Epidemiologic and clinical factors of Chlamydia trachomatis in black, Hispanic and white female adolescents.

Rates of genital infection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis were determined prospectively in 396 sexually active female adolescents from three ethnically different urban teen clinics. The organisms were identified respectively in cultures of specimens from 21%, 7% and 6% of all adolescents; 28%, 16% and 20% of blacks; 23%, 4% and 2% of Hispanics, and 14%, 2% and 1% of whites. C trachomatis was identified in specimens from 27% of pregnant adolescents and from 42% of adolescents who had gonorrhea or trichomoniasis. Of 85 Chlamydia-positive adolescents, 47 (55%) were asymptomatic. Physical findings significantly associated (P <.001) with chlamydial infection were vaginal discharge, cervical inflammation and mucopurulent endocervical discharge. Not significantly associated (P >.05) with Chlamydia were the use of oral contraception or symptoms of lower abdominal pain, vaginal discharge or dysuria. Because in sexually active female adolescents C trachomatis is three times more common than N gonorrhoeae, care givers need to consider routine screening or epidemiologic treatment (or both) for both pathogens.