Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242172 (pelvic inflammatory disease)
 3,755 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Trospectomycin sulfate (trospectomycin, TRS) is a novel, broad-spectrum, aminocyclitol antibiotic that is being developed clinically for the treatment of upper respiratory tract infections, bacterial vaginosis, pelvic inflammatory disease, and gonorrhea. This study investigated the bactericidal activity (by time-kill kinetics) and the postantibiotic effect (PAE) of TRS. Species-dependent bacteriostatic/bactericidal activity was observed for TRS; the antibiotic was bacteriostatic for Staphylococcus epidermidis, Enterococcus faecalis, and Escherichia coli, and bactericidal for Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, and Bacteroides fragilis (one of two test strains). When TRS was tested at four times its minimum inhibitory concentration or at a maximum test concentration of 32 micrograms/ml, with a 1-hr exposure period, the following PAE values were recorded: S. epidermidis 30032, 1.8 hr, En. faecalis ATCC 29212, 1.6 hr, E. coli UC 311, 1.5 hr, E. coli UC 9451, 1.5 hr, H. influenzae 30063, greater than 4.0 hr, B. fragilis ATCC 25285, 5.2 hr, and B. fragilis UC 12199, 6.7 hr. The broad-spectrum PAE that was observed for TRS is somewhat unique compared with other antibiotics.
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PMID:The bactericidal activity and postantibiotic effect of trospectomycin. 138 66

Bacterial vaginosis (BV) is the most common of the vaginitides affecting women of reproductive age. It appears to be due to an alteration in the vaginal ecology by which Lactobacillus spp., the predominant organisms in the healthy vagina, are replaced by a mixed flora including Prevotella bivia, Prevotella disiens, Porphyromonas spp., Mobiluncus spp., and Peptostreptococcus spp. All of these organisms except Mobiluncus spp. are also members of the endogenous vaginal flora. While evidence from treatment trials does not support the notion that BV is sexually transmitted, recent studies have shown an increased risk associated with multiple sexual partners. It has also been suggested that the pathogenesis of BV may be similar to that of urinary tract infections, with the rectum serving as a reservoir for some BV-associated flora. The organisms associated with BV have also been recognized as agents of female upper genital tract infection, including pelvic inflammatory disease, and the syndrome BV has been associated with adverse outcome of pregnancy, including premature rupture of membranes, chorioamnionitis, and fetal loss; postpartum endometritis; cuff cellulitis; and urinary tract infections. The mechanisms by which the BV-associated flora causes the signs of BV are not well understood, but a role for H2O2-producing Lactobacillus spp. in protecting against colonization by catalase-negative anaerobic bacteria has been recognized. These and other aspects of BV are reviewed.
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PMID:Bacterial vaginosis. 174 64

Seventy-six postpubertal women were referred from a municipal hospital emergency room within 60 h of sexual assault for evaluation. Of the 76 victims, 20 (26%) had active Chlamydia trachomatis infection detected by culture (11 subjects), a fourfold serologic titer rise (6), or both (3). The risk of acquiring C. trachomatis infection after sexual assault was 3%-16%. Pelvic inflammatory disease was detected in 8 (11%) of the 76 victims. Bacterial vaginosis was diagnosed in 38 women (50%), at least 8 of whom appeared to have been infected during the assault. Trichomoniasis was found in 17 victims (22%), at least 5 of whom may have acquired the infection at the time of the assault. In view of the high rates of these infections and the poor compliance with follow-up (76% [58/76] kept their appointments), all postpubertal victims of sexual assault should be offered treatment with ceftriaxone, 250 mg intramuscularly, followed by 100 mg of oral doxycycline and 500 mg of oral metronidazole twice daily for 7 days.
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PMID:Sexually transmitted diseases in postpubertal female rape victims. 189 34

Reproductive tract infection is an often unrecognized, but relatively common, cause of abnormal reproductive tract bleeding. Postcoital bleeding, menorrhagia, metrorrhagia, and oral contraceptive break-through bleeding are potentially infection-related complaints. The microorganisms most often associated with abnormal reproductive tract bleeding include: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus type 2, and microorganisms associated with bacterial vaginosis. The clinical conditions cervicitis, endometritis, and pelvic inflammatory disease and the related microorganisms are discussed, as are strategies for clinical management and counseling.
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PMID:Abnormal bleeding associated with reproductive tract infection. 193 76

Bacterial vaginitis is responsible for approximately 10 million office visits per year. This condition may disrupt marriages and cause psychologic stress that may be reflected in the individual's work and social life. Bacterial vaginitis also has been thought to lead to postpartum endometritis, pelvic cellulitis, pelvic inflammatory disease, and chorioamnionitis.
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PMID:Bacterial vaginitis. 193 10

Bacterial vaginosis, the most common infectious cause of vaginitis, is characterized by a shift in normal vaginal flora from predominantly aerobic to mainly anaerobic flora. Incidence rates in various studies have ranged from 1-0-45%. Unclear are both the pathophysiology of the observed reduction in lactobacilli and whether bacterial vaginosis is sexually transmitted. Evidence for sexual transmission is provided by a significantly greater incidence of bacterial vaginosis in women with more than 5 sexual partners compared to those in a lifelong monogamous relationship, while bacterial detection in virgins and the failure to demonstrate benefits of partner treatment argue against sexual transmission. Use of an IUD does appear to be a risk factor. The only symptom consistently reported by women with bacterial vaginosis is a malodorous vaginal discharge; however, over half of women with this condition are asymptomatic. The standard criterion for diagnosis includes the presence of 3 of the following signs: the clue cell, homogeneous discharge that adheres to but is easily wiped off the vaginal wall, an elevated vaginal pH, and the potassium hydroxide test for volatile amines. Of concern is the potential for serious sequelae. The abnormal bacterial flora associated with vaginosis significantly impede the white blood cell response to infection. Gynecologic-obstetric sequelae include pelvic inflammatory disease, endometritis, postoperative vaginal cuff infections, preterm labor, premature rupture of membranes, and chorioamnionitis. Metronidazole and clindamycin are the most effective treatment agents. Given the long-term risks associated with bacterial vaginosis, a full course of antibiotics should be considered in both obstetric patients with this condition and women undergoing outpatient ambulatory invasive surgical procedures.
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PMID:Bacterial vaginosis: current review with indications for asymptomatic therapy. 195 77

In an epidemiological survey of 2128 women attending a sexually transmitted diseases clinic for the first time and 200 attending two primary health clinics, 26% and 27% respectively were found to have bacterial vaginosis. The prevalence increased significantly with age, being diagnosed in 22.8% (326/1431) of women aged 14-24 years, and in 33.3% (232/697) of those aged greater than or equal to 25 years. Bacterial vaginosis was associated with gonorrhoea and with chlamydial infection, but was negatively associated with genital papillomavirus infection and yeast infection. Women using barrier contraceptives had a significantly lower prevalence of bacterial vaginosis than those using an intrauterine device or no contraceptive. Women less than or equal to 24 years old using oral contraceptives had a significantly lower prevalence of bacterial vaginosis than those not using contraceptives. Patients without gonorrhoea or chlamydial infection but with vaginal or urethral inflammatory signs had a significantly higher prevalence of bacterial vaginosis than those without inflammatory signs. These findings may have implications regarding complications associated with lower genital tract infections and may strengthen the hypothesis that bacterial vaginosis is a risk factor for pelvic inflammatory disease.
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PMID:Prevalence of bacterial vaginosis and its association with genital infections, inflammation, and contraceptive methods in women attending sexually transmitted disease and primary health clinics. 196 91

Frequently, encountered gynaecologic infections and pathogens involved are presented. A review is given of bartholinitis, vulvovaginitis-bacterial vaginosis, candidiasis, trichomoniasis cervicitis and pelvic inflammatory disease: Neisseria gonorrhoeae, Chlamydia trachomatis and herpes simplex virus 2. Of each infection a thorough description of clinical symptoms and diagnostic criteria is followed by up-to-date treatment advices. For vulvovaginitis, cervicitis and pelvic inflammatory disease antifungal and antimicrobial agents, route of administration, the required daily dosage and time of administration are presented in an overview table.
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PMID:Gynaecological infections and strategies for treatment. 207 77

Bacterial vaginosis is a disease that results from massive overgrowth of vaginal bacterial flora. The exact etiology is unknown. The major components of the normal bacterial flora, peroxide-producing lactobacilli, are replaced by non-peroxide-producing lactobacilli, allowing overgrowth of anaerobic and gram-negative aerobic flora. Anaerobic bacteria produce enzymes, aminopeptidases, that degrade protein and decarboxylases that convert amino acids and other compounds to amines. Those amines contribute to the signs and symptoms associated with the syndrome, raising the vaginal pH and producing a discharge odor. The excessive amounts of bacteria characteristic of the syndrome attach to epithelial cell surfaces, resulting in "clue" cells. Nearly half the patients report no noticeable symptoms, but many develop a characteristic copious, malodorous discharge within six months if untreated. Serious infectious sequelae are associated with bacterial vaginosis, including salpingitis, abscesses, endometritis and pelvic inflammatory disease. There is also a danger to pregnant women because of premature rupture of the membranes and premature labor. Clindamycin and metronidazole are considered effective therapy for the disease. Treatment of sexual partners remains controversial since sexual transmission has not been proven unequivocally.
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PMID:Advances in the understanding of bacterial vaginosis. 267 62

Among 640 randomly selected women who were attending a sexually transmitted disease clinic and did not have trichomoniasis, 33% had bacterial vaginosis as defined by a composite of four clinical criteria: (1) Vaginal discharge was homogeneous; (2) vaginal discharge had a pH greater than or equal to 4.7; (3) vaginal discharge had an amine-like odor when mixed with 10% potassium hydroxide; (4) vaginal discharge contained clue cells representing greater than or equal to 20% of vaginal epithelial cells. Previously published Gram stain criteria for bacterial vaginosis correlated better than results of semiquantitative cultures for Gardnerella vaginalis with presence or absence of clue cells and with composite clinical criteria. Of 293 women with bacterial vaginosis by Gram stain criteria, 65% had symptoms of increased vaginal discharge and/or vaginal malodor, while 74% had signs of characteristic homogeneous vaginal discharge or amine-like odor. Elevated vaginal pH was the least specific and amine-like odor the least sensitive sign of bacterial vaginosis. Gram stain criteria for bacterial vaginosis were not associated with the concentrations of endocervical or vaginal inflammatory cells but were significantly associated with a clinical diagnosis of pelvic inflammatory disease. After adjusting for coinfection, sexual behavior, and other variables, bacterial vaginosis remained associated with adnexal tenderness (odds ratio = 9.2, p = 0.04). Bacterial vaginosis, previously implicated as a risk factor for obstetric infections, may be a risk factor for pelvic inflammatory disease.
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PMID:Diagnosis and clinical manifestations of bacterial vaginosis. 325 75


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