Transactions of the annual meeting of the american gynecological and obstetrical societyPredictive value of the clinical diagnosis of lower genital tract infection in women☆
Section snippets
Methods
Nonpregnant women between the ages of 18 and 45 years who have ≥1 untreated genital complaints were enrolled under a research protocol that was approved by the institutional review board at Magee-Womens Hospital, Pittsburgh, Pa, and the United States Department of Defense. After written and verbal informed consent was obtained, women were enrolled prospectively in a study that was aimed at developing improved diagnostic testing for lower genital tract infections in women. Women were enrolled at
Results
Among the 598 women who were enrolled, 60% were black, 32% were white, 0.6% were Asian, 0.5% were Hispanic, 5% were of another ethnicity, and 1% were multiethnic or biracial. Most of the enrolled patients were unmarried and employed and had a history of ≥1 previous genital tract infections. More complete demographics are shown in Table I.
The overall infection rates by laboratory diagnosis (the gold standard) among the 598 women with lower genital complaints were bacterial vaginosis in 276 women
Comment
The data support the hypothesis that the presumptive diagnosis of lower genital tract infections in women with genital tract complaints invariably leads to significant numbers of women being misdiagnosed or under diagnosed. This diagnostic inaccuracy is also accompanied by a significant number of women who are treated and labeled with presumed infection who, in fact, are not infected with the suspected pathogens. In this study, the sensitivity data indicate that only 30% of women with Neisseria
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Supported by a Department of Defense grant no. DAMD17-96-1-6298.
Presented at the Twenty-Second Annual Meeting of the American Gynecological and Obstetrical Society, Napa, California, September 18-20, 2003.