Characterization of genital chlamydia amongst female sex workers in Nairobi, Kenya

Introduction: genital chlamydia, which is caused by diverse Chlamydia trachomatis genotypes, is largely asymptomatic. We aimed to identify C. trachomatis genotypes causing genital chlamydia among female sex workers attending a sex workers outreach program clinic in Nairobi, Kenya. Methods: this cross-sectional study was conducted between 18 April 2017 and 19 March 2021. Genitourinary complaints from eligible female sex workers were documented using a structured questionnaire. Endocervical swabs were collected for laboratory analysis. C. trachomatis plasmid DNA was extracted, PCR-amplified, and sequenced. Consensus sequences were generated and aligned with reference sequences to determine the C.trachomatis genotypes. Bivariate analysis was used to determine the association between genitourinary complaints and genital chlamydia. Results: endocervical swabs were collected from a total of 348 participants. Of these, 46 (13.2%) were positive for C. trachomatis. Most (297, 85.3%) of the participants presented with pelvic discharge with or without other symptoms. Fifteen (15, 4.3%) had abdominal pain and 3 (0.9%) had an itchy vulva. There was no statistically significant relationship between clinical presentation and genital chlamydia. Twenty-three samples were successfully sequenced. Each sequence was at least 90% identical to each of the 13 references C. trachomatis genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b and L3. Conclusion: we found no significant association between individual genitourinary complaints and genital chlamydia infection. The C. trachomatis genotypes circulating amongst female sex workers in Nairobi could be related to genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b, and L3.

Análisis molecular y filogenético del genotipo F de Chlamydia trachomatis aislados en México en 2011 / Molecular and phylogenetic analysis of the F genotype of Chlamydia trachomatis isolated in Mexico in 2011

Resumen Antecedentes: Chlamydia trachomatis es la bacteria que se detecta con mayor frecuencia en las infecciones de transmisión sexual. Se han identificado 20 genotipos de C. trachomatis mediante el gen ompA y varias genovariantes mediante el análisis de polimorfismo de un solo nucleótido (SNP). En México, el genotipo F es el más frecuente. Objetivo: Identificar la existencia de subtipos del genotipo F. Método: Se analizaron siete cepas del genotipo F de C. trachomatis aisladas en 2011, mediante secuenciación de nucleótidos y mapeo con enzimas de restricción. Resultados: El análisis de SNP mostró dos cepas con el mismo SNP en el nucleótido 288 (C288T), mientras que con enzimas de restricción se identificó una variante con diferente RFLP (polimorfismo de la longitud de fragmentos de restricción) cuando se tratan con la mezcla de enzimas HinfI y TaqI. Conclusión: En México se encuentran dos subtipos del genotipo F y solo las enzimas de restricción HinfI y TaqI pueden identificar la existencia de uno de estos genotipos F.

Abstract Background: Chlamydia trachomatis is the most frequently identified bacterium in sexually transmitted infections. Twenty C. trachomatis genotypes have been determined using the ompA gene and several genovariants by single nucleotide polymorphism (SNP) analysis. In Mexico, the F genotype is the most frequent. Objective: To identify subtypes of the F genotype. Method: Seven C. trachomatis genotype F strains isolated in 2011 were analyzed by nucleotide sequencing and restriction enzyme mapping. Results: SNP analysis showed two strains with the same SNP at nucleotide 288 (C288T), while with res-triction enzymes, a variant with different RFLP (restriction fragment length polymorphism) was identified when treated with the mixture of HinfI and TaqI enzymes. Conclusion: In Mexico, there are two subtypes of F, and only with restriction enzymes HinfI and TaqI can identify one of the genovariants of the F genotype.

PCR múltiplex para el diagnóstico de microorganismos atípicos transmitidos sexualmente / Multiplex PCR testing for the atypical microorganisms diagnosis sexually transmitted

Resumen Antecedentes: Las infecciones de transmisión sexual son un problema de salud pública mundial. El análisis rutinario incluye solo pruebas microbiológicas y serológicas para el diagnóstico de patógenos. Los microorganismos atípicos como Chlamydia trachomatis y micoplasmas no son identificados debido a los requerimientos. Además, no es incluida Gardnerella vaginalis, aunque se asocia a la vaginosis bacteriana. Objetivo: Desarrollar una PCR múltiplex para el diagnóstico de C. trachomatis, micoplasmas y G. vaginalis. Método: Se estandarizó la PCR múltiplex utilizando oligonucleótidos para C. trachomatis (gen ompA, orf6 plasmídico), Mycoplasma/Ureaplasma y G. vaginalis (genes rRNA16s). Resultados: Se estandarizaron pruebas de PCR múltiplex para los microorganismos estudiados, optimizándose las concentraciones y condiciones de las reacciones múltiplex. Se obtuvieron PCR dúplex para C. trachomatis (ompA, orf6), Chlamydia/Gardnerella y Chlamydia/micoplasmas y tríplex para Chlamydia/Mycoplasma/Ureaplasma. También un cuádruplex para Chlamydia/Mycoplasma/Ureaplasma/Gardnerella. Los resultados fueron verificados por PCR e hibridación automática (HybriSpot 12) y análisis in silico. Conclusión: Se desarrollaron pruebas de PCR múltiplex con una alta sensibilidad y especificidad para la identificación de C. trachomatis, micoplasmas y G. vaginalis.

Abstract Background: Sexually transmitted infections are a global public health problem. Routine analysis includes microbiological and serological tests for the diagnosis of pathogens. Atypical microorganisms such as Chlamydia trachomatis and mycoplasmas are not determined due to the requirements for their identification. Furthermore, Gardnerella vaginalis is not included despite being associated with bacterial vaginosis. Objective: To develop a multiplex PCR to diagnose Chlamydia, mycoplasmas, and Gardnerella. Method: Standardization of multiplex PCR tests was carried out using oligonucleotides for the identification of Chlamydia (ompA gene, plasmid orf6), Mycoplasma/Ureaplasma and Gardnerella (rRNA16s genes). Results: Multiplex PCR tests were standardized for the microorganisms studied, optimizing the concentrations and conditions of the multiplex reactions. Duplex PCR was obtained for Chlamydia (ompA, orf6), Chlamydia/Gardnerella, and Chlamydia/mycoplasmas, and triplex PCR for Chlamydia/mycoplasmas. Also, a quadruplex for Chlamydia, Mycoplasma/Ureaplasma and Gardnerella. PCR and automatic hybridization verified the results obtained (HybriSpot 12) and in silico analysis. Conclusion: Multiplex PCR tests with high sensitivity and specificity were developed to identify C. trachomatis, mycoplasmas, and G. vaginalis.

Prevalencia de la chlamydia trachomatis en pacientes sometidas a técnicas de reproducción asistida. Cienfuegos, 2016-2018

Fundamento: la Chlamydia trachomatis es el agente causal de una de las infecciones de transmisión sexual más comunes en el mundo. Provoca cervicitis, endometritis y salpingitis; las secuelas incluyen enfermedad inflamatoria pélvica, embarazo ectópico e infertilidad por obstrucción tubárica. Objetivo: determinar la prevalencia de infección por Chlamydia trachomatis en pacientes sometidas a técnicas de reproducción asistida. Métodos: estudio de serie de casos desarrollado en el Hospital General Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, durante el periodo comprendido del 2016- 2018. Incluyó pacientes sometidas a técnicas de reproducción asistida que estaban infestadas con Chlamydia trachomatis. Se analizaron las variables edad, antecedentes patológicos personales y ginecobstétricos, número de parejas sexuales, años de infertilidad, antecedentes de uso de dispositivo intrauterino, antecedentes de enfermedad inflamatoria pélvica, resultado del test de Chlamydia, así como criterio o no de fertilización in vitro, como indicador de que ocurrió daño a nivel de las trompas. Resultados: la edad estuvo comprendida entre los 19 y 40 años, con promedio de 35,7 años. El germen se detectó en el 42 % de las parejas, con predominio de las de Cienfuegos. El 47,6 % de las pacientes que tenían una chlamydiasis refirió haber tenido de una a tres parejas. El 54 %, por su afectación, requería de fertilización in vitro. Hubo una alta incidencia en el tiempo siendo infértiles, con el 72,6 % con más de cuatro años. Conclusiones: las infecciones por Chlamydia trachomatis pueden influir en la fertilidad de las mujeres.

Background: Chlamydia trachomatis is the causal agent of one of the most common sexually transmitted infections in the world. Causes cervicitis, endometritis and salpingitis; after effects include pelvic inflammatory disease, ectopic pregnancy, and infertility due to tubal obstruction. Objective: to determine the prevalence of Chlamydia trachomatis infection in patients undergoing assisted reproductive techniques. Methods: case series study developed at the Dr. Gustavo Aldereguía Lima Hospital General Universitario, Cienfuegos, during 2016-2018. It included patients subjected to assisted reproduction techniques who were infested with Chlamydia trachomatis. The variables age, personal and gynecological pathological history, number of sexual partners, years of infertility, history of intrauterine device use, history of pelvic inflammatory disease, Chlamydia test result, as well as criteria or not for in vitro fertilization were analyzed as an indicator that damage occurred at the level of the tubes. Results: the age was between 19 and 40 years old, with an average of 35.7 years. The germ was detected in 42% of the couples, with a predominance of those from Cienfuegos. 47.6% of the patients who had chlamydiasis reported having had from one to three partners. 54%, due to their involvement, required in vitro fertilization. There was a high incidence over time being infertile, with 72.6% over four years. Conclusions: Chlamydia trachomatis infections can influence fertility in women.

Prevalencia de infección por Chlamydia trachomatis y relación con el perfil de conductas sexuales en adolescentes y mujeres jóvenes de la Provincia de Osorno, Chile

Introducción: La infección por Chlamydia trachomatis es la ITS bacteriana más frecuente del mundo. En el cervix se presenta mayormente de forma asintomática y afecta especialmente a mujeres jóvenes y adolescentes. Puede producir daño permanente en el tracto reproductor femenino, se asocia a parto prematuro, infecciones neonatales transmitidas vía vertical y mayor riesgo de adquirir otras ITS como VIH Y VPH. Por estos motivos se han establecido estrategias de tamizaje para detectar y tratar precozmente la infección asintomática por C. trachomatis en diferentes países. En nuestro país no contamos con un programa nacional de tamizaje. Objetivo: Determinar la prevalencia de infección asintomática por Chlamydia trachomatis en mujeres entre 12 y 21 años de la Provincia de Osorno, Región de Los Lagos, Chile. Pacientes y Métodos: Se desarrolló un estudio de diseño transversal con una cohorte única de mujeres adolescentes y jóvenes consultantes en el Policlínico de Alto Riesgo Obstétrico y de Ginecología Infantil y Adolescente, del Hospital Base de Osorno, entre enero de 2019 y enero 2020. Se determinó el estado de infección asintomática mediante RPC en tiempo real para C. trachomatis. Se realizó una encuesta a fin de determinar características demográficas, hábitos y conductas sexuales de las pacientes estudiadas. Resultados: Fueron reclutadas 124 mujeres entre 12 a 21 años de edad, de las cuales, 36 (29,3%) se encontraban embarazadas al momento del estudio. La prevalencia de infección asintomática por C. trachomatis fue de 14/124 (11,3%). En las mujeres gestantes se encontraron 6/36 (16,7%) casos positivos de infección por C. trachomatis y 8/88 (9,1%) en las no gestantes. Existe una mayor frecuencia de infección asintomática a menor edad de inicio de actividad sexual (33,3% en aquellas que inician entre 11-12 años vs. 16,2% en las que inician entre 1314 años, 7,4% entre 15-16 y 8% entre 17-21 años; p < 0,05). Esta tendencia no fue observada al comparar el estado de infección con el tiempo de vida sexual activa. Sólo 15,7% de las pacientes utilizó preservativo en todas sus relaciones sexuales. Discusión: La infección asintomática por C. trachomatis es frecuente en las mujeres adolescentes y jóvenes sexualmente activas. Las pacientes con inicio más temprano de la actividad sexual coital (bajo 13 años de edad) podrían estar en mayor riesgo. Se requiere con urgencia establecer la frecuencia nacional de infección para desarrollar una estrategia sanitaria para su pesquisa y manejo oportuno en nuestro país.

Background: Chlamydia trachomatis infection is the world most common bacterial STI. At uterine cervix it presents mostly asymptomatically and especially affects young women and adolescents. It can cause permanent damage to the female reproductive tract and is associated with premature birth, connatal infections and increased risk of acquiring other STIs such as HIV and HPV. For these reasons, other countries have established screening strategies to detect and treat asymptomatic C. trachomatis infection. Our country don't have a national screening program. Aim: To determine the prevalence of C. trachomatis asymptomatic infection in adolescent and young women in Osorno province, Los Lagos Region, Chile. Methods: A crosssectional study was performed in adolescent and young women who consult at Hospital Base Osorno in the MaternoFetal and PediatricAdolescent Gynecology ambulatory clinics, between January 2019 and January 2020. The status of asymptomatic infection was determined by PCR for C. trachomatis. A survey was carried out to determine the demographic characteristics, habits and sexual behaviors. Results: 124 women between 12 and 21 years of age were recruited, of which 36 (29,3%) were pregnant at the time of the study. The prevalence of asymptomatic infection by C. trachomatis was 11.3.%. In pregnant women, there were 6/36 (16.7%) positive cases for C. trachomatis and 8/88 (9.1%) in nonpregnant women. We found a higher frequency of asymptomatic infection at younger age of first sexual intercourse (33% in adolescents at 11-12 years old vs. 16.2% at 13-14, 7.4% at 15-16 and 8% at 17-21; p<0.05). Only 15.7% of the patients utilized condoms in all their intercourses. Discussion: Asymptomatic C. trachomatis infection is common in adolescent and young women, with a higher risk in those who onset sexual activity at an early age (less than 13 years old). It is urgently required to determine the national frequency of asymptomatic C. trachomatis infection to develop a national strategy for screening and timely treatment.

Mycoplasma Genitalium and Chlamydia Trachomatis Prevalence, Co-Infection and Relevant Factors in An Epidemiology Study (2016 - 2019) In Ho Chi Minh, Vietnam

Chlamydia trachomatis and Mycoplasma genitalium are two common types of sexually transmitted infections. However, currently in Vietnam, there is no report on the rate of patients infected by the two types of bacteria. In this study, there were 6194 patients visiting the STI clinic of the HCMC Hospital of Dermato-Venereology, Vietnam, from 2016 to 2019. The results show that the proportion of patients positive with CT and MG is in-dependent on time. The infection rate is mainly at the age of 21 - 30 (53.4%). The CT infection rate in female and male is equal (17.3% vs 17.4%) while the rate of MG in female is lower (5.1% vs 7, 8%). The rate of pa-tients co-infected with either CT or MG is 4.5%, 17% and 5.7% respectively, time independence. This study may give better understandings of the epidemiological characteristics of MG and CT in Vietnam.

Progress in detection methods for urogenital Chlamydia trachomatis infection / 中华微生物学和免疫学杂志

Urogenital Chlamydia trachomatis ( Ct) infection is a serious sexually transmitted disease worldwide. The early diagnosis and treatment of Ct infection is critical for disease control. This review summarized the progress in the development of methods for detecting Ct infection and discussed the advantages and disadvantages of various methods. The emerging omics techniques in recent years are expected to be new tools for the detection of Ct infection. It is necessary to develop the omics techniques into rapid and accurate point-of-care tests that can be carried out in various testing environments for more effective patient management and disease control.

Gene expression profile in human cervical epithelial cells infected with Chlamydia trachomatis / 中华微生物学和免疫学杂志

Objective:To compare gene expression profiles in normal human cervical epithelial cells (HcerEpic) before and after Chlamydia trachomatis ( Ct) infection. Methods:HcerEpic cells that were pretreated with DEAE-D were infected with Ct serotype E standard strain and then cultured for 44 h. Uninfected HcerEpic cells were used as the control group. Total RNA was extracted from the cells in each group and reverse transcribed to construct a cDNA library. Differences in gene expression profiles between the two groups were analyzed by high-throughput sequencing and the representative genes were selected for verification by qPCR. Results:A total of 23 997 genes were detected, including 125 differentially expressed genes. Among the 125 genes, 119 were up-regulated and six were down-regulated. GO analysis showed that the differentially expressed genes were enriched in several biological processes including defense response to virus, typeⅠinterferon signaling pathway and cellular responses to typeⅠinterferons. KEGG enrichment analysis showed the differentially expressed genes were mainly enriched in the pathways related to virus infections, such as influenza A virus, herpes simplex virus, EB virus and HPV, and NOD-like receptor pathway.Conclusions:There were significant differences in transcriptome profiles of HcerEpic cells before and after Ct infection. The differentially expressed genes were mainly enriched in the interferon pathway, which was closely related to the antiviral processes in cells. qPCR verified the differentially expressed genes and the genes closely related to the interferon pathway, such as ISG15, IFIT2, OASL and UBE2L6.

Progress of Chlamydia trachomatis in children with respiratory tract infections / 国际儿科学杂志

Chlamydia trachomatis is one of the atypical pathogens, also a strict intracellular parasite with unique developmental cycle of prokaryotic microorganisms, resulting in infantile respiratory infections and conjunctivitis.Chlamydia trachomatis is associated with respiratory diseases such as chronic cough and bronchial asthma in children.Children infected with Chlamydia trachomatis generally have a good prognosis after treatment.At present, important progress has been made in the development of Chlamydia trachomatis vaccine.This article reviews the progress in etiology, epidemiology, clinical features, laboratory inspection, diagnosis, treatment and prevention of Chlamydia trachomatis, providing a new direction for clinical recognition and effective treatment of Chlamydia trachomatis infection.

Epidemiological characteristics of genital Chlamydia trachomatis infections in Shaoxing City from 2012 to 2021 / 预防医学

Objective@#To investigate the epidemiological characteristics of genital Chlamydia trachomatis infections in Shaoxing City from 2012 to 2021, so as to provide the evidence for improving the control strategy of genital C. trachomatis infections.@*Methods@#Data pertaining of patients with genital C. trachomatis infections in Shaoxing City from 2012 to 2021 were retrieved from Chinese Disease Prevention and Control Information System, and the incidence of genital C. trachomatis infections was calculated. The trends in incidence of genital C. trachomatis infections were analyzed using annual percent change (APC), and temporal, human and temporal distributions of genital C. trachomatis infections were descriptively analyzed.@*Results@#A total of 18 235 cases with genital C. trachomatis infection were reported in Shaoxing City from 2012 to 2021, and the annual average incidence was 36.36/105. The incidence of genital C. trachomatis infections appeared a tendency towards a rise in Shaoxing City from 2012 to 2021 (APC=4.51%, t=2.663, P=0.029). The reported incidence of genital C. trachomatis infections was significantly higher among females than among males (60.46/105 vs. 12.50/105; χ2=7 935.467, P<0.001), and 76.04% infections (13 866 cases) occurred at ages of 20 to <40 years, while a high incidence rate of genital C. trachomatis infections was seen among patients at ages of 25 to <30 years (154.23/105). In addition, high incidence rates were seen in Keqiao District (57.93/105) and Yuecheng District (51.78/105). @*Conclusions@#The incidence of genital C. trachomatis infections appeared a tendency towards a rise in Shaoxing City from 2012 to 2021, and the infection predominately occurred among women and young individuals.

Expression and Detection Value of 6 Chlamydia Trachomatis Protein Antibodies in Tubal Factor Infertility / 中山大学学报(医学科学版)

ObjectiveTo further study the pathogenic role of different types of Chlamydia trachomatis （CT） proteins in tubal factor infertility， evaluate the clinical detection value of Chlamydia trachomatis protein antibody in predicting tubal factor infertility. MethodsA total of 58 cases of tubal factor infertility （TFI）， 41 cases of fertile controls （FC） and 18 cases of infertile controls （IFC） were included. For serum detection， first， CT-IgG ELISA kit was used to detect the expression of CT-IgG in serum of three groups of people； then， 6 kinds of Chlamydia trachomatis proteins were expressed and purified in the early stage to establish the antibody test for these proteins， and ELISA detection method was used to detect the expression of their antibodies in the serum of TFI group， FC group and IFC group， respectively； and finally， the antibody OD value of the 6 kinds of Chlamydia trachomatis proteins in the three groups of subjects were statistically described， and CT-IgG was used as the reference standard to draw the receiver operating characteristic curve （ROC curve） of each CT antibody. The Youden Index determines the cutoff value for each antibody. Taking TFI as the reference class， two disordered multiple classification logistic regression models were established with the FC and IFC groups， respectively； and the reference class was used to explore the value of various antibodies and age in predicting TFI， FC and IFC of Chlamydia trachomatis. The back-off method was used to screen the variables. ResultsThe OD value of CT376 antibody in the TFI group was higher than that in the FC group （0.86 vs. 0.60， P=0.026）. The CT376 antibody OD value in the TFI group was higher than that in the IFC group （0.86 vs. 0.64， P=0.026）. The CT443 antibody OD value in the IFC group was higher than that in the TFI group （0.59 vs. 0.34， P=0.036） and higher than that in the FC group （0.59 vs. 0.30， P=0.02）. The multiple classification logistic regression analysis established between TFI and FC showed that CT-IgG ［P<0.001， OR=0.084， 95%CI （0.025， 0.284）］， CT376 antibody ［P=0.068， OR=0.359， 95%CI （0.120， 1.078）］. CT-IgG is an independent risk factor for tubal infertility， and CT376 antibody cannot be an independent risk factor for tubal infertility. The multiple classification logistic regression analysis established between TFI and IFC showed that among infertile patients， CT-IgG ［P<0.05， OR=0.194， 95%CI （0.046， 0.817）］， CT376 antibody ［P<0.05， OR=0.176， 95%CI （0.038， 0.818）］ and CT381 antibody ［P<0.05， OR=0.112， 95%CI （ 0.016， 0.796）］ were independent risk factors for tubal infertility. ConclusionThe expression of CT376 antibody in tubal infertility patients is higher than that in fertile and infertile controls， suggesting that CT-induced tubal factor infertility may be related to CT376. CT-IgG， and CT376 antibodies are meaningful in predicting CT-induced tubal factor infertility.

Etiología de las infecciones de transmisión sexual (ITS) diagnosticadas por la técnica de PCR múltiple-hibridación en población colombiana de la ciudad de Medellín atendida en el Laboratorio Clínico VID / Etiology of sexually transmitted infections (STIs) diagnosed by multiplex PCR-hibridization assay technique in a Colombian population attending the VID Clinical Laboratory in Medellin

Introducción. Las infecciones de transmisión sexual (ITS) son y seguirán siendo un serio problema de salud pública en todo el mundo según los datos de la OMS, con el agravante que la mayoría de los casos son asintomáticos y, además, no existe otro reservorio distinto al humano. El diagnóstico se puede realizar con pruebas tradicionales y moleculares, estas últimas incluyen la reacción en cadena de la polimerasa (PCR), de las cuales existen varios tipos, entre ellas, la PCR múltiple que tiene la capacidad de detectar ITS polimicrobianas a partir de una sola muestra. El objetivo de este estudio fue establecer cuáles fueron las infecciones de transmisión sexual más frecuentes en diferentes grupos de pacientes, así como determinar la utilidad del uso de la técnica de PCR múltiple en el diagnóstico de las ITS. Metodología. Se trata de un estudio observacional de corte transversal realizado entre los años 2021 y 2022 con pacientes que acudieron al servicio de diagnóstico del Laboratorio Clínico VID por sospecha de ITS. Las muestras recolectadas fueron evaluadas utilizando una prueba comercial basada en la técnica de PCR múltiple e hibridación. Las muestras procesadas fueron: orina e hisopados de endocérvix, uretra, recto, faringe y úlceras. Resultados. Se estudiaron 1.027 pacientes, de estos, 228 (22,2 %) fueron positivos para diferentes agentes de trasmisión sexual, distribuidos así: 50 (21,9 %) mujeres, 129 (56,6 %) hombres heterosexuales y 49 (21,5 %) hombres que tenían sexo con hombres (HSH). La edad promedio de las mujeres fue 30 años, y la de ambos grupos de hombres fue 36 años. Los microorganismos más frecuentemente identificados en mujeres fueron: C. trachomatis (A-K) en 28,6 %, seguido de virus herpes simplex tipo 2 (VHS-2) en 26,8 % y N. gonorrhoeae en 17,9 %. En hombres heterosexuales fueron C. trachomatis (A-K) en 37,5 %, N. gonorrhoeae en 21,5 % y VHS-2 en 18,7 %. En HSH fueron C. trachomatis (L1-L3) en 32,7 %, seguido de N. gonorrhoeae en 27,6 %, y de C. trachomatis (A-K) y VHS-2, ambos en 13,8 %. En 11 hombres heterosexuales, 8 HSH y en 6 mujeres, se identificó infección polimicrobiana. Conclusiones. C. trachomatis (A-K) fue el microorganismo más prevalente causante de ITS, seguido de N. gonorrhoeae en ambos grupos de hombres, y de VHS-2 en las mujeres, muy similar a lo reportado a nivel mundial. La prueba de PCR múltiple permite la detección de infecciones polimicrobianas comúnmente asociadas a ITS y el diagnóstico es preciso y confiable, incluso en pacientes asintomáticos

Sexually transmitted infections (STIs) are and will continue to be a serious public health problem throughout the world according to WHO data, with the aggravating factor that most cases are asymptomatic and, furthermore, there is no other reservoir other than humans. The diagnosis can be made with traditional and molecular tests, the latter include the polymerase chain reaction (PCR), of which there are several types, among them, multiplex PCR that has the capacity to detect polymicrobial STIs from a single sample. The objective of this study was to establish which were the most frequent sexually transmitted infections in different groups of patients, as well as to determine the usefulness of the multiplex PCR technique in the diagnosis of STIs. Methodology. This is an observational, cross-sectional study carried out between 2021 and 2022 with patients who attended the VID Clinical Laboratory for suspected STIs. The collected samples were evaluated using a commercial test based on the multiplex PCR technique and hybridization. The samples processed were: urine and swabs from endocervix, urethra, rectum, pharynx, and ulcers. Results. The study included 1,027 patients, of these, 228 (22.2%) were positive for different sexually transmitted agents, distributed as follows: 50 (21.9%) women, 129 (56.6%) heterosexual men and 49 (21.5%) men who had sex with men (MSM). The average age of the women was 30 years, and that of both groups of men was 36 years. The microorganisms most frequently identified in women were: C. trachomatis (A-K) in 28.6%, followed by herpes simplex virus type 2 (HSV-2) in 26.8% and N. gonorrhoeae in 17.9%. In heterosexual men they were C. trachomatis (A-K) in 37.5%, N. gonorrhoeae in 21.5% and HSV-2 in 18.7%. In MSM they were C. trachomatis (L1-L3) in 32.7%, followed by N. gonorrhoeae in 27.6%, and C. trachomatis (A-K) and HSV-2, both in 13.8%. Polymicrobial infection was identified in 11 heterosexual men, 8 MSM, and 6 women. Conclusions. C. trachomatis (A-K) was the most prevalent STI-causing microorganism, followed by N. gonorrhoeae in both groups of men, and HSV-2 in women, very similar to that reported worldwide. The multiplex PCR test allows the detection of polymicrobial infections commonly associated with STIs and the diagnosis is accurate and reliable, even in asymptomatic patients

Infecciones por Chlamydia trachomatis en una unidad de cuidados intensivos neonatales / Chlamydia trachomatis infections in a neonatal intensive care unit

Las infecciones por Chlamydia trachomatis han aumentado su prevalencia, especialmente en jóvenes embarazadas. Esto adquiere relevancia en pediatría por el elevado riesgo de transmisión vertical al neonato y su potencial gravedad en el lactante. Estas infecciones requieren de un alto índice de sospecha, por cuadro clínico atípico y signos radiológicos inespecíficos. Los métodos diagnósticos convencionales presentan limitaciones para su detección. Las técnicas moleculares son las recomendadas por su elevada sensibilidad, especificidad y rapidez, lo cual permite una terapéutica adecuada y oportuna. En este estudio, desarrollado en una unidad de cuidados intensivos neonatales de un hospital de alta complejidad durante 12 años, se describieron las características de la población, su presentación clínica y evolución. La detección microbiológica se realizó por métodos moleculares. Se incluyeron 29 pacientes (p) con infección por C. trachomatis (3,9% del total de muestras enviadas),13 p con infección respiratoria y 16 p con compromiso ocular. La mediana de edad fue de 19 días al momento del diagnóstico y el 65% de las gestantes tenía <25 años. Veinticuatro p (83%) eran recién nacidos a término y 23 p (79%) previamente sanos. Nueve p (31%) presentaron fiebre al momento del ingreso y 12 (41%) eosinofilia. De los 13 p con enfermedad respiratoria, 9 (69%) consultaron por tos y 11 (85%) con hipoxemia, con requerimientos de oxígeno en 8 (61%), asistencia respiratoria mecánica en 3 (23%) y uno (16%) requirió ECMO. Los hallazgos radiológicos mostraron un patrón intersticial inespecífico. Nueve p (31%) presentaron coinfección y uno falleció asociado a influenza A (AU)

The prevalence of Chlamydia trachomatis infections has increased, especially among young pregnant women. This is of particular relevance in pediatrics due to the high risk of motherto-child transmission and the potential severity of the infection in infants. A high index of suspicion is required for these infections due to the atypical clinical features and non-specific radiological signs. The usefulness of conventional diagnostic methods is limited. Molecular techniques are recommended because of their high sensitivity, specificity, and speed, allowing for adequate and timely treatment. In this 12-year study conducted in a neonatal intensive care unit of a tertiary-care hospital, patient characteristics, clinical presentation, and outcome are described. Microbiological detection was performed using molecular methods. Twenty-nine patients with C. trachomatis infection (3.9% of the total samples submitted), of whom 13 had respiratory tract infection and 16 ocular involvement, were included. The median age at diagnosis was 19 days and 65% of the mothers were <25 years old. Twenty-four p (83%) were term newborns and 23 patients (79%) were previously healthy. On admission, 9 patients (31%) had fever and 12 (41%) had eosinophilia. Of the 13 patients with respiratory tract involvement, 9 (69%) consulted for cough and 11 (85%) had hypoxemia, requiring oxygen in 8 (61%), mechanical ventilation in 3 (23%), and ECMO in 1 (16%). Radiological findings showed a nonspecific interstitial pattern. Nine patients (31%) presented with coinfection, one of whom died due to an associated influenza A infection (AU)

Seropositivity of Chlamydia trachomatis & Toxoplasma gondii among male partners of infertile couples in Odisha, India: A facility based exploratory study

Chlamydia trachomatis (CT) is the most common curable sexually transmitted non-viral infection, which can cause urethritis, prostatitis, orchitis and epididymitis among males. Toxoplasma gondii, a protozoan causes toxoplasmosis among humans. These infections may lead to decreased fertility. Hence, this study was aimed to estimate the seropositivity of CT and T. gondii infection among the male partners of infertile couples in Odisha, India. In this facility-based cross-sectional study, first void urine, seminal fluid and blood sample were collected from 153 males attending infertility clinics including 74 healthy controls. Urine and seminal fluid were tested through polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay was used to detect immunoglobulin (Ig) G, IgA and IgM anti-Chlamydia and IgM anti-Toxoplasma antibodies through serum. The prevalence of CT was 1.26 per cent (95% CI: 0.03-6.85) as estimated from semen samples using PCR. We detected anti-Chlamydia antibodies IgM-four per cent [95% confidence interval (CI): 0.83-11.24]; IgA-28.16 per cent (95% CI: 18.13-40.09) and IgG-12.5 per cent (95% CI: 5.87-22.4) among participants. Anti-Toxoplasma antibodies IgM were observed in 27.63 per cent (95% CI: 17.98-39.08) of participants. None of the control samples were found positive. Overall seropositivity of CT and Toxoplasma infections is comparable, which suggests that greater attention is required for screening these infections at clinics, especially among infertile couples.

Linfogranuloma venéreo / Venereal lymphogranuloma

El Linfogranuloma venéreo (LGV) es una infección de transmisión sexual (ITS) ulcerativa poco frecuente causada por la bacteria Chlamydia trachomatis (CT), serotipos L1, L2 y L3, originada por el contacto no protegido genital, anal y/u oral. Se asocia con co-infecciones de otras ITS, entre ellas las ocasionadas por el virus de la inmunodeficiencia humana (VIH) y la sífilis. Endémico en áreas tropicales y subtropicales de África, Sudeste Asiático, Latinoamérica y el Caribe, a partir del 2003 se han registrado nuevos brotes en Europa, América del Norte y Australia, en especial entre la población de hombres que tienen sexo con hombres (HsH) y en pacientes VIH positivos. Si bien lo más frecuente de observar en HsH es la proctitis con escasa repercusión ganglionar regional, se debe sospechar LGV ante toda úlcera ano-genital transitoria y linfadenopatías inguinales en esta población. Se presenta un caso de LGV en un paciente HsH no VIH cuya forma de inicio genital permitió el diagnóstico y el tratamiento adecuado.

Lymphogranuloma venereum (LGV) is a rare ulcerative sexually transmitted infection (STI) caused by the bacterium Chlamydia trachomatis (CT), serotypes L1, L2 and L3, caused by unprotected genital, anal and/or oral contact. It is associated with co-infections with other STIs, including those caused by the human immunodeficiency virus (HIV) and syphilis. Endemic in tropical and subtropical areas of Africa, Southeast Asia, Latin America and the Caribbean, since 2003 there have been new outbreaks in Europe, North America and Australia, especially among the population of men who have sex with men (MSM) and in HIV positive patients. Although the most common sign to observe in MSM is proctitis with little regional lymph node repercussion, LGV should be suspected in the presence of any transient anogenital ulcer and inguinal lymphadenopathy in this population. We present a case of LGV in a non-HIV MSM patient whose form of genital onset led to diagnosis and treatment.

Detección de infección por Chlamydia trachomatis en mujeres sexualmente activas en Venezuela / Detection of Chlamydia trachomatis infection in sexually active women in Venezuela

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

Introduction: Genital Chlamydia trachomatis infection is one of the most frequent in the world; about 85 million new cases of this pathology are registered each year, which causes severe complications in women and newborns. Objective: To determine the clinical-epidemiological characteristics of C. trachomatis infection in sexually active Venezuelan women. Materials and methods: Descriptive, cross-sectional, and field study based on the clinical history and physical examination, detection of infection with immunoenzymatic assay with anti-LPS polyclonal antibody and confirmation of results with molecular biology test. The sample consisted of 100 sexually active women over 12 years of age from Carabobo state, Venezuela. Results: The women were mostly between 20 and 45 years old, in 25% of them IgG antibodies to C. trachomatis were detected and in 84% of these the infection was confirmed by PCR, in none of the women IgM antibodies to C. trachomatis were found. Conclusion: Chronic infection characterizes women between 20 and 45 years of age; the immunoenzymatic test yielded false positives corroborated by PCR.

The Correlation between Chlamydia Trachomatis and Female Infertility: A Systematic Review / A correlação entre clamídia trachomatis e infertilidade feminina: Uma revisão sistemática

Abstract The impact of Chlamydia trachomatis (CT) infection on female's fertility is not completely established yet, since the level of evidence associating these factors is still weak. Hence, the goal of the present review is to contribute to a better elucidation of this matter. The electronic database chosen was the Medline/PubMed, with the last survey on May 11, 2021. Publication date was used as a filter, with the previous 5 years having been selected. The following describers were used: chlamydia trachomatis AND infertility; chlamydia trachomatis AND tubal alteration AND infertility; chlamydia AND low pregnancy rates. From the 322 studies screened, 293 that failed to meet our eligibility criteria were excluded. Subsequently, we removed seven studies for not having the possible correlation between CT infections and female infertility as its main focus, and three for being about sexually transmitted infections (STIs) in general. Moreover, two studies designed as reviews were also excluded. Ergo, we included 17 studies in our qualitative analysis. The authors conducted research individually and analyzed carefully the studies selected. As we retrieved the information needed for our study through reading the texts, no contact was made with the authors of the studies selected. This systematic review corroborates the hypothesis that CT infection potentiates female infertility, as 76.47% of the included studies found a positive correlation between them. We conclude that there is an important association between CT infection and female infertility. Ergo, making CT screening part of the infertility investigation routine is relevant and has a reasonable justification.

Resumo O impacto da infecção por Chlamydia trachomatis (CT) na fertilidade feminina ainda não está completamente estabelecido, uma vez que o nível de evidência associando esses fatores ainda é insignificante. Assim, o objetivo desta revisão é contribuir para uma melhor elucidação deste assunto. A base de dados eletrônica escolhida foi a Medline/PubMed, com a última pesquisa em 11 de maio de 2021. Utilizou-se como filtro a data de publicação, sendo selecionados os 5 anos anteriores. Foram usados os seguintes descritores: Chlamydia trachomatis E infertility; Chlamydia trachomatis E tubal alteration E infertility; Chlamydia E low pregnancy rates. Dos 322 estudos selecionados, 293 que não atenderam aos nossos critérios de elegibilidade foram excluídos. Posteriormente, retiramos sete estudos por não terem como foco principal a possível correlação entre infecção por CT e infertilidade feminina e três por tratarem de infecções sexualmente transmissíveis (ISTs) em geral. Além disso, dois estudos concebidos como revisões também foram excluídos. Portanto, incluímos 17 estudos em nossa análise qualitativa. Os autores realizaram pesquisas individualmente e analisaram criteriosamente os estudos selecionados. Como obtivemos as informações necessárias para nosso estudo por meio da leitura dos textos, nenhum contato foi feito com os autores. Esta revisão sistemática corrobora a hipótese de que a infecção por CT potencializa a infertilidade feminina, pois 76,47% dos estudos incluídos encontraram correlação positiva entre eles. Concluímos que existe uma associação importante entre infecção por CT e infertilidade feminina. Portanto, tornar os procedimentos de triagem por CT parte da rotina de investigação de infertilidade é relevante e justificável.

A pilot study to determine Neisseria gonorrhoeae–Chlamydia trachomatis coinfection rates in symptomatic patients attending STI Clinics, New Delhi, India

Background: Neisseria gonorrhoeae and Chlamydia trachomatis are the two most prevalent bacterial sexually transmitted infections. For over two decades, treatment guidelines have recommended empirical co-treatment for N.gonorrhoeae and C.trachomatis as symptoms overlap and co-infection is common. Studies from India estimating the same are limited and mostly based on conventional techniques. Aim and Objective: The aim of this study was to determine the frequency of N.gonorrhoeae and C.trachomatis coinfection using nucleic acid amplification tests. Further, we assessed the utility of pus cell estimation in Gram stained smears as a screening tool for inclusion of samples for molecular diagnosis. Methods: This was a prospective study conducted at two tertiary care hospitals; 100 patients (55 females and 45 males) with genitourinary discharge attending STI clinics were recruited, and endocervical or urethral swabs were collected. PCRs for N.gonorrhoeae and C.trachomatis were put up. In addition, microscopy and culture for gonococcus was performed followed by antimicrobial susceptibility testing. Statistical analysis was performed using the SPSS 16 software. Results: N.gonorrhoeae infection was more common than C.trachomatis. A total of 14 patients were positive by PCR (9 males and 5 females) for gonococcus. However, culture was positive only in 8 male patients. PCR for C.trachomatis was positive in 9 (4 males and 5 females) and the co-infection rate was 5%. The sensitivity and negative predictive value of pus cell estimation was 100% for males and 64% and 94.6% respectively for females. All isolates were susceptible to extended spectrum cephalosporins and azithromycin. Limitation: The sample size of the study was small. Conclusion: Frequency of N.gonorrhoeae/C.trachomatis coinfection in symptomatic STI patients is low. Coinfection is considerably overestimated and necessary confirmation of etiological diagnosis could reduce widespread empirical administration of broad-spectrum antibiotics.

Linfogranuloma venéreo genital en un hombre que tiene sexo con hombre: reporte de caso no importado en Chile / Lymphogranuloma venerous genital in men who have sex with men: a non-imported case report in Chile

Resumen El linfogranuloma venéreo (LGV) es una infección de transmisión sexual (ITS) causada por Chlamydia trachomatis. En los últimos años, ha emergido principalmente en hombres que tienen sexo con hombres (HSH). Es frecuente su asociación con otras ITS como el virus de inmunodeficiencia humana (VIH) y la sífilis. Si bien el compromiso genital es la forma de presentación clásica, el síndrome anorrectal constituye el principal cuadro clínico en la actualidad. Presentamos el caso de un HSH con infección por VIH en terapia anti-retroviral, herpes genital recurrente y sífilis latente tratada, sin viajes recientes al extranjero, con adenopatías inguinales fistulizadas a piel, asociada a una úlcera genital dolorosa, sin síntomas anorrectales ni sistémicos, refractario a múltiples tratamientos antibacterianos y antivirales. El estudio con RPC de secreción de la fístula fue positiva a C. trachomatis. Se trató con doxiciclina por seis semanas, con buena respuesta clínica, sin complicaciones.

Abstract Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by Chlamydia trachomatis bacteria. In the past years, it has emerged as a relevant infectious agent, mainly affecting men who have sex with men (MSM), frequently associated with other sexually transmitted infections as human immunodeficiency virus (HIV) and syphilis. Even though genital lesions correspond to the classical presentation of LGV, nowadays anorectal syndrome is more frequently reported. We present a MSM patient, HIV infected, being treated with antiretroviral drugs, with a history of recurrent genital herpes, also recently treated for a syphilis in a latent stage. He had no recent trips. He referred inguinal fistulized enlarged lymph nodes, associated with a painful genital ulcer, he denied anorectal or systemic symptoms. He had been treated with multiple antibiotic and antiviral drugs, with no clinical response. Molecular studies from the content of the fistulized lymph node identified C. trachomatis. The patient received doxycycline for 6 weeks, showing good clinical response.

A systematic review of the prevalence of selected sexually transmitted infections in young people in Latin America / Revisión sistemática de la prevalencia de determinadas infecciones de transmisión sexual en la población joven en América Latina / Revisão sistemática da prevalência de determinadas infecções sexualmente transmissíveis em jovens na América Latina

ABSTRACT Objective. To estimate the burden of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and human papillomavirus (HPV) infections among people aged 10 to 25 in Latin America and the Caribbean. Methods. The MEDLINE, EMBASE, and LILACS databases were searched, as well as documents from regional organizations or national health Institutions. Population-based studies that reported prevalence or incidence of CT, NG, TP, and HPV detected through confirmatory tests in adolescents and young people were included. Two reviewers independently selected studies and extracted data. The quality of studies was assessed using the Newcastle-Ottawa Scale. Pooled estimators were calculated in cases where heterogeneity was <70%; when not feasible, prevalence ranges were reported. Results. Out of a total of 3 583 references, 15 prevalence studies complied with the inclusion criteria. Due to substantial heterogeneity (>70%), it was not possible to pool frequency estimators. Among the general population, the prevalence of CT infection ranged between 2.1% and 30.1% (9 studies, 5 670 participants); for NG, prevalence ranged between 0% and 2.9% (8 studies, 5 855 participants); for TP, prevalence varied between 0% and 0.7% (3 studies, 11 208 participants), and for HPV infection, prevalence ranged between 25.1% and 55.6% (8 studies, 3 831 participants). Conclusions. Reliable, population-based data on sexually transmitted infections (STIs) in adolescents and youth in Latin America and the Caribbean are limited. Additional studies are needed to better understand the burden of STIs in this population. However, given the substantial prevalence of STIs detected, countries need public health policies for prevention, early diagnosis, and treatment of STIs in young people.

RESUMEN Objetivo. Calcular la carga de infecciones por Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (PT) y el virus del papiloma humano (VPH) en personas de edades comprendidas entre los 10 y los 25 años en América Latina y el Caribe. Métodos. Se realizaron búsquedas en las bases de datos MEDLINE, EMBASE y LILACS, así como en documentos de organizaciones regionales o instituciones nacionales de salud. Se incluyeron estudios poblacionales que notificaron la prevalencia o la incidencia de CT, NG, TP y VPH, detectados mediante pruebas confirmatorias en adolescentes y jóvenes. Dos revisores seleccionaron de forma independiente los estudios y extrajeron los datos. La calidad de los estudios se evaluó mediante la escala de Newcastle-Ottawa. Se hicieron estimaciones combinadas en los casos en que la heterogeneidad era <70 %; cuando no era posible, se presentaron los rangos de prevalencia. Resultados. De un total de 3 583 referencias, 15 estudios de prevalencia cumplieron los criterios de inclusión. Debido a una significativa heterogeneidad (>70%), no fue posible agrupar las estimaciones de frecuencia. En la población general, la prevalencia de infección por CT fluctuó entre 2,1 % y 30,1 % (9 estudios y 5 670 participantes); en el caso de NG, la prevalencia fluctuó entre 0 % y 2,9 % (8 estudios y 5 855 participantes); en el caso de PT, la prevalencia varió entre 0 % y 0,7 % (3 estudios y 11 208 participantes) y en el caso de infección por VPH, la prevalencia fluctuó entre 25,1 % y 55,6 % (8 estudios y 3 831 participantes). Conclusiones. Los datos poblacionales fiables sobre las infecciones de transmisión sexual (ITS) en adolescentes y jóvenes en América Latina y el Caribe son limitados. Es necesario hacer estudios adicionales para comprender mejor la carga de las ITS en este grupo poblacional. Sin embargo, dada la significativa prevalencia de ITS detectada, los países requieren políticas de salud pública para la prevención, el diagnóstico temprano y el tratamiento de las ITS en la población joven.

RESUMO Objetivo. Estimar a carga de infecção por Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP) e papilomavírus humano (HPV) na população entre 10 e 25 anos de idade na América Latina e no Caribe. Métodos. Foi realizada uma pesquisa nas bases de dados MEDLINE, EMBASE e LILACS, assim como da documentação de entidades regionais ou nacionais que atuam na área da saúde. Foram incluídos na revisão estudos populacionais que registraram a incidência ou a prevalência de infecção por CT, NG, TP e HPV, verificada por meio de exames confirmatórios realizados em adolescentes e jovens. Dois revisores trabalharam de modo independente na seleção dos estudos e extração dos dados. A qualidade dos estudos foi avaliada utilizando a Escala de Newcastle-Ottawa. Foi feito o cálculo dos estimadores combinados quando a heterogeneidade era <70% e apresentada a variação da prevalência nos outros casos quando essa estimativa não foi possível. Resultados. Das 3 583 referências levantadas, 15 eram estudos de prevalência que satisfizeram os critérios de inclusão. Devido à heterogeneidade considerável entre os estudos (>70%), não foi possível combinar os estimadores de frequência. Na população geral, a prevalência de infecção por CT variou entre 2,1% e 30,1% (9 estudos, 5 670 participantes); a de NG, entre 0 e 2,9% (8 estudos, 5 855 participantes); a de TP, entre 0 e 0,7% (3 estudos, 11 208 participantes); e a de infecção por HPV, entre 25,1% e 55,6% (8 estudos, 3 831 participantes). Conclusões. Faltam dados populacionais confiáveis relativos a infecções sexualmente transmissíveis (ISTs) em adolescentes e jovens na América Latina e no Caribe. Outros estudos devem ser realizados para um entendimento melhor da carga dessas infecções na população. Diante da elevada prevalência verificada, os países precisam dispor de políticas de saúde pública para prevenção, diagnóstico precoce e tratamento de ISTs na população jovem.'