The prevalence of Chlamydia trachomatis in fresh tissue specimens from patients with ectopic pregnancy or tubal factor infertility as determined by PCR and in-situ hybridisation

Abstract

The prevalence of chlamydial DNA determined by PCR and in-situ hybridisation (ISH) in fresh tissue specimens (endometrium, fallopian tube and ovary) was investigated in 33 women presenting with ectopic pregnancy (EP), 14 women with tubal factor infertility (TFI) and 50 control patients from the UK and the West Indies. In the UK EP group, chlamydial DNA was detected by PCR in 56% of patients; similar results were found in the Trinidad EP group (67%). In the TFI group, chlamydial DNA was detected in (71%) of patients by PCR. The detection of Chlamydia trachomatis DNA by ISH was highest in the TFI group (43%). Women presenting with EP and TFI showed evidence of previous or current genital C. trachomatis infection, underlining the importance of this microorganism in the development of these conditions. Importantly, chlamydial DNA could be detected in DNA preparations from the endometrium, fallopian tube and ovary of EP and TFI patients at the time of surgery.

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

“…Similar findings were reported by five previous studies that were unable to detect C. trachomatis DNA in 189 tubal samples collected from EP patients with positive serological markers of C. trachomatis (5,8,19,37,50). In contrast, C. trachomatis DNA was found in 0.03 to 70% of the cases in another five studies (4,15,33,47,70). One explanation for the nondetection of chlamydial DNA in our case group could be the small sample size.…”

“…Nucleic acid amplification tests, which include N-PCR, are more typically used for screening and diagnosing chlamydial infections. The plasmid target DNA is present only in C. trachomatis and at 7 to 10 copies per genome; therefore, targeting it with PCR increases the sensitivity and specificity of the test (4,5,18). We targeted plasmid DNA using N-PCR, but chlamydial DNA was not detected in any of our 14 patients with ectopic pregnancy.…”

“…Detection rates of chlamydial DNA have varied considerably in different studies of fallopian tubes from patients with EP (range, 0.03 to 70%; mean, 26%) (4,15,33,47,70). Chlamydial mRNA was also detected by reverse transcription-PCR (RT-PCR) in one study that included 10 patients, and the authors suggested that their results indicated the presence of metabolically active C. trachomatis organisms (15).…”

Murine Oviduct Epithelial Cell Cytokine Responses toChlamydia muridarumInfection Include Interleukin-12-p70 Secretion

“…Clinical data suggests that C. trachomatis evades immune-mediated elimination to cause persistent infections in some individuals (4,11,45,54,57,64,68). In women, chronic or recurrent C. trachomatis urogenital infections scar the Fallopian tubes, resulting in infertility and ectopic pregnancies, the two clinically important sequelae of infection (12,13).…”

Tubal Damage, Infertility and Tubal Ectopic Pregnancy: Chlamydia trachomatis and Other Microbial Aetiologies

“…The finding of chlamydial RNA in Fallopian tube biopsy samples collected from women with ectopic pregnancies suggested that viable, metabolically active bacteria were present in the Fallopian tubes of these women (Gerard et al, 1998). Chlamydial DNA has also been detected in the Fallopian tube tissue collected from women at the time of ectopic pregnancy (Barlow et al, 2001;Noguchi et al, 2002). A report to the contrary regarding the detection of chlamydial DNA in fresh tissue from the Fallopian tubes of women with ectopic pregnancy has, however, also been published and suggested that persistent chlamydial infection of Fallopian tubes was rare in ectopic pregnancy (Bjartling et al, 2007).…”