Laboratory detection of bacterial pathogens and clinical and laboratory response of syndromic management in patients with cervical discharge: A retrospective study

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dc.contributor.authorYadav, Deepikaen_US
dc.contributor.authorSingh, Sanjayen_US
dc.contributor.authorDhawan, Benuen_US
dc.contributor.authorSood, Seemaen_US
dc.contributor.authorGupta, Someshen_US
dc.date.accessioned2023-08-10T07:30:55Z
dc.date.available2023-08-10T07:30:55Z
dc.date.issued2023-06
dc.description.abstractBackground: Cervical discharge as part of cervicitis and pelvic inflammatory disease is a cause of significant morbidity in sexually active women worldwide. Non-gonococcal and non- chlamydial bacterial pathogens are becoming more prevalent. Aims: This study aims to determine bacterial pathogens causing cervical discharge using culture and/or polymerase chain reaction and assess the clinical and laboratory response to the conventional syndromic kit regimen established by the World Health Organisation. Methods: A retrospective review of records of women with cervical discharge over one year period. Culture and/or polymerase chain reaction results of endocervical swabs of various bacterial pathogens at baseline and after four weeks of treatment with syndromic kit regimen were recorded. Results: A total of 70 case records were reviewed for clinical details, out of which results of bacterial culture and polymerase chain reaction were available for 67 cases. Infectious aetiology was found in 30 (44.7%) patients with Ureaplasma species being the most common organism isolated on culture (18, 26.8%) and polymerase chain reaction (25, 37.3%), respectively. Polymerase chain reaction for Chlamydia trachomatis and Mycoplasma hominis was positive in ten (14.9%) and four (6%) cases, respectively. None of the patients showed positive culture for Neisseria gonorrhoeae. Coinfection was seen in eight (11.9%) patients with the majority showing Chlamydia trachomatis and Ureaplasma spp. coinfection (five patients). Forty one cases (58.5%) received tab. cefixime 400 mg and tab. azithromycin one gram stat (kit 1), while 29 cases (43.3%) received tab. cefixime 400 mg stat, tab. metronidazole 400 mg and cap. doxycycline 100 mg, both twice daily for 14 days (kit 6). Minimal to no clinical improvement with treatment was seen in 14 out of 32 cases (44%) at the end of four weeks with the conventional kit regimen. Post-treatment culture and/or polymerase chain reaction were positive in nine out of 28 cases (32.1%) with Ureaplasma spp. being the most common. Limitations: Retrospective study design, small sample size and fewer cases with follow-up data were the main limitations. Conclusion: Ureaplasma spp. was the most common infectious cause of cervical discharge in our patients. Treatment given as part of syndromic management led to a clinical and microbiological response in around half and two-third cases, respectively.en_US
dc.identifier.affiliationsDepartments of Dermatology and Venereologyen_US
dc.identifier.affiliationsMicrobiology, All India Institute of Medical Sciences, New Delhi, Indiaen_US
dc.identifier.citationYadav, Deepikaen_US
dc.identifier.citationSingh, Sanjayen_US
dc.identifier.citationDhawan, Benuen_US
dc.identifier.citationSood, Seemaen_US
dc.identifier.citationGupta, Somesh. Laboratory detection of bacterial pathogens and clinical and laboratory response of syndromic management in patients with cervical discharge: A retrospective study. Indian Journal of Dermatology, Venereology and Leprology. 2023 Jun; 89(3): 431-435en_US
dc.identifier.issn0973-3922
dc.identifier.issn0378-6323
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/223144
dc.languageenen_US
dc.publisherScientific Scholaren_US
dc.relation.issuenumber3en_US
dc.relation.volume89en_US
dc.source.urihttps://doi.org/10.25259/IJDVL_506_2021en_US
dc.subjectCervical dischargeen_US
dc.subjectcervicitisen_US
dc.subjectpelvic inflammatory diseaseen_US
dc.subjectsyndromic managementen_US
dc.subjectgenital mycoplasmaen_US
dc.titleLaboratory detection of bacterial pathogens and clinical and laboratory response of syndromic management in patients with cervical discharge: A retrospective studyen_US
dc.typeJournal Articleen_US
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