Detecção de Chlamydia trachomatis pela técnica de Reação em Cadeia de Polimerase (PCR) em mulheres atendidas na clínica de infertilidade do Hospital Dona Francisca Mendes, Manaus - Amazonas

Abstract

Chlamydia trachomatis is a sexually transmitting bacterium that causes great impact on females reproductive health and also, constitutes an important problem for the publichealth. The infection by C. trachomatis is estimated about 90 million cases worldwide. C. trachomatis is considerated the most prevalent sexually transmitting bacterium mainly in developing countries and causes diseases on urogenital tract, venereal limphogranuloma and others. One of the risks of infection is the practice without protection among adolescents. The recurring risk is common without the use of preservatives. The diagnostic is critical because most of the times the infection is assynptomatic. In females, the infection by C. trachomatis cause pelvic inflammatory disease (PID) and the consequences can lead to infertility, ectopic pregnancy and chronicle pelvic pain. The nucleic acid amplification techniques allow us to use small amount of samples to detect Chlamydia. The choice of the technique to detect Chlamydia trachomatis was Polymerase Chain Reaction (PCR) that offers greater sensitivity and specificity than tests as immunoassay and bacteria culture, for estimate the prevalence of this pathogen in endocervical samples of infertiles women attended in the clinic of infertility of the Dona Francisca Mendes University Hospital, in Manaus-Am-Brazil. The study population consisted of 106 women with infertility diagnosis and was realized medical gynecologic examination to obtain samples for the amplification of Chlamydia trachomatis DNA plasmid. Informations of the socialeconomic-demographs variations and clinics variations were obtained through questionaire and through signature consent term that were aplicated for each patient that participated in this study. For the statistical analysis were used the software Epi-Info 3.3 for Windows and the significant level used in the tests were 5%. The prevalence found for Chlamydial infection by the PCR method were 52,8%. To confirm the weak band found of 241 pb at the amplification region, were realized the analysis on the 6% Poliacrilamid gel and DNA sequencing of DNA Chlamydial plasmid. In relation to the PCR test and socialdemographs variations, the statistical analysis demonstrated significant assocation of 5% (p < 0,05) only for the family income (2 to 4 salaries). About variability of genes, were verified at ten samples that were sequenced minimal variations from 1,1% up to 3,3% comparing to the Chlamydia trachomatis plasmid. Due to the high prevalence found of Chlamydia trachomatis in this study, were verified the necessity to implant the detections programs in large scale, using the PCR method in clinicals samples, for having the most sensitive and specificity to determine the reduction of this pathogen in sexually active men and women.