Differences in sexually transmitted infection-associated cervical infections in pelvic inflammatory disease patients between adolescents and adults

Abstract

Objective

Pelvic inflammatory disease (PID) is an infection of female reproductive organs mainly in sexually active patients, which can cause serious complications throughout life. We aimed to analyze the risk factors and differences in sexually transmitted infections (STIs) between adolescents and adult PID patients.

Materials and methods

We conducted a retrospective study based on descriptive and statistical analyses of the clinical records of patients with PID treated with antibiotics between January 2013 and December 2023 at Busan Paik Hospital. In this study, we analyzed the clinical characteristics of patients and the types of cultured bacteria in vaginal discharge, as well as their association with STIs according to age.

Results

Three hundred patients required hospitalization and treatment with antibiotics. Thirty-nine (13.0 %) were adolescent patients, and 261 (87 %) were adult patients. Infections of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, and Trichomonas vaginalis were more prevalent in adolescents than in adult patients (P < 0.001, 0.001, 0.013, <0.001, 0.004 and 0.010, respectively). Although Lactobacillus spp. was predominant among the cultured strains in both adolescents and adults, it was detected in 29.6 % of adolescent patients and 48.4 % of adults; its detection rates were relatively lower among adolescents (P = 0.071). Among adolescents, 30.6 % were smokers, while 13.3 % were smokers among adult patients. Although there was a higher prevalence of smoking among adolescents, the statistical analysis did not show a significant difference in smoking prevalence between adolescents and adults (P = 0.08).

Conclusion

In this study, adolescents with PID exhibited a higher prevalence of STIs compared to adults. Additionally, One-third of these adolescents were smokers and did not use barrier protection. PID in adolescents has distinct risk factors, causative bacteria, and clinical features compared to adults. Hence, it is crucial to develop effective strategies for treating and preventing STIs in this population.