1887

Abstract

The association between the clinical features of genital chlamydial infection and organism genotype and load was evaluated. Chlamydial DNA was detected and quantified in genital swabs from 233 (7 %) of 3384 consecutive patients attending a genitourinary medicine clinic. The chlamydia-positive subcohort comprised 132 (57 %) females and 101 (43 %) males. Clinical features were present in 33 % women and 72 % men. The chlamydial load was found to be higher in women (median load: 5.6 log) than men (median load: 3.5 log). Single variable analysis failed to show a significant association between chlamydial load and clinical features ( value = 0.3). Owing to the limited amount of clinical material, information on chlamydial genotypes was available for 70 % ( = 162) of chlamydia-positive patients. However, multivariable analysis of these samples did show a significant association between chlamydial load and clinical features ( value = 0.02). This discrepancy is most probably due to the difference in the amount of data analysed by single variable (data from 233 patients) and multivariable (data from 162 patients) analysis. The distribution of chlamydia genotypes was as follows: type E (46 %), F (22 %), D (8 %), K (8 %), G (7 %), J (4 %), I (1 %) and H (0.6 %). No statistically significant association was observed between chlamydial genotype and clinical features in either single variable ( value = 0.6) or multivariable ( value = 0.4) analysis. These findings suggest that chlamydial load and diversity in the A gene plays little, if any, role in the pathogenesis of genital chlamydial infection.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.028076-0
2011-07-01
2020-01-29
Loading full text...

Full text loading...

/deliver/fulltext/jmm/60/7/881.html?itemId=/content/journal/jmm/10.1099/jmm.0.028076-0&mimeType=html&fmt=ahah

References

  1. Batteiger B. E. , Lennington W. , Newhall W. J. V , Katz B. P. , Morrison H. T. , Jones R. B. . ( 1989; ). Correlation of infecting serovar and local inflammation in genital chlamydial infections. . J Infect Dis 160:, 332–336. [CrossRef].[PubMed]
    [Google Scholar]
  2. Boisvert J. F. , Koutsky L. A. , Suchland R. J. , Stamm W. E. . ( 1999; ). Clinical features of Chlamydia trachomatis rectal infection by serovar among homosexually active men. . Sex Transm Dis 26:, 392–398. [CrossRef].[PubMed]
    [Google Scholar]
  3. CMO EAG ( 1998; ). Main Report of the CMO’s Expert Advisory Group on Chlamydia trachomatis. London:: Department of Health;.
    [Google Scholar]
  4. Dean D. , Oudens E. , Bolan G. , Padian N. , Schachter J. . ( 1995; ). Major outer membrane protein variants of Chlamydia trachomatis are associated with severe upper genital tract infections and histopathology in San Francisco. . J Infect Dis 172:, 1013–1022. [CrossRef].[PubMed]
    [Google Scholar]
  5. Eckert L. O. , Suchland R. J. , Hawes S. E. , Stamm W. E. . ( 2000; ). Quantitative Chlamydia trachomatis cultures: correlation of chlamydial inclusion-forming units with serovar, age, sex, and race. . J Infect Dis 182:, 540–544. [CrossRef].[PubMed]
    [Google Scholar]
  6. Geisler W. M. , Suchland R. J. , Whittington W. L. , Stamm W. E. . ( 2001; ). Quantitative culture of Chlamydia trachomatis: relationship of inclusion-forming units produced in culture to clinical manifestations and acute inflammation in urogenital disease. . J Infect Dis 184:, 1350–1354. [CrossRef].[PubMed]
    [Google Scholar]
  7. Geisler W. M. , Suchland R. J. , Whittington W. L. , Stamm W. E. . ( 2003; ). The relationship of serovar to clinical manifestations of urogenital Chlamydia trachomatis infection. . Sex Transm Dis 30:, 160–165. [CrossRef].[PubMed]
    [Google Scholar]
  8. Gomes J. P. , Borrego M. J. , Atik B. , Santo I. , Azevedo J. , Brito de Sá A. , Nogueira P. , Dean D. . ( 2006; ). Correlating Chlamydia trachomatis infectious load with urogenital ecological success and disease pathogenesis. . Microbes Infect 8:, 16–26. [CrossRef].[PubMed]
    [Google Scholar]
  9. Jalal H. , Stephen H. , Al-Suwaine A. , Sonnex C. , Carne C. . ( 2006; a). The superiority of polymerase chain reaction over an amplified enzyme immunoassay for the detection of genital chlamydial infections. . Sex Transm Infect 82:, 37–40. [CrossRef].[PubMed]
    [Google Scholar]
  10. Jalal H. , Stephen H. , Curran M. D. , Burton J. , Bradley M. , Carne C. . ( 2006; b). Development and validation of a rotor-gene real-time PCR assay for detection, identification, and quantification of Chlamydia trachomatis in a single reaction. . J Clin Microbiol 44:, 206–213. [CrossRef].[PubMed]
    [Google Scholar]
  11. Jalal H. , Stephen H. , Alexander S. , Carne C. , Sonnex C. . ( 2007; a). Development of real-time PCR assays for genotyping of Chlamydia trachomatis . . J Clin Microbiol 45:, 2649–2653. [CrossRef].[PubMed]
    [Google Scholar]
  12. Jalal H. , Stephen H. , Bibby D. F. , Sonnex C. , Carne C. A. . ( 2007; b). Molecular epidemiology of genital human papillomavirus and Chlamydia trachomatis among patients in Cambridge – will vaccines protect?. Int J STD AIDS 18:, 617–621. [CrossRef]
    [Google Scholar]
  13. Lysén M. , Osterlund A. , Rubin C. J. , Persson T. , Persson I. , Herrmann B. . ( 2004; ). Characterization of ompA genotypes by sequence analysis of DNA from all detected cases of Chlamydia trachomatis infections during 1 year of contact tracing in a Swedish County. . J Clin Microbiol 42:, 1641–1647. [CrossRef].[PubMed]
    [Google Scholar]
  14. Michel C. E. , Sonnex C. , Carne C. A. , White J. A. , Magbanua J. P. , Nadala E. C. Jr , Lee H. H. . ( 2007; ). Chlamydia trachomatis load at matched anatomic sites: implications for screening strategies. . J Clin Microbiol 45:, 1395–1402. [CrossRef].[PubMed]
    [Google Scholar]
  15. Millman K. , Black C. M. , Stamm W. E. , Jones R. B. , Hook E. W. III , Martin D. H. , Bolan G. , Tavaré S. , Dean D. . ( 2006; ). Population-based genetic epidemiologic analysis of Chlamydia trachomatis serotypes and lack of association between ompA polymorphisms and clinical phenotypes. . Microbes Infect 8:, 604–611. [CrossRef].[PubMed]
    [Google Scholar]
  16. Morré S. A. , Rozendaal L. , Van Valkengoed I. G. , Boeke A. J. , Van Voorst Vader P. C. , Schirm J. , de Blok S. , Van Den Hoek J. A. , Van Doornum G. J. et al. ( 2000; ). Urogenital Chlamydia trachomatis serovars in men and women with a symptomatic or asymptomatic infection: an association with clinical manifestations?. J Clin Microbiol 38:, 2292–2296.[PubMed]
    [Google Scholar]
  17. Oehme A. , Gaschler G. , Straube E. . ( 2003; ). Genotyping of Chlamydia trachomatis strains from cultured isolates and nucleic acid amplification test-positive specimens. . Int J Med Microbiol 293:, 225–228. [CrossRef].[PubMed]
    [Google Scholar]
  18. Sayada C. , Denamur E. , Xerri B. , Orfila J. , Catalan F. , Elion J. . ( 1992; ). [Epidemiology of Chlamydia trachomatis using analysis of gene encoding of the major outer membrane protein]. . Pathol Biol (Paris) 40:, 583–589 (in French).[PubMed]
    [Google Scholar]
  19. Suchland R. J. , Eckert L. O. , Hawes S. E. , Stamm W. E. . ( 2003; ). Longitudinal assessment of infecting serovars of Chlamydia trachomatis in Seattle public health clinics: 1988-1996. . Sex Transm Dis 30:, 357–361. [CrossRef].[PubMed]
    [Google Scholar]
  20. Van de Laar M. J. , Van Duynhoven Y. T. , Fennema J. S. , Ossewaarde J. M. , Van den Brule A. J. , Van Doornum G. J. , Coutinho R. A. , Van den Hoek J. A. . ( 1996; ). Differences in clinical manifestations of genital chlamydial infections related to serovars. . Genitourin Med 72:, 261–265.[PubMed] [CrossRef]
    [Google Scholar]
  21. Van Duynhoven Y. T. H. P. , Ossewaarde J. M. , Derksen-Nawrocki R. P. , Van der Meijden W. I. , Van de Laar M. J. W. . ( 1998; ). Chlamydia trachomatis genotypes: correlation with clinical manifestations of infection and patients’ characteristics. . Clin Infect Dis 26:, 314–322. [CrossRef].[PubMed]
    [Google Scholar]
  22. Wiggins R. , Graf S. , Low N. , Horner P. J. . for the Chlamydia Screening Studies (ClaSS) Study Group ( 2009; ). Real-time quantitative PCR to determine chlamydial load in men and women in a community setting. . J Clin Microbiol 47:, 1824–1829. [CrossRef].[PubMed]
    [Google Scholar]
  23. Workowski K. A. , Stevens C. E. , Suchland R. J. , Holmes K. K. , Eschenbach D. A. , Pettinger M. B. , Stamm W. E. . ( 1994; ). Clinical manifestations of genital infection due to Chlamydia trachomatis in women: differences related to serovar. . Clin Infect Dis 19:, 756–760. [CrossRef].[PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.028076-0
Loading
/content/journal/jmm/10.1099/jmm.0.028076-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error