Background This is a case-control study comparing women presenting with pelvic inflammatory disease (PID) (cases), and women presenting for routine cervical and/or sexually transmitted infection screening (cases) to examine the cervico-vaginal microbiota associated with PID. Currently, there is limited understanding of the association of the cervico-vaginal microbiota with PID.
Methods The study design is a case-control study with prospective recruitment of women presenting with PID and asymptomatic women presenting for routine cervical or sexual health screening. Cervical and posterior vaginal fornix specimens are collected for the study for microbiota (presented here) and gene expression analysis. Participant demographic data, clinical chart review to ensure consistency of recruitment and response to treatment of PID cases, and self-collected questionnaire on sexual, reproductive, and gynaecological history were also analysed. Antibiotic treatment in the month preceding recruitment and pregnancy were exclusion criteria.
Results The study is still progressing, to date 38 control participants have been recruited and 12 cases consistent with PID. The analysis indicates that Lactobacillus iners (referred to as community state type 3 in vaginal microbiome) dominant vaginal microbial communities were significantly more frequently detected in cases. Additionally, cases were significantly more likely to have taken antibiotics in the past year, had recent partner change and/or self reported vaginal symptoms such as thrush or BV in the preceding 3 months. These are all factors which would potentially impact vaginal microbiota.
Conclusion Pelvic inflammatory disease is known to be associated with sexual behaviour but a sexually transmitted infection is not always detected in PID. Here, we have found preliminary indications that a microbiota previously associated with sexually transmitted infection risk is also associated with PID. This is pilot data and further numbers are needed before conclusions can be reached.
Disclosure No significant relationships.
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