Цель: выявление инфекций, передаваемых половым путем, у женщин с трубной беременностью.
Материалы и методы: в 121 случае трубной беременности исследовали признаки инфекции Chlamydia trachomatis, Мycoplasma hominis/genitalium, Ureaplasma urealyticum, Neisseria spр. (в том числе, N. gonorrhoeae) и Trichomonas vaginalis.
Результаты: обычно выявляли U. urealyticum, реже – M. hominis, еще реже – остальные возбудители. В большинстве случаев (73,55%) при патологии маточных труб выявляли наличие в сыворотке крови антител G к МОМР и Pgp3 C. trachomatis.
Выводы: для выявления патологии маточных труб можно использовать исследование антител к МОМР.
Objective: to identify sexually transmitted infections in women with tubal pregnancy.
Materials and methods: 121 patients with tubal pregnancy were examined for the presence of Chlamydia trachomatis, Mycoplasma hominis/genitalium, Ureaplasma urealyticum, Neisseria spp. (including N. gonorrhoeae) and Trichomonas vaginalis infection.
Results: U. urealyticum was the most common pathogen, while M. hominis was a more rare agent, and other agents were detected even more rarely. In most cases (73,55%) tubal pathology was associated with presence of serum G antibodies against the Chlamydial major outer membrane protein (MOMP) and Pgp3.
Conclusion: MOMP antibodies can be used for verification of the fallopian tubespathology.
1. Клинические лекции по акушерству и гинекологии. Под ред. А.Н.Стрижакова, А.И.Давыдова, Л.Д.Белоцерковцевой. М.: Медицина, 2000.
2. Joki-Korpela P, Sahrakorpi N, Halttunen M et al. The role of C. trachomatis infection in male infertility. Fertil Steril 2009; 91: 1448–50.
3. Mardh PA. Influence of infection with Chlamydia trachomatis on pregnancy outcome, infant health and life-long sequelae in infected offspring. Best Pract Res Clin Obstet Gynaecol 2002; 16: 847–64.
4. Sun J, Schoborg RV. The host adherens junction molecule nectin-1 is degraded by chlamydial protease-like activity factor (CPAF) in Chlamydia trachomatis-infected genital epithelial cells. Microbes and Infection 2009; 11: 12–9.
5. Pellati D, Mylonakis I, Bertoloni G et al. Genital tract infections and infertility. Eur J Obst Gynecol Reproduct Biol 2008; 140: 3–11.
6. Sharma K, Aggarwal A, Arora U. Seroprevalence of Chlamydia trachomatis in women with bad obstetric history and infertility. Indian J Med Sci 2002; 56 (5): 216–7.
7. Sönmez S, Sönmez E, Yasar L et al. Can screening Chlamydia trachomatis by serological tests predict tubal damage in infertile patients? New Microbiology 2008; 31: 75–9.
8. Akande V, Turner C, Horner P et al. Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for practice. Human Fertility 2010; 13 (3): 115–25.
9. Molano M, Meijer CJ, Weiderpass E et al. The natural course of C. trachomatis infection in asymptomatic Colombian women: a 5-year follow-upstudy. J Infect Dis 2005; 191: 907–16.
10. Land JA, Evers JL, Goossens VJ. How to use Chlamydia antibody testing in subfertility patients. Hum Reprod 1998; 13: 1094–8.
11. Dietrich W, Rath M, Stanek G et al. Multiple site sampling does not increase the sensitivity of Chlamydia trachomatis detection in infertility patients. Fertil Steril 2010; 1 (93): 68–71.
12. Gerard HC, Branigan PJ, Balsara GR et al. Viability of Chlamydia trachomatis in fallopian tubes of patients with ectopic pregnancy. Fertil Steril 1998; 70 (5): 945–8.
13. Patton DL, Askienazy-Elbhar M, Henry-Suchet J et al. Detection of Chlamydia trachomatis in fallopian tube tissue in women with postinfectious tubal infertility. Am J Obstet Gynecol 1994; 171: 95–101.
14. Hakim EA, Gordon UD, Akande VA. The relationship between serum Chlamydia antibody levels and severity of disease in infertile women with tubal damage. Arch Gynecol Obstet 2010; 281: 727–33.
15. Baczynska A, Funch P, Fedder J et al. Morphology of human Fallopian tubes after infection with Mycoplasma genitalium and Mycoplasma hominis in vitro organ culture study. Hum Reprod 2007; 4 (22): 968–79.
16. Macmillan S, Templeton A. Screening for Chlamydia trachomatis in Subfertile Women. Hum Reprod 1999; 14 (12): 3009–12.
17. Rabenau HF., Köhler E, Peters M et al. Low correlation of serology with detection of Chlamydia trachomatis by ligase chain reaction and antigen EIA. Infect 2000; 28: 97–102.
18. Hogan RJ, Mathews SA, Mukhopadhyay S et al. Chlamydial persistence: beyond the biphasic paradigm. Infect Immun 2004; 72: 1843–55.
19. Witkin SS, Linhares I, Giraldo P et al. Individual immunity and susceptibility to female genital tract infection. Ed. Gerard HC, Branigan PJ, Balsara GR et al. 1998. Am J Obstet Gynecol 2002; 183: 252–6.
20. Morre SA, van den Brule AJ, Rozendaal L et al. The natural course of asymptomatic Chlamydia trachomatis infections: 45% clearance and no development of clinical PID after one-year follow-up. Int J std AIDS 2002; 13 (Suppl. 2): 12–8.
21. Gerard HC, Branigan PJ, Schumacher HR, Hudson AP. Synovial Chlamydia trachomatis in patients with reactive arthritis. Reiter’s syndrome are viable but show aberrant gene expression. J Rheumatol 1998; 25: 734–42.
22. Пересада О.А. Внематочная беременность (клиническая лекция). Медицинские новости. 2007; 1 (2): 7–17.
23. Veenemans LMW, Linden PJQ, Van Der. The value of Chlamydia trachomatis antibody testing in predicting tubal factor infertility. Hum Reprod 2002; 17 (3): 695–8.
24. Akande VА, Hunt LP, Cahill DJ et al. Tubal damage in infertile women: prediction using chlamydia serology. Hum Reprod 2003; 9 (18): 1841–7.
25. Coppus SFPJ, Opmeer BC, Logan S et al. The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy: a clinical prediction model approach. Hum Reprod 2007; 22 (5): 1353–8.
26. den Hartog JE, Lardionjie CM, Severens JL et al. Screening strategies for tubal factor subfertility. Hum Reprod 2008; 23: 1840–8.
27. Punnonen R, Terho P, Nikkanen V, Meurman О. Chlamydial serology in infertile women by immunofluorescence. Fertil Steril 1979; 31: 656–9.
28. Minassian SS, Wu CH, Jungkind D et al. Chlamydial antibody, as determined with an enzyme-linked immunosorbent assay, in tubal factor infertility. J Reprod Med 1990; 35: 141–5.
29. den Hartog JE, Land JA, Stassen FRM et al. Serological markers of persistent C. trachomatis infections in women with tubal factor subfertility. Hum Reprod 2005; 4 (20): 986–90.
________________________________________________
1. Клинические лекции по акушерству и гинекологии. Под ред. А.Н.Стрижакова, А.И.Давыдова, Л.Д.Белоцерковцевой. М.: Медицина, 2000.
2. Joki-Korpela P, Sahrakorpi N, Halttunen M et al. The role of C. trachomatis infection in male infertility. Fertil Steril 2009; 91: 1448–50.
3. Mardh PA. Influence of infection with Chlamydia trachomatis on pregnancy outcome, infant health and life-long sequelae in infected offspring. Best Pract Res Clin Obstet Gynaecol 2002; 16: 847–64.
4. Sun J, Schoborg RV. The host adherens junction molecule nectin-1 is degraded by chlamydial protease-like activity factor (CPAF) in Chlamydia trachomatis-infected genital epithelial cells. Microbes and Infection 2009; 11: 12–9.
5. Pellati D, Mylonakis I, Bertoloni G et al. Genital tract infections and infertility. Eur J Obst Gynecol Reproduct Biol 2008; 140: 3–11.
6. Sharma K, Aggarwal A, Arora U. Seroprevalence of Chlamydia trachomatis in women with bad obstetric history and infertility. Indian J Med Sci 2002; 56 (5): 216–7.
7. Sönmez S, Sönmez E, Yasar L et al. Can screening Chlamydia trachomatis by serological tests predict tubal damage in infertile patients? New Microbiology 2008; 31: 75–9.
8. Akande V, Turner C, Horner P et al. Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for practice. Human Fertility 2010; 13 (3): 115–25.
9. Molano M, Meijer CJ, Weiderpass E et al. The natural course of C. trachomatis infection in asymptomatic Colombian women: a 5-year follow-upstudy. J Infect Dis 2005; 191: 907–16.
10. Land JA, Evers JL, Goossens VJ. How to use Chlamydia antibody testing in subfertility patients. Hum Reprod 1998; 13: 1094–8.
11. Dietrich W, Rath M, Stanek G et al. Multiple site sampling does not increase the sensitivity of Chlamydia trachomatis detection in infertility patients. Fertil Steril 2010; 1 (93): 68–71.
12. Gerard HC, Branigan PJ, Balsara GR et al. Viability of Chlamydia trachomatis in fallopian tubes of patients with ectopic pregnancy. Fertil Steril 1998; 70 (5): 945–8.
13. Patton DL, Askienazy-Elbhar M, Henry-Suchet J et al. Detection of Chlamydia trachomatis in fallopian tube tissue in women with postinfectious tubal infertility. Am J Obstet Gynecol 1994; 171: 95–101.
14. Hakim EA, Gordon UD, Akande VA. The relationship between serum Chlamydia antibody levels and severity of disease in infertile women with tubal damage. Arch Gynecol Obstet 2010; 281: 727–33.
15. Baczynska A, Funch P, Fedder J et al. Morphology of human Fallopian tubes after infection with Mycoplasma genitalium and Mycoplasma hominis in vitro organ culture study. Hum Reprod 2007; 4 (22): 968–79.
16. Macmillan S, Templeton A. Screening for Chlamydia trachomatis in Subfertile Women. Hum Reprod 1999; 14 (12): 3009–12.
17. Rabenau HF., Köhler E, Peters M et al. Low correlation of serology with detection of Chlamydia trachomatis by ligase chain reaction and antigen EIA. Infect 2000; 28: 97–102.
18. Hogan RJ, Mathews SA, Mukhopadhyay S et al. Chlamydial persistence: beyond the biphasic paradigm. Infect Immun 2004; 72: 1843–55.
19. Witkin SS, Linhares I, Giraldo P et al. Individual immunity and susceptibility to female genital tract infection. Ed. Gerard HC, Branigan PJ, Balsara GR et al. 1998. Am J Obstet Gynecol 2002; 183: 252–6.
20. Morre SA, van den Brule AJ, Rozendaal L et al. The natural course of asymptomatic Chlamydia trachomatis infections: 45% clearance and no development of clinical PID after one-year follow-up. Int J std AIDS 2002; 13 (Suppl. 2): 12–8.
21. Gerard HC, Branigan PJ, Schumacher HR, Hudson AP. Synovial Chlamydia trachomatis in patients with reactive arthritis. Reiter’s syndrome are viable but show aberrant gene expression. J Rheumatol 1998; 25: 734–42.
22. Пересада О.А. Внематочная беременность (клиническая лекция). Медицинские новости. 2007; 1 (2): 7–17.
23. Veenemans LMW, Linden PJQ, Van Der. The value of Chlamydia trachomatis antibody testing in predicting tubal factor infertility. Hum Reprod 2002; 17 (3): 695–8.
24. Akande VА, Hunt LP, Cahill DJ et al. Tubal damage in infertile women: prediction using chlamydia serology. Hum Reprod 2003; 9 (18): 1841–7.
25. Coppus SFPJ, Opmeer BC, Logan S et al. The predictive value of medical history taking and Chlamydia IgG ELISA antibody testing (CAT) in the selection of subfertile women for diagnostic laparoscopy: a clinical prediction model approach. Hum Reprod 2007; 22 (5): 1353–8.
26. den Hartog JE, Lardionjie CM, Severens JL et al. Screening strategies for tubal factor subfertility. Hum Reprod 2008; 23: 1840–8.
27. Punnonen R, Terho P, Nikkanen V, Meurman О. Chlamydial serology in infertile women by immunofluorescence. Fertil Steril 1979; 31: 656–9.
28. Minassian SS, Wu CH, Jungkind D et al. Chlamydial antibody, as determined with an enzyme-linked immunosorbent assay, in tubal factor infertility. J Reprod Med 1990; 35: 141–5.
29. den Hartog JE, Land JA, Stassen FRM et al. Serological markers of persistent C. trachomatis infections in women with tubal factor subfertility. Hum Reprod 2005; 4 (20): 986–90.
FSI Rostov Scientific Research Institute of Obstetrics and Pediatrics of the Ministry of Health and Social Development of the Russian Federation, Rostov-on-Don