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Infectious Diseases in Obstetrics and... 2015The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity.... (Review)
Review
The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.
Topics: Abscess; Cellulitis; Female; Gynecologic Surgical Procedures; Host-Pathogen Interactions; Humans; Parametritis; Pelvic Infection; Postoperative Complications; Risk Factors; Surgical Wound Infection; Vagina; Vaginitis
PubMed: 25788822
DOI: 10.1155/2015/614950 -
BMJ (Clinical Research Ed.) Oct 2019
Topics: Aftercare; Anti-Bacterial Agents; Asymptomatic Infections; DNA, Bacterial; Female; Humans; Male; Mass Screening; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Prevalence; Risk Factors; Sexually Transmitted Diseases, Bacterial; Urethritis
PubMed: 31628115
DOI: 10.1136/bmj.l5820 -
Journal of Women's Health (2002) Jan 2024Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general... (Meta-Analysis)
Meta-Analysis
Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general female population. However, the etiology of endometriosis remained unclear. We aimed to systematically assess the association between pelvic inflammatory disease (PID) and the risk of endometriosis. Eligible studies published until May 21, 2022, were retrieved from the PubMed, EMBASE, and Web of Science databases. The studies were included based on the following criteria: (1) original articles on the association between PID and risk of endometriosis; (2) randomized controlled trials and cross-sectional, case-control, and cohort studies; and (3) studies involving humans. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the studies included in this systematic review. The association between PID and risk of endometriosis was evaluated using the overall odds ratio (OR) and correlative 95% confidence interval (CI). The meta-analysis included 14 studies with 747,733 patients. The mean prevalence of PID in women with endometriosis was 33.80%. Our quantitative synthesis revealed that endometritis was associated with a significantly increased risk of endometriosis (OR: 1.63, 95% CI: 1.53-1.74, = 59%). We study a statistically significant association between PID and the risk of endometriosis. In particular, endometritis might play an important role in endometriosis, based on the lower heterogeneity of the subgroup analysis. This finding suggests that reducing the incidence of endometritis might aid in the prevention and treatment of endometriosis.
Topics: Female; Humans; Endometriosis; Pelvic Inflammatory Disease; Endometritis; Cross-Sectional Studies; Pelvic Pain
PubMed: 37851499
DOI: 10.1089/jwh.2023.0300 -
Disease-a-month : DM Aug 2016
Review
Topics: Female; Humans; Pelvic Inflammatory Disease; Sexually Transmitted Diseases; United States
PubMed: 27107781
DOI: 10.1016/j.disamonth.2016.03.015 -
The Journal of Infectious Diseases Aug 2021Chlamydia trachomatis (CT) causes pelvic inflammatory disease, which may result in tubal factor infertility (TFI) in women. Serologic assays may be used to determine the... (Review)
Review
Chlamydia trachomatis (CT) causes pelvic inflammatory disease, which may result in tubal factor infertility (TFI) in women. Serologic assays may be used to determine the proportion of women with and without TFI who have had previous CT infection and to generate estimates of infertility attributable to chlamydia. Unfortunately, most existing CT serologic assays are challenged by low sensitivity and, sometimes, specificity for prior CT infection; however, they are currently the only available tests available to detect prior CT infection. Modeling methods such as finite mixture modeling may be a useful adjunct to quantitative serologic data to obtain better estimates of CT-related infertility. In this article, we review CT serological assays, including the use of antigens preferentially expressed during upper genital tract infection, and suggest future research directions. These methodologic improvements, coupled with creation of new biomarkers for previous CT infection, should improve our understanding of chlamydia's contribution to female infertility.
Topics: Antibodies, Bacterial; Biomarkers; Chlamydia Infections; Chlamydia trachomatis; Female; Humans; Infertility, Female; Pelvic Inflammatory Disease; Serology
PubMed: 34396401
DOI: 10.1093/infdis/jiab047 -
The Journal of Emergency Medicine Apr 2016
Topics: Chlamydia Infections; Diagnosis, Differential; Female; Hepatitis; Humans; Pelvic Inflammatory Disease; Peritonitis; Tomography, X-Ray Computed; Young Adult
PubMed: 27016955
DOI: 10.1016/j.jemermed.2015.11.006 -
Spine Deformity Oct 2020Retrospective case series.
STUDY DESIGN
Retrospective case series.
OBJECTIVES
To describe how pediatric patients with spinal and pelvic osteomyelitis are diagnosed and treated and assess the diagnostic value of magnetic resonance imaging (MRI), needle aspiration biopsy (NAB), and blood cultures in this population. Spinal and pelvic osteomyelitis de novo are uncommon in children and minimal literature exists on the subject. Research has shown that NAB and blood cultures have variable diagnostic yield in adult native osteomyelitis. At our institution, there is no standard protocol for diagnosing and treating pediatric spinal and pelvic osteomyelitis de novo.
METHODS
All diagnoses of spinal and pelvic osteomyelitis at a pediatric tertiary care center from 2003 to 2017 were reviewed. Patients aged 0-21 at diagnosis were included. Patients with osteomyelitis resulting from prior spinal operations, wounds, or infections and those with chronic recurrent multifocal osteomyelitis were eliminated. All eligible patients' diagnoses were confirmed by MRI.
RESULTS
29 patients (18 men, 11 women) met the inclusion criteria. The median age at diagnosis was 11 years old (range 1-18). More than half of all cases (17/29, 59%) affected the lumbar spine. The most common symptoms were back pain (20/29, 69%), fever (18/29, 62%), hip pain (11/29, 38%), and leg pain (8/29, 28%). The majority of NABs and blood cultures performed were negative, but of the positive tests Staphylococcus aureus was the most prevalent bacteria. 86% (25/29) had an MRI before a diagnosis was made and 72% (13/18) had an NAB performed post-diagnosis.
CONCLUSIONS
MRI is a popular and helpful tool in diagnosing spinal osteomyelitis de novo. NAB cultures are often negative but can be useful in determining antibiotic treatment.
LEVEL OF EVIDENCE
Level IV.
Topics: Adolescent; Biopsy, Fine-Needle; Blood Culture; Child; Child, Preschool; Female; Humans; Infant; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Osteomyelitis; Pelvic Inflammatory Disease; Retrospective Studies; Sensitivity and Specificity; Spinal Diseases; Staphylococcal Infections
PubMed: 32306283
DOI: 10.1007/s43390-020-00110-8 -
European Journal of Clinical... Feb 2020Mycoplasma genitalium was first isolated from the urethral swabs of two symptomatic men with urethritis in 1980. It is a sexually transmitted bacterium associated with a... (Review)
Review
Mycoplasma genitalium was first isolated from the urethral swabs of two symptomatic men with urethritis in 1980. It is a sexually transmitted bacterium associated with a number of urogenital conditions in women like cervicitis, endometritis, pelvic inflammatory disease, infertility, and susceptibility to human immunodeficiency virus (HIV). However, M. genitalium may also act like a stealth pathogen at female reproductive tract, giving no symptoms. Its prevalence varies between different groups, with the average being 0.5-10% in the general population and 20-40% in women with sexually transmitted infections. The recommended treatment of this infection is azithromycin as a single 1-g dose. However, in recent years, macrolide resistance has increased which is significantly lowering the cure rate, being less than 50% in some studies. New treatment regimens need to be investigated due to increasing drug resistance. The discussion and suggestion of an algorithm for management of this infection is the highlight of this paper.
Topics: Anti-Bacterial Agents; Asymptomatic Infections; Azithromycin; Drug Resistance, Bacterial; Female; Humans; Macrolides; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; Prevalence; Reproductive Tract Infections; Sexually Transmitted Diseases; Urethritis
PubMed: 31522281
DOI: 10.1007/s10096-019-03707-8 -
Clinical Infectious Diseases : An... Aug 2015To determine the association between Mycoplasma genitalium infection and female reproductive tract syndromes through meta-analysis, English-language, peer-reviewed... (Review)
Review
To determine the association between Mycoplasma genitalium infection and female reproductive tract syndromes through meta-analysis, English-language, peer-reviewed studies were identified via PubMed, Embase, Biosis, Cochrane Library, and reference review. Two reviewers independently extracted data. Random-effects models were employed to calculate summary estimates, between-study heterogeneity was evaluated using I(2) statistics, publication bias was assessed via funnel plots and the Begg and Egger tests, and methodologic quality was rated. Mycoplasma genitalium infection was significantly associated with increased risk of cervicitis (pooled odds ratio [OR], 1.66 [95% confidence interval {CI}, 1.35-2.04]), pelvic inflammatory disease (pooled OR, 2.14 [95% CI, 1.31-3.49]), preterm birth (pooled OR, 1.89 [95% CI, 1.25-2.85]), and spontaneous abortion (pooled OR, 1.82 [95% CI, 1.10-3.03]). Risk of infertility was similarly elevated (pooled OR, 2.43 [95% CI, .93-6.34]). In subanalyses accounting for coinfections, all associations were stronger and statistically significant. Testing of high-risk symptomatic women for M. genitalium may be warranted.
Topics: Female; Humans; Infertility, Female; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Outcome; Uterine Cervicitis
PubMed: 25900174
DOI: 10.1093/cid/civ312 -
Annals of Emergency Medicine Jul 2019
Topics: Female; Gynecological Examination; Humans; Pelvic Inflammatory Disease; Sexually Transmitted Diseases; Uterine Cervicitis
PubMed: 31248496
DOI: 10.1016/j.annemergmed.2019.02.012