title: Quantitative culture of Chlamydia trachomatis: relationship of inclusion-forming units produced in culture to clinical manifestations and acute inflammation in urogenital disease.
abstract: The relationship of Chlamydia trachomatis inclusion-forming units in quantitative culture to clinical manifestations and inflammation in urogenital disease was assessed in 1179 patients attending a sexually transmitted diseases clinic. In women, greater inclusion-forming unit counts were associated with cervical mucopus (3000 vs. 450 ifu), amount and character of cervical discharge, > or =30 polymorphonuclear cells (PMNL) per high-power field (hpf) on Gram stain (2050 vs. 320 ifu), and diagnoses of mucopurulent cervicitis (MPC; 2550 vs. 300 ifu) and pelvic inflammatory disease (PID; 3000 vs. 578 ifu). In men, greater inclusion-forming unit counts were associated with urethral discharge (85 vs. 44 ifu), amount and character of discharge, and > or =10 PMNL/hpf (95 vs. 50 ifu). These associations persisted on multivariate analysis. Thus, chlamydial replication is associated with MPC and PID in women, urethritis in men, and inflammation in both. Since infections with high inclusion counts may be the most transmissible, identification and treatment of patients with these chlamydia-associated syndromes is important in control programs.
authors.affiliation: Division of Allergy and Infectious Diseases, School of Medicine, University of Washington, Seattle, WA 98195, USA.
authors.forename: W M
authors.initials: WM
authors.lastname: Geisler
authors.forename: R J
authors.initials: RJ
authors.lastname: Suchland
authors.forename: W L
authors.initials: WL
authors.lastname: Whittington
authors.forename: W E
authors.initials: WE
authors.lastname: Stamm
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D015169:Colony Count, Microbial; D003430:Cross-Sectional Studies; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D006801:Humans; D002479:Inclusion Bodies / Q000382:microbiology*; D008297:Male; D052801:Male Urogenital Diseases; D000292:Pelvic Inflammatory Disease / Q000382:microbiology; D014526:Urethritis / Q000382:microbiology; D002575:Uterine Cervicitis / Q000382:microbiology