Prevalence of Chlamydia trachomatis among women attending an antenatal clinic in Bangkok

Cervical swabs from 140 Thai pregnant women were cultured for Chlamydia trachomatis twice during the first and the third trimester. Serum samples for antichlamydial antibodies was also studied from 126 women; 12 of women were culture positive on both occasions. Chlamydia was isolated from 24% of women aged 20-24 years, compared to only 9% of women 25-30 years. Antibody were detected to the genital serotypes (D-K) in 31 (25%) of 126 women who were tested. 70% of women who were culture positive had antibody titer greater than or equal to 1:64 compared to 7% of women who were culture negative.     

Usefulness of real-time PCR in detecting Chlamydia trachomatis and Neisseria gonorrhoeae in endocervical swabs and first-voided urine specimens

We evaluated performance of Abbott RealTime CT/NG assay (real-time PCR, Abbott Japan) for detect Chlamydia trachomatis and Neisseria gonorrhoeae by real-time PCR in 88 female patients with cervicitis symptoms seen at gynecological clinics and 100 male patients with urethritis symptoms seen at urological or dermatology clinics in Kitakyushu, Japan. Endocervical swab and first-voided urine (FVU) specimens were then collected from women and FVU specimens from men. Detection rates of C. trachomatis and N. gonorrhoeae by real-time PCR in the 3 types of specimens were compared to those by ProbeTec ET assay (ProbeTec, BD Diagnostic System). The overall positive concordance between real-time PCR and ProbTec were 97.1% (66/68) for C. trachomatis and 100% (33/33) for N. gonorrhoeae, C. trachomatis detection yielded 3 discordant results in endocervical specimens and 1 discordant result in male FVU by real-time PCR and ProbTec. Three of 4 reexamined using Aptime Combo 2 Assay (Fuji Rebio Inc.) were positive for C. trachomatis. Endocervical swab and FVU specimen results for C. trachomatis were discordant in 3 cases in real-time PCR and 4 in ProbeTec. Subjects with 2 or more positive endocervical awab results in female or male FVU specimens were assumed to be "true positive" for C. trachomatis. The sensitivities of real-time PCR for detecting C. trachomatis was 94.4% in endocervical swabs, 77.8% in female FVU and 97.4% in the male FVU. The sensitivities for real-time PCR for detecting N. gonorrhoeae was 100% in all 3 specimentypes. Abbott RealTime CT/NG assay was useful for detecting C. trachomatis using endocervical swabs or male FVU specimens and for detecting N. gonorrhoeae using endocervical swabs and all FVU specimens.     

Evaluation of an automated extraction method for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Cobas Amplicor PCR from different sample materials

A commercially available automated device (MagNA Pure LC) was adapted for nucleic acid extraction of urogenital specimen for subsequent PCR detection of Chlamydia trachomatis and Neisseria gonorrhoeae in a clinical laboratory. Results were compared to the standard manual extraction procedure and showed excellent correlation, with even slightly increased sensitivity.     

Re-infection of Neisseria gonorrhoeae and Chlamydia trachomatis infections among men who have sex with men

Our aim was to determine the incidence of re-infection of men who have sex with men (MSM) for rectal Neisseria gonorrhoeae (RNg) and rectal Chlamydia trachomatis (RCt) infection. The medical records of 126 MSM diagnosed with RNg or RCt infections at Melbourne Sexual Health Centre were reviewed. A total of 68 of the 126 (54%) MSM were re-tested. Among the HIV-positive MSM, 17 (81%) of 21 were re-tested and eight were positive (47%, 95% confidence interval [CI] 23-72%). Among the 51 (49%) of 105 of the HIV-negative or unknown MSM re-tested, 13 (25%, 14-40) were positive. Of the 21 infections identified, five cases were symptomatic. The incidence of rectal infections among MSM is high and prior RNg or RCt should be included as a risk factor for frequent screening.     

Evaluation of the new nucleic acid amplification system for direct detection of Chlamydia trachomatis and Neisseria gonorrhoeae in women

The performance of a real-time DNA amplification assay, BD ProbeTec ET System (BDPT, BD Diagnostic Systems), to detect Chlamydia trachomatis and Neisseria gonorrhoeae on endocervical and oropharyngeal samples was evaluated. After obtaining informed consent, 364 endocervical, 363 urine and 247 oropharyngeal specimens were collected from 307 cases. The overall agreement rate of the BDPT and Amplicor (AMP, Roche) assays for the detection of C. trachomatis and N. gonorrhoeae in endocervical samples was 99.2% (361/364) for C. trachomatis and 99.5% (362/364) for N. gonorrhoeae. Assay of oropharyngeal swabs by the BDPT yielded 21 C. trachomatis positives, and 19 of them were C. trachomatis negative by the DNA probe assay (Gen-Probe PACE). The AMP assay showed that 16/19 (84.2%) of the BDPT +/DNA probe - samples were positive. The BDPT also yielded 21 N. gonorrhoeae positives, 15 of which were negative with the DNA probe. Additional testing showed that all 15 BDPT +/DNA probe - samples were positive by the established nested PCR method. Our data suggest that the performance of the BDPT is comparable to that of AMP for detection of C. trachomatis and N. gonorrhoeae in endocervical swab samples and that it may be a useful method for detecting of C. trachomatis and N. gonorrhoeae in oropharyngeal samples clinically.     

Usefulness of the mailed specimens for mass examination of Chlamydia trachomatis and Neisseria gonorrhoeae with EIA

The infections with C. trachomatis and N. gonorrhoeae have recently been determined routinely with the commercial kits for detecting the antigens of these organisms in both the clinical and mass examination laboratories. In mass examination, a change during transporting the specimens must be avoided. Hence, a study on whether the antigens were changed with atmospheric temperature was carried out. As for C. trachomatis, no change in antigen was found on the enzyme immunoassay (EIA) absorbance of the antigen quantity corresponding to the cell of 4.8 x 10(4), 2.4 x 10(4) and 6.0 x 10(3) (IFU/ml) until 5 days at 4, 25 and 37 degrees C respectively after sampling. The coefficient variation was found out to be ca. 10%. In a test on antigen stability of N. gonorrhoeae, similar results to that of C. trachomatis were obtained on the following antigen quantity: 2.4 x 10(3), 3.3 x 10(2) and 9.0 x 10 (CFU/ml) under the same conditions as in the above. The coefficient variation was found out to be 10% or less. To investigate whether there is any difference on the stability of C. trachomatis antigen between mailing and hand carrying, a total of 133 specimens collected from many clinics were subjected to the detection of antigen with the commercial EIA kits. The results of comparison on both transport methods were as follows: agreement rate 96.2%, positive rate 100% and negative rate 95.2%. The highly correlation between the both transportation was confirmed in the detection of antigen; that is, Y = 1.03X + 0.03, r = 0.936.(ABSTRACT TRUNCATED AT 250 WORDS)     

Performance of strand displacement amplification assay in the detection of Chlamydia trachomatis and Neisseria gonorrhoeae

This study is a critical analysis of certain amplification assays for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections which have demonstrated that the plasmid-free variant of C. trachomatis is frequently responsible for infection in our patients. Specifically, we evaluated the performance of the strand displacement amplification (SDA) assay in detecting either C. trachomatis or N. gonorrhoeae in 1,190 clinical samples, both urogenital and ocular, from 1,005 consecutive patients. The results obtained with the BDProbeTec ET System were compared with three referenced amplification methods for C. trachomatis (detecting the 16S rRNA gene, the omp1 gene and the plasmid of C. trachomatis) and with both the culture method as well as an amplification assay followed by genetic identification performed using the MicroSeq 500 16S ribosomal DNA-based system for N. gonorrhoeae. The sensitivity of SDA (76%) in detecting C. trachomatis is significantly low when compared with that of other molecular techniques employing 16S rDNA or omp1 as a target. The specificity of the methods for detecting C. trachomatis was excellent, ranging from 99.4 to 100%. Furthermore, the results of SDA in detecting N. gonorrhoeae also provided excellent results (100% specificity and sensitivity).     

Chlamydia trachomatis infection among HIV-infected women attending an AIDS clinic in the city of Manaus,Brazil

This was a cross-sectional study aimed to determine the prevalence of and to identify risk factors for Chlamydia trachomatis (CT) among human immunodeficiency virus (HIV)-infected women attending the acquired immunodeficiency syndrome (AIDS) clinic in the city of Manaus, Brazil, in 2009-2010. Participants answered a questionnaire containing demographic, epidemiological, and clinical data. A genital specimen was collected during examination to detect CT-DNA by hybrid capture, and blood samples were taken to determine CD4⁺T and HIV viral load. There were 329 women included in the study. Median age was 32 years (IQR = 27-38) and median schooling was nine years (IQR = 4-11). The prevalence of CT was 4.3% (95%CI: 2.1-6.5). Logistic regression analysis showed that age between 18-29 years [OR = 4.1(95%CI: 1.2-13.4)] and complaint of pelvic pain [OR = 3.7 (95%CI: 1.2-12.8)] were independently associated with CT. The use of condom was inversely associated with CT [OR = 0.39 (95%CI: 0.1-0.9)]. The results showed that younger women who did not use condoms are at a higher risk for CT. Screening for sexually transmitted infections must be done routinely and safe sexual practices should be promoted among this population.     

Risk of coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in Nova Scotia

BACKGROUND:

The frequency of Chlamydia trachomatis and Neisseria gonorrhoeae coinfection can vary depending on their individual incidence and prevalence rates.

OBJECTIVE:

To determine the frequency of C trachomatis and N gonorrhoeae coinfections by evaluating the results of testing in 2007 and 2008 to better inform testing and treatment decisions.

METHODS:

Specimens from the same patient submitted on the same day served as the basis for the present study. The age, sex and the source of the specimen were also linked to the accession number. Infection and coinfection rates were analyzed in both males and females.

RESULTS:

Concurrent testing was performed on 41,567 female specimens and 1827 male specimens, of which, 1495 female samples (3.6%) tested positive for C trachomatis infection and 88 (0.2%) tested positive for N gonorrhoeae infections. Only 31 females were coinfected; however, for those between 11 and 25 years of age, 25 of 61 females (40.1%) with N gonorrhoeae infection also tested positive for C trachomatis infection; conversely, 25 of 1248 females (2.0%) with C trachomatis infection also tested positive for N gonorrhoeae infection. For males, 213 (11.7%) tested positive for C trachomatis infection, and 59 (3.2%) tested positive for N gonorrhoeae infection. In 30 males with N gonorrhoeae between 11 and 25 years of age, and 149 males with C trachomatis, eight coinfections were observed (26.7% and 5.3%, respectively). Of those older than 25 years of age, only five of 905 men and six of 19,465 women were coinfected. None of the 10,935 women who were 30 years of age or older had coinfections.

CONCLUSION:

The N gonorrhoeae coinfection rate in males with C trachomatis may justify empirical antimicrobials; however, in females, the proportion of coinfected may not justify empirical treatment for N gonorrhoeae infection when the C trachomatis test is positive and N gonorrhoeae testing has not been performed.     

High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in Western French Guiana

The purpose of this study was to estimate the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in western French Guiana and to analyze associated factors with both infections. A retrospective study was conducted in a sexually transmitted infections clinic in 2017. Women (n = 338) were tested by real-time polymerase chain reaction for vaginal, anal and throat CT and NG infections. Men (n = 192) were evaluated using urine specimens. Socio-demographic and sexual behaviour data were collected by nurses with a structured questionnaire. The prevalence of CT and NG infections among women were 24.3% and 13.3%, respectively, and 12.0% and 7.3% among men. Women aged under 25 years had a higher risk of CT and NG infections than women aged 35 years or more. Another risk factor for CT infection was low educational level, and occasional unprotected sex for NG infection. CT and NG infections were associated with reporting symptoms among men. Very high prevalences of CT and NG infections among women and men were found, which suggest that a large-scale screening strategy should be implemented in French Guiana.     

Features of Chlamydia trachomatis and Neisseria gonorrhoeae infection in male Army recruits

Non-health care-seeking male United States Army recruits were tested for Chlamydia trachomatis (n=2245) and Neisseria gonorrhoeae (n=884), using a urine ligase chain reaction test to determine prevalence and potential risk factors for infection. The prevalence of chlamydial infection was 5.3%. Black race, a new sex partner, a history of trichomonas, and the presence of symptoms were associated with chlamydial infection. The prevalence of N. gonorrhoeae infection was 0.6%. Only a reported history of or positive test for C. trachomatis was associated with gonorrheal infection. Of those testing positive for chlamydia, 14% reported symptoms versus 40% of those with gonorrhea. Younger age was not a predictor of either infection, as has been shown for women. A substantial number of male army recruits are infected with C. trachomatis, but few are infected with N. gonorrhoeae. Screening on the basis of symptoms alone would miss the majority of both infections.     

Detection of Chlamydia trachomatis antigens by enzyme immunoassay and immunofluorescence in genital specimens from symptomatic and asymptomatic men and women

Chlamydia trachomatis antigens were detected in populations with the following infection prevalences: 26.5% (36 of 136) of men and 27.7% (48 of 173) of women attending a sexually transmitted disease clinic, 16.3% (53 of 324) of women attending a Planned Parenthood clinic, and 3.4% (4 of 117) of an obstetrics and gynecologic practice. Compared with cell culture of the combined female cervical specimens (15.8% prevalence), the respective sensitivities of Chlamydiazyme (Abbott Laboratories, North Chicago, Illinois) and Microtrak (Syva, Palo Alto, California) were 98.3% and 87.9%, specificities were 97.5% and 98.4%, positive predictive values were 87.7% and 92.7%, and negative predictive values were 99.7% and 97.5%. Both assays were 70.0% sensitive with male urethral specimens, and the other parameters of performance ranged between 84.0% and 97.2%. The antigen detection assays, compared with culture, performed equally well in subjects without or with clinical signs.     

The prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis in victims of sexual assault

The prevalence of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in 232 sexual assault victims who presented for examinations between August 1, 1987, and July 31, 1988, was determined. Results are reported for cervical, rectal, and oropharyngeal NG cultures and for cervical and rectal CT smears. Results from a one-week follow-up are also reported. Cervical test results from the initial sexual assault examination were compared with cervical tests on 399 randomly selected female emergency department patients who presented for other gynecological conditions or lower abdominal pain. The victims of sexual assault had ten of 210 positive cervical NG cultures (4.76%), and 13 of 213 positive cervical CT smears (6.1%) at the first visit. These prevalence rates were not significantly different (P = .3058). There were none of 28 positive rectal NG cultures (0%) and one of 22 positive rectal CT smears (4.34%) (P = .451). None of the 43 oral NG cultures was positive. Seventy-three victims returned for follow-up examination. No follow-up cervical, rectal, or oral NG cultures were positive. However, one of 53 follow-up cervical smears for CT was positive, but this was not significantly different than for cervical NG (P = .461). Sexually assaulted patients had ten of 210 (4.76%) cervical NG cultures positive, and nonassaulted patients showed 53 of 393 positives (13.4%) (P less than .001). Assaulted patients had 13 of 213 (6.1%) cervical CT smears positive, and nonassaulted patients showed 33 of 352 (9.3%) positives (P = .11).(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of diagnostic efficacy of PCR methods for Chlamydia trachomatis infection in genital and urine specimens of symptomatic men and women in India

In India, given the scarce availability of sensitive and specific methods, Chlamydia trachomatis genital infections may lead to severe clinical complications when left undiagnosed or underdiagnosed. The present study was conducted to evaluate the diagnostic efficiency and feasibility of polymerase chain reaction (PCR) assays using genital and urine specimens from men and women in India. Genital swabs and urine specimens collected from 143 patients attending the sexually transmitted disease (STD) clinic, Government General Hospital, Chennai, were tested by culture and a plasmid based PCR. Culture was positive in 27 (18.9%) patients. PCR gave positive results for 46 (32.2%) cases using genital specimens, and the positivity rate in urine was 25.2%. Once the discordant results between culture and PCR had been resolved by using a major outer membrane protein PCR, the overall sensitivity, specificity, and positive and negative predictive values for the plasmid PCR in genital specimens were 100%, 98%, 95.7%, and 100%, respectively. Corresponding values for urine PCR were 81.8%, 100%, 100%, and 92.5%, respectively. The prevalence of confirmed C. trachomatis infection was 30.8% in this STD population. The results confirmed the need to use sensitive and specific molecular assays like PCR to prevent underdiagnosis of genital chlamydial infections and to facilitate better clinical management of this infection in India.     

Slips, breaks and 'falls': condom errors and problems reported by men attending an STD clinic

The objective was to comprehensively assess the prevalence of condom-use errors and problems among male clients attending a public sexually transmitted disease (STD) clinic. Men (n = 278) attending an STD clinic completed an anonymous questionnaire. Seven errors and six problems were assessed. Summative scores were tested for associations with three key variables. Of 834 condom-protected events: 19% were associated with 'fit and feel' problems, 15% involved breakage, 14% involved lost erection, 9% were associated with lost erection while applying condoms, 8% involved slippage during withdrawal and 7% involved slippage during sex. A mean of 6.4 errors/problems were observed. None of these summative variables (total errors, total problems or total of errors and problems) were significantly associated with age, minority status or whether men indicated they had ever been taught how to use condoms. Multiple types of condom-use errors and problems may be highly prevalent among high-risk men attending public STD clinics.     

Performance of a rapid molecular test to detect Chlamydia trachomatis and Neisseria gonorrhoeae in women with pelvic inflammatory disease

ObjectiveThe aim of this study was to investigate the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in women with pelvic inflammatory disease (PID) and the usefulness and cost-effectiveness of a rapid molecular test for the diagnosis and clinical management of PID.MethodsThis observational study included 75 patients with mild-to-moderate PID (n = 33), severe PID (n = 29) and non-specific lower abdominal pain (NSAP) (n = 13). CT/NG infections were analyzed using a standard and a rapid test. A cost analysis was carried out.ResultsSamples of 19 patients (25.3%) were CT/NG positive. Concordance between rapid and standard tests was 100%. No significant differences were observed in the incidence of CT/NG in mild-to-moderate compared to severe PID. Costs differed according only to disease severity.ConclusionsRapid molecular tests could help with the diagnosis of PID in sexually active women in clinical settings in which a standard technique is not available.     

Sociodemography of genital co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis in Coventry, UK

While genital co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis in the same individual is relatively common, little is known about the characteristics of individuals co-infected with both pathogens. We describe the sociodemographic and geographic characteristics of those with genital co-infection with N. gonorrhoeae and C. trachomatis.We reviewed the case-notes of all patients presenting with co-infection between March 1989 and February 2000.Incidence rates were calculated for those aged 15-64 living in the 18 different electoral wards of the city and subjects were assigned a Townsend deprivation score based on residence. A total of 332 cases of co-infection were included over the study period (overall mean annual incidence rate 16.1 [95% confidence interval [CI] 9.9-22.3]/100,000). The infection rate was significantly higher in those of black ethnicity (rate: 82.6/10(5), relative rate 5.81, 95% CI [4.03-8.38],P = 0.0001) than in those of other ethnicities. The highest incidence was noted in men aged 20-24 (n = 81, 45.6%) and in women aged 15-19 (n = 66, 45.2%) years, living in the most deprived area of the city. After controlling for year of diagnosis, those aged 25-64 years had significantly lower incidence rates (0.13 [0.10-0.17], P = 0.0001, Poisson regression) than those aged < 20 years. Increased incidence rates were also associated with high deprivation scores.There is a complex interaction between age, sex, ethnicity, geographic distribution, social deprivation and the risk of acquiring genital co-infection with N. gonorrhoeae and C. trachomatis. This study may help to identify the geographic areas of high incidence of sexually transmitted diseases in Coventry, and could be used as the baseline to measure the need for subsequent interventions.     

Evaluation of an enzyme immunoassay for detection of Chlamydia trachomatis in urogenital specimens

Chlamydiazyme (Abbott), an enzyme-linked immunoassay (EIA), was evaluated using cell culture on Hela 229 cells as the method of reference. Samples were acquired from 611 female and 280 male patients attending the outpatient clinic for sexually transmitted disease at the University Hospital in Rotterdam, The Netherlands. The prevalences of chlamydia culture-positive female and male patients were 7.8% and 14.4% respectively. The overall sensitivity and specificity values of the EIA were respectively 68.1% and 95.8% in the female and 92.1% and 92.0% in the male population. Samples which were culture-negative but EIA-positive were re-examined by a second direct test (IDEA; Boots Celltech). If the samples from 12 females and 11 males which were negative on culture but positive with both direct tests are considered as failures of cell culture, the sensitivity of the EIA in females almost equalled cell culture (74.6% versus 79.9%) and in males was even higher (93.9% versus 77.6%). Serotyping of the cultured strains revealed that all serovars of Chlamydia trachomatis occurring in this study could be detected by the EIA. The EIA offers a relatively simple and rapid test for diagnosis of C. trachomatis infections in high-risk populations.     

Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis

Among 149 consecutive infants with ophthalmia neonatorum in Nairobi, Neisseria gonorrhoeae was recovered from 43%, Chlamydia trachomatis from 13%, and both microorganisms from 4%. Three of five isolates of C. trachomatis belonged to trachoma serovars. The sensitivity and specificity of a gram-stained smear for the diagnosis of gonococcal conjunctivitis were 86% and 90%, respectively. Patients with gonococcal conjunctivitis had more purulent discharge, a higher clinical severity score, and a younger age at onset of disease. Corneal epithelial edema with superficial keratitis was present in four (16%) of 25 patients with gonococcal conjunctivitis but in none of 22 other patients (P = .07). N. gonorrhoeae or C. trachomatis was isolated from the pharynx in 11 (15%) and six (23%) cases, respectively. Oropharyngeal gonococcal infection was associated with coughing (P = .007).