Azithromycin Efficacy in Asymptomatic Rectal Chlamydial Infection in Men Who Have Sex With Men: A More Definitive Answer Soon?

Batteiger, Byron E.

doi:10.1097/olq.0000000000000639

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…In humans, C. trachomatis strains most frequently infect the cervix and urethra but can also colonize the pharynx, conjunctiva, and GI tract. Chlamydial GI infections are often asymptomatic, can persist without overt signs or symptoms of infection, and are less sensitive to the standard-of-care antibiotic therapy (single-dose azithromycin) ( 6 , 8 , 9 , 26 – 28 ). Because of the propensity of GI infections to persist, even following antibiotic therapy, it has been proposed that chlamydial GI infection is a reservoir for genital tract reinfections ( 7 – 10 ).…”

Section: Discussionmentioning

confidence: 99%

Chlamydia muridarum Genital and Gastrointestinal Infection Tropism Is Mediated by Distinct Chromosomal Factors

et al. 2018

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Some members of the genus Chlamydia, including the human pathogen Chlamydia trachomatis, infect multiple tissues, including the genital and gastrointestinal (GI) tracts. However, it is unknown if bacterial targeting to these sites is mediated by multifunctional or distinct chlamydial factors. We previously showed that disruption of individual large clostridial toxin homologs encoded within the Chlamydia muridarum plasticity zone were not critical for murine genital tract infection. Here, we assessed whether cytotoxin genes contribute to C. muridarum GI tropism. Infectivity and shedding of wild-type (WT) C. muridarum and three mutants containing nonsense mutations in different cytotoxin genes, tc0437, tc0438, and tc0439, were compared in mouse genital and GI infection models. One mutant, which had a nonsense mutation in tc0439, was highly attenuated for GI infection and had a GI 50% infectious dose (ID50) that was 1,000 times greater than that of the WT. GI inoculation with this mutant failed to elicit anti-chlamydial antibodies or to protect against subsequent genital tract infection. Genome sequencing of the tc0439 mutant revealed additional chromosomal mutations, and phenotyping of additional mutants suggested that the GI attenuation might be linked to a nonsense mutation in tc0600. The molecular mechanism underlying this dramatic difference in tissue-tropic virulence is not fully understood. However, isolation of these mutants demonstrates that distinct chlamydial chromosomal factors mediate chlamydial tissue tropism and provides a basis for vaccine initiatives to isolate chlamydia strains that are attenuated for genital infection but retain the ability to colonize the GI tract and elicit protective immune responses.

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Section: Discussionmentioning

confidence: 99%

Chlamydia muridarum Genital and Gastrointestinal Infection Tropism Is Mediated by Distinct Chromosomal Factors

et al. 2018

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Epidemiology of symptomatic infective anoproctitis in a population of men having sex with men (MSM)

et al. 2022

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Extragenital Gonorrhea and Chlamydia Among Men and Women According to Type of Sexual Exposure

Bamberger¹,

Graham²,

Dennis

et al. 2019

Sexual Trans Dis

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Background Current guidelines recommend screening for extragenital gonorrhea (GC) and chlamydia (CT) only among men having sex with men (MSM). Extragenital GC and CT is associated with treatment failure and disease transmission. The prevalence of extragenital GC/CT infections in women and in men having sex with women (MSW) are less well studied. We sought to determine the prevalence of extragenital CG and CT among all persons attending a sexually transmitted diseases clinic who engaged in extragenital sexual activity. Methods We examined demographic and clinical data of all patients who engaged in extragenital sexual activity between January 2012 and October 2014. Nucleic acid amplification testing for GC and CT was performed at sites of exposure among all men and women at pharyngeal, rectal, and urogenital sites. Multivariable logistic regression analyses were performed to determine the extent that age, race/ethnicity, and number of sexual partners predicted a positive test result. Results Pharyngeal GC was found in 3.1% of MSW, representing 35% of the GC infections in MSW. Thirty-six percent of MSW with pharyngeal GC tested negative at their urogenital site. Pharyngeal GC in MSW prevalence was higher among those with younger age or a higher number of sex partners. Pharyngeal GC, rectal GC, and rectal CT rates were 8.5%, 15.0%, and 16.5%, respectively, among MSM and 3.8%, 4.8%, and 11.8% among women having sex with men (WSM), respectively. Conclusions Extragenital GC and CT rates of infection was highest among MSM but was also observed in WSM and MSW, representing an unrecognized disease burden.

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Azithromycin Efficacy in Asymptomatic Rectal Chlamydial Infection in Men Who Have Sex With Men: A More Definitive Answer Soon?

Cited by 3 publications

References 17 publications

Chlamydia muridarum Genital and Gastrointestinal Infection Tropism Is Mediated by Distinct Chromosomal Factors

Chlamydia muridarum Genital and Gastrointestinal Infection Tropism Is Mediated by Distinct Chromosomal Factors

Epidemiology of symptomatic infective anoproctitis in a population of men having sex with men (MSM)

Extragenital Gonorrhea and Chlamydia Among Men and Women According to Type of Sexual Exposure

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