Men and women have comparable Chlamydia trachomatis loads at extragenital locations, which researchers say argues for “similar transmission potential and clinical relevance,” according to findings published in The Journal of Infectious Diseases.
“Chlamydia trachomatis (CT) is the most reported bacterial sexually transmitted infection worldwide,” Julien N.A.P. Wijers, of the Department of Sexual Health, Infectious Diseases and Environmental Health at South Limburg Public Health Service in the Netherlands, and colleagues wrote. “CT is associated with reproductive sequelae in women, such as pelvic inflammatory disease, ectopic pregnancy, infertility and chronic lower abdominal pain. The CT bacterial load, frequently expressed as the number of CT bacteria/mL, could potentially affect transmission of the disease and sequelae. Currently, it is not clear what determines a high CT load in a patient.”
Several studies have evaluated the CT load at various anatomic locations and in different sample types, according to the researchers. . However, that research used varying methods to quantify and report the loads, making them harder to compare. Therefore, Wijers and colleagues assessed the CT loads of all relevant urogenital and extragenital sites using the same methods to assess differences in cycle quantification values.
The researchers collected data from 7,900 CT-positive samples between 2012 and 2018. Cycle quantification (Cq) values were used as an inversely proportional measure for CT load, according to the study, and multivariable linear regression analyses were used to evaluate differences in mean Cq values per sample type.
Vaginal swabs had the lowest Cq values (31), followed by urine samples (32.5), anorectal swabs (34) and oropharyngeal swabs (36.8; P < .001). Comparable Cq values for oropharyngeal (36.4 vs 37.3) and anorectal (34.2 vs 33.9) samples were observed between men and women. Urogenital Cq values were lower among men and women aged less than 25 years (32.2 and 30.7, respectively) than men and women aged 25 years or older (32.8 and 31.9, respectively; P < .001). Urogenital Cq values were also higher in patients with HIV (33.8 vs. 32.6; P < .03).
“To our knowledge, this is the first and largest study to date providing a comparison of the CT load of all anatomic sites in both men and women estimated by Cq values. Our objectives were to assess whether different sample types have a different CT load and whether age and coinfection with [Neisseria gonorrhoeae], HIV or syphilis were associated with it. . . ,” the authors wrote. “Men and women have a similar CT load at extragenital locations, arguing for similar transmission potential and clinical relevance. Older patients and patients coinfected with HIV had a lower CT load, suggesting exposure to previous CT infections, potentially leading to some partial immunity reducing CT load.” – by Caitlyn Stulpin
Disclosures: The authors report no relevant financial disclosures.
