{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:31:05Z","timestamp":1786113065161,"version":"build-2736575974"},"reference-count":33,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001232","name":"Royal Australasian College of Physicians","doi-asserted-by":"publisher","award":["Research entry scholarship"],"award-info":[{"award-number":["Research entry scholarship"]}],"id":[{"id":"10.13039\/501100001232","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003521","name":"Department of Education, Australian Government","doi-asserted-by":"publisher","award":["Research training scholarship"],"award-info":[{"award-number":["Research training scholarship"]}],"id":[{"id":"10.13039\/501100003521","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1173361"],"award-info":[{"award-number":["GNT1173361"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2033299"],"award-info":[{"award-number":["GNT2033299"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,7,23]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      and\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      are established causes of pelvic inflammatory disease (PID), but up to 70% of cases with PID have neither infection detected. We determined the prevalence of and trends in\n                      <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                      and bacterial vaginosis (BV) detection among women with non-\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      \/\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      PID to inform testing and treatment strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective case series to determine the number of cases with PID (defined by presence of a minimum of uterine, adnexal or cervical motion tenderness) with\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      ,\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      ,\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      and\/or BV detected between 2014 and 2024 at Melbourne Sexual Health Centre (MSHC). We examined trends in testing and detection of each infection over time and, among cases with PID tested for all four infections, determined the proportion with each infection detected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 3000 cases with PID during the study period. Over the 11 years, the proportion of cases with PID tested for\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      and\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      was stable and high, with rises in their detection (range=7%\u201319%,\u2009P\n                      <jats:sub>trend<\/jats:sub>\n                      =0.021; 1%\u20137%, P\n                      <jats:sub>trend<\/jats:sub>\n                      &lt;0.001, respectively). Both the proportion tested for BV and\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      (89%\u201395%, 91%\u201397%, P\n                      <jats:sub>trend<\/jats:sub>\n                      =&lt;0.001, respectively) and with BV and\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      detected (22%\u201337%, 6%\u201314%, P\n                      <jats:sub>trend<\/jats:sub>\n                      &lt;0.001, respectively) significantly increased over time. Among 2557 (85%) cases tested for all four infections, 927 (36%) had 1 and 256 (10%) had &gt;1 infection detected. Among 2149 (84%) non-\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      \/\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      cases with PID, 26% had BV, 6% had\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      and 4% were co-infected with BV and\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      ; &gt;50% had none of the infections detected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this retrospective study of cases with PID attending MSHC between 2014 and 2024,\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      and\/or\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      were detected in &lt;20% of all cases. Among non-\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      \/\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      cases with PID, BV and\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      detection was common and increased over time. Prospective case-control and sequencing studies are needed to determine the aetiologic contribution of BV,\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      and other additional candidate organisms to PID.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2026-056959","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T17:20:11Z","timestamp":1785950411000},"page":"sextrans-2026-056959","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Infections detected in women with pelvic inflammatory disease: a retrospective case series"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1754-4920","authenticated-orcid":false,"given":"Kay","family":"Htaik","sequence":"first","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"},{"name":"School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona S","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"},{"name":"School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5710-2671","authenticated-orcid":false,"given":"Erica L","family":"Plummer","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"},{"name":"School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3147-0541","authenticated-orcid":false,"given":"Laura Grimminck","family":"Matthews","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"},{"name":"School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishtha","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5012-5659","authenticated-orcid":false,"given":"Natasha L","family":"Wild","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"},{"name":"School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":false,"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"},{"name":"School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3679-9195","authenticated-orcid":false,"given":"Lenka A","family":"Vodstrcil","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Bayside Health, Carlton, Victoria, Australia"},{"name":"School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"2026080510200673000_sextrans-2026-056959v1.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7287.658"},{"key":"2026080510200673000_sextrans-2026-056959v1.2","unstructured":"Goller J , Fairley C , Guy R , et al . Aetiology of infections associated with 1228 cases of pelvic inflammatory disease in an urban Australian sexual health clinic setting. 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