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      Risk of Pelvic Inflammatory Disease in Relation to Chlamydia and Gonorrhea Testing, Repeat Testing, and Positivity: A Population-Based Cohort Study

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          Population-based linkage of health records in Western Australia: development of a health services research linked database

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            A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease.

            Controversy surrounds the association between bacterial vaginosis (BV) and pelvic inflammatory disease (PID). Women (N = 1,140) were ascertained at five US centers, enrolled (1999-2001), and followed up for a median of 3 years. Serial vaginal swabs were obtained for Gram's stain and cultures. PID was defined as 1) histologic endometritis or 2) pelvic pain and tenderness plus oral temperature >38.8 degrees C, leukorrhea or mucopus, erythrocyte sedimentation rate >15 mm/hour, white blood cell count >10,000, or gonococcal/chlamydial lower genital infection. Exploratory factor analysis identified two discrete clusters of genital microorganisms. The first correlated with BV by Gram's stain and consisted of the absence of hydrogen peroxide-producing lactobacillus, Gardnerella vaginalis, Mycoplasma hominis, anaerobic gram-negative rods, and, to a lesser degree, Ureaplasma urealyticum. The second, unrelated to BV by Gram's stain, consisted of Enterococcus species and Escherichia coli. Being in the highest tertile in terms of growth of BV-associated microorganisms increased PID risk (adjusted rate ratio = 2.03, 95% confidence interval: 1.16, 3.53). Carriage of non-BV-associated microorganisms did not increase PID risk. Women with heavy growth of BV-associated microorganisms and a new sexual partner appeared to be at particularly high risk (adjusted rate ratio = 8.77, 95% confidence interval: 1.11, 69.2). When identified by microbial culture, a combination of BV-related microorganisms significantly elevated the risk of acquiring PID.
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              Evidence for the use of an algorithm in resolving inconsistent and missing Indigenous status in administrative data collections

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                Author and article information

                Journal
                Clinical Infectious Diseases
                Oxford University Press (OUP)
                1058-4838
                1537-6591
                February 01 2018
                January 18 2018
                November 09 2017
                February 01 2018
                January 18 2018
                November 09 2017
                : 66
                : 3
                : 437-443
                Affiliations
                [1 ]Kirby Institute, University of New South Wales (UNSW)
                [2 ]Sydney Sexual Health Centre, Sydney Hospital
                [3 ]School of Population and Global Health, University of Melbourne
                [4 ]School of Medicine, University of Notre Dame, Fremantle
                [5 ]Faculty of Pharmacy and School of Public Health, University of Sydney
                [6 ]Centre for Health Services Research, University of Western Australia
                [7 ]Centre for Population Health Research, Curtin University, Perth
                [8 ]Insitute for Health Research, University of Notre Dame, Fremantle
                [9 ]South Australian Health and Medical Research Institute, Adelaide
                [10 ]School of Public Health and Community Medicine, UNSW, Sydney, Australia
                Article
                10.1093/cid/cix769
                29136127
                6eb8b4c6-964f-4776-bee3-68cb1f8950ea
                © 2017
                History

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