title: Chlamydial infection in a high risk population: association with vaginal flora patterns.
abstract: OBJECTIVE
  This study aimed to determine the frequency of Chlamydia trachomatis (CT) infection among high risk Brazilian women and evaluate its association with vaginal flora patterns.
  
  
  METHODS
  This was a cross-sectional study, performed in an outpatient clinic of Bauru State Hospital, São Paulo, Brazil. A total of 142 women were included from 2006 to 2008. Inclusion criteria was dyspareunia, pain during bimanual exam, presence of excessive cervical mucus, cervical ectopy or with three or more episodes of abnormal vaginal flora (AVF) in the previous year before enrollment. Endocervical CT testing was performed by PCR. Vaginal swabs were collected for microscopic assessment of the microbial flora pattern. Gram-stained smears were classified in normal, intermediate or bacterial vaginosis (BV), and recognition of Candida sp. morphotypes. Wet mount smears were used for detection of Trichomonas vaginalis and aerobic vaginitis (AV).
  
  
  RESULTS
  Thirty-four of 142 women (23.9%) tested positive for CT. AVF was found in 50 (35.2%) cases. The most frequent type of AVF was BV (17.6%). CT was strongly associated with the presence of AV (n = 7, 4.9%, P = 0.018), but not BV (n = 25, 17.6%, P = 0.80) or intermediate flora (n = 18, 12.7%, P = 0.28).
  
  
  CONCLUSIONS
  A high rate of chlamydial infection was found in this population. Chlamydia infection is associated with aerobic vaginitis.
authors.affiliation: Department of Pathology, Botucatu Medical School, São Paulo State University (UNESP), Distrito de Rubião Junior s/n., Botucatu, São Paulo 18618-970, Brazil.
authors.forename: Camila
authors.initials: C
authors.lastname: Marconi
authors.forename: Gilbert G G
authors.initials: GG
authors.lastname: Donders
authors.forename: Laura F
authors.initials: LF
authors.lastname: Martin
authors.forename: Bruna R A
authors.initials: BR
authors.lastname: Ramos
authors.forename: Marli T C
authors.initials: MT
authors.lastname: Duarte
authors.forename: Cristina M G L
authors.initials: CM
authors.lastname: Parada
authors.forename: Andréa R
authors.initials: AR
authors.lastname: Tristão
authors.forename: Márcia G
authors.initials: MG
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology*; D002692:Chlamydia trachomatis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D012306:Risk; D014621:Vagina / Q000382:microbiology*; D014627:Vaginitis / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult