Assessment of Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycobacterium tuberculosis infections in women undergoing laparoscopy: the role of peritoneal fluid sampling

Background. Aim of this study was to assess the role of peritoneal fluid sampling for detection of bacterial infections due to Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycobacterium tuberculosis (MT) in women undergoing laparoscopic investigation. The potential link between microbiological positive result(s) and types of gynecological pathology was also evaluated.
Materials and Methods. A large sample of women (n=1377) with their peritoneal fluids taken laparoscopically was studied. Data of microbiological and clinical/histopathological findings were entered into a database from a retrospective chart review. Culture and/or microscopy were used to detect NG or MT infection, whereas CT infection was detected using a PCR-based test.
Results and Conclusions. Of all the patients (14 to 50 years aged), 463 (33.6%) had endometriosis, 1179 (85.6%) had a pathology/condition other than endometriosis, and 71 (5.2%) had no pathology as histologically documented. None of the patients had peritoneal fluid samples positive for NG or MT. In contrast, 30 (2.2%) of 1377 patients had peritoneal fluid samples positive for CT. Except for 3 women with no histopathological alteration, all the CT positive patients had either endometriosis (n=12) or non-endometriosis (n=13) pathology. Two remaining patients were diagnosed with both the pathologies. Accordingly, no significant association (OR) was found between CT positivity and pathology [only endometriosis, 1.13 (95%CI, 0.30-4.20)]; [only non-endometriosis, 0.53 (95%CI, 0.15-1.87)]. While confirming the low positivity rate for the CT molecular detection, the present data indicate the need for prospective studies to firmly establish the clinical usefulness of peritoneal fluid diagnostic in gynecological settings.