Influence of Mycoplasma and Chlamydia infections on severity of chronic pelvic inflammatory disease and vaginal flora

OBJECTIVE To observe the influence of Ureaplasma urealyticum (Uu) and Chlamydia trachomatis (Ct) infections on severity of chronic pelvic inflammatory disease (CPID) and vaginal flora. METHODS A total of 185 patients with CPID who were treated in gynecology department of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from Jan 2019 to Nov 2022 were assigned as the case group, meanwhile, 150 healthy women who received physical examination were randomly chosen as the control group. The prevalence of Uu and Ct infections, status of vaginitis and vaginal flora were observed. RESULTS The proportions of the subjects who had Uu and Ct infections were significantly higher in the case group than in the control group(P<0.05). There was no significant difference in the prevalence rates of vaginal inflammations between the two groups. Grade Ⅰ or Grade Ⅳ was dominant among the vaginal flora density and diversity in the case group, and grade Ⅱb was dominant among the Lactobacillus. Grade Ⅱ or Grade Ⅲ was dominant among the vaginal flora density and diversity in the control group, and grade Ⅱa was dominant among the Lactobacillus. The proportion of the subjects who had abnormal vaginal microecosystem was higher in the case group than in the control group, and there was significant difference(P<0.05). In the case group, the patients with Uu or Ct infection had more severe illness condition than the patients without Uu or Ct infection; grade I or grade IV was dominant among the vaginal flora density and diversity, and the proportion of the Uu or Ct infection patients who had abnormal vaginal microecosystem was higher, and there were significant differences(P<0.05). CONCLUSION The CPID patients have high prevalence rates of Uu and Ct infections as well as the abnormal vaginal flora. The patients with Uu or Ct infection have more severe illness condition and abnormal vaginal microecosystem, and the non-bacterial pathogenic microorganisms such as Uu and Ct may play a significant role in pathogenesis and progression of CPID.