E-Poster with pre-recorded video presentation Lorne Infection and Immunity 2021

Screening for Chlamydia trachomatis infection in tubal ectopic pregnancy patients in India: Is serology the answer (#254)

Shipra Pant 1 , Astha Dimri 1 , Renu Arora 2 , Sheikh Raisuddin 3 , Fouzia Siraj 4 , Sangita Rastogi 1
  1. Molecular Microbiology laboratory, ICMR-National Institute of Pathology, , Sriramachari Bhawan, Safdarjung hospital campus, Post Box no. 4909, NEW DELHI, Delhi, India
  2. Department of Obstetrics & Gynaecology, VMMC & Safdarjung hospital, NEW DELHI, Delhi, India
  3. Department of Medical Elementology and Toxicology, Jamia Hamdard, Hamdard Nagar, NEW DELHI, Delhi, India
  4. ICMR-National Institute of Pathology, Sriramachari Bhawan, Safdarjung hospital campus, Post Box no. 4909, NEW DELHI, Delhi, India

Introduction:

Ectopic (tubal) pregnancy (EP) is of major concern worldwide as it is the main cause of maternal morbidity and mortality during the first trimester. Infection with Chlamydia trachomatis (CT) is considered as an important risk factor for EP. A high prevalence of CT has been reported from our country in various studies. However, studies on frequency of infection are still meagre in women with EP. It seems worthwhile to find a reliable estimate about CT infection in women with EP in a developing country like India prior to formulating guidelines for effective screening strategy and clinical management. Hence, the aim of the present study was to find the magnitude of CT infection by quantitating the anti-chlamydial IgG antibodies in women with tubal EP in a major tertiary hospital in north India.

 

Materials and Methods:

50 EP patients were enrolled from Department of Obstetrics and Gynecology, VMMC and Safdarjung hospital (SJH), New Delhi (India) for collection of 5.0 ml of non-heparinized blood. The study had the hospital ethical approval and prior informed written consent was further obtained from each patient. The presence of CT infection was studied by detecting IgG antibodies specific to CT by a commercial enzyme-linked immunosorbent assay (ELISA) kit (Euroimmun, Germany) as per manufacturer’s guidelines.

Results:

27/ 50 (54%) tubal pregnancy patients were found to have IgG antibodies to CT. The cut-off value of absorbance (A) was calculated as 0.0577. Mean value of (A) in seropositive EP women was statistically significant (P<0.05) in comparison to the seronegative women (1.122 versus 0.178). Patients with (A) ranges from 0.0577 – 0.999 were considered as low positives with n=12 and (A) value >0.0001 were high positives (HP) with n=15. Maximum seroprevalence (55.5%; P<0.05) was found among those in the HP group of EP patients.  

 

Conclusions:

Results indicate that quantitation of anti-CT IgG antibodies in HP patients can serve as an initial screening tool for detection of chlamydial infection in women with tubal EP. However, serology should be followed by more confirmatory testing, viz.: molecular diagnosis of infection for clinical management.  

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