A Review of the Challenges and Complexities in the Diagnosis, Etiology, Epidemiology, and Pathogenesis of Pelvic Inflammatory Disease

被引:22
作者
Hillier, Sharon L. [1 ,2 ]
Bernstein, Kyle T. [3 ]
Aral, Sevgi [3 ]
机构
[1] Univ Pittsburgh, Dept Obstet Gynecol & Reprod Sci, Pittsburgh, PA USA
[2] Magee Womens Res Inst, 204 Craft Ave, Pittsburgh, PA 15213 USA
[3] Ctr Dis Control & Prevent, Div SID Prevent, Atlanta, GA USA
关键词
PID; Chlamydia; gonorrhea; bacterial vaginosis; endometritis; Mycoplasma genitalium; OUTER-MEMBRANE PROTEIN; NEISSERIA-GONORRHOEAE; BACTERIAL VAGINOSIS; IMMUNE-RESPONSES; TRACT DISEASE; UNITED-STATES; WOMEN; SALPINGITIS; BURDEN;
D O I
10.1093/infdis/jiab116
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Pelvic inflammatory disease (PID) is a syndrome that causes substantial morbidity, including chronic pelvic pain, to women globally. While limited data are available from low- and middle-income countries, national databases from the United States and Europe suggest that PID incidence may be decreasing but the rate of decrease may differ by the etiologic cause. Recent studies of women with PID have reported that fewer than half of women receiving a diagnosis of PID have gonococcal or chlamydial infection, while Mycoplasma genitalium, respiratory pathogens, and the constellation of bacteria associated with bacterial vaginosis may account for a substantial fraction of PID cases. The clinical diagnosis of PID is nonspecific, creating an urgent need to develop noninvasive tests to diagnose PID. Advances in serologic testing for Chlamydia trachomatis and Neisseria gonorrhoeae could advance epidemiologic studies, while the development of vaccines against these sexually transmitted pathogens could affect incident PID and associated morbidity.
引用
收藏
页码:S23 / S28
页数:6
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