Association Between the Level of Inflammation at Each Anatomical Sexual Activity from Gram Staining and Neisseria gonorrhoeae and Chlamydia trachomatis Infections

Abstract

Objective: This study aimed to determine the association between the severity of inflammation at each anatomical sexual activity from gram staining with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections. Materials & Methods: This study was conducted using laboratory test data from patients at the Bangrak Sexually Transmitted Infections Center. The data obtained consisted of gram staining, which was divided by the number of polymorphonuclear leukocytes (PMNL), NG culture, and Nucleic Acid Amplification Test (NAAT) for NG and CT results. Results: For the diagnostic association between PMNL and NG infection, the results revealed that samples with urethral PMNL 3+ or 4+ carried a significant likelihood ratio (LR) for positive infection, LR 5.61 (P<0.001) and LR 59.66 (P<0.001), respectively. Cervical, rectal, and pharyngeal PMNL was not related to infection. For CT infection, urethral gram stains with PMNL levels were greater than or equal to 2+ and cervical specimens with PMNL 4+ were associated with CT infection. Rectal and pharyngeal PMNL showed no significant association with CT infection. Conclusion: Determination of PMNL levels from gram staining contributes to the diagnosis of patients with NG and CT in the urethra, particularly for patients with a high degree of inflammation.

Keywords

• Gram staining
• culture
• nucleic acid amplification test
• Neisseria gonorrhoeae
• Chlamydia trachomatis