Chlamydia trachomatis infections — The Royal Women's Hospital experience

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Abstract
During the 18‐month period from December 1, 1985 to May 31, 1987 Chlamydia trachomatis was the most‐common sexually‐transmitted agent to be identified at The Royal Women's Hospital, Melbourne. It was isolated from 4% of all specimens for which such culture was requested and was found five‐times more frequently than was Neisseria gonorrhoeae. A review of the clinical presentation and the management of the 100 public patients for this period whose cervical specimens were found to give positive results for the presence of chlamydiae revealed that 77% of the women were less than 25 years of age, 78% of the women were single and 65% of the women were nulliparous. Thirty‐five women were asymptomatic carriers of chlamydiae. Of the remaining 65 patients with symptoms, 46% experienced pelvic pain, 39% experienced a vaginal discharge and 26% experienced irregular bleeding. The importance of abnormal bleeding is emphasized. In patients who presented for therapeutic abortions, morbidity occurred in 19% of those who were carriers of Chl. trachomatis; accordingly, screening for chlamydiae as a routine is recommended in such patients. Furthermore, because of the risk of pelvic inflammatory disease and its consequences, it is important not only to treat female patients in whom chlamydiae have been isolated, but also to treat and to follow‐up their sexual partners simultaneously.

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