, respectively), and those with a purulent
      discharge were less likely to be positive than men with a clear or white
      discharge. Stepwise multiple logistic regression suggested the following risk
      factors for chlamydial infection in men: polymorphonuclear leukocytes,
      gram-stained smear negative for intracellular diplococci, age under 25 years,
      history of discharge, discharge for more than 7 days, and no dysuria. Risk
      factors for women included age less than 25 years, unmarried status, gonorrhea,
      an abnormal cervix, pelvic inflammatory disease, and no recent antibiotic use.
OABL- eng
OTO - PIP
OT  - *Age Factors
OT  - Americas
OT  - *Bacterial And Fungal Diseases
OT  - Barrier Methods
OT  - Biology
OT  - *Chlamydia
OT  - *Comparative Studies
OT  - Contraception
OT  - Demographic Factors
OT  - Developed Countries
OT  - Developing Countries
OT  - *Diseases
OT  - *Epidemiologic Methods
OT  - Family Planning
OT  - *Gonorrhea
OT  - *Infections
OT  - Measurement
OT  - North America
OT  - *Northern America
OT  - Population
OT  - Population Characteristics
OT  - *Prevalence
OT  - Reproductive Tract Infections
OT  - Research Methodology
OT  - *Risk Factors
OT  - *Sex Factors
OT  - *Sexually Transmitted Diseases
OT  - *Signs And Symptoms
OT  - Studies
OT  - United States
OT  - Vaginal Diaphragm
GN  - PIP: TJ: AMERICAN JOURNAL OF EPIDEMIOLOGY.
EDAT- 1988/08/01
MHDA- 1988/08/01 00:01
CRDT- 1988/08/01 00:00
PST - ppublish
SO  - Am J Epidemiol. 1988 Aug;128(2):298-308.

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