Persistent Chlamydia trachomatis genital infection: laboratory diagnosis and treatment

Abstract

If Chlamydia trachomatis (Ct) can not be cleared in time after invading human genital tract, it tends to cause persistent infection and induce severe sequelae, such as tubal infertility. Laboratory examination is of great value in the diagnosis of persistent Ct infection. Combined detection of antibodies to CT443 and CT381, or antibodies to Ct heat shock protein 60 (HSP60) , CT376, CT557 and CT443, can predict female tubal infertility with a specificity of 100% and a high sensitivity. Nucleic acid amplification techniques can be used to detect low Ct loads and to increase detection rates of Ct in patients with persistent infection. In clinic, antibacterial agents are the mainstay of treatment for Ct infection. Azithromycin in combination with metronidazole for 5 days or doxycycline combined with metronidazole for 7 days can be recommended for the treatment of persistent or recurrent nongonococcal urethritis. However, further studies are needed to confirm the efficacy of tryptophan metabolism-related drugs and glucocorticoids in the auxiliary treatment of persistent Ct infection. Key words: Chlamydia trachomatis; Reproductive tract infections; Clinical laboratory techniques; Diagnosis; Therapeutic uses