Subsequent sexually transmitted infection after outpatient treatment of pelvic inflammatory disease

Maria E Trent, Shang En Chung, Lynette Forrest, Jonathan Ellen

Research output: Contribution to journalArticle

Abstract

Objective: To determine the frequency of recurrent sexually transmitted infections (STIs) and/or pelvic inflammatory disease (PID), the average time until subsequent infection following a baseline PID diagnosis, and age- and insurance-related associations with subsequent diagnoses. Design: This study used prospective longitudinal follow-up of STI and/or PID outcome data from electronic medical records. Setting: An urban academic hospital system. Participants: A total of 110 adolescent girls treated for PID as outpatients in pediatric ambulatory sites. Main Exposure: Electronic medical records used to assess subsequent PID diagnoses and/or infections with Neisseria gonorrhoeae or Chlamydia trachomatis during the study window. Main Outcome Measures: Demographic, health care use, and STI and/or PID outcome data were examined. Incidence of an STI and/or PID was calculated as incident cases per person-months of exposure. Cox proportional hazard modeling was performed to evaluate the incidence of STI by age or insurance status. Results: The mean (SD) age was 16.8 (1.9) years, 89% of patients were black, and 39% had laboratory results that were positive for N gonorrhoeae or C trachomatis at baseline. Thirty-four percent of patients had an additional diagnosis of an STI during the 48-month follow-up window (incidence, 3.1 per 100 person-months) and the mean (SD) time to a subsequent STI and/or PID was 377 (297) days. Of those patients, 67% (n = 18) had chlamydia, 11% had gonorrhoeae, and 44% had PID. There were no differences based on age or insurance status. Conclusions: Adolescents treated for PID are at risk for subsequent STI and/or PID for a 48-month period. Given the need to prevent future infections in these vulnerable youths, efforts to explore the value of ongoing strategies for risk reduction after diagnosis are warranted.

Original languageEnglish (US)
Pages (from-to)1022-1025
Number of pages4
JournalArchives of Pediatrics and Adolescent Medicine
Volume162
Issue number11
DOIs
StatePublished - Nov 2008

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Pelvic Inflammatory Disease
Sexually Transmitted Diseases
Outpatients
Therapeutics
Insurance Coverage
Gonorrhea
Electronic Health Records
Incidence
Infection
Chlamydia
Neisseria gonorrhoeae
Chlamydia trachomatis
Urban Hospitals
Risk Reduction Behavior
Insurance
Demography
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Subsequent sexually transmitted infection after outpatient treatment of pelvic inflammatory disease. / Trent, Maria E; Chung, Shang En; Forrest, Lynette; Ellen, Jonathan.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 162, No. 11, 11.2008, p. 1022-1025.

Research output: Contribution to journalArticle

Trent, Maria E ; Chung, Shang En ; Forrest, Lynette ; Ellen, Jonathan. / Subsequent sexually transmitted infection after outpatient treatment of pelvic inflammatory disease. In: Archives of Pediatrics and Adolescent Medicine. 2008 ; Vol. 162, No. 11. pp. 1022-1025.
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abstract = "Objective: To determine the frequency of recurrent sexually transmitted infections (STIs) and/or pelvic inflammatory disease (PID), the average time until subsequent infection following a baseline PID diagnosis, and age- and insurance-related associations with subsequent diagnoses. Design: This study used prospective longitudinal follow-up of STI and/or PID outcome data from electronic medical records. Setting: An urban academic hospital system. Participants: A total of 110 adolescent girls treated for PID as outpatients in pediatric ambulatory sites. Main Exposure: Electronic medical records used to assess subsequent PID diagnoses and/or infections with Neisseria gonorrhoeae or Chlamydia trachomatis during the study window. Main Outcome Measures: Demographic, health care use, and STI and/or PID outcome data were examined. Incidence of an STI and/or PID was calculated as incident cases per person-months of exposure. Cox proportional hazard modeling was performed to evaluate the incidence of STI by age or insurance status. Results: The mean (SD) age was 16.8 (1.9) years, 89{\%} of patients were black, and 39{\%} had laboratory results that were positive for N gonorrhoeae or C trachomatis at baseline. Thirty-four percent of patients had an additional diagnosis of an STI during the 48-month follow-up window (incidence, 3.1 per 100 person-months) and the mean (SD) time to a subsequent STI and/or PID was 377 (297) days. Of those patients, 67{\%} (n = 18) had chlamydia, 11{\%} had gonorrhoeae, and 44{\%} had PID. There were no differences based on age or insurance status. Conclusions: Adolescents treated for PID are at risk for subsequent STI and/or PID for a 48-month period. Given the need to prevent future infections in these vulnerable youths, efforts to explore the value of ongoing strategies for risk reduction after diagnosis are warranted.",
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