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Waters MB, Hybiske K, Ikeda R, Kaltenboeck B, Manhart LE, Kreisel KM, Khosropour CM. Chlamydia trachomatis Seroassays Used in Epidemiologic Research: A Narrative Review and Practical Considerations. J Infect Dis 2024; 230:250-262. [PMID: 39052727 PMCID: PMC11272089 DOI: 10.1093/infdis/jiae199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/20/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024] Open
Abstract
Chlamydia trachomatis (CT) is a sexually transmitted infection that can lead to adverse reproductive health outcomes. CT prevalence estimates are primarily derived from screening using nucleic acid amplification tests (NAATs). However, screening guidelines in the United States only include particular subpopulations, and NAATs only detect current infections. In contrast, seroassays identify past CT infections, which is important for understanding the public health impacts of CT, including pelvic inflammatory disease and tubal factor infertility. Older seroassays have been plagued by low sensitivity and specificity and have not been validated using a consistent reference measure, making it challenging to compare studies, define the epidemiology of CT, and determine the effectiveness of control programs. Newer seroassays have better performance characteristics. This narrative review summarizes the "state of the science" for CT seroassays that have been applied in epidemiologic studies and provides practical considerations for interpreting the literature and employing seroassays in future research.
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Affiliation(s)
| | - Kevin Hybiske
- Department of Medicine, University of Washington, Seattle
| | - Ren Ikeda
- Department of Medicine, University of Washington, Seattle
| | - Bernhard Kaltenboeck
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | | | - Kristen M Kreisel
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Nguyen H, Do Ngoc A, Nguyen Le V, Nguyen Thi NQ, Hoang Thi Y, Hoang CD, Tran Quang P, Vu Van D. Prevalence, risk factors and genotyping of chlamydia trachomatis from endocervical specimens of infertile women at a tertiary care hospital, Vietnam. Int J STD AIDS 2024:9564624241230342. [PMID: 38294256 DOI: 10.1177/09564624241230342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
BACKGROUND To our knowledge, the prevalence, risk factors and distribution of C. trachomatis genotypes are rarely mentioned in Vietnam. This study aimed to find the prevalence, risk factors and distribution of C. trachomatis genotypes in infertile Vietnamese women. METHODS Endocervical swabs were collected from infertile women at the National Hospital of Obstetrics and Gynecology, Vietnam, between January 2020 and December 2021. All samples were analyzed for C. trachomatis presence by Cobas 4800 CT/NG Test. Sequencing methods of ompA gene were used to determine the C. trachomatis genotypes. An approximately 1200 bp ompA fragment was aligned with reference sequences from GenBank to identify the corresponding genotype. RESULTS The prevalence of endocervical C. trachomatis infection was 15.6% of 761 participants. Factors independently associated with CT infection among infertile women, obtained by multivariate analysis, included abnormal vaginal discharge, cervicitis, lower abdominal pain, a history of ectopic pregnancy, having more than one sex partner, and age at first intercourse. Among the samples, genotype E (25.93%) was most frequently found, followed by genotypes D/Da (22.23%), F (13.58%), G/Ga (12.35%), J (12.35%), H (6.17%), K (3.70%), B/Ba (2.47%), and I/Ia (1.23%), respectively. Genotype F was related to types of infertility, and genotype H was associated with a history of miscarriage. CONCLUSIONS The present study indicated a high prevalence of C. trachomatis in infertile Vietnamese women. The most common genotypes found in this population were E, D, and F. Our findings suggest that routine screening is necessary for early detection and performance of infection control methods.
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Affiliation(s)
- Hoa Nguyen
- Pelvic Floor Centre, National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam
| | - Anh Do Ngoc
- Department of Laboratory Medicine, 103 Military Hospital, Hanoi, Vietnam
- Department of Medical Parasitology, Military Medical University, Hanoi, Vietnam
| | - Van Nguyen Le
- Department of Laboratory Medicine, 103 Military Hospital, Hanoi, Vietnam
| | | | - Yen Hoang Thi
- Department of Science and Training, National Institute of Malariology Parasitology and Entomology, Hanoi, Vietnam
| | - Canh Dinh Hoang
- Department of Science and Training, National Institute of Malariology Parasitology and Entomology, Hanoi, Vietnam
| | - Phuc Tran Quang
- Department of Science and Training, National Institute of Malariology Parasitology and Entomology, Hanoi, Vietnam
| | - Du Vu Van
- Treatment on Demand Department, National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam
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Smirnova NS, Kostarnoy AV, Kondratev AV, Gancheva PG, Grumov DA, Gintsburg AL. Diagnostic Value of IgA Antibody Measurement in Tick-Borne Spotted Fever (Astrakhan Rickettsial Fever). Microbiol Spectr 2022; 10:e0168721. [PMID: 35467375 PMCID: PMC9241626 DOI: 10.1128/spectrum.01687-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/25/2022] [Indexed: 12/29/2022] Open
Abstract
Tick-borne spotted fevers caused by Rickettsia occur worldwide. The symptoms of this bacterial infection are similar to those of viral infection, and thus, diagnostic accuracy has special clinical importance. One of the commonly used methods for the diagnosis of tick-borne spotted fever is enzyme-linked immunosorbent assay (ELISA), which is based on estimation of the presence of specific IgM antibodies in blood. However, IgA analysis has not been used for the diagnosis of rickettsial diseases thus far. We investigated the diagnostic value of IgA antibody determination using patient sera collected in the Astrakhan region of Russia, where an isolated site of Astrakhan rickettsial fever (ARF) caused by Rickettsia conorii subsp. caspia is located. Our investigation was performed on serum samples collected from 185 patients diagnosed with Astrakhan rickettsial fever from May to October 2019. Western blot analysis revealed that specific IgA antibodies, as well as IgM antibodies, from patient sera bind to high-molecular-weight pathogen proteins with similar masses. The obtained data show that the determination of IgM alone allows for serological confirmation of diagnosis in only 46.5% of cases but that the determination of both IgM and IgA increases this rate to 66.5%. Taken together, the findings show an important diagnostic value of IgA evaluation for tick-borne spotted fever rickettsiosis. IMPORTANCE Tick-borne spotted fevers caused by Rickettsia occur worldwide. The symptoms of this bacterial infection are similar to the symptoms of viral infection, and thus, diagnostic accuracy has special clinical importance. The most serious spotted fever group rickettsiosis is Rocky Mountain fever in the United States, which is caused by Rickettsia rickettsii, and disease complications can lead to hemiparesis, blindness, or amputation. Rickettsia conorii subsp. caspia causes a rickettsial spotted fever named Astrakhan rickettsial fever (ARF). One of the commonly used methods for the diagnosis of tick-borne spotted fevers is ELISA, which is based on estimation of the presence of specific IgM antibodies in blood, though IgA has not been used for the diagnosis of rickettsial diseases thus far. In this study, we showed that both IgA and IgM should be analyzed in the blood serum samples of patients to significantly enhance the accuracy of diagnostics of tick-borne spotted fever rickettsiosis.
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Affiliation(s)
- Nina S. Smirnova
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Alexey V. Kostarnoy
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Alexey V. Kondratev
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Petya G. Gancheva
- Laboratory of Immunobiotechnology, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Daniil A. Grumov
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Alexander L. Gintsburg
- Laboratory of Gene Engineering of Pathogenic Microorganisms, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
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Shibasaki Y, Sohda M, Ogawa H, Katayama C, Ozawa N, Komine C, Suga K, Osone K, Okada T, Shiraishi T, Katoh R, Yokobori T, Sano A, Sakai M, Shirabe K, Saeki H. Bowel obstruction due to Chlamydia trachomatis: a case report and review of literature. Surg Case Rep 2021; 7:47. [PMID: 33590344 PMCID: PMC7883945 DOI: 10.1186/s40792-021-01130-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/02/2021] [Indexed: 11/11/2022] Open
Abstract
Background Chlamydial infection is a difficult-to-diagnose type of sexually transmitted disease that occurs mainly in young people. We report a case of bowel obstruction caused by intrapelvic adhesions formed by chlamydial infection. Case presentation This patient was a 23-year-old woman who had been suffering from acute abdominal pain. She had been previously treated several times for intrapelvic abscesses and had a history of chlamydial infection. Endometriosis was thought to be the cause of her pelvic abscess based on endoscopic findings. Computed tomography demonstrated a small bowel obstruction caused by a pelvic abscess. However, the diagnosis could not be confirmed. She underwent laparoscopic surgery and was diagnosed with bowel obstruction due to adhesion of chlamydial infection based on the intraoperative findings and Chlamydia trachomatis antibody test. She was discharged 5 days after surgery. Conclusions It is necessary to consider the possibility of chlamydial infection as a cause for lower abdominal pain and unexplained bowel obstruction in female patients.
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Affiliation(s)
- Yuta Shibasaki
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Makoto Sohda
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
| | - Hiroomi Ogawa
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Chika Katayama
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Naoya Ozawa
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Chika Komine
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Kunihiko Suga
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Katsuya Osone
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Takuhisa Okada
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Takuya Shiraishi
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Ryuji Katoh
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Takehiko Yokobori
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.,Innovative Medical Research Center, Gunma University Hospital, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Akihiko Sano
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Makoto Sakai
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Ken Shirabe
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
| | - Hiroshi Saeki
- Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan
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Le MT, Nguyen VQH, Nguyen LNT, Ngo VQT, Nguyen HB, Cao NT. Is Chlamydia trachomatis PCR Detection from Cervical Canal Swabs Associated with Tubal Obstruction? FERTILITY & REPRODUCTION 2020. [DOI: 10.1142/s2661318220500012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: To determine the relationship between a Chlamydia trachomatis PCR positive diagnosis from cervical canal swabs and the presence of tubal diseases among infertile women in Vietnam. Methods: In this cross-sectional descriptive study, women who sought infertility treatment at the Center for Reproductive Endocrinology & Infertility, Hue University Hospital, Vietnam, from June 2016 to June 2017 were enrolled. All study participants were interviewed, and PCR tests were then performed to diagnose Chlamydia from cervical canal swabs. Hysterosalpingogram (HSG) was carried out to examine the uterine cavity and fallopian tubes. Results: Among 568 women whose mean age was 32.0 ± 5.1 years, the prevalence of C. trachomatis infection as detected by PCR was 5.8%. Eighty-one percent (460/568) of infertile women had normal HSG results, and abnormal HSG results were more frequent in women over 35 years old, in women with secondary infertility, and in those with a history of miscarriage or genital tract infection. However, there was no relationship between C. trachomatis PCR positivity and HSG results in infertile women. Conclusions: The diagnosis of C. trachomatis infection using the cervical swabs is the useful but not an effective method for routine practice for predicting tubal obstruction in infertile women.
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Affiliation(s)
- Minh Tam Le
- Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Hue University, Vietnam
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Vu Quoc Huy Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Le Na Thi Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Viet Quynh Tram Ngo
- Department of Microbiology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Hoang Bach Nguyen
- Department of Microbiology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Ngoc Thanh Cao
- Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Hue University, Vietnam
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
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Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, Chico RM, Smolak A, Newman L, Gottlieb S, Thwin SS, Broutet N, Taylor MM. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ 2019; 97:548-562P. [PMID: 31384073 PMCID: PMC6653813 DOI: 10.2471/blt.18.228486] [Citation(s) in RCA: 880] [Impact Index Per Article: 176.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/08/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016. METHODS For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI. FINDINGS For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); trichomoniasis 0.6% (95% UI: 0.4-0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases. CONCLUSION Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021.
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Affiliation(s)
- Jane Rowley
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Stephen Vander Hoorn
- School of Mathematics and Statistics, University of Melbourne, Melbourne, Australia
| | | | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University, Örebro, Sweden
| | - Laith J Abu-Raddad
- Department of Healthcare Policy and Research, Weill Cornell Medical College - Qatar, Doha, Qatar
| | - R Matthew Chico
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, England
| | - Alex Smolak
- Department of Healthcare Policy and Research, Weill Cornell Medical College - Qatar, Doha, Qatar
| | - Lori Newman
- Enteric and Sexually Transmitted Infections Branch, National Institute of Allergy and Infectious Diseases, Washington DC, United States of America
| | - Sami Gottlieb
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Soe Soe Thwin
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Melanie M Taylor
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
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Beyuo T, Oppong SA, Samba A, Beyuo VM. Chlamydia trachomatis infection among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility. Int J Gynaecol Obstet 2019; 146:200-205. [PMID: 31162639 DOI: 10.1002/ijgo.12875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/01/2019] [Accepted: 05/30/2019] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine the prevalence of Chlamydia trachomatis infection and the correlates of tubal pathology among Ghanaian women undergoing hysterosalpingography for suspected tubal factor infertility. METHODS A cross-sectional study was conducted among 189 women with infertility who underwent hysterosalpingography at Korle Bu Teaching Hospital, Ghana, from September 1 to November 30, 2016. Demographic data; obstetric and gynecologic history; and hysterosalpingography findings were collected using a structured questionnaire. Endocervical swabs were tested for the presence of Chlamydia trachomatis using a rapid antigen-based diagnostic kit. Associations between the variables were assessed using bivariate analysis. RESULTS Positive test results for Chlamydia trachomatis were recorded among 15 participants, giving an overall prevalence of 7.9% (95% confidence interval [CI] 4.1%-11.7%). In all, 67 (35.4%) participants had abnormal findings on hysterosalpingography, with 40 (21.2%) displaying bilateral tubal occlusion. The remaining 122 (64.6%) women had normal findings on hysterosalpingography. Eight participants with normal tubal appearance tested positive for Chlamydia trachomatis (prevalence 6.6%, 95% CI 2.2%-11.0%), whereas seven participants with abnormal tubal appearance tested positive (prevalence 10.4%, 95% CI 3.1%-17.7%; P=0.402). No associations were found between participant characteristics and tubal pathology. CONCLUSION The prevalence of Chlamydia trachomatis did not differ by hysterosalpingography findings.
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Affiliation(s)
- Titus Beyuo
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Korle Bu Accra, Ghana.,Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, University of Ghana, Korle Bu Accra, Ghana
| | - Samuel A Oppong
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Korle Bu Accra, Ghana.,Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, University of Ghana, Korle Bu Accra, Ghana
| | - Ali Samba
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Korle Bu Accra, Ghana.,Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, University of Ghana, Korle Bu Accra, Ghana
| | - Vera M Beyuo
- Department of Ophthalmology, Korle Bu Teaching Hospital, Korle Bu Accra, Ghana
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Bagheri S, Roghanian R, Golbang N, Golbang P, Nasr Esfahani MH. Molecular Evidence of Chlamydia trachomatis Infection and Its Relation to Miscarriage. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2018; 12:152-156. [PMID: 29707933 PMCID: PMC5936614 DOI: 10.22074/ijfs.2018.5184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 08/09/2017] [Indexed: 11/05/2022]
Abstract
Background Chlamydia trachomatis (CT) infection is the most common sexually transmitted disease in the world
that can persist and also ascend in the genital tract. This intracellular and silent infection is related to some adverse
pregnancy outcomes, such as miscarriage. The aims of this study were to explore the best CT screening tests using
blood and vaginal samples and to investigate the correlation between CT infection and the incidence of miscarriage. Materials and Methods This case-control study was done in October 2013 through June 2014, using purposive
sampling from 157 female participants with or without a history of miscarriage. The samples were taken after each
participant had signed a letter of consent and had completed a questionnaire. To achieve the objectives of this study,
polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) tests were performed on vaginal
swabs and blood samples, respectively. Results PCR results showed a significantly higher CT infection rate in the miscarriage group compared to the control
group (11.3 vs. 0%, P=0.007). Anti-CT IgG and IgA antibodies were found in 4.2 and 2.1% of cases in the miscarriage
group, and in 1.7 and 6.7% of cases in the control group, respectively (P>0.05). Despite lower humoral responses in
this study, positive samples were detected only by one of the following techniques; PCR, ELISA IgA and ELISA IgG.
It also should be noted that PCR worked best in terms of detection. Conclusion Based on the obtained data, there is a strong association between molecular evidence of CT infection
and miscarriage. A higher rate of CT detection in molecular tests compared to serological assays suggests that PCR
could be used as the first-choice assay for detection of C. trachomatis. However, the importance of serological tests in
detecting potential past CT infection or upper genital infection not amenable to sampling is undeniable.
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Affiliation(s)
- Sahar Bagheri
- Department of Biology, Faculty of Science, University of Isfahan, Isfahan, Iran
| | - Rasoul Roghanian
- Department of Biology, Faculty of Science, University of Isfahan, Isfahan, Iran. Electronic Address:
| | - Naser Golbang
- Department of Biology, Faculty of Science, University of Isfahan, Isfahan, Iran
| | - Pouran Golbang
- Department of Obstetrics and Gynecology, Emam Khomeini Hospital, Falavarjan, Isfahan, Iran
| | - Mohammad Hossein Nasr Esfahani
- Departmen of Reproductive Biotechnology, Reproductive Biomedicine Research Centre, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
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Joolayi F, Navidifar T, Mohammad Jaafari R, Amin M. Comparison of Chlamydia trachomatis infection among infertile and fertile women in Ahvaz, Iran: A case-control study. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.11.713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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10
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Menon S, Stansfield SH, Walsh M, Hope E, Isaia L, Righarts AA, Niupulusu T, Temese SVA, Iosefa-Siitia L, Auvaa L, Tapelu SA, Motu MF, Suaalii-Sauni T, Timms P, Hill PC, Huston WM. Sero-epidemiological assessment of Chlamydia trachomatis infection and sub-fertility in Samoan women. BMC Infect Dis 2016; 16:175. [PMID: 27102989 PMCID: PMC4839085 DOI: 10.1186/s12879-016-1508-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 04/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background In our recent village-based cross-sectional study, the prevalence of nucleic acid amplification technique (NAAT) diagnosed Chlamydia trachomatis (CT) in sexually active Samoan women was very high (36 %), and test positivity was associated with sub-fertility. We conducted a serological and epidemiological analysis in these participants to identify if serological data can provide further insight into the potential contribution of CT to sub-fertility in this population. Methods Serological prediction of CT associated sub-fertility was conducted using a series of commercial tests. The correlation between fertility or sub-fertility, behavioral factors, and serologically predicted CT associated sub-fertility was determined. Results A positive antibody reaction against the Chlamydia Major Outer Membrane Protein (MOMP) was significantly associated with sub-fertility, with 50 % of infertile women being positive. Serum IgG and IgA antibodies against MOMP correlated with current infection measured by urine NAAT, suggesting longer term infections are common in this population. Chlamydia pneumoniae antibodies were frequently detected in this population (84 %), and unexpectedly, were significantly associated with sub-fertility. Conclusions The high prevalence of chlamydial infection and of positive chlamydial sub-fertility results suggests that CT is an important and frequent contributory factor to sub-fertility in this population.
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Affiliation(s)
- S Menon
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - S H Stansfield
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - M Walsh
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - E Hope
- National University of Samoa, Apia, Samoa
| | - L Isaia
- National Health Service Laboratory Division, Apia, Samoa
| | - A A Righarts
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - T Niupulusu
- Samoa Family Health Association, Apia, Samoa
| | - S V A Temese
- Centre for Samoan Studies, National University of Samoa, Apia, Samoa
| | | | - L Auvaa
- National University of Samoa, Apia, Samoa
| | | | - M F Motu
- Samoa National Council of Churches, Apia, Samoa
| | | | - P Timms
- Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Australia
| | - P C Hill
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - W M Huston
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. .,School of Life Sciences, Faculty of Science, University of Technology Sydney, Broadway, Sydney, NSW, Australia. .,School of Life Sciences, University of Technology Sydney, PO BOX 123, Broadway, Sydney, NSW, 2007, Australia.
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11
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Ahmadi MH, Mirsalehian A, Bahador A. Association of Chlamydia trachomatis with infertility and clinical manifestations: a systematic review and meta-analysis of case-control studies. Infect Dis (Lond) 2016; 48:517-23. [PMID: 27064452 DOI: 10.3109/23744235.2016.1160421] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Chlamydia trachomatis is one of the sexually transmitted pathogens causing reproductive health-threatening diseases worldwide. However, its role in infertility, particularly in asymptomatic individuals, is not yet definitely determined. Methods For the study, electronic databases were searched using the following keywords; 'Chlamydia trachomatis', 'prevalence', 'frequency', 'fertile', 'infertile', 'case', 'control', 'symptomatic' and 'asymptomatic'. Finally, after some exclusions, 34 studies (19 fertile-infertile and 15 symptomatic-asymptomatic) from different countries were included in the study and meta-analysis was performed on the data collected. Results Odds ratios (ORs) for urogenital C. trachomatis prevalence in males in the fertile-infertile group, for infertile and fertile individuals, ranged from 1.3-3.7 and in females from 1.04-4.8, and the overall OR for both genders was 2.2 (95% CI). In the symptomatic-asymptomatic group, the overall OR in males and females was 4.9 (95% CI = 1.1-21.7) and 3.3 (95% CI = 1.7-6.3), respectively. In all of the analyses, there were high levels of heterogeneity (I(2) >50%, p-value <0.05) and, except for the females in the symptomatic-asymptomatic group, neither Egger's tests nor Begg's tests were statistically significant for publication bias. Conclusions C. trachomatis can impact on the potential for fertility and cause clinical manifestations and complications in both males and females. Thus, national programmes for adequate diagnosis, screening and treatment of infected individuals, particularly asymptomatic ones, seem to be necessary.
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Affiliation(s)
- Mohammad Hossein Ahmadi
- a Department of Microbiology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Akbar Mirsalehian
- a Department of Microbiology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Abbas Bahador
- a Department of Microbiology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
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12
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Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women. Clin Microbiol Rev 2015; 28:969-85. [PMID: 26310245 DOI: 10.1128/cmr.00035-15] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Chlamydia trachomatis is the most common bacterial sexually transmitted pathogen worldwide. Infection can result in serious reproductive pathologies, including pelvic inflammatory disease, ectopic pregnancy, and infertility, in women. However, the processes that result in these reproductive pathologies have not been well defined. Here we review the evidence for the human disease burden of these chlamydial reproductive pathologies. We then review human-based evidence that links Chlamydia with reproductive pathologies in women. We present data supporting the idea that host, immunological, epidemiological, and pathogen factors may all contribute to the development of infertility. Specifically, we review the existing evidence that host and pathogen genotypes, host hormone status, age of sexual debut, sexual behavior, coinfections, and repeat infections are all likely to be contributory factors in development of infertility. Pathogen factors such as infectious burden, treatment failure, and tissue tropisms or ascension capacity are also potential contributory factors. We present four possible processes of pathology development and how these processes are supported by the published data. We highlight the limitations of the evidence and propose future studies that could improve our understanding of how chlamydial infertility in women occurs and possible future interventions to reduce this disease burden.
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13
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Ghosh M, Choudhuri S, Ray RG, Bhattacharya B, Bhattacharya S. Association of Genital Chlamydia trachomatis Infection with Female Infer-tility, Study in a Tertiary Care Hospital in Eastern India. Open Microbiol J 2015; 9:110-6. [PMID: 26464610 PMCID: PMC4598383 DOI: 10.2174/1874285801509010110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 06/19/2015] [Accepted: 06/22/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis is recognized as one of the most common sexually transmitted pathogen in the world. 50-80% of infected females are asymptomatic. These untreated women are at risk of developing chronic sequelae leading to tubal pathology causing infertility. Infertility is defined as 1 year of unprotected intercourse without pregnancy. It may be primary or secondary. Aim : To find out the association of genital Chlamydia trachomatis infection with female infertility. Materials and Methodology : This case control study has been carried out in collaboration with R. G. Kar Medical College and Institute of Post Graduate Medical Education & Research, India, between July 2012 and June 2013. 40 infertile and 40 pregnant women were enrolled by purposive sampling as per inclusion and exclusion criteria. ELISA test was performed to detect serum IgG and IgA antibody against recombinant analogs of MOMP and 3 different PCR assays were done targeting MOMP and rRNA DNA from DNA extracted from first void urine. Results : IgG seropositivity was significantly higher (15% vs 0%, P=.0255) in cases than controls, though there was no significant difference in the proportion of IgA seropositivity among 2 groups (12.5% vs 2.5%, P=0.2007). Out of 80 samples 2 samples showed the production of amplicons with R1 - R2 primers. Only 1 sample gave positive result with production of amplicons with all the 3 primers used (R1 - R2, CT0005 - CT06 and JM15 - JM16). Conclusion : Persistent C. trachomatis infection must be recognized as a risk factor of infertility in this region of India. The low PCR positivity in FVU sample helps to conclude the diagnostic utility of serological tests in screening of infertile women.
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Affiliation(s)
- Mallika Ghosh
- National Institute of Cholera & Enteric Diseases, Kolkata 700010, India
| | - Subhadip Choudhuri
- Department of Biochemistry, Institute of Post Graduate Medical Education & Research, Kolkata 700020, India
| | - Reena Ghosh Ray
- Department of Microbiology, R. G. Kar Medical College, Kolkata 700004, India
| | - Basudev Bhattacharya
- Department of Biochemistry, Institute of Post Graduate Medical Education & Research, Kolkata 700020, India
| | - Sujata Bhattacharya
- Department of Microbiology, R. G. Kar Medical College, Kolkata 700004, India
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14
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Prevalence and diagnostic significance of specific IgA and anti-heat shock protein 60 Chlamydia trachomatis antibodies in subfertile women. Eur J Clin Microbiol Infect Dis 2014; 33:761-6. [PMID: 24413970 DOI: 10.1007/s10096-013-2008-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 10/21/2013] [Indexed: 10/25/2022]
Abstract
The objective of the present study was to evaluate the clinical usefulness of the simultaneous measurement of three serological markers of chlamydial infection in women with tubal factor infertility (TFI) and spontaneous miscarriage. Serum was collected from 87 patients (33 with TFI and 54 with spontaneous miscarriage) and analyzed for the presence of IgG and IgA antibodies against Chlamydia trachomatis MOMP antigen (Dia.Pro) and IgG antibodies to chlamydial heat shock protein 60 (cHSP60) antigen (Medac). We determined a high degree (64.5 %) of seropositivity against chlamydial antigens in our study population. The prevalence of persistent chlamydial infection has tended to be higher in the group of patients with TFI (41.4 %) than in patients with spontaneous miscarriage (21.3 %). The serum level of IgA, as a marker of active infection, was statistically higher in the TFI group with persistent infection than in the corresponding spontaneous miscarriage group (p = 0.008), while the serum level of IgG showed no statistically significant differences compared with the spontaneous miscarriage group with persistent infection (p = 0.227). Also, using the receiver operating characteristic (ROC) curve, we found that the serum level of IgA has the ability to discriminate patients with persistent chlamydial infection between the TFI and miscarriage groups, with a sensitivity and specificity of 74.3 % and 71.4 %, respectively. To the best of our knowledge, the present study is the first study which, besides the already confirmed linkage between serologic evidence of persistent chlamydial infection and TFI, also confirmed associations between spontaneous miscarriage and serologic evidence of persistent chlamydial infection.
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