Genital Chlamydia Trachomatis Research Articles

Standardised protocol for a prospective international multicentre clinical-based evaluation of point-of-care tests for the screening of genital and extragenital chlamydial and gonococcal infections in men who have sex with men and for the screening of genital chlamydial, gonococcal and Trichomonas vaginalis infections in at risk women

IntroductionIn 2016, WHO estimated there were roughly 374 million new infections among adults of the following four curable sexually transmitted infections (STIs): chlamydia (caused by Chlamydia trachomatis (CT)), gonorrhoea (Neisseria...

Characterization of genital chlamydia trachomatis infection among women attending infertility and gynecology clinics in Hunan, China

BackgroundGenital infection with Chlamydia trachomatis (C. trachomatis) is a major public health issue worldwide. It can lead to cervicitis, urethritis, and infertility. This study was conducted to determine the characteristics of genital C. trachomatis infection among women attending to the infertility and gynecology clinics.MethodsEndocervical swabs were collected from 8,221 women for C. trachomatis nucleotide screening and genotyping, while serum samples were collected for C. trachomatis pgp3 antibody determination using luciferase immunosorbent assays.ResultsHigh C. trachomatis DNA prevalence (3.76%) and seroprevalence (47.46%) rates were found, with genotype E (27.5%) being the most prevalent. C. trachomatis omp1 sense mutation was associated with cervical intraepithelial neoplasia (CIN) (odds ratio [OR] = 6.033, 95% confidence interval [CI] = 1.219–39.185, p = 0.045). No significant differences in C. trachomatis seroprevalence rates were observed between women with detectable C. trachomatis DNA in the infertility and routine physical examination groups (86.67% vs. 95%, p > 0.05); however, among women with negative C. trachomatis DNA, the former group had a markedly higher seroprevalence than the latter group (56.74% vs. 20.17%, p < 0.001). C. trachomatis DNA, but not pgp3 antibody, was significantly associated with CIN (OR = 4.087, 95% CI = 2.284–7.315, p < 0.001).ConclusionOur results revealed a high prevalence, particularly seroprevalence, of C. trachomatis among women with infertility. Furthermore, we found an association between C. trachomatis omp1 sense mutations and CIN. Therefore, C. trachomatis serves as a risk factor for CIN.

MicroRNAs as Potential Biomarkers for the Diagnosis, Treatment, and Prognosis of Sexually Transmitted Diseases: Recent Advances and Future Directions

Sexually transmitted diseases (STDs), including condyloma acuminatum (CA), syphilis, gonorrhea, genital Chlamydia trachomatis (CT), and acquired immune deficiency syndrome (AIDS)/human immunodeficiency virus (HIV) infection, are a group of diseases primarily transmitted through sexual contact, similar behaviors, and indirect contact. These diseases exert a profound impact on both the physical and mental health of patients and impose a substantial socioeconomic burden. Nonetheless, there is a lack of satisfactory treatment options and preventive strategies currently. Research has revealed aberrant expression patterns of microRNAs (miRNAs) in the tissues and blood of individuals with STDs, which are involved in the regulation of essential cellular processes, including proliferation, differentiation, and apoptosis. Consequently, miRNAs hold promise as crucial biomarkers for early diagnosis, disease assessment, prognosis, and potential therapeutic targets for STDs. This systematic review presents pertinent research on miRNAs in the context of STDs to establish a theoretical foundation for clinical diagnosis and treatment strategies.

Sexual transmission of urogenital bacteria: whole metagenome sequencing evidence from a sexual network study.

Sexual transmission of the urogenital microbiota may contribute to adverse sexual and reproductive health outcomes. The extent of sexual transmission of the urogenital microbiota is unclear as prior studies largely investigated specific pathogens. We used epidemiologic data and whole metagenome sequencing to characterize urogenital microbiota strain concordance between participants of a sexual network study. Individuals who screened positive for genital Chlamydia trachomatis were enrolled and referred their sexual contacts from the prior 60-180 days. Snowball recruitment of sexual contacts continued for up to four waves. Vaginal swabs and penile urethral swabs were collected for whole metagenome sequencing. We evaluated bacterial strain concordance using inStrain and network analysis. We defined concordance as ≥99.99% average nucleotide identity over ≥50% shared coverage; we defined putative sexual transmission as concordance between sexual contacts with <5 single-nucleotide polymorphisms per megabase. Of 138 participants, 74 (54%) were female; 120 (87%) had genital chlamydia; and 43 (31%) were recruited contacts. We identified 115 strain-concordance events among 54 participants representing 25 bacterial species. Seven events (6%) were between sexual contacts including putative heterosexual transmission of Fannyhessea vaginae, Gardnerella leopoldii, Prevotella amnii, Sneathia sanguinegens, and Sneathia vaginalis (one strain each), and putative sexual transmission of Lactobacillus iners between female contacts. Most concordance events (108, 94%) were between non-contacts, including eight female participants connected through 18 Lactobacillus crispatus and 3 Lactobacillus jensenii concordant strains, and 14 female and 2 male participants densely interconnected through 52 Gardnerella swidsinskii concordance events.IMPORTANCEEpidemiologic evidence consistently indicates bacterial vaginosis (BV) is sexually associated and may be sexually transmitted, though sexual transmission remains subject to debate. This study is not capable of demonstrating BV sexual transmission; however, we do provide strain-level metagenomic evidence that strongly supports heterosexual transmission of BV-associated species. These findings strengthen the evidence base that supports ongoing investigations of concurrent male partner treatment for reducing BV recurrence. Our data suggest that measuring the impact of male partner treatment on F. vaginae, G. leopoldii, P. amnii, S. sanguinegens, and S. vaginalis may provide insight into why a regimen does or does not perform well. We also observed a high degree of strain concordance between non-sexual-contact female participants. We posit that this may reflect limited dispersal capacity of vaginal bacteria coupled with individuals' comembership in regional transmission networks where transmission may occur between parent and child at birth, cohabiting individuals, or sexual contacts.

Progress in research of self-sampling for detection of genital chlamydia trachomatis and related factors in men who have sex with men

Laboratory testing is a vital chain in the prevention and control of genital chlamydia trachomatis infection. The prevalence of genital chlamydia trachomatis infection is high, but the detection rate of the infection is low in men who have sex with men (MSM) in China. Self-sampling for genital chlamydia trachomatis detection by MSM is a new option to address this problem, which would play a significant role in expanding genital chlamydia trachomatis infection screening in this population. This paper summarizes the progress in research of self-sampling for the detection of genital chlamydia trachomatis and the related factors in MSM both at home and abroad to provide reference for the promotion of self-sampling for the detection of genital chlamydia trachomatis in this population.

Knowledge about and prevalence of Chlamydia trachomatis in a population-based sample of emerging Croatian adults.

To determine the prevalence of genital Chlamydia trachomatis (chlamydia) infection, knowledge about chlamydia and experience of previous testing for chlamydia, we carried out a national probability-based survey in emerging adults aged 18-25 years in Croatia in 2021-2022. Participants (n = 1197), members of a national online panel, completed a web-based questionnaire that collected information on socio-demographics, sexual behaviours and knowledge about sexually transmitted infections (STIs). Urine specimens from a sample of sexually experienced participants were self-collected and tested for chlamydia using Cobas 4800 CT/NG test. To achieve broad representativeness of the emerging adult population in the country, we applied post-hoc weighting for gender and age. Multivariable ordinary least squares linear regression was used to determine correlates of knowledge about chlamydia infection and binomial logistic regression to assess correlates of the willingness to test for chlamydia. Among 448 participants who sent in their urine specimens chlamydia prevalence was 2.5% (95% CI 1.2-5.1) in women and 1.0% (0.3-3.2%) in men. A total of 8.0% of women and 4.7% men reported testing for chlamydia prior to the survey. About a quarter of the sample was characterized by not answering correctly any of the six questions related to knowledge about chlamydia, while only 9.6% had five or six correct answers. In the multivariable analysis, significantly higher odds of willingness to test for chlamydia were found in females compared to males (OR = 1.34, p = 0.024), those with better knowledge about the infection (OR = 1.11, p = 0.005), and those with lower religiosity (OR = 0.91, p = 0.017). In conclusion, prevalence of chlamydia in emerging adults in Croatia is considerable. Efforts to control this infection should focus on primary prevention and targeted testing combined with effective case management strategies.

The Effect of Amoxicillin Pre-Exposure on Treatment Outcomes and Antimicrobial Susceptibility in Patients with Urogenital Chlamydia trachomatis Infection.

We investigated the influence of amoxicillin pre-exposure on treatment outcomes, Chlamydia trachomatis (CT) culture, the presence of drug-resistant genes, minimum inhibitory concentrations (MICs), and fractional inhibitory concentrations (FICs) in CT clinical strains. Additionally, we explored the effect of different antimicrobial combinations on CT. Clinical data of 62 patients with CT infection were recorded. Of these, 33 had pre-exposure to amoxicillin and 29 did not. Among patients with pre-exposure, 17 received azithromycin and 16 received minocycline. Among the patients without pre-exposure, 15 received azithromycin and 14 received minocycline. All patients underwent microbiological cure follow-ups one month after completing the treatment. 23S rRNA gene mutations, acquisition of tet(M) and tet(C) were detected using reverse transcription PCR (RT-PCR) and PCR, respectively. The MICs and FICs of azithromycin, minocycline, and moxifloxacin, alone or in combination, were determined using the microdilution and checkerboard methods, respectively. More cases of treatment failure occurred in pre-exposed patients, in both treatment groups (P <0.05). No 23S rRNA gene mutations or tet(M) and tet(C) acquisitions were found. More inclusion bodies were cultured from patients without amoxicillin pre-exposure than from those with pre-exposure (P <0.0001). The MICs of all antibiotics were higher in pre-exposed patients than in those without pre-exposure (P <0.01). The FICs of azithromycin plus moxifloxacin were lower than those of the other antibiotic combinations (P <0.0001). The synergy rate of azithromycin plus moxifloxacin was significantly higher than those of azithromycin plus minocycline and minocycline plus moxifloxacin (P <0.001). The FICs of all antibiotic combinations were comparable between isolates from the two patient groups (all P >0.05). Pre-exposure to amoxicillin in CT patients may inhibit CT growth and decrease sensitivity of CT strains to antibiotics. Azithromycin plus moxifloxacin may be a promising treatment regimen for genital CT infections with treatment failure.

Influx of podoplanin-expressing inflammatory macrophages into the genital tract following Chlamydiainfection.

Genital Chlamydia trachomatis infection remains a major health issue as it causes severe complications including pelvic inflammatory disease, ectopic pregnancy and infertility in females as a result of infection-associated chronic inflammation. Podoplanin, a transmembrane receptor, has been previously reported on inflammatory macrophages. Thus, strategies that specifically target podoplanin might be able to reduce local inflammation. This study investigated the expression level and function of podoplanin in a C.trachomatis infection model. C57BL/6 mice infected with the mouse pathogen Chlamydia muridarum were examined intermittently from days 1 to 60 using flow cytometry analysis. Percentages of conventional macrophages (CD11b+ CD11c- F4/80+ ) versus inflammatory macrophages (CD11b+ CD11c+ F4/80+ ), and the expression of podoplanin in these cells were investigated. Subsequently, a podoplanin-knockout RAW264.7 cell was used to evaluate the function of podoplanin in C.trachomatis infection. Our findings demonstrated an increased CD11b+ cell volume in the spleen at day 9 after the infection, with augmented podoplanin expression, especially among the inflammatory macrophages. A large number of podoplanin-expressing macrophages were detected in the genital tract of C.muridarum-infected mice. Furthermore, analysis of the C.trachomatis-infected patients demonstrated a higher percentage of podoplanin-expressing monocytes than that in the noninfected controls. Using an invitro infection in a transwell migration assay, we identified that macrophages deficient in podoplanin displayed defective migratory function toward C.trachomatis-infected HeLa 229 cells. Lastly, using immunoprecipitation-mass spectrometry method, we identified two potential podoplanin interacting proteins, namely, Cofilin 1 and Talin 1 actin-binding proteins. The present study reports a role of podoplanin in directing macrophage migration to the chlamydial infection site. Our results suggest a potential for reducing inflammation in individuals with chronic chlamydial infections by targeting podoplanin.

Chlamydia trachomatis Seropositivity and Associated Risk Factors Among Women Attending A Northern Nigerian Tertiary Hospital.

Genital Chlamydia trachomatis (Ct) is the commonest bacterial sexually transmitted infection globally. Acquisition of Ct infection is affected by biological and behavioural factors. Determine the prevalence of Ct infection and identify risk factors associated with Ct infection in sexually active fertile women in Northern Nigeria. One hundred and fifty sexually active women presenting to the Obstetrics and Gynaecology department of Ahmadu Bello University Teaching Hospital, Zaria were studied. Socio-demographic characteristics and history of risk factors for acquisition of genital Ct were obtained from the participants using a questionnaire. Their sera were tested for the presence of Ct immunoglobulin G using Enzyme-Linked Immunosorbent Assay. The mean ages ± standard deviation of seropositive and seronegative women were 29.1 ± 7.3 years and 28.9 (SD 6.7) years respectively (P = 0.438). The prevalence of Ct infection was 6.7% (10/150). Occupation was associated with Ct seropositivity (P = 0.02). Number of sexual partners, age at coitarche; duration of sexual exposure and previous history suggestive of sexually transmitted infection were not associated with Ct seropositivity (P > 0.05). A low prevalence of Ct was found among fertile women. Lack of regular source of personal income was associated with Ct infection but the sexual behavioural factors studied were not.

Prevalence of genital Chlamydia trachomatis at a Tertiary Care Hospital in North India: A 10-year observational study.

Prevalence of genital Chlamydia trachomatis at a Tertiary Care Hospital in North India: A 10-year observational study.

Accuracy of pooling specimens from different individuals in the detection of genital Chlamydia trachomatis infection: a Meta analysis

Objective: To determine the accuracy of pooled specimens from multiple individuals for detection of infection with Chlamydia trachomatis. Methods: By April 2022, PubMed and Embase searched relevant studies published in peer-reviewed journals. The QUADAS-2 scale of a quality assessment tool was used to assess the quality of the studies. A curve of summary receiver operating characteristic was applied as a comprehensive assessment of diagnosed accuracy. A bivariate mixed-effects model was used for overall value merging in sensitivity and specificity. In addition, the subgroup analyses regarding sample type, testing method, and the number of samples per pool were performed. Results: A total of 14 846 subjects were included in the analysis. Three studies were from the United States, three from Canada, three from Denmark, two from Lithuania, two from India, two from the Netherlands, and one from Australia, Russia, and Singapore. Compared with the individual specimens, the pooled specimens of multiple individuals had an overall sensitivity of 0.98 (95%CI: 0.97-0.99) and specificity of 1.00 (95%CI: 1.00-1.00) for the detection of Chlamydia trachomatis. Results from the subgroup showed that the overall sensitivity of ligase chain reaction was significantly higher than that of PCR in the diagnosis of pooled samples. Conclusion: It is concluded from the published studies that the pooled specimens were substantially consistent with the single specimens in detecting infection with Chlamydia trachomatis.

The association between adverse pregnancy outcomes with genital Chlamydia Trachomatis infection among pre-pregnancy couples in Shenzhen, China: A cross-sectional study.

To investigate the prevalence of adverse pregnancy outcomes (APOs) in women and the impact of pre-pregnancy couples' genital Chlamydia Trachomatis (GCT) infection and other infections on APOs. Data on genital infections were collected from the Free Pre-pregnancy Health Check (FPHC) in Shenzhen, China. Data on APOs were collected from a 1-year telephone follow-up of pregnancy status and subsequent pregnancy outcomes. APO data were used to count adverse outcomes, and logistic regression was conducted to determine the association between APOs and GCT infection. From December 2018 to December 2019, among 4,429 couples who underwent FPHC; 1,925 were pregnant, and 1,816 couples were tracked for pregnancy outcomes, including 1,471 normal pregnancies and 345 (19.00%) APOs. The rest of 109 pregnant couples did not answer the phone or refused to answer the pregnancy outcome during the follow-up. Among APOs, the number of spontaneous abortions was 122 (35.36%), the number of macrosomia was 85 (24.64%), the number of low birth weight (LBW) & preterm births (PTB) was 39 (11.30%), the number of LBW was 34 (9.86%), and the number of PTB was 31 (8.99%). The prevalence of GCT infection in females and males was 4.24% [95% Confidence Interval, (CI): 3.41-5.27%] and 3.58% (95% CI: 2.79-4.57%), respectively. More than half (52.69%, 49/93) of the couples were GCT-concordant. The prevalence of APOs in couples without GCT infection was 18.74% (332/1,772). The prevalence of APOs in female GCT-discordant was 32.14% (9/28), and the prevalence of APOs in male GCT-discordant was 25% (4/16). The prevalence of APOs in GCT-concordant was 12.24% (6/49). Multivariable analysis indicated that females 30-35 years old [adjusted Odds Ratio (aOR) = 1.08, 95% CI: 1.01-1.17] and over 35 years old (aOR = 1.16, 95% CI: 1.03-1.32) were more likely to experiencing APOs. Although only women's age was found to be associated with APOs, the prevalence of APOs with GCT-discordant in couples, especially female GCT-discordant, was higher than in those without infection or who were GCT-concordant, suggesting that these groups, especially in older women, should be paid more attention to in follow-ups to improve reproductive health.

Rhein inhibits Chlamydia trachomatis infection by regulating pathogen-host cell.

The global incidence of genital Chlamydia trachomatis infection increased rapidly as the primary available treatment of C. trachomatis infection being the use of antibiotics. However, the development of antibiotics resistant stain and other treatment failures are often observed in patients. Consequently, novel therapeutics are urgently required. Rhein is a monomer derivative of anthraquinone compounds with an anti-infection activity. This study investigated the effects of rhein on treating C. trachomatis infection. Rhein showed significant inhibitory effects on the growth of C. trachomatis in multiple serovars of C. trachomatis, including D, E, F and L1, and in various host cells, including HeLa, McCoy and Vero. Rhein could not directly inactivate C. trachomatis but could inhibit the growth of C. trachomatis by regulating pathogen-host cell interactions. Combined with azithromycin, the inhibitory effect of rehin was synergistic both in vitro and in vivo. Together these findings suggest that rhein could be developed for the treatment of C. trachomatis infections.

Prevalence of genital &lt;em&gt;Chlamydia trachomatis&lt;/em&gt; among women of reproductive age attending outpatient clinic at Kisumu County Referral Hospital, Kenya, 2021

Background.Chlamydia trachomatis is a common a sexually transmitted infections (STI). Asymptomatic Chlamydia is undetectable because it is asymptomatic. In Kenyan women ages 18 to 49, the disease is poorly understood.MethodsThis cross-sectional study was conducted at Kisumu County Referral Hospital, Kenya. 385 women consented and completed the electronic questionnaire. The women then provided vaginal swab samples which were tested for Chlamydia trachomatis using Chlamydia rapid diagnostic test kit.ResultsA total of 29 (7.5%) patients tested positive and were given medication. 65.2% of 385 participants were 18-25, with 5.7% prevalence. Women preferred self vaginal swab collection over health worker collection (0.3%). Multiple sexual partners, coinfection with other STIs, and upper tract infections are linked to genital Chlamydia. 92% of participants didn’t know Chlamydia’s effects.ConclusionsThe study’s prevalence of genital Chlamydia trachomatis was within previous estimates. Populations and screening methods vary. Patient and community education about genital Chlamydia infection is needed. Multiple sexual partners, marital status, education, and STI history are risk factors. Most women preferred self vaginal swab collection.

Detection of Chlamydia trachomatis infection in sexually active women in Venezuela

ResumenIntroducción. La infección genital por Chlamydia trachomatis es una de las más frecuentes en el mundo. Cada año se registran cerca de 85 millones de nuevos casos de esta enfermedad, que cursa con graves complicaciones en la mujer y recién nacido. Objetivo. Determinar las características clínico-epidemiológicas de la infección por C. trachomatis en mujeres venezolanas sexualmente activas.Materiales y métodos. Es un estudio descriptivo, transversal y de campo, sustentado en la historia clínica y el examen físico, la detección de infección con la prueba inmunoenzimática con anticuerpos policlonales anti-LPS y la confirmación de los resultados con la de biología molecular. La muestra estuvo conformada por 100 mujeres sexualmente activas mayores de 12 años de edad, del estado Carabobo, Venezuela.Resultados. La mayoría de las mujeres se encontraba entre los 20 y los 45 años de edad. En el 25 % de las mismas, se detectaron anticuerpos IgG anti-C. trachomatis y, en el 84 % de estas, se confirmó la infección mediante PCR; en ninguna de las mujeres se hallaron anticuerpos IgM anti-C. trachomatis.Conclusión. La infección crónica predomina en las mujeres entre los 20 y los 45 años de edad; la prueba inmunoenzimática arrojó falsos positivos corroborados por PCR.

Refinement of water-filtered infrared A (wIRA) irradiations of in vitro acute and persistent chlamydial infections.

Water-filtered infrared A (wIRA) alone or in combination with visible light (VIS) exerts anti-chlamydial effects in vitro and in vivo in acute infection models. However, it has remained unclear whether reduced irradiation duration and irradiance would still maintain anti-chlamydial efficacy. Furthermore, efficacy of this non-chemical treatment option against persistent (chronic) chlamydial infections has not been investigated to date. To address this knowledge gap, we evaluated 1) irradiation durations of 5, 15 or 30min in genital and ocular Chlamydia trachomatis acute infection models, 2) irradiances of 100, 150 or 200mW/cm2 in the acute genital infection model and 3) anti-chlamydial activity of wIRA and VIS against C. trachomatis serovar B and E with amoxicillin (AMX)- or interferon γ (IFN-γ)-induced persistence. Reduction of irradiation duration reduced anti-chlamydial efficacy. Irradiances of 150 to 200mW/cm2, but not 100mW/cm2, induced anti-chlamydial effects. For persistent infections, wIRA and VIS irradiation showed robust anti-chlamydial activity independent of the infection status (persistent or recovering), persistence inducer (AMX or IFN-γ) or chlamydial strain (serovar B or E). This study clarifies the requirement of 30min irradiation duration and 150mW/cm2 irradiance to induce significant anti-chlamydial effects in vitro, supports the use of irradiation in the wIRA and VIS spectrum as a promising non-chemical treatment for chlamydial infections and provides important information for follow-up in vivo studies. Notably, wIRA and VIS exert anti-chlamydial effects on persistent chlamydiae which are known to be refractory to antibiotic treatment.

Phototherapy-Based Treatment for Sexually Transmitted Infections—Shining Light into Unexplored Territory

New therapeutic strategies are urgently needed to overcome drawbacks in the treatment of some infections, particularly sexually transmitted infections (STI). STIs are easily spread by the transmission of various bacteria, viruses, and parasites with some of the infections being incurable or even lethal, leading to a serious impact on reproductive health worldwide. Phototherapy (PT) is a major therapeutic approach based on the controlled administration of light in the visible, near infrared, or UV spectrum, with or without the application of an external photosensitizer. Despite the fact that PT has not been explored to its full potential in the control of STIs, it has already demonstrated good clinical response rates and lower recurrence rates in genital infections. For instance, increasing evidence has demonstrated that 5-aminolevulinic acid photodynamic therapy (5-ALA-PDT) is effective in the treatment of condyloma acuminatum (CA), by eliminating the causative latent human papillomavirus (HPV) infection, and also in the antiviral treatment of recurrent genital herpes simplex virus (HSV) infections. The clinical application of PDT is a new treatment for oral fungal infection caused by Candida albicans in adult acquired immune deficiency syndrome (AIDS) patients, with human immunodeficiency virus (HIV), and could also be used for genital fungal infections. Another antimicrobial PT strategy, water-filtered infrared A combined with visible light irradiation, has been shown to be effective against genital Chlamydia trachomatis bacterial infection, and an optical nano-genosensor has been designed for the diagnosis of trichomoniasis, a parasitic Trichomonas vaginalis infection. This review aims to summarize the published evidence for the effectiveness of PT in the treatment of STIs, and for the suppression of STI-related pathogens of various types.

Genetic and clinical characteristics of genital Chlamydia trachomatis infection in Guangzhou, China.

Genital Chlamydia trachomatis (CT) is one of the most common agents of sexually transmitted infections and can cause severe disorders. This study aimed to analyse the genetic and clinical characteristics of genital CT infection among women in Guangzhou, China. From September 2020 to August 2021, a total of 8955 female patients were enrolled in this study. The presence of genital CT was detected by real-time PCR, and 273 positive samples were randomly selected for further genetic and clinical characteristics analysis. The positive rate of genital CT infection was 7.5% (670/8955), with the highest rate in women aged 21-30years. A total of 8 genotypes were identified: DH, J, K, and recombinant genotype Ba/D. The predominant genotype was J (n=78, 28.6%), followed by E (n=63, 23.1%), F (n=48, 17.6%), and D (n=38, 13.9%). Abnormal vaginal discharge (n=165, 61.8%), cervical columnar epithelial ectopy (n=124, 46.4%), vaginal itching (n=77, 28.8%), and lower abdominal pain (n=61, 22.8%) were the predominant symptoms. Additionally, genotype G infection exhibited a significantly higher rate of abnormal vaginal discharge (P=0.03) and genotype D infection exhibited a higher white blood cell count (P=0.01) than the other genotypes. Phylogenetic analysis revealed a total of 20 variants with 25 mutation positions and the H2 variant in four patients was first discovered in our study. Genotypes J, E, F, and D were the major genotypes of genital CT in Guangzhou, and they manifested as abnormal vaginal discharge, cervical columnar epithelial ectopy, vaginal itching, and lower abdominal pain. The present study provides guidance for future integrated interventions to reduce the burden of genital CT infection and accelerate the development of vaccines.

High rates of anorectal chlamydia in women: a cross-sectional study in general practice.

Genital and anorectal Chlamydia trachomatis (CT) frequently present together in sexually transmitted infection (STI) clinics. To investigate the prevalence of co-occurrent genital and anorectal chlamydia infection, and to study whether sexual behaviour is associated with anorectal infection. A cross-sectional study in general practices in the north of the Netherlands. Women attending general practice with an indication for genital chlamydia testing were included and asked to complete a structured questionnaire on sexual behaviour. Anorectal infection prevalence was compared according to testing indications: standard versus experimental (based on questionnaire answers). Variables associated with anorectal chlamydia were analysed by univariate and multivariate logistic regression analyses. Data could be analysed for 497 of 515 women included. Overall, 17.8% (n = 87/490) were positive for CT; of these, 72.4% (n = 63/87) had co-occurrent genital and anorectal infection, 13.8% (n = 12/87) had genital infection only, and 12.6% (n = 11/87) had anorectal infection only. Rectal infection was missed in 69.3% of cases using the standard indication alone, while adding the sexual history still missed 20.0%. Age was the only variable significantly associated with anorectal infection. The prevalence of anorectal disease is high among women who visit their GP with an indication for genital CT testing. Many anorectal infections are missed despite taking comprehensive sexual histories, meaning that standard treatment of genital infection with azithromycin may result in rectal persistence. Performing anorectal testing in all women with an indication for genital CT testing is, therefore, recommended.

Antimicrobial Resistance for Chlamydia Trachomatis Genital Infection during Pregnancy in Japan.

The current study examined the antimicrobial resistance of Chlamydia trachomatis (CT) genital infection during pregnancy in Japan. We requested 2,146 obstetrical facilities that are members of Japan Association of Obstetricians and Gynecologists to provide information of CT screening tests and antimicrobial resistance in pregnant women between April 2020 and March 2021. The prevalence of CT genital infection in Japan was 2.1%. The antimicrobial resistance was recognized in 2.0 and 2.4% of the cases using azithromycin and clarithromycin, respectively. There were no significant differences in the antimicrobial resistance rate between the 2 analogues (P = 0.28). In Japan, azithromycin and clarithromycin have effectively treated genital CT infections during pregnancy.