Chlamydia Trachomatis In Women Research Articles

Molecular Diagnosis of Chlamydia trachomatis in Women with Frequent Abortions

Molecular Diagnosis of Chlamydia trachomatis in Women with Frequent Abortions

Expression of HPV-16 E6 and E7 oncoproteins alters Chlamydia trachomatis developmental cycle and induces increased levels of immune regulatory molecules.

Infection with Human Papillomavirus (HPV) is a recognized risk factor for Chlamydia trachomatis (CT) infection and vice versa. Coinfection of HPV and CT in women is a very common and usually asymptomatic finding that has been linked to increased risk of cervical cancer. It has been demonstrated that CT facilitates the entry of multiple high risk HPV genotypes, leading to damage of the mucosal barrier and interfering with immune responses and viral clearance, which ultimately favours viral persistence and malignant transformation. Although the facilitating effects elicited by CT infection on viral persistence have been reported, little is known about the consequences of HPV infection on CT development. Herein, we took advantage of a genetically modified human cervical cell line co-expressing HPV-16 major oncogenic proteins E6 and E7, as an experimental model allowing to investigate the possible effects that HPV infection would have on CT development. Our results show that CT infection of HPV-16 E6E7 expressing cells induced an upregulation of the expression of E6E7 oncoproteins and host cell inhibitory molecules PD-L1, HVEM and CD160. Additionally, smaller chlamydial inclusions and reduced infectious progeny generation was observed in E6E7 cells. Ultrastructural analysis showed that expression of E6 and E7 did not alter total bacterial counts within inclusions but resulted in increased numbers of reticulate bodies (RB) and decreased production of infectious elementary bodies (EB). Our results indicate that during CT and HPV coinfection, E6 and E7 oncoproteins impair RB to EB transition and infectious progeny generation. On the other hand, higher expression of immune inhibitory molecules and HPV-16 E6E7 are cooperatively enhanced in CT-infected cells, which would favour both oncogenesis and immunosuppression. Our findings pose important implications for clinical management of patients with HPV and CT coinfection, suggesting that screening for the mutual infection could represent an opportunity to intervene and prevent severe reproductive health outcomes, such as cervical cancer and infertility.

P-459 Sexually transmitted infections in women and fecundability – A prospective cohort study

Abstract Study question Does a previous infection with Chlamydia trachomatis (CT) or genital herpes simplex virus (HSV) affect fecundability, and does recency of infection play a role? Summary answer Previous infection with CT or HSV in women was not appreciably associated with fecundability. However, a recent CT infection was associated with slightly lower fecundability. What is known already Worldwide, 1 million people contract sexually transmitted infections (STIs) every day. CT and genital HSV infections are among the most common STIs. Untreated CT in women can cause pelvic inflammatory disease (PID), which can lead to scarring and narrowing of the fallopian tubes and the lower uterus, thus complicating the ability to conceive. Also, an association between genital HSV in women and PID has been suggested. However, it is uncertain to what extent CT and HSV infections in women are associated with fecundability, defined as the per-cycle probability of conception, and whether recency of the infection plays a role. Study design, size, duration We conducted a prospective cohort study of female participants included in two Danish preconception cohorts: SnartGravid.dk (‘Soon Pregnant’, 2007-2011) and SnartForældre.dk (‘Soon Parents’, 2011-ongoing). At enrollment, participants had to be non-pregnant, aged 18-45 years, in a relationship with a male partner, not using contraception or fertility treatment, and trying to conceive. Participants completed a baseline questionnaire and bimonthly follow-up questionnaires until conception or up to 12 months after study entry. Participants/materials, setting, methods We analyzed data from 10475 women. At study entry, participants reported if they had ever been diagnosed (including year of first diagnosis) with CT or HSV. Fecundability ratios (FRs) were calculated using proportional probability regression models and 95% confidence intervals (CIs). The analyses were adjusted for age, income, educational attainment, other STIs, and smoking, reported at study entry. The reference groups were either women with no CT or no HSV diagnosis. Main results and the role of chance At study entry, 2603 (24.9%) of participants reported a history of infection with CT, and 766 (7.3%) with HSV. Using life table methods, 84.7% of participants conceived within 12 cycles of follow-up. Compared with the reference group, the adjusted FR for women ever diagnosed with CT was 0.98 (CI: 0.93-1.04) and 0.96 (CI: 0.88-1.06) for women ever diagnosed with HSV. Compared with the reference group, a recent CT infection was associated with slightly lower fecundability: adjusted FRs for women diagnosed 0-2 years, 2-5 years, and more than 5 years before study entry were 0.84 (CI: 0.71-0.99), 1.01 (CI: 0.90-1.12), and 1.00 (CI: 0.93-1.07), respectively. The association between recency of a HSV infection compared to the reference group was less evident: adjusted FRs for 0-2 years, 2-5 years, and more than 5 years since study entry were 0.93 (CI: 0.72-1.21), 0.97 (CI: 0.77-1.22), and 0.91 (0.75-1.09), respectively. Limitations, reasons for caution Misclassification of exposure is possible, as CT and HSV infections are often asymptomatic and hence undiagnosed. In addition, self-report may have resulted in misclassification of infection type and year. Further, we lacked information on severity or frequency of infections. Wider implications of the findings Women diagnosed with STIs often experience psychological distress concerning their future ability to conceive. Our finding of no overall association between previous diagnoses of CT or HSV may reassure women wanting to conceive. Still, testing for STIs remains important because untreated infections can damage the female reproductive system. Trial registration number Not applicable

Natural Clearance of Chlamydia trachomatis Infection Is Associated With Distinct Differences in Cervicovaginal Metabolites.

Natural clearance of Chlamydia trachomatis in women occurs in the interval between screening and treatment. In vitro, interferon-γ (IFN-γ)-mediated tryptophan depletion results in C. trachomatis clearance, but whether this mechanism occurs in vivo remains unclear. We previously found that women who naturally cleared C. trachomatis had lower cervicovaginal levels of tryptophan and IFN-γ compared to women with persisting infection, suggesting IFN-γ-independent pathways may promote C. trachomatis clearance. Cervicovaginal lavages from 34 women who did (n = 17) or did not (n = 17) naturally clear C. trachomatis were subjected to untargeted high-performance liquid chromatography mass-spectrometry to identify metabolites and metabolic pathways associated with natural clearance. In total, 375 positively charged metabolites and 149 negatively charged metabolites were annotated. Compared to women with persisting infection, C. trachomatis natural clearance was associated with increased levels of oligosaccharides trehalose, sucrose, melezitose, and maltotriose, and lower levels of indoline and various amino acids. Metabolites were associated with valine, leucine, and isoleucine biosynthesis pathways. The cervicovaginal metabolome in women who did or did not naturally clear C. trachomatis is distinct. In women who cleared C. trachomatis, depletion of various amino acids, especially valine, leucine, and isoleucine, suggests that amino acids other than tryptophan impact C. trachomatis survival in vivo.

A pilot clinical validation study of a self-collected vaginal swab device for the detection of chlamydia trachomatis in women.

Chlamydia trachomatis (C. trachomatis) is one of the most prevalent preventable sexually transmitted diseases (STDs) in the world. In women, C. trachomatis infection can lead to long-term complications such as pelvic inflammatory disease (PID), and other related conditions such as ectopic pregnancies and even tubal factor infertility. These complications are preventable given early detection and clinical intervention, but these efforts are often hampered by asymptomatic silent infections, and non-compliance to screenings for STDs. Some women do not get tested out of concerns for violation of privacy, and fear of discomfort. Clinicians often use a multitude of tests to determine if a patient is infected by C. trachomatis, including a Polymerase Chain Reaction (PCR) test of First catch urine (FCU) samples. However, these tend to be inconvenient to store and transport, as they carry risk of spillage and have stringent refrigeration requirements. Moreover, given the gold-standard recommendations set forth by the Centres for Disease Control (CDC), the current technique can be inconvenient in remote areas where refrigeration and transport may not always be reliable. The current study therefore looks at the potential of a self-collected vaginal swab device that relies on Nucleic Acid Amplification Tests (NAATs), is dry-stored, and does not require refrigeration, to detect the presence of C. trachomatis in women. The study found evidence to suggest that the self-collection device has the potential to aid clinicians in the diagnosis of C. trachomatis in women when compared to doctor-collected vaginal discharge samples as the designated standard, FCU, and blood serology. Moreover, as a self-collection device it has the potential to break down some of the barriers to STD screening especially in young women, such as violation of privacy. The device therefore has a potential to encourage screening and therefore a potentially effective tool in the fight against the spread of preventable sexually transmitted diseases.

Incident urogenital and anorectal Chlamydia trachomatis in women: the role of sexual exposure and autoinoculation: a multicentre observational study (FemCure)

BackgroundAnorectal infections with Chlamydia trachomatis (CT) are common in women visiting STI outpatient clinics. We here evaluated the risk posed by sexual exposure and by alternate anatomical site infection for...

Pharyngeal screening for Chlamydia trachomatis, more harm than good?

Urogenital Chlamydia trachomatis infections can result in urethritis in men and late sequelae in women, such as pelvic inflammatory disease and infertility. Heterosexual transmission of chlamydia is in most cases via genital contact. Pharyngeal C trachomatis infections are for the vast majority asymptomatic and without complications. However, the clinical relevance of transmission to genital sites via orogenital contact is a matter of ongoing debate. Male-to-female transmission of C trachomatis via oral sex has been described, 1 Marcus CJL Kohn RP Barry PM Philip SS Bernstein KT Chlamydia trachomatis and Neisseria gonorrhoeae transmission from the female oropharynx to the male urethra. Sex Transm Dis. 2011; 38: 372-373 Google Scholar but in general, the pharyngeal C trachomatis bacterial load is lower 2 Wijers JNAP Dukers-Muijrers NHTM van Liere GAFS Dirks JAMC Wolffs PFG Hoebe CJPA Men and women have an equal oropharyngeal and anorectal Chlamydia trachomatis bacterial load: a comparison of 3 anatomic sites. J Infect Dis. 2021; 223: 1582-1589 Google Scholar and pharyngeal C trachomatis viability is diminished in comparison with anorectal and urogenital infections. 3 Dukers-Muijrers NHTM Wolffs P Lucchesi M et al. Oropharyngeal Chlamydia trachomatis in women; spontaneous clearance and cure after treatment (FemCure). Sex Transm Infect. 2021; 97: 147-151 Google Scholar Routine universal testing versus selective or incidental testing for oropharyngeal Chlamydia trachomatis in women in the Netherlands: a retrospective cohort studyNo optimal testing scenario was available for pharyngeal C trachomatis, in which only a selection of high-risk women needs to be tested to find most pharyngeal C trachomatis infections. The relative low prevalence of pharyngeal-only C trachomatis (0·5%) and probably limited clinical and public health effect do not provide support for routine universal testing. Full-Text PDF

Routine universal testing versus selective or incidental testing for oropharyngeal Chlamydia trachomatis in women in the Netherlands: a retrospective cohort study

Pharyngeal Chlamydia trachomatis in women might contribute to autoinoculation and transmission to sexual partners. Data for effectiveness of different testing practices for pharyngeal C trachomatis are scarce. We therefore aimed to assess the prevalence of pharyngeal C trachomatis, determinants, and effectiveness of different testing practices in women. We did a retrospective cohort study, in which surveillance data for all women visiting sexually transmitted infection clinics in all regions in the Netherlands between Jan 1, 2008, and Dec 31, 2017, were used. We collected consultation-level data and individual-level data from 2016 onwards for sociodemographic characteristics, sexual behaviour in the past 6 months, self-reported symptoms, and STI diagnoses. The primary outcome was the positivity rate of pharyngeal C trachomatis infection compared between routine universal testing (>85% tested pharyngeally per clinic year), selective testing (5-85% tested pharyngeally per clinic year), and incidental testing (<5% pharyngeally tested per clinic year). We calculated the number of missed infections by extrapolating the positivity rate assessed by routine universal testing to all selectively tested women. We used multivariable generalised estimating equations logistic regression analyses to assess independent risk factors for pharyngeal C trachomatis and used the assessed risk factors as testing indicators for comparing alternative testing scenarios. Between Jan 1, 2008, and Dec 31, 2017, a total of 550 615 consultations with at least one C trachomatis test was recorded, of which 541 945 (98·4%) consultations (including repeat visits) were included in this analysis. Pharyngeal C trachomatis positivity was lower in the routine universal testing group than in the selective testing group (1081 [2·4%; 95% CI 2·2-2·5] of 45 774 vs 3473 [2·9%; 2·8-3·0] of 121 262; p<0·0001). The positivity rate was also higher among consultations done in the incidental testing group (44 [4·1%; 95% CI 3·1-5·5] of 1073; p<0·0001) than in the routine universal testing group. Based on extrapolation, selective testing would have hypothetically missed 64·4% (95% CI 63·5-65·3; 6363 of 9879) of the estimated total of C trachomatis infections. The proportion of pharyngeal-only C trachomatis was comparable between routinely universally tested women (22·9%) and selectively tested women (20·4%), resulting in a difference of 2·5% (95% CI -0·3 to 5·3; p=0·07). When using risk factors for pharyngeal C trachomatis as testing indicators, 15 484 (79·6%) of 19 459 women would be tested to detect 398 (80·6%) of 494 infections. No optimal testing scenario was available for pharyngeal C trachomatis, in which only a selection of high-risk women needs to be tested to find most pharyngeal C trachomatis infections. The relative low prevalence of pharyngeal-only C trachomatis (0·5%) and probably limited clinical and public health effect do not provide support for routine universal testing. Public Health Service South Limburg.

Feasibility of anorectal chlamydia testing in women: a cross-sectional survey among general practitioners.

Anorectal Chlamydia trachomatis (CT) may be clinically relevant for women in general practice. Although anorectal CT testing in this setting may prevent underdiagnosis and undertreatment, its feasibility is questioned as GPs currently rarely order anorectal CT tests, for yet unknown reasons. To explore the feasibility of anorectal CT testing in women in general practice. GPs across the Netherlands were invited directly (n = 1481) and by snowball sampling (n = 330) to join an online cross-sectional survey that asked about the acceptability of and barriers for (standard) anorectal testing in women during CT-related consultations. Data were analysed with univariable and multivariable logistic regression models. The questionnaire was opened by 514 respondents (28%, 514/1811) and 394 fully completed it. GPs' acceptability of anorectal testing by either self-sampling or provider-sampling was high (86%). Twenty-eight percent of GPs felt neutral, and 43% felt accepting towards standard anorectal testing. Nevertheless, 40% of GPs had never tested for anorectal CT in women, which was associated with a reported difficulty in asking about anal sex (odds ratio [OR]: 3.07, 95% confidence interval [CI]: 1.21-7.80), infrequency of anal sexual history taking (OR: 11.50, 95% CI: 6.39-20.72), low frequency of urogenital CT testing (OR 3.44, 95%-CI: 1.86-6.38) and with practicing in a non-urban area (OR: 2.27, 95% CI: 1.48-3.48). Acceptability of anorectal testing was not associated with the studied factors. This quantitative survey shows that anorectal CT testing is feasible based on its acceptability, but is likely hindered by a lower awareness of (anorectal) CT in GPs.

Factors associated with Chlamydia trachomatis in women with vaginitis attending in primary health care

Chlamydia trachomatis is recognized as the causative agent of one of the most common and curable sexually transmitted infections (STIs). In women, it can be a trigger for pelvic inflammatory disease, a risk factor for infertility or acquisition of other STIs. To determine CT in women with vaginitis and associate it with sociodemographic, sexual, clinical, and vaginal microbiota factors. 121 female volunteers > 18 years of age, with a clinical diagnosis of vaginitis and abnormal vaginal discharge, attending in primary health care services (PHC) in Temuco-Chile were recluted. A vaginal discharge sample was taken, determining C. trachomatis by polymerase chain reaction and vaginal microbiota by Gram stain. Clinical, sociodemographic and sexual data were collected by survey. Age range was 18-61 years. The frequency of C. trachomatis was 14.9%. C. trachomatis was associated with a higher number of sexual partners in the last 5 years (p = 0.001), oral plus anal sex (p = 0.055) and sex toys (p = 0.027); there was a non-significant association with bacterial vaginosis 31.2% (p = 0.091) and initiation of sexual activity < 18 years 20.6% (p = 0.07). It would be beneficial to incorporate in the gynecological semiology of the women attended in PHC services, the factors found to favor C. trachomatis infection, as this could help the management of this STI.

Etiologies of genital inflammation and ulceration in symptomatic Rwandan men and women responding to radio promotions of free screening and treatment services.

IntroductionThe longstanding inadequacies of syndromic management for genital ulceration and inflammation are well-described. The Rwanda National Guidelines for sexually transmitted infection (STI) syndromic management are not yet informed by the local prevalence and correlates of STI etiologies, a component World Health Organization guidelines stress as critical to optimize locally relevant algorithms.MethodsRadio announcements and pharmacists recruited symptomatic patients to seek free STI services in Kigali. Clients who sought services were asked to refer sexual partners and symptomatic friends. Demographic, behavioral risk factor, medical history, and symptom data were collected. Genital exams were performed by trained research nurses and physicians. We conducted phlebotomy for rapid HIV and rapid plasma reagin (RPR) serologies and vaginal pool swab for microscopy of wet preparation to diagnose Trichomonas vaginalis (TV), bacterial vaginosis (BV), and vaginal Candida albicans (VCA). GeneXpert testing for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) were conducted. Here we assess factors associated with diagnosis of NG and CT in men and women. We also explore factors associated with TV, BV and VCA in women. Finally, we describe genital ulcer and RPR results by HIV status, gender, and circumcision in men.ResultsAmong 974 men (with 1013 visits), 20% were positive for CT and 74% were positive for NG. Among 569 women (with 579 visits), 17% were positive for CT and 27% were positive for NG. In multivariate analyses, factors associated with CT in men included younger age, responding to radio advertisements, <17 days since suspected exposure, and not having dysuria. Factors associated with NG in men included not having higher education or full-time employment, <17 days since suspected exposure, not reporting a genital ulcer, and having urethral discharge on physical exam. Factors associated with CT in women included younger age and < = 10 days with symptoms. Factors associated with NG in women included younger age, lower education and lack of full-time employment, sometimes using condoms vs. never, using hormonal vs. non-hormonal contraception, not having genital ulcer or itching, having symptoms < = 10 days, HIV+ status, having BV, endocervical discharge noted on speculum exam, and negative vaginal wet mount for VCA. In multivariate analyses, only reporting >1 partner was associated with BV; being single and RPR+ was associated with TV; and having < = 1 partner in the last month, being pregnant, genital itching, discharge, and being HIV and RPR negative were associated with VCA. Genital ulcers and positive RPR were associated with being HIV+ and lack of circumcision among men. HIV+ women were more likely to be RPR+. In HIV+ men and women, ulcers were more likely to be herpetic rather than syphilitic compared with their HIV- counterparts.ConclusionsSyndromic management guidelines in Rwanda can be improved with consideration of the prevalence of confirmed infections from this study of symptomatic men and women representative of those who would seek care at government health centers. Inclusion of demographic and risk factor measures shown to be predictive of STI and non-STI dysbioses may also increase diagnostic accuracy.

Oropharyngeal Chlamydia trachomatis in women; spontaneous clearance and cure after treatment (FemCure)

ObjectivesWomen attending STI clinics are not routinely tested for oropharyngeal Chlamydia trachomatis (CT) infections. We aimed to assess spontaneous clearance of oropharyngeal CT and cure after antibiotic treatment in women.MethodsWomen...

Are rapid NAATs on urine, vaginal, or cervical specimens as accurate as laboratory-based tests for diagnosing Neisseria gonorrhoeae and Chlamydia trachomatis in women?

Are rapid NAATs on urine, vaginal, or cervical specimens as accurate as laboratory-based tests for diagnosing Neisseria gonorrhoeae and Chlamydia trachomatis in women?

Molecular Detection of Ureaplasma urealyticum and Chlamydia trachomatis in Women with Endometriosis

Molecular Detection of Ureaplasma urealyticum and Chlamydia trachomatis in Women with Endometriosis

Chlamydia trachomatis screening in preterm labor: A systematic review and meta-analysis

ObjectiveSpontaneous preterm labor (PTL) is responsible for approximately half of all preterm births with intrauterine infection being an important risk factor for PTL. Chlamydia trachomatis infections have been associated with preterm prelabor rupture of membranes (P-PROM) and preterm birth, but its impact on PTL has not previously been specified. The aim of this study was to evaluate the overall prevalence of Chlamydia trachomatis infections in pregnant women with threatened PTL compared to those not in threatened PTL. Study designA literature search was performed in electronic databases using combinations of: “Chlamydia”, “vaginal cervical infection” and “preterm labor.” Cohort and case-controlled studies examining threatened PTL and Chlamydia trachomatis infection demonstrated by culture or NAAT methods at time of diagnosis of threatened labor. The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines for reporting of observational studies for systematic reviews was used. Bias was assessed with the Methodological Index for Non-Randomized Studies (MINORS) score. Meta-analysis was performed using a random effects model. ResultsFour studies were identified. A total of 591 women were included, 309 in the threatened PTL, and 282 controls not in threatened PTL. Women presenting in PTL had an increased risk of screening positive for Chlamydia trachomatis compared to the control group (27/308 (9%) vs 3/282 (1%); OR 7.74, 95% CI 2.64–22.71). ConclusionsThe incidence of Chlamydia trachomatis in women with threatened PTL is approximately 9%, and significantly increased compared to asymptomatic controls. Women with threatened PTL should be considered for screening for Chlamydia trachomatis.

Prevalence, risk factors and molecular characterization of Chlamydia trachomatis in pregnant women from Córdoba, Argentina: A prospective study

BackgroundChlamydia trachomatis causes the most prevalent bacterial Sexual Transmitted Infection. In pregnant women, untreated chlamydial infections are associated with abortions, premature rupture of membranes, postpartum endometritis, low birth weight and transmission to the newborn. In Córdoba, Argentina, there is little knowledge about the prevalence of Chlamydia trachomatis in women in their third trimester of pregnancy, so, the aim of this study was to evaluate Chlamydia trachomatis prevalence and genotypes present in Cordovan pregnant women with different age and socioeconomic status.Methods and findingsDesign: prospective study.Settings: Women population from Cordoba city, Argentina.Population: Pregnant women having 35 to 37 weeks of gestation.Methods: Five hundred and nine cervical swabs were collected. Each sample was subjected to DNA extraction and PCR for Chlamydia trachomatis using primers NRO/NLO and CTP1/CTP2. Positives samples were sequenced to determine genotype. Main outcome measures: Demographic data of the patients were collected to detect a population at risk for this infection.ResultsA prevalence of 6.9% (35/509) for Chlamydia trachomatis infection was detected, with 32/295 and 3/214 from pregnant women with low or better economic resources respectively (p = 0,0001). Results showed a significantly increased rate of 11.6% (30/258) in women under 25 years compared with 2% (5/251) in patients over that age (p = 0,00003). Genotype E was the most prevalent.ConclusionsWith these results, we can say that pregnant women under 25 years old and low economic resources are one of the populations in which the screening programs of Chlamydia trachomatis should focus.

COMPARATIVE STUDY OF IMMUNOLOGICAL METHODS FOR THE DIAGNOSIS OF CHLAMYDIA TRACHOMATIS IN WOMEN WITH CERVICITIS AND INFERTILITY.

08Jan 2019 COMPARATIVE STUDY OF IMMUNOLOGICAL METHODS FOR THE DIAGNOSIS OF CHLAMYDIA TRACHOMATIS IN WOMEN WITH CERVICITIS AND INFERTILITY. Abrar A. H. Sahi , Khairallah A.S. Mohammed and Zainab Y. Al Salman. Southern Technical University, Health & Medical Technology College, Basrah/Iraq. Basra Hospital for Women and Children,Basrah /Iraq.

An Adaptive Chlamydia trachomatis-Specific IFN-γ-Producing CD4+ T Cell Response Is Associated With Protection Against Chlamydia Reinfection in Women.

Background: Adaptive immune responses that mediate protection against Chlamydia trachomatis (CT) remain poorly defined in humans. Animal chlamydia models have demonstrated that CD4+ Th1 cytokine responses mediate protective immunity against reinfection. To better understand protective immunity to CT in humans, we investigated whether select CT-specific CD4+ Th1 and CD8+ T cell cytokine responses were associated with protection against CT reinfection in women.Methods: Peripheral blood mononuclear cells were collected from 135 CT-infected women at treatment and follow-up visits and stimulated with CT antigens. CD4+ and CD8+ T-cells expressing IFN-γ, TNF-α, and/or IL-2 were assessed using intracellular cytokine staining and cytokine responses were compared between visits and between women with vs. without CT reinfection at follow-up.Results: A CD4+TNF-α response was detected in the majority (77%) of study participants at the treatment visit, but a lower proportion had this response at follow-up (62%). CD4+ IFN-γ and CD4+ IL-2 responses occurred less frequently at the treatment visit (32 and 18%, respectively), but increased at follow-up (51 and 41%, respectively). CD8+ IFN-γ and CD8+ TNF-α responses were detected more often at follow-up (59% for both responses) compared to the treatment visit (30% for both responses). At follow-up, a CD4+IFN-γ response was detected more often in women without vs. with reinfection (60 vs. 33%, P = 0.005).Conclusions: Our findings suggest that a CT-specific CD4+ IFN-γ response is associated with protective immunity against CT reinfection and is thus an important component of adaptive immunity to CT in women.

Impact of bacterial traces belonging to the Enterobacteriaceae on the prevalence of Chlamydia trachomatis in women visiting a community hospital in Japan.

We explored the bacteria present in the vaginal microbiota facilitating the prevalence of Chlamydia trachomatis in women visiting a community hospital in Sapporo, Japan, by amplicon sequencing. A total of 273 cervical swab samples were collected, and bacterial vaginosis was evaluated in all specimens by assessment of the Nugent score. In 16 of the samples, bacterial 16S rDNA could not be detected and they were therefore omitted from subsequent experiments (n=257). A significant negative correlation was observed between the Nugent scores and the amount of Lactobacillus 16S rDNA. Among the 257 samples, chlamydial plasmid was detected in 20 samples and was used for amplicon sequencing. No significant association between the Nugent score and the prevalence of C. trachomatis was detected. Based on the results of chlamydial plasmid detection and the Nugent score, chlamydia-negative samples (n=27) were randomly selected. Finally, the number of operational taxonomic units (OTUs) obtained from amplicon sequencing was compared between chlamydia-positive (n=20) and -negative samples (n=27), revealing that a significant difference was only detected for the OTU numbers of Enterobacteriaceae between the C. trachomatis-positive and -negative groups. However, almost all of the samples utilized for amplicon sequencing failed to grow on MacConkey agar plates and produce indole. Taken together, we concluded that traces of bacteria, not live bacteria, belonging to the Enterobacteriaceae indicated the flow of bacteria through the anogenital route along with gut indole, and the resulting impact on the prevalence of C. trachomatis in the cervicogenital tract of women in Japan.

A PRISMA systematic review and meta-analysis on Chlamydia trachomatis infections in Iranian women (1986-2015).

Background:Chlamydia trachomatis (CT) is the cause of genital tract infections in women. Some evidence has shown the role of this infection with CT in spontaneous abortions. The purpose of this study is to study the frequency of CT infection in Iranian women.Methods:This study was performed based on PRISMA guidelines. A total of 75 articles published in Google Scholar, PubMed, ISI Web of Science, Biological abs, Iranmedex, SID, and Scopus databases were found (1986–2015) using the following keywords: CT in women, CT and Iranian women, CT and infection in Iran, CT and pregnancy in Iran, CT and preterm delivery in Iran, CT and preterm labor in Iran, CT and fertility in Iran, CT and infertility in Iran, and CT and abortion in Iran. Finally, 40 studies from different regions of Iran were included. Statistical analyses were performed using R3 and STATA 12.Results:From 1986 to 2015, the lowest rate of prevalence was from 2010 to 2011 (3.9%) and the highest prevalence rate was in 2009 (69.39%) in northern Iran. Fixed effects for different parts of Iran (North, South, East, and West) were Pooled proportion: 0.13 (95% confidence interval [CI] = 0.12–0.14) and for samples (cervical, vaginal, urine, and blood) the pooled proportion was = 0.14 (95% CI = 0.12–0.14).Conclusion:CT infection in this study was prevalent in urine samples and the rate of CT was observed from culture methods in comparison to other methods. Because women with CT play an important role because of sexual activity for transmission and untreated women are at risk of developing sequels. Also, most studies in Iran use sensitive polymerase chain reaction tests for the detection of genital CT infections.