Effect of treatment for <i>Chlamydia trachomatis</i> during pregnancy

Rastogi, Sangita; Das, Banashree; Salhan, Sudha; Mittal, Aliza

doi:10.1016/s0020-7292(02)00371-5

Cited by 46 publications

(47 citation statements)

References 20 publications

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“…Pregnant women could be a specific target group for C. trachomatis screening. Antenatal screening, as recommended by the Centers for Disease Control and Prevention (3), may be beneficial for decreasing morbidity among women themselves but also to prevent vertical (infant) and horizontal (partner) transmission (2,6,8,9,24). Screening of pregnant women usually yields prevalences similar to those obtained with nonpregnant women.…”

Section: Discussionmentioning

confidence: 99%

Use of Pooled Urine Samples and Automated DNA Isolation To Achieve Improved Sensitivity and Cost-Effectiveness of Large-Scale Testing for Chlamydia trachomatis in Pregnant Women

et al. 2005

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The success of large-scale screening for Chlamydia trachomatis depends on the availability of noninvasive samples, low costs, and high-quality testing. To evaluate C. trachomatis testing with pregnant women, first-void urine specimens from 750 consecutive asymptomatic pregnant women from the Rotterdam area (The Netherlands) were collected. Initially, we investigated the performance of three different DNA isolation methods with 350 of these urines and 70 pools of 5 of the same subset of urine samples. The routinely used COBAS AMPLICOR test was compared to the COBAS AMPLICOR test with prior DNA isolation by use of the MagNA Pure large-volume kit and the MagNA Pure bacterial DNA isolation kit. The latter combination provided the best DNA test for pooled urines, with a sensitivity twice that of the other methods. Next, using all 750 urines, the COBAS AMPLICOR performance for individual testing was compared to pooled testing with the standard COBAS AMPLICOR procedure and subsequently to pooled testing with COBAS AMPLICOR in combination with the MagNA Pure bacterial DNA isolation kit. The sensitivity of COBAS AMPLICOR was 65% on individual and 42% on pooled urines but improved to 92% on pooled urines with the MagNA Pure bacterial DNA isolation kit, making this combination the best screening method. The C. trachomatis prevalence in this population appeared to be 6.4%. Additionally, the cost of the combined MagNA Pure bacterial DNA isolation kit and COBAS AMPLICOR method on pooled urines was only 56% of the cost of the standard COBAS AMPLICOR test applied to individual urines. Costs per positive case detected in the combined method were 39% of standard costs.Chlamydia trachomatis is one of the major sexually transmitted pathogens, and high prevalences of chlamydial infection have been documented for asymptomatic women in many European countries (34). Asymptomatic carriers are of substantial importance in the transmission of C. trachomatis infection within a community. Asymptomatic chlamydial infection in pregnant women imposes an additional risk for acute and chronic consequences for the women themselves and their (unborn) offspring (2,6,8,9,16). In The Netherlands, C. trachomatis causes most sexually transmitted infections, with approximately 60,000 new cases estimated for a total population of 16 million in the year 2000. Studies in general practice have shown an increase in the incidence of chlamydial infections (26), but data covering other specific target groups outside of the sexually transmitted disease (STD) outpatient clinics are sparse (1). Dutch population-based screening for C. trachomatis is still under debate, with cost-effectiveness of screening, complexity of sampling, the reliability of test methods, and the nature of the target population as major issues of discussion (23).In order to investigate the prevalence of chlamydial infection during pregnancy in Rotterdam, and the risk factors and consequences of chlamydial infection during pregnancy for women and newborns, a follow-up study was planned. We ex...

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Section: Discussionmentioning

confidence: 99%

Use of Pooled Urine Samples and Automated DNA Isolation To Achieve Improved Sensitivity and Cost-Effectiveness of Large-Scale Testing for Chlamydia trachomatis in Pregnant Women

et al. 2005

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“…Also, as uSpA is a forme fruste of ReA, and taken together, both ReA as well as uSpA constitute the seronegative spondyloarthropathy group, patients categorized as uSpA by a rheumatologist were also included in the study. Furthermore, despite a high prevalence of genital C. trachomatis in our country [17][18][19][20][21][22][23][24][25], this pathogen appears to be overlooked in seronegative spondyloarthropathies such as ReA and uSpA in India. In order to find the magnitude of the problem, we investigated patients with ReA or uSpA in a case-control study by molecular and nonmolecular methods for the intra-articular presence of C. trachomatis MOMP, plasmid genes, and local or systemic anti-chlamydial IgA or IgG antibodies.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Chlamydia trachomatis in patients with reactive arthritis and undifferentiated spondyloarthropathy

Prabhash

Bhakuni

Rastogi

2014

J Infect Dev Ctries

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Introduction: There is a paucity of information on the frequency of Chlamydia trachomatis-induced reactive arthritis (ReA) and undifferentiated spondyloarthropathy (uSpA) in India. In this study, arthritic patients suffering from ReA, uSpA, and rheumatoid arthritis (RA) were screened to investigate the presence of C. trachomatis infection in the synovial fluid (SF) or serum by molecular and nonmolecular methods. Methodology: A total of 76 arthritic patients with ReA (n = 16) and uSpA (n = 22) composed the study group while those with RA (n = 38) served as controls. The detection of C. trachomatis DNA was done by semi-nested PCR (snPCR) and nested PCR (nPCR) targeting two different genes of C. trachomatis, namely major outer membrane protein and plasmid, respectively. The presence of serum or SF immunoglobulin IgG and IgA antibodies against C. trachomatis was studied by commercial enzyme-linked immunosorbent assay kits. Results: The SF from 9 of 38 (23.6%) patients (5 with ReA and 4 with uSpA) was positive for at least one C. trachomatis DNA by snPCR or nPCR in comparison to RA (1/38 [2.6%]; p value < 0.05). There was no correlation between the snPCR or nPCR and the serological results of patients with ReA or uSpA. Conclusions: As molecular diagnostic techniques established intra-articular C. trachomatis infection among this group of seronegative spondyloarthropathies in India, these findings should be viewed with concern, and snPCR or nPCR should be considered for a more reliable diagnosis.

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“…Sexually transmitted C. trachomatis genitourinary infection is a widespread public health concern globally including in India because of its increased prevalence (Rastogi et al, 2003(Rastogi et al, , 2014Mittal et al, 2004;Reddy et al, 2004) and potentially devastating reproductive consequences in females, particularly in relation to adverse obstetric outcomes such as RSA. Although the immunopathologic consequences of infection and the adverse effects that C. trachomatis has on the female genital tract are well established, the underlying mechanism of Chlamydia-induced spontaneous abortion in women warrants further research.…”

Section: Discussionmentioning

confidence: 99%

Expression of prostaglandin receptors in Chlamydia trachomatis-infected recurrent spontaneous aborters

Singh

Prasad

Singh

et al. 2016

Journal of Medical Microbiology

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A study was undertaken to quantify the expression of prostaglandin (PG) receptors and find the effect of gestational age on expression of PG receptor genes in Chlamydia trachomatis-infected recurrent spontaneous aborters (RSA). Endometrial curettage tissue (ECT) was collected from 130 RSA (Group I) and 100 age-matched controls (Group II) at the Department of Obstetrics and Gynecology, Safdarjung Hospital, New Delhi (India). PCR was performed for diagnosis of C. trachomatis cryptic plasmid; mRNA expression of PG receptor genes was assessed by real-time PCR (q-PCR), while serum progesterone/estrogen levels were determined by respective commercial kits. Data were evaluated statistically. A total of 15.4 % RSA (GroupI) were diagnosed as C. trachomatis-positive (200 bp), whereas controls were uninfected. q-PCR showed significant upregulation (P<0.0001) of PGE2 (EP-1, EP-2, EP-3, EP-4), PGF2a (FP) and PGI2 (IP) receptors in Group I versus Group II. The expression of PG receptors increased significantly with advanced gestational age (P<0.002); however, only contractile receptors, EP-1, EP-3 and FP, were positively correlated with gestational age in Group-I. In infected RSA, mean serum progesterone level was significantly low (P<0.0001) while serum oestrogen was high (P<0.0001). Overall, the data suggest that increased expression of PG receptors, particularly contractile gene receptors (EP-1, EP-3, FP), with advanced gestational age and altered steroid levels could be a possible risk factor for abortion in Chlamydia-infected RSA.

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Effect of treatment for Chlamydia trachomatis during pregnancy

Abstract: Our findings suggest that routine screening and treatment of C. trachomatis infection in pregnant women, especially those in high risk groups, should be mandatory to reduce the adverse effects on obstetric outcome.

Cited by 46 publications

References 20 publications

Use of Pooled Urine Samples and Automated DNA Isolation To Achieve Improved Sensitivity and Cost-Effectiveness of Large-Scale Testing for Chlamydia trachomatis in Pregnant Women

Use of Pooled Urine Samples and Automated DNA Isolation To Achieve Improved Sensitivity and Cost-Effectiveness of Large-Scale Testing for Chlamydia trachomatis in Pregnant Women

Diagnosis of Chlamydia trachomatis in patients with reactive arthritis and undifferentiated spondyloarthropathy

Expression of prostaglandin receptors in Chlamydia trachomatis-infected recurrent spontaneous aborters

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