Chlamydia trachomatis Incidence and Re-Infection among Young Women – Behavioural and Microbiological Characteristics

Walker, Jennifer; Tabrizi, Sepehr N.; Fairley, Christopher K.; Chen, Marcus Y; Bradshaw, Catriona; Twin, Jimmy; Taylor, Nicole; Donovan, Basil; Kaldor, John; McNamee, Kathleen; Urban, Eve; Walker, Sandra; Currie, Marian J.; Birden, Hudson; Bowden, Francis J.; Gunn, Jane; Pirotta, Marie; Gurrin, Lyle C.; Harindra, V; Garland, Suzanne M.; Hocking, Jane S

doi:10.1371/journal.pone.0037778

Cited by 110 publications

(119 citation statements)

References 43 publications

(59 reference statements)

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“…Serovars E and F are generally found to be predominant in most countries, including Australia, Netherlands, and Sweden (28)(29)(30)(31)(32). Using omp1 PCR-based restriction fragment length polymorphism genotyping, Lan et al (33) reported that in women Ͻ30 years old, serovars D (4/21 asymptomatic women) and I (4/21 asymptomatic women) were associated with asymptomatic infection, while serovar G was associated with symptomatic infection (4/30 symptomatic cases).…”

Section: Chlamydial Serovars Can Associate With Repeat Infection and mentioning

confidence: 99%

“…Batteiger et al studied a longitudinal cohort of 210 adolescent women (14 to 17 years old) in the United States and found that 121 experienced repeat infections (79). In a longitudinal cohort in Australia, 1,116 women (16 to 25 year old) were followed up and 14 reinfections were observed in a total of 81 women who were at risk of repeat infection (3 of these had two episodes of reinfection) (cumulative risk over 12 months of 20.3%; 95% confidence interval [CI], 13.2 to 37.6%) (32). Interestingly, in this study in Australia, the organism load was lower in reinfections than in prevalent infections detected at the study baseline (32) but there were no associations between patient characteristics and reinfection (32) (possibly because the study was underpowered to detect an effect).…”

Section: Repeat Infection and Infertilitymentioning

confidence: 99%

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Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women

et al. 2015

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SUMMARY Chlamydia trachomatis is the most common bacterial sexually transmitted pathogen worldwide. Infection can result in serious reproductive pathologies, including pelvic inflammatory disease, ectopic pregnancy, and infertility, in women. However, the processes that result in these reproductive pathologies have not been well defined. Here we review the evidence for the human disease burden of these chlamydial reproductive pathologies. We then review human-based evidence that links Chlamydia with reproductive pathologies in women. We present data supporting the idea that host, immunological, epidemiological, and pathogen factors may all contribute to the development of infertility. Specifically, we review the existing evidence that host and pathogen genotypes, host hormone status, age of sexual debut, sexual behavior, coinfections, and repeat infections are all likely to be contributory factors in development of infertility. Pathogen factors such as infectious burden, treatment failure, and tissue tropisms or ascension capacity are also potential contributory factors. We present four possible processes of pathology development and how these processes are supported by the published data. We highlight the limitations of the evidence and propose future studies that could improve our understanding of how chlamydial infertility in women occurs and possible future interventions to reduce this disease burden.

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Section: Chlamydial Serovars Can Associate With Repeat Infection and mentioning

confidence: 99%

Section: Repeat Infection and Infertilitymentioning

confidence: 99%

Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women

et al. 2015

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“…While background antibiotic use may impact the transmission of STIs on a population level, it may also impact clinical practices since it affects the outcome of an STI diagnostic test and may interact with subsequent treatment. Studies among men and young women receiving antenatal, general practitioner, or sexual health care in Australia demonstrated that recent antibiotic use was associated with a lower prevalence and incidence of genital C. trachomatis (1,15,16,17). However, the specific antibiotic agents were not studied.…”

mentioning

confidence: 99%

Antibiotic Use before Chlamydia and Gonorrhea Genital and Extragenital Screening in the Sexually Transmitted Infection Clinical Setting

Dukers-Muijrers

Liere

Wolffs

et al. 2015

Antimicrob Agents Chemother

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bBackground antibiotic use (i.e., administration of antibiotics not directly related to Chlamydia trachomatis or Neisseria gonorrhoeae infections) has been associated with a lower prevalence of genital C. trachomatis infection in a clinical setting. Associations with specific antibiotic types or with N. gonorrhoeae are lacking. Here, we assessed the prevalence of antibiotic use, the different classes and agents used, and their association with a subsequent sexually transmitted infection (STI) clinic C. trachomatis and N. gonorrhoeae test result. At our STI clinic, we systematically registered whether antibiotics were used in the past month (in 29% of the cases, the specific antibiotic agent was named). Patients were screened for urogenital C. trachomatis and N. gonorrhoeae; a third of them were also screened for anorectal and oropharyngeal C. trachomatis and N. gonorrhoeae. The proportion of antibiotics used and their association with C. trachomatis and N. gonorrhoeae prevalence were assessed for heterosexual men, men who have sex with men (MSM), and women. During 14,775 clinic consultations, antibiotic use was reported by 12.2% (95% confidence interval [CI], 11.7% to 12.7%), i.e., 14.8% of women, 8.6% of heterosexual men, and 11.6% of MSM. The most reported antibiotics were penicillins, tetracyclines, and macrolides, respectively. The prevalence was 11.0% (95% CI, 10.3% to 11.3%) for C. trachomatis and 1.9% (95% CI, 1.7% to 2.1%) for N. gonorrhoeae. Only tetracycline use was associated with a lower C. trachomatis prevalence (3%). Overall antibiotic use was associated with lower anorectal C. trachomatis prevalence in MSM only (odds ratio, 0.4; 95% CI, 0.2 to 0.8). STI clinic visitors commonly report recent antibiotic use. Even in a country with low antibiotic consumption, tetracycline use impacted C. trachomatis prevalence, while there was a notable absence of association with azithromycin.

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“…Repeated detection of chlamydia after screening and treatment is common. About 20-30% of treated women followed prospectively have a repeat positive chlamydia test by 12 months [198,199], despite routine partner notification efforts. In a prospective cohort study of young women who were screened for chlamydia every three months, the point prevalence of chlamydia remained at around 10% throughout follow up [200].…”

Section: Impact Of Chlamydia Screening On Transmission Of Chlamydiamentioning

confidence: 99%

Opportunistic testing for urogenital infection with Chlamydia trachomatis in south-western Switzerland, 2012: a feasibility study

et al. 2015

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The feasibility of opportunistic screening of urogenital infections with Chlamydia trachomatis was assessed in a cross-sectional study in 2012, in two cantons of south-western Switzerland: Vaud and Valais. Sexually active persons younger than?30 years, not tested for C. trachomatis in the last three months, were invited for free C. trachomatis testing by PCR in urine or self-applied vaginal swabs. Of 2,461 consenting participants, 1,899 (77%) were women and all but six (0.3%) submitted a sample. Forty-seven per cent of female and 25% of male participants were?younger than?20 years. Overall, 134 (5.5%) of 2,455 tested participants had a positive result and were followed up. Seven per cent of all candidates for screening were not invited, 10% of invited candidates were not eligible, 15% of the eligible candidates declined participation, 5% of tested participants testing positive were not treated, 29% of those treated were not retested after six months and 9% of those retested were positive for C. trachomatis. Opportunistic C. trachomatis testing proved technically feasible and acceptable, at least if free of charge. Men and peripheral rural regions were more difficult to reach. Efforts to increase testing and decrease dropout at all stages of the screening procedure are necessary.

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Chlamydia trachomatis Incidence and Re-Infection among Young Women – Behavioural and Microbiological Characteristics

Cited by 110 publications

References 43 publications

Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women

Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women

Antibiotic Use before Chlamydia and Gonorrhea Genital and Extragenital Screening in the Sexually Transmitted Infection Clinical Setting

Opportunistic testing for urogenital infection with Chlamydia trachomatis in south-western Switzerland, 2012: a feasibility study

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