Antibody was first detected at 11 years of age, likely coinciding with sexual debut. The prevalence of antibody was higher and appeared earlier in females, mirroring national surveillance trends based on nucleic acid amplification testing. The delay in male antibody detection may be due to biological or behavioral differences between genders. These data are critical in informing potential C. trachomatis vaccine strategies.
Objective To determine current seroepidemiology of CT infection in children in a US inner city population. Design/methods Anonymized serum samples were obtained from children in 2 hospitals in Brooklyn, NY from 2012-2015. CT IgG was determined using EIA (Ani Labsystems). The following age strata were used: 11-12, 13-14, 15-16, 17-18, 19-20 y. Results 512 sera were included in the final analysis. Mean age 17 y. There were 192 (37.5%) males and 320 (62.5%) females. CT antibody was first detected at 16 y and 18 y for females and males, respectively. The prevalence per age-cohort were: Females: 11-14 y-0, 15-16 y-3.64%, 17-18 y -15.9%, 19-20 y -14.75%; Males: 11-16 y-0, 17-18 y-8.51%, 18-20 y-9.33%. Conclusions The prevalence of antibody was higher in girls than their male counterparts, mirroring national trends based on NAATs. Antibody was first detected in females at 16 y and males at 17 y, reflecting sexual debut. Prior data from this cohort found antibody in% infants < 1 y, which disappeared between 1 and 16 y. The delay in male antibody detection may be due to later exposure and/or anatomical and physiological factors between the sexes. These data are critical in informing potential CT vaccine strategies. Future studies using a larger sample size and other populations will allow more precise estimates of age and gender-specific prevalence. Introduction CT remains the most prevalent sexually transmitted infection in developed and developing countries. Prenatal screening and treatment of pregnant women has resulted in a dramatic decrease of perinatal CT l infection (conjunctivitis, pneumonia) in the US. Before the implementation of screening,~50% of infants born to mothers with CT infection developed chlamydial conjunctivitis and/or pneumonia. However, there have been no studies of the incidence of perinatal CT infection, including seroepidemiologic studies, following the implementation of screening and treatment as recommended by the CDC in 1993. Methods Anonymized banked serum and prospectively collected samples from children in Brooklyn, NY, were tested for CT IgG using the MIF assay. Serum samples were divided into 2 groups: 1: collected from 1991-1995, 2: from 2001-2013. Pts with C. pneumoniae (CP) infection (culture and/or antibody) were excluded. Results 491 serum samples were identified (age range 0-20), 71 samples were excluded due to evidence of CP infection. 34% of subjects <10 y in group 1 (pre-universal screening) had IgG against CT, while there were no positives in group 2 (post-universal screening), p < 0.0001. Children >10 y had a prevalence of 32% in group 1 and 3.48% in group 2, p < 0.0001. Conclusion Children <10 yr in group 1 (pre-screening) had relatively high rates of seropositivity, which were likely due to perinatal infection. This antibody was not due to CP, as sera from children with CP infection were excluded. The significantly lower rates in group 2 (post-screening) confirm that prenatal screening and treatment of pregnant women has been effective for prevention of CT infection in in...
BackgroundChlamydia pneumoniae (Cpn) is unique in its ability to cause chronic infections, potentially triggering asthma exacerbations as well as subsequent asthma development. Th1-mediated immunity and IFN-γ are critical for clearing chlamydial infections. Persistent or recent Cpn infection may be identified in vitro by detecting T-helper cytokine IFN-γ produced by peripheral blood mononuclear cells (PBMC) stimulated by Cpn. Inhaled corticosteroids (ICS) may have an inhibitory effect on IFN-γ. Prior studies have shown increased Th2 responses upon in vitro Cpn stimulation with increased age. Our aim was to determine whether age and inhaled corticosteroid (ICS) use affect Cpn-induced PBMC produced IFN-γ levels.MethodsPediatric and adult subjects with (n = 23) and without (n = 10) asthma were enrolled. PBMC obtained from all subjects were stimulated with Cpn (MOI = 0.1 x48h) in vitro. IFN-γ levels in culture supernatants were determined by ELISA and reported as pg/mL. Nasopharyngeal (NP) swabs were tested for Cpn using Real-Time PCR. Statistical analysis for continuous variables was performed using the Mann–Whitney U test.ResultsNone of the subjects were positive for Cpn by PCR on NP swab. Levels of IFN-γ produced by PBMC stimulated by Cpn were similar between asthmatic vs. control subjects (41.7 vs. 68.8, respectively; P = 0.72) and between pediatric and adult subjects with asthma (IFN-γ 54 vs. 20.1 respectively, P = 0.95). Pediatric subjects with asthma who received ICS had lower IFN-γ levels than those who did not (median IFN-γ 25.5 vs. 209; P = 0.003).ConclusionOur finding of lower IFN-γ levels among asthma patients on ICS compared with those not on ICS suggests that ICS use may dampen the systemic inflammatory response. While we did not find a statistically significant difference between pediatric and adult age groups in this pilot study, there was a trend to higher Cpn-induced IFN-γ levels among younger pediatric subjects. Future prospective studies should further define predictors of diminished IFN-γ responses in patients with asthma.Disclosures All authors: No reported disclosures.
BackgroundGroup A Streptococcus (GAS), is currently diagnosed by throat culture or rapid antigen detection test (RADT) by a healthcare provider (HP), usually in an outpatient (OP) setting. There is current interest in expanding OTC diagnostics (FDA approved for HIV and hepatitis C) to other infectious diseases such as GAS pharyngitis. There are no data on parental acceptance of such a test. Our aim was to determine parental acceptance of expanding OTC diagnostic availability for GAS pharyngitis testing.MethodsCaregivers of 3–18 years old in OP primary care pediatric clinics were given a questionnaire: data included demographics (excluding all patient identifiers), interest in buying/using an OTC GAS test, education level, type of health insurance (HI), comfort level swabbing their child, interest in available support/free hotline with the test. Statistical analysis included Mann–Whitney U test for non-continuous and T-test for continuous variables.Results90 questionnaires were collected, 14 duplicates excluded. 34 (45%) parents indicated they would buy an OTC GAS test, 35 (46%) would not, 4 (5%) were unsure, 3 (4%) did not respond. There was no correlation between interest in OTC test and age (P = NS), or education level (P = NS). There was a trend of OTC test interest among those with private HI vs. Medicaid (P = 0.067). There was a statistically significant association between interest in buying an OTC GAS test and the following variables: high self-swab comfort level and availability of support (P = 0.009 and 0.001, respectively). The majority of participants [73/76 (96%)] did not respond to questions about acceptable pricing.ConclusionThere was mixed interest in OTC GAS testing among respondents. Neither age nor educational level affected interest. Surprisingly, 96% of respondents declined to select a price they would pay for an OTC GAS test. Greater interest in OTC GAS testing among respondents with private HI suggests those parents are more likely to purchase the kits to avoid an HP visit (and co-payment). Since most respondents were comfortable self-swabbing or unsure, further education including swab tutorial and support availability may lead to greater comfort level with such testing.Disclosures All authors: No reported disclosures.
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