Trachomatis Infection In Women Research Articles

The vaginal microbiome of South African pregnant women living with human immunodeficiency virus (HIV) with and without Chlamydia trachomatis infection

BackgroundChlamydia genital infections continue to be a serious health concern globally. Previous studies have reported that Chlamydia trachomatis infection alters the vaginal microbiota of infected women. This study investigated differences in the vaginal microbiome of South African pregnant women living with HIV with and without C. trachomatis infection.MethodsThis was a cross-sectional study among 385 pregnant women, recruited from the King Edward VIII Hospital in Durban, South Africa. C. trachomatis was detected using the Applied Biosystems™ TaqMan® Assays. A total of 40 samples, 20 C. trachomatis positive and 20 C. trachomatis negative, were selected for sequencing. The sequencing of the vaginal microbiome was performed using the PacBio platform. Statistical analysis was performed on IBM SPSS version 26.ResultsThe prevalence of C. trachomatis infection was 12.2% (47/385). The genus Gardnerella (32.14% vs. 24.02%) and species in the genus Gardnerella (31.97% vs. 24.03%) were more abundant in the C. trachomatis-infected group compared to the uninfected group. Lactobacillus iners were also more abundant in the C. trachomatis-infected women (28.30%) compared to the uninfected women. However, these observed patterns did not reach statistical significance. Discriminant analysis showed that the class Alpha-Proteobacteria; order Bacillales; family Enterococcaceae; the genera Enhydrobacter, Enterococcus, and Parabacteroides; Enterococcus spp.; and Pseudomonas stutzeri significantly contributed to a model separating C. trachomatis-infected women from the uninfected group (p < 0.05).ConclusionThe organisms and taxa that significantly contributed to separating the vaginal microbiota of C. trachomatis-infected women from the uninfected women in this study cohort have not been previously observed in association with C. trachomatis infection or the vaginal microbiota. Future studies in larger cohorts that will investigate the role of these microorganisms in C. trachomatis infection and the vaginal microbiota are required.

The serodiagnositic value of Chlamydia trachomatis antigens in antibody detection using luciferase immunosorbent assay.

Among the different antigens used in the detection of anti-Chlamydia trachomatis antibodies, significant differences in sensitivity and specificity have been observed. Further evaluation of C. trachomatis antigens in antibody detection is urgently needed for the development and application of C. trachomatis serologic assays. Chlamydia trachomatis antigens Pgp3, TmeA, InaC, and HSP60 were selected and used in luciferase immunosorbent assay (LISA). The detection results obtained from well-defined C. trachomatis positive and negative samples were compared with the commercial C. trachomatis ELISA (Mikrogen) for performance evaluation. Pgp3, TmeA, InaC, and HSP60-based LISA showed sensitivity of 92.8, 88.8, 90.4, and 94.4%, and specificity of 99.2, 99.2, 99.2, and 92%, respectively. ROC analysis indicated that Pgp3-based LISA showed similar performance to Mikrogen ELISA (AUC 0.986 vs. 0.993, p = 0.207). Furthermore, four C. trachomatis antigens achieved strong diagnostic efficiency, i.e., positive likelihood ratios [+LR] ≥ 10 in C. trachomatis-infected women and negative likelihood ratios [-LR] ≤ 0.1 in C. trachomatis negative low exposure risk children, but only Pgp3 and TmeA showed strong diagnostic value in general adults. In addition, Pgp3, TmeA, and InaC, but not HSP60, achieved high performance, i.e., both positive predictive value (PPV) and negative predictive value (NPV) ≥ 90.9%, and showed no significant cross-reactivity with anti-Chlamydiapneumoniae. Three C. trachomatis species-specific antigens Pgp3, TmeA, and InaC show superior performance in the detection of anti-C. trachomatis antibody, indicating the potential to be used in developing C. trachomatis serologic tests.

CHLAMYDIA TRACHOMATIS INFECTION IN PELVIC INFLAMMATORY DISEASE PATIENTS – A SNAP SHOT

Background: Chlamydia trachomatis is a sexually transmitted infection which due to its asymptomatic nature remains undiagnosed and presents as pelvic inflammatory disease in females. The objective of the study is to find prevalence and risk factors associated with positive testing of Chlamydia trachomatis infection in women suffering from pelvic inflammatory disease visiting a tertiary care hospital in Pakistan. Material and Methods: This cross-sectional study was carried out at Department of Microbiology, Army Medical College/ National University of Medical Sciences from March 2019 to September 2019. This cross-sectional study was conducted among women presenting with pelvic inflammatory disease over a period of seven months. Socio-demographic and behavioral data were collected and real-time PCR diagnostic method was used to detect the presence of Chlamydia trachomatis infection in urine samples. Samples were collected by non-probability convenient sampling technique; Samples were analyzed for risk factors identification and association with Chlamydia trachomatis infection was determined. Results: The prevalence of Chlamydia trachomatis was 12 (20%) out of total 60 participants. Maximum positive cases were seen in 20-24 years of age group. Risk factors i.e., age, number of sexual partners, gross monthly income, level of education, place of residence and past sexual history were evaluated. Positive association p =0.046 was found between number of sexual partners and Chlamydia trachomatis infection. Conclusion: Chlamydia trachomatis a sexually transmitted infection is deadly infection because of its wide range of complications. Therefore, it should be diagnosed promptly and treated effectively. Due to its asymptomatic nature individuals having risk factors should be screened as early possible to avoid complications. Information about Chalamydia trachomatis risk factors and education about how to avoid infection should be given to individuals on large scale. Keywords: Chlamydia trachomatis, Pelvic inflammatory disease, Polymerase chain reaction

Removal of the spleen abrogates the long-term hydrosalpinx pathology following Chlamydiagenital infection

Abstract C. trachomatis infections in women may cause pelvic inflammatory disease, chronic pelvic pain, and infertility. In the mouse model, genital Chlamydia disseminates systemically to infect the spleen. Removal of the spleen (splenectomy) abrogates hydrosalpinx pathology in the female reproductive tract (FRT), although it does not affect FRT Chlamydia clearance. Ascension of Chlamydia to the upper FRT (uteri, ovaries, oviducts) is critical for the development of hydrosalpinx. Over the course of genital infection, splenectomized mice exhibit significantly lower Chlamydia burden in the upper FRT and the GI tract compared to controls. Based on the report that Chlamydia-specific IgA secreted in the FRT protects against genital Chlamydia challenge, we hypothesized that splenectomy induces IgA secretion in the FRT. Examination of vaginal washes revealed that unlike controls, splenectomized mice exhibit Chlamydia-specific IgA by 4 weeks post-infection (wpi). However, the presence of IgA at this time did not explain the significant reduction in Chlamydia ascension observed by 2 wpi. Unlike controls, splenectomized mice additionally exhibit Chlamydia-specific IgM antibodies in vaginal secretions as early as 2 wpi. Naïve mice infected with Chlamydia pre-incubated with vaginal washes of splenectomized mice collected at 2 or 6 wpi exhibited reduced Chlamydia burden in the FRT, ILNs, spleen, and the GI tract at 3 and 7 days post-infection compared to controls. Secreted IgM and IgA thus neutralize Chlamydia, diminish its ascension in the upper FRT and thus abrogate the long-term hydrosalpinx pathology. This work reveals a previously unknown role that the spleen plays in the regulation of antibody secretion in the FRT mucosa. Supported by a grant from NIH (1 R21 AI159743-01)

Association of functional superoxide gene polymorphism with chlamydia trachomatis-associated recurrent spontaneous abortion

Oxidative stress generated by Chlamydia trachomatis infection is associated with reproductive complications such as recurrent spontaneous abortion. Aim of prospective study was to evaluate whether single nucleotide polymorphisms (SNPs) of SOD1 and SOD2 gene are associated with C. trachomatis-infected recurrent spontaneous abortion (RSA). 150 patients with history of RSA and 150 patients with history of successful deliveries were recruited from Department of Obstetrics and Gynecology, Safdarjung hospital, New Delhi, India. Urine and non-heparinized blood samples were collected and C. trachomatis was detected by polymerase chain reaction (PCR). Using qualitative real time PCR, SNPs rs4998557 (SOD1) and rs4880 (SOD2) were screened in enrolled patients. Level of 8-hydroxyguanosine (8-OHdG), 8-isoprostane (8-IP), progesterone and estrogen was determined by enzyme-linked immunosorbent assays and correlated with SNPs. Significant differences were found in frequency of AA genotype of SOD1 gene among RSA patients versus controls, (82% and 54.66%, respectively; p = 0.02; OR 0.40; CI 95%). Frequency of AA genotype of SOD1 gene among RSA patients with C. trachomatis infection was 87.33%, while in uninfected RSA patients was 71.33% (p < 0.0001; OR 8; CI 95%). No significant relation was found between SOD2 (rs4880) genotype and RSA. Furthermore, significant increase in 8-OHdG, 8-IP and estrogen and significant decrease in progesterone was observed among patients carrying AA genotype. Findings suggest the clinical importance of AA genotype along with 8-OHdG, 8-IP and estrogen and progesterone in screening C. trachomatis-infected RSA women.

Induction of Transmucosal Protection by Oral Vaccination with an Attenuated Chlamydia.

Chlamydia muridarum has been used to study chlamydial pathogenesis because it induces mice to develop hydrosalpinx, a pathology observed in C. trachomatis-infected women. We identified a C. muridarum mutant that is no longer able to induce hydrosalpinx. In the current study, we evaluated the mutant as an attenuated vaccine. Following an intravaginal immunization with the mutant, mice were protected from hydrosalpinx induced by wild-type C. muridarum. However, the mutant itself productively colonized the mouse genital tract and produced infectious organisms in vaginal swabs. Nevertheless, the mutant failed to produce infectious shedding in the rectal swabs following an oral inoculation. Importantly, mice orally inoculated with the mutant mounted transmucosal immunity against challenge infection of wild-type C. muridarum in the genital tract. The protection was detected as early as day 3 following the genital challenge infection and the orally immunized mice were protected from any significant pathology in the upper genital tract. However, the same orally immunized mice failed to prevent the colonization of wild-type C. muridarum in the gastrointestinal tract. The transmucosal immunity induced by the oral mutant was further validated in the airway. The orally vaccinated mice were protected from both lung infection and systemic toxicity caused by intranasally inoculated wild-type C. muridarum although the same mice still permitted the gastrointestinal colonization by the wild-type C. muridarum. These observations suggest that the mutant C. muridarum may be developed into an intracellular oral vaccine vector (or IntrOv) for selectively inducing transmucosal immunity in extra-gut tissues.

Significant Associations between Chlamydia trachomatis and Neisseria gonorrhoeae Infections in Human Immunodeficiency Virus-Infected Pregnant Women.

There is a lack of data on the burden of Chlamydia trachomatis and Neisseria gonorrhoeae among human immunodeficiency virus- (HIV-) infected pregnant women in South Africa. We conducted a cross-sectional study which included 385 HIV-infected pregnant women attending antenatal clinic at the King Edward VIII Hospital in Durban, South Africa. The women provided vaginal swabs which were tested for C. trachomatis and N. gonorrhoeae. The prevalence of the individual STIs was as follows: C. trachomatis (47/385, 12.2%) and N. gonorrhoeae (16/385, 4.1%). Having a circumcised partner, testing positive for N. gonorrhoeae, and perceiving themselves of being at risk for infection were shown to increase the risk for C. trachomatis infection. Without controlling for the other factors, testing positive for N. gonorrhoeae increased the risk for C. trachomatis infection by 10-fold (OR: 10.17, 95% CI: 3.39-29.66, p < 0.001). Similarly, adjusting for the other factors, the risk for C. trachomatis infection in women who tested positive for N. gonorrhoeae was 9-fold (OR: 9.16, 95% CI: 2.19-40.18, p = 0.003). The following factors were associated with the increased risk of N. gonorrhoeae infection: not knowing their partner's HIV status, partner having other partners, and C. trachomatis infection status. Without controlling for the other factors, testing positive for C. trachomatis increased the risk for N. gonorrhoeae infection by 6-fold (OR: 6.52, 95% CI: 2.22-18.49, p < 0.001). Similarly, adjusting for the other factors, the risk for N. gonorrhoeae infection in women who tested positive for C. trachomatis was 6-fold (OR: 6.09, 95% CI: 1.73-22.03, p = 0.005). We found a significant association between C. trachomatis and N. gonorrhoeae in the pregnant women and the risk factors associated with these pathogens. Future studies are urgently required to investigate the impact of C. trachomatis/N. gonorrhoeae coinfections in HIV pregnant women since this data is lacking in our setting. In addition, etiological screening of C. trachomatis and N. gonorrhoeae during antenatal clinic is urgently required to prevent adverse pregnancy and birth outcomes associated with these infections.

Metagenomic Shotgun Sequencing of Endocervical, Vaginal, and Rectal Samples among Fijian Women with and without Chlamydia trachomatis Reveals Disparate Microbial Populations and Function across Anatomic Sites: a Pilot Study.

ABSTRACTChlamydia trachomatis is a sexually transmitted pathogen and a global public health concern. Little is known about the microbial composition and function across endocervical, vaginal, and rectal microbiomes in the context of C. trachomatis infection. We evaluated the microbiomes of 10 age-matched high-risk Fijian women with and without C. trachomatis using metagenomic shotgun sequencing (MSS). Lactobacillus iners and Lactobacillus crispatus dominated the vagina and endocervix of uninfected women. Species often found in higher relative abundance in bacterial vaginosis (BV)—Mageeibacillus indolicus, Prevotella spp., Sneathia spp., Gardnerella vaginalis, and Veillonellaceae spp.—were dominant in C. trachomatis-infected women. This combination of BV pathogens was unique to Pacific Islanders compared to previously studied groups. The C. trachomatis-infected endocervix had a higher diversity of microbiota and microbial profiles that were somewhat different from those of the vagina. However, community state type III (CST-III) and CST-IV predominated, reflecting pathogenic microbiota regardless of C. trachomatis infection status. Rectal microbiomes were dominated by Prevotella and Bacteroides, although four women had unique microbiomes with Gardnerella, Akkermansia, Bifidobacterium, and Brachyspira. A high level of microbial similarity across microbiomes in two C. trachomatis-infected women suggested intragenitorectal transmission. A number of metabolic pathways in the endocervix, driven by BV pathogens and C. trachomatis to meet nutritional requirements for survival/growth, 5-fold higher than that in the vagina indicated that endocervical microbial functions are likely more diverse and complex than those in the vagina. Our novel findings provide the impetus for larger prospective studies to interrogate microbial/microbiome interactions that promote C. trachomatis infection and better define the unique genitorectal microbiomes of Pacific Islanders.IMPORTANCE Chlamydia trachomatis is the primary cause of bacterial sexually transmitted infections worldwide, with a disturbing increase in annual rates. While there is a plethora of data on healthy and pathogenic vaginal microbiomes—defining microbial profiles and associations with sexually transmitted infections (STIs)—far fewer studies have similarly examined the endocervix or rectum. Further, vulnerable populations, such as Pacific Islanders, remain underrepresented in research. We investigated the microbial composition, structure, and function of these anatomic microbiomes using metagenomic shotgun sequencing among a Fijian cohort. We found, primarily among C. trachomatis-infected women, unique microbial profiles in endocervical, vaginal, and rectal microbiomes with an increased diversity and more complex microbial pathways in endocervical than vaginal microbiomes. Similarities in microbiome composition across sites for some women suggested intragenitorectal transmission. These novel insights into genitorectal microbiomes and their purported function require prospective studies to better define Pacific Islander microbiomes and microbial/microbiome interactions that promote C. trachomatis infection.

Doxycycline: the universal treatment for anogenital chlamydia

The results of the randomised trial in The Lancet Infectious Diseases by Olivia Peuchant and colleagues are welcomed and should come as no surprise. 1 Peuchant O Lhomme E Martinet P et al. Doxycycline versus azithromycin for the treatment of anorectal Chlamydia trachomatis infection in women concurrent with vaginal infection (CHLAZIDOXY study): a multicentre, open-label, randomised, controlled, superiority trial. Lancet Infect Dis. 2022; (published online May 9.)https://doi.org/10.1016/S1473-3099(22)00148-7 Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar After all, doxycycline is known to be more efficacious than azithromycin for the treatment of rectal chlamydia in men, 2 Lau A Kong FYS Fairley CK et al. Azithromycin or doxycycline for asymptomatic rectal Chlamydia trachomatis. N Engl J Med. 2021; 384: 2418-2427 Crossref PubMed Scopus (20) Google Scholar and randomised data from Peuchant and colleagues' study now confirm the same is true for women. However, the issue in women is slightly more intriguing, given around two-thirds of the women had not had anal sex and rectal infection was thought to come mainly from contamination or autoinoculation from the genital tract. 1 Peuchant O Lhomme E Martinet P et al. Doxycycline versus azithromycin for the treatment of anorectal Chlamydia trachomatis infection in women concurrent with vaginal infection (CHLAZIDOXY study): a multicentre, open-label, randomised, controlled, superiority trial. Lancet Infect Dis. 2022; (published online May 9.)https://doi.org/10.1016/S1473-3099(22)00148-7 Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar So one could reasonably ask, does persistence of chlamydial rectal infection really matter? We and the authors of this important trial think it does matter; additionally, we think that this finding should further support doxycycline as the treatment of choice for chlamydial infections in men and now in women at any anatomical site. Doxycycline versus azithromycin for the treatment of anorectal Chlamydia trachomatis infection in women concurrent with vaginal infection (CHLAZIDOXY study): a multicentre, open-label, randomised, controlled, superiority trialThe microbiological anorectal cure rate was significantly lower among women who received a single dose of azithromycin than among those who received a 1-week course of doxycycline. This finding suggests that doxycycline should be the first-line therapy for C trachomatis infection in women. Full-Text PDF

Doxycycline versus azithromycin for the treatment of anorectal Chlamydia trachomatis infection in women concurrent with vaginal infection (CHLAZIDOXY study): a multicentre, open-label, randomised, controlled, superiority trial

Anorectal infections with Chlamydia trachomatis are commonly found in women. Although the efficacy of doxycycline and azithromycin is comparable in the treatment of urogenital infection, their efficacies toward anorectal infection remain unclear. We therefore aimed to compare a single dose of azithromycin with a 7-day course of doxycycline for the treatment of anorectal C trachomatis infection in women with concurrent vaginal infection. We did a multicentre, open-label, randomised, controlled, superiority trial involving four sexually transmitted infection screening centres and three pregnancy termination centres in France. We included sexually active adult women (≥18 years) with a positive C trachomatis vaginal swab who agreed to provide self-collected anorectal swabs for C trachomatis detection. Participants were randomly assigned (1:1), using block sizes of six and eight and stratification by each investigating centre, to orally receive either azithromycin (a single 1-g dose, with or without food) or doxycycline (100 mg in the morning and evening at mealtimes for 7 days [ie, 100 mg of doxycycline twice per day for 7 days]). All laboratory staff who did the bacteriological analyses, but not the participants and the investigators, were masked to the treatment groups. The primary outcome was the microbiological anorectal cure rate defined as a C trachomatis-negative nucleic acid amplification test (NAAT) result in anorectal specimens 6 weeks after treatment initiation among women who had a baseline C trachomatis-positive anorectal NAAT result. The primary analysis was done in the modified intention-to-treat population, with multiple imputation, which included all women who underwent randomisation and had a C trachomatis-positive vaginal and anorectal NAAT result at baseline. Adverse events were reported in all women who underwent randomisation. This study is registered with ClinicalTrials.gov, number NCT03532464. Between Oct 19, 2018, and April 17, 2020, we randomly assigned a total of 460 participants to either the doxycycline group (n=230) or the azithromycin group (n=230). Four (1%) of 460 participants were excluded because they refused to take doxycycline or were found to be ineligible after randomisation. Among the 456 participants, 357 (78%) had a concurrent C trachomatis-positive anorectal NAAT result at baseline; 184 (52%) of 357 were in the doxycycline group and 173 (48%) were in the azithromycin group (ie, the modified intention-to-treat population). Microbiological anorectal cure occurred in 147 (94%) of 156 participants in the doxycycline group (28 missing values) versus 120 (85%) of 142 in the azithromycin group (31 missing values; adjusted odds ratio with imputation of missing values 0·43 [95% CI 0·21-0·91]; p=0·0274). Reported adverse events possibly related to treatment were notified in 53 (12%) of 456 women: 24 (11%) of 228 in the doxycycline group and 29 (13%) of 228 in the azithromycin group. Gastrointestinal disorders were the most frequently occurring, in 43 (9%) of 456 women: 17 (8%) of 228 in the doxycycline group and 26 (11%) of 228 in the azithromycin group. The microbiological anorectal cure rate was significantly lower among women who received a single dose of azithromycin than among those who received a 1-week course of doxycycline. This finding suggests that doxycycline should be the first-line therapy for C trachomatis infection in women. French Ministry of Health. For the French translation of the abstract see Supplementary Materials section.

Immunoassay to categorize chlamydial inflammatory disease in women to develop biomarker from peptide derived stimulant and its response to cytokine

Chlamydia trachomatis infection in women can result in serious sequelae such as pelvic inflammatory disease and infertility. Previous research has suggested that peptide epitopes from HtrA and HSP60 are potential biomarkers for immune cell reactions. Thus, in this study we tested the hypothesis that these peptides could be used for future development of an immunoassay to detect at-risk women of pathology by a profile of the cytokine response. Our findings indicate that some chlamydial peptide antigens stimulated cervical mononuclear cell production of IL-6 and IFN-y resulting from cervical cell proliferation from women with pelvic inflammatory disease (PID) and/or cervicitis to a greater extent than that observed in negative control cohorts. Proliferative response of cervical cells induced by peptide antigens strongly reduces IL-10 concentration. We evaluated the suitability of different pairs of peptide antigens for the predictive value of chlamydial infection based on the cytokine induction. Whilst the cytokine response was not statistically significant, the data suggests that an immunoassay may be possible to develop in future for early detection of serious chlamydial infection sequelae.

Prevalence of Endocervical Chlamydia trachomatis Infection and Related Risk Factors Among Women Attending Gynecology Clinic of Birjand University of Medical Sciences, East of Iran

Background: Chlamydia trachomatis is one of the most common sexually transmitted infections in the world. However, there is no detailed information on its incidence, especially in developing countries where routine laboratory diagnosis is unavailable. Objectives: This study aimed to investigate the prevalence of endocervical C. trachomatis infection and related risk factors among women attending the University Gynecology Clinic of Birjand, East of Iran. Methods: This cross-sectional study was conducted on 195 women attending the University Gynecology Clinic in South Khorasan, Birjand. Endocervical sampling was performed in a lithotomy position using a sterile brush. Identification of C. trachomatis was performed by real-time PCR method using GeneProof C. trachomatis PCR kit. Data on socio-demography and potential risk factors for genital infection were analyzed using SPSS software (version 21). Results: In the study, the prevalence rate of C. trachomatis among women was reported 4.1% (8/195 subjects). Statistical analysis showed that the rate of C. trachomatis infection in women was only statistically related to the history of vaginal infection (P = 0.001). Although there was no statistically significant association between chlamydial infection and age, the highest infection rate was in women less than 30 years old. Conclusions: Given the relatively significant incidence of C. trachomatis infection among women, our findings highlight the importance of routine screening and early diagnosis of C. trachomatis to control the infection.

A Comparative Study of Prevalence of Chlamydia Trachomatis Infection among Infertile and Fertile Women at a Tertiary Care Center

Background and Aim: Chlamydia trachomatis is an obligate intracellular Gram-negative bacterium causing sexually transmitted infection leading to urogenital infections which are asymptomatic. If untreated, leads to complications such as chronic pelvic pain, inflammation, and occlusion of the fallopian tubes, resulting in infertility and ectopic pregnancy. The association is found between C. trachomatis infection and female infertility with a prevalence rate of 15%–30%. The aim was to determine the prevalence of C. trachomatis infection in women with infertility. Materials and Methods: This was a hospital-based cross-sectional study of patients presenting with or without infertility. Group A (75 cases) cases with infertility with or without symptoms of pelvic inflammatory disease. Group B (75 cases) with no infertility matching age, symptoms with Group A. After history, physical examination cervical swab for chlamydial antigen and serology sample was taken and processed. Positive cases were followed by hysterosalpingography (HSG) and laparoscopy. Results: Out of 150 patients, 14 were positive for chlamydia in cases and 4 in the control group. Chlamydial prevalence was four times more in cases as compared to the control group, which is significant. The mean age was 27.97 + 4.520 years. Out of 14 positive cases, 8 (57.14%) had symptoms, whereas 6 (42.85%) were asymptomatic; in controls, 2 were symptomatic, whereas 2 were asymptomatic. HSG and laparoscopy were positive in chlamydia positive cases. Conclusion: It can be presumed that there is a significant role of C. trachomatis in infertility and also there is an association between chlamydia antigen detection and tubal factor infertility.

Chlamydia trachomatis IgM and gG antibodies and associated risk factors of among positive and negative HIV women attending consultation at the Mbouo-Banjoun Presbyterian Hospital West Region of Cameroon

Background:Chlamydia trachomatis (CT) infection in the genitourinary tract is the most prevalent bacterial sexually transmitted disease (STD) worldwide. Genital chlamydial infection has a huge impact on sexual and reproductive health, and it is very common in developed and developing countries. This study aimed to determine the seroprevalance and risk factors for C. trachomatisinfection in women seeking medical care in the locality of Mbouo-BanjounWest Region of Cameroon. Methods: We conducted a cross-sectional hospital based study from November 2016 to June 2017 in which we recruited 204 consenting women aged 18 to 55 years. A questionnaire was administered to study participants and potential risk factors for Chlamydia exposure sought. Venous blood was collected and serum from each participant analysed for C. trachomatis infection as evidenced by positive anti-C. trachomatisIgG and IgM antibodies detected using the Sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA) technique. The proportion of anti-C. trachomatis antibody was calculated and predictors of C. trachomatis infection analysed by univariate and multivariate regression. Epi-Info 7 was used for statistical analyses. A p &lt; 0.05 was considered significant in all analyses. Results: The seroprevalence of anti-C. trachomatisantibodies (IgM or IgG) was found to be62.25% [127/204]. Among seropositive women, 37.15% [77/204] were seropositive for IgG antibodies while 47.54% [97/204] were seropositive for IgM antibodies and 23.04% [47/204] where seropositive for both IgM and IgG antibodies. Among the risk factors evaluated, marital status (P= 0.03) and knowledge of Chlamydia (P= 0.001) were observed to be an independent risk factor of C. trachomatisinfection. Conclusions: Our findings suggest recent C. trachomatisexposure is high in our study population, and may constitute a significant risk factor for, ocular and pulmonary infection in new born child, infertility to women. Education and screening of HIV-positive individuals and pregnant women for C. trachomatisinfection may be important primary prevention strategies in this population.

Seropevalence of Chlamydia trachomatis among women attending consultation at the Mbouo-Banjoun Presbyterian Hospital West Region of Cameroon

Background: Chlamydia trachomatis (CT) infection in the genitourinary tract is the most prevalent bacterial sexually transmitted disease (STD) worldwide. Genital chlamydial infection has a huge impact on sexual and reproductive health, and it is very common in developed and developing countries. This study aimed to determine the seroprevalance and risk factors for C. trachomatis infection in women seeking medical care in the locality of Mbouo-Banjoun West Region of Cameroon. Methods and materials: We conducted a cross-sectional hospital based study from November 2016 to June 2017 in which we recruited 204 consenting women aged 18 to 55 years. A questionnaire was administered to study participants and potential risk factors for Chlamydia exposure sought. Venous blood was collected and serum from each participant analysed for C. trachomatis infection as evidenced by positive anti- C. trachomatis IgG and IgM antibodies detected using the Sandwich Enzyme-Linked ImmunoSorbent Assay (ELISA) technique. The proportion of anti- C. trachomatis antibody was calculated and predictors of C. trachomatis infection analysed by univariate and multivariate regression. Epi-Info 7 was used for statistical analyses. A p < 0.05 was considered significant in all analyses. Results: The seroprevalence of anti- C. trachomatis antibodies (IgM or IgG) was found to be 62.25% [127/204]. Among seropositive women, 37.15% [77/204] were seropositive for IgG antibodies while 47.54% [97/204] were seropositive for IgM antibodies and 23.04% [47/204] where seropositive for both IgM and IgG antibodies. Among the risk factors evaluated, marital status (p = 0.03) and knowledge of Chlamydia (p = 0.001) were observed to be an independent risk factor of C. trachomatis infection. Conclusion: Our findings suggest recent C. trachomatis exposure is high in our study population, and may constitute a significant risk factor for, ocular and pulmonary infection in new born child, infertility to women. Education and screening of HIV-positive individuals and pregnant women for C. trachomatis infection may be important primary prevention strategies in this population.

The role of Chlamydia trachomatis in preterm delivery: a case-control study in Besat Hospital, Sanandaj, Iran (2018-2019)

Background and Objectives:Preterm delivery is an important subject in gynecology, obstetrics and pediatrics. It is defined as regular uterine contractions every five to eight minutes or less, lasting for 30 seconds. It is associated with progressive changes in the cervix, resulting in delivery after 22 weeks and before 37 weeks of gestation. This study aimed to evaluate the role of Chlamydia trachomatis infection in women with preterm delivery.Materials and Methods:This case-control study was performed on 75 women with preterm delivery (case group) and 75 women with term delivery (control group). The research tools included a questionnaire, polymerase chain reaction (PCR) assay of cervical swab samples and ELISA assay of umbilical cord blood samples. Fisher’s exact test and t test were also performed to compare qualitative variables between the two groups.Results:In this study, the mean age of subjects was 26.55 ± 0.53 years in the control group and 26.76 ± 0.56 years in the case group. The prevalence of C. trachomatis in the cervical swab samples was 7 (9.33%) in the control group and 2 (2.67%) in the case group. There was no C. trachomatis IgM antibody in either of the groups, while there was 1 (1.33%) C. trachomatis IgG antibody in both groups.Conclusion:The results of the present study showed that there was no significant relationship between C. trachomatis infection and preterm delivery.

Innate Lymphoid Cells Are Required for Endometrial Resistance to Chlamydia trachomatis Infection.

In some women, sexually transmitted Chlamydia trachomatis may ascend to infect the endometrium, leading to pelvic inflammatory disease. To identify endometrial innate immune components that interact with Chlamydia, we introduced C. trachomatis into mouse endometrium via transcervical inoculation and compared the infectious yields in mice with and without immunodeficiency. Live C. trachomatis recovered from vaginal swabs or endometrial tissues peaked on day 3 and then declined in all mice with or without deficiency in adaptive immunity, indicating a critical role for innate immunity in endometrial control of C. trachomatis infection. Additional knockout of interleukin 2 receptor common gamma chain (IL-2Rγc) from adaptive immunity-deficient mice significantly compromised the endometrial innate immunity, demonstrating an important role for innate lymphoid cells (ILCs). Consistently, deficiency in IL-7 receptor alone, a common gamma chain-containing receptor required for ILC development, significantly reduced endometrial innate immunity. Furthermore, mice deficient in RORγt or T-bet became more susceptible to endometrial infection with C. trachomatis, suggesting a role for group 3-like ILCs in endometrial innate immunity. Furthermore, genetic deletion of gamma interferon (IFN-γ) but not IL-22 or antibody-mediated depletion of IFN-γ from adaptive immunity-deficient mice significantly compromised the endometrial innate immunity. Finally, depletion of NK1.1+ cells from adaptive immunity-deficient mice both significantly reduced IFN-γ and increased C. trachomatis burden in the endometrial tissue, confirming that mouse ILCs contribute significantly to endometrial innate immunity via an IFN-γ-dependent effector mechanism. It will be worth investigating whether IFN-γ-producing ILCs also improve endometrial resistance to sexually transmitted C. trachomatis infection in women.

Does tumour necrosis factor alpha-induced cyclooxygenase-2 expression lead to spontaneous abortion in Chlamydia trachomatis-infected women

Cytokines might be involved in spontaneous abortion by triggering inflammatory mediators (Cyclooxygenases (Cox)) leading to spontaneous abortion in Chlamydia trachomatis (Ct)-infected women. Study aimed to quantitate the expression of pro-inflammatory cytokines (TNF-α, IFN-γ, IL-8) and Cox-2 in endometrial curettage tissue (ECT) of Spontaneous Aborters (SA). SA (n = 135) and 120 age-matched controls were enrolled from SJH, New Delhi, India. PCR was performed for detection of Ct MOMP gene (537 bp) in ECT. mRNA expression of pro-inflammatory cytokines and Cox-2 was assessed by real-time qPCR. Data was statistically evaluated. 14.8% SA were diagnosed as Ct-positive. Elevated expression of TNF-α, IFN-γ, IL-8 and Cox-2 was observed in Ct-infected SA. Ct-positive recurrent aborters showed significantly higher cytokine expression. Significant positive correlation was found between expression of Cox-2 and TNF-α in infected SA. Data suggested an increased expression of Th-1 cytokines, particularly TNF-α that induced Cox-2 expression in ECT, leading to spontaneous abortion in Ct-infected pregnant women.

Impact of genital Chlamydia trachomatis infection on reproductive outcomes among infertile women undergoing tubal flushing: a retrospective cohort at a fertility centre in Uganda

BackgroundThe impact of current C. trachomatis on clinical pregnancy and live birth rates among women undergoing tubal flushing is largely unknown. This study aimed to investigate whether current female genital C. trachomatis infection affects the chance of achieving a clinical pregnancy and a live birth, among infertile women undergoing tubal flushing, at a fertility centre in Uganda.MethodsA retrospective Cohort study at a peri-urban fertility centre. A total of 253 eligible women with tubal factor infertility, who underwent tubal flushing, were enrolled and categorised according to their exposure to current genital C. trachomatis infection. These women were followed up for a period of 12 months, with the primary outcome measure being clinical pregnancy and live birth. Secondary outcome measures included pregnancy loss and procedural related adverse events.ResultsExposure to current genital C. trachomatis infection reduced chance of clinical pregnancy (adjusted relative risk 0.42; 95% confidence interval, 0.18–0.96) and a live birth (adjusted relative risk 0.37; 95% confidence interval, 0.14–0.95) after tubal flushing. Women with current C. trachomatis infection had an increased risk of adverse events (adjusted relative risk, 1.20; 95% confidence interval, 1.08–1.34). However, current C. trachomatis infection did not affect the risk of spontaneous abortion and ectopic pregnancy.ConclusionCurrent genital C. trachomatis infection in women with tubal factor infertility, undergoing tubal flushing, lowers their chance of pregnancy and live birth.

Are Rectal and Genital Chlamydia Trachomatis Infections in Women Related to Anal Sex, Autoinoculation / Contamination

Are Rectal and Genital Chlamydia Trachomatis Infections in Women Related to Anal Sex, Autoinoculation / Contamination