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Published in: BMC Infectious Diseases 1/2024

Open Access 01-12-2024 | Chlamydia Trachomatis | Research

Characterization of genital chlamydia trachomatis infection among women attending infertility and gynecology clinics in Hunan, China

Authors: Qianting Zhou, Jiayan Li, Lipei Luo, Shuling Min, Li Wang, Lixiu Peng, Yinglan Hou, Ping He, Song He, Shixing Tang, Hongliang Chen

Published in: BMC Infectious Diseases | Issue 1/2024

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Abstract

Background

Genital infection with Chlamydia trachomatis (C. trachomatis) is a major public health issue worldwide. It can lead to cervicitis, urethritis, and infertility. This study was conducted to determine the characteristics of genital C. trachomatis infection among women attending to the infertility and gynecology clinics.

Methods

Endocervical swabs were collected from 8,221 women for C. trachomatis nucleotide screening and genotyping, while serum samples were collected for C. trachomatis pgp3 antibody determination using luciferase immunosorbent assays.

Results

High C. trachomatis DNA prevalence (3.76%) and seroprevalence (47.46%) rates were found, with genotype E (27.5%) being the most prevalent. C. trachomatis omp1 sense mutation was associated with cervical intraepithelial neoplasia (CIN) (odds ratio [OR] = 6.033, 95% confidence interval [CI] = 1.219–39.185, p = 0.045). No significant differences in C. trachomatis seroprevalence rates were observed between women with detectable C. trachomatis DNA in the infertility and routine physical examination groups (86.67% vs. 95%, p > 0.05); however, among women with negative C. trachomatis DNA, the former group had a markedly higher seroprevalence than the latter group (56.74% vs. 20.17%, p < 0.001). C. trachomatis DNA, but not pgp3 antibody, was significantly associated with CIN (OR = 4.087, 95% CI = 2.284–7.315, p < 0.001).

Conclusion

Our results revealed a high prevalence, particularly seroprevalence, of C. trachomatis among women with infertility. Furthermore, we found an association between C. trachomatis omp1 sense mutations and CIN. Therefore, C. trachomatis serves as a risk factor for CIN.
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Literature
1.
go back to reference Chen Y, Chen J, Yang L, Jiang Y, Li L, Yi W, et al. Distribution of Chlamydia Trachomatis Genotypes in Infective diseases of the female Lower Genital Tract. Med Sci Monit. 2017;23:4477–81.CrossRefPubMedPubMedCentral Chen Y, Chen J, Yang L, Jiang Y, Li L, Yi W, et al. Distribution of Chlamydia Trachomatis Genotypes in Infective diseases of the female Lower Genital Tract. Med Sci Monit. 2017;23:4477–81.CrossRefPubMedPubMedCentral
2.
go back to reference Hsu MC, Tsai PY, Chen KT, Li LH, Chiang CC, Tsai JJ, et al. Genotyping of Chlamydia trachomatis from clinical specimens in Taiwan. J Med Microbiol. 2006;55:301–8.CrossRefPubMed Hsu MC, Tsai PY, Chen KT, Li LH, Chiang CC, Tsai JJ, et al. Genotyping of Chlamydia trachomatis from clinical specimens in Taiwan. J Med Microbiol. 2006;55:301–8.CrossRefPubMed
3.
go back to reference Jurstrand M, Falk L, Fredlund H, Lindberg M, Olcen P, Andersson S, et al. Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted disease patients in Sweden. J Clin Microbiol. 2001;39:3915–9.CrossRefPubMedPubMedCentral Jurstrand M, Falk L, Fredlund H, Lindberg M, Olcen P, Andersson S, et al. Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted disease patients in Sweden. J Clin Microbiol. 2001;39:3915–9.CrossRefPubMedPubMedCentral
4.
go back to reference Oakeshott P, Kerry S, Aghaizu A, Atherton H, Hay S, Taylor-Robinson D, et al. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. BMJ. 2010;340:c1642.CrossRefPubMedPubMedCentral Oakeshott P, Kerry S, Aghaizu A, Atherton H, Hay S, Taylor-Robinson D, et al. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. BMJ. 2010;340:c1642.CrossRefPubMedPubMedCentral
5.
go back to reference Nunes A, Borrego MJ, Gomes JP. Genomic features beyond Chlamydia trachomatis phenotypes: what do we think we know? Infect Genet Evol. 2013;16:392–400.CrossRefPubMed Nunes A, Borrego MJ, Gomes JP. Genomic features beyond Chlamydia trachomatis phenotypes: what do we think we know? Infect Genet Evol. 2013;16:392–400.CrossRefPubMed
6.
go back to reference Lysen M, Osterlund A, Rubin CJ, Persson T, Persson I, Herrmann B. 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. 2004;42:1641–7.CrossRefPubMedPubMedCentral Lysen M, Osterlund A, Rubin CJ, Persson T, Persson I, Herrmann B. 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. 2004;42:1641–7.CrossRefPubMedPubMedCentral
7.
go back to reference Batteiger BE. The major outer membrane protein of a single Chlamydia trachomatis serovar can possess more than one serovar-specific epitope. Infect Immun. 1996;64:542–7.CrossRefPubMedPubMedCentral Batteiger BE. The major outer membrane protein of a single Chlamydia trachomatis serovar can possess more than one serovar-specific epitope. Infect Immun. 1996;64:542–7.CrossRefPubMedPubMedCentral
8.
go back to reference Brunham R, Yang C, Maclean I, Kimani J, Maitha G, Plummer F. Chlamydia trachomatis from individuals in a sexually transmitted disease core group exhibit frequent sequence variation in the major outer membrane protein (omp1) gene. J Clin Invest. 1994;94:458–63.CrossRefPubMedPubMedCentral Brunham R, Yang C, Maclean I, Kimani J, Maitha G, Plummer F. Chlamydia trachomatis from individuals in a sexually transmitted disease core group exhibit frequent sequence variation in the major outer membrane protein (omp1) gene. J Clin Invest. 1994;94:458–63.CrossRefPubMedPubMedCentral
9.
go back to reference Morre SA, Ossewaarde JM, Lan J, van Doornum GJ, Walboomers JM, MacLaren DM, et al. Serotyping and genotyping of genital Chlamydia trachomatis isolates reveal variants of serovars Ba, G, and J as confirmed by omp1 nucleotide sequence analysis. J Clin Microbiol. 1998;36:345–51.CrossRefPubMedPubMedCentral Morre SA, Ossewaarde JM, Lan J, van Doornum GJ, Walboomers JM, MacLaren DM, et al. Serotyping and genotyping of genital Chlamydia trachomatis isolates reveal variants of serovars Ba, G, and J as confirmed by omp1 nucleotide sequence analysis. J Clin Microbiol. 1998;36:345–51.CrossRefPubMedPubMedCentral
10.
go back to reference Blomquist PB, Mighelsen SJ, Wills G, McClure E, Ades AE, Kounali D, et al. Sera selected from national STI surveillance system shows Chlamydia trachomatis PgP3 antibody correlates with time since infection and number of previous infections. PLoS ONE. 2018;13:e0208652.CrossRefPubMedPubMedCentral Blomquist PB, Mighelsen SJ, Wills G, McClure E, Ades AE, Kounali D, et al. Sera selected from national STI surveillance system shows Chlamydia trachomatis PgP3 antibody correlates with time since infection and number of previous infections. PLoS ONE. 2018;13:e0208652.CrossRefPubMedPubMedCentral
11.
go back to reference Gwyn S, Cooley G, Goodhew B, Kohlhoff S, Banniettis N, Wiegand R, et al. Comparison of platforms for testing antibody responses against the Chlamydia trachomatis Antigen Pgp3. Am J Trop Med Hyg. 2017;97(6):1662–8.CrossRefPubMedPubMedCentral Gwyn S, Cooley G, Goodhew B, Kohlhoff S, Banniettis N, Wiegand R, et al. Comparison of platforms for testing antibody responses against the Chlamydia trachomatis Antigen Pgp3. Am J Trop Med Hyg. 2017;97(6):1662–8.CrossRefPubMedPubMedCentral
12.
go back to reference Jones CA, Hadfield J, Thomson NR, Cleary DW, Marsh P, Clarke IN, et al. The Nature and Extent of plasmid variation in Chlamydia trachomatis. Microorganisms. 2020;8(3):373.CrossRefPubMedPubMedCentral Jones CA, Hadfield J, Thomson NR, Cleary DW, Marsh P, Clarke IN, et al. The Nature and Extent of plasmid variation in Chlamydia trachomatis. Microorganisms. 2020;8(3):373.CrossRefPubMedPubMedCentral
13.
go back to reference Chen X, Munoz B, Mkocha H, Gaydos CA, Dize L, Quinn TC, et al. Risk of seroconversion and seroreversion of antibodies to Chlamydia trachomatis pgp3 in a longitudinal cohort of children in a low trachoma prevalence district in Tanzania. PLoS Negl Trop Dis. 2022;16:e0010629.CrossRefPubMedPubMedCentral Chen X, Munoz B, Mkocha H, Gaydos CA, Dize L, Quinn TC, et al. Risk of seroconversion and seroreversion of antibodies to Chlamydia trachomatis pgp3 in a longitudinal cohort of children in a low trachoma prevalence district in Tanzania. PLoS Negl Trop Dis. 2022;16:e0010629.CrossRefPubMedPubMedCentral
14.
go back to reference Chen H, Luo L, Wen Y, He B, Ling H, Shui J, et al. Chlamydia trachomatis and human papillomavirus infection in women from Southern Hunan Province in China: a large observational study. Front Microbiol. 2020;11:827.CrossRefPubMedPubMedCentral Chen H, Luo L, Wen Y, He B, Ling H, Shui J, et al. Chlamydia trachomatis and human papillomavirus infection in women from Southern Hunan Province in China: a large observational study. Front Microbiol. 2020;11:827.CrossRefPubMedPubMedCentral
15.
go back to reference Gao X, Chen XS, Yin YP, Zhong MY, Shi MQ, Wei WH, et al. Distribution study of Chlamydia trachomatis serovars among high-risk women in China performed using PCR-restriction fragment length polymorphism genotyping. J Clin Microbiol. 2007;45:1185–9.CrossRefPubMedPubMedCentral Gao X, Chen XS, Yin YP, Zhong MY, Shi MQ, Wei WH, et al. Distribution study of Chlamydia trachomatis serovars among high-risk women in China performed using PCR-restriction fragment length polymorphism genotyping. J Clin Microbiol. 2007;45:1185–9.CrossRefPubMedPubMedCentral
16.
go back to reference Lewis J, Price MJ, Horner PJ, White PJ. Genital Chlamydia trachomatis infections clear more slowly in Men Than women, but are less likely to become established. J Infect Dis. 2017;216:237–44.CrossRefPubMedPubMedCentral Lewis J, Price MJ, Horner PJ, White PJ. Genital Chlamydia trachomatis infections clear more slowly in Men Than women, but are less likely to become established. J Infect Dis. 2017;216:237–44.CrossRefPubMedPubMedCentral
17.
go back to reference Luo LP, He P, Liu QT, Jiang YH, Zhang YN, Li QZ, et al. Prevalence and genotype distribution of HPV infection among 214,715 women from Southern China, 2012–2018: baseline measures prior to mass HPV vaccination. BMC Infect Dis. 2021;21(1):328.CrossRefPubMedPubMedCentral Luo LP, He P, Liu QT, Jiang YH, Zhang YN, Li QZ, et al. Prevalence and genotype distribution of HPV infection among 214,715 women from Southern China, 2012–2018: baseline measures prior to mass HPV vaccination. BMC Infect Dis. 2021;21(1):328.CrossRefPubMedPubMedCentral
18.
go back to reference Taheri Beni B, Jenab A, Roghanian R, Motamedi H, Golbang N, Golbang P, et al. Genotyping of Endocervical Chlamydia trachomatis strains and detection of serological markers of Acute and chronic inflammation in their host. Int J Fertil Steril. 2012;6:101–6.PubMedPubMedCentral Taheri Beni B, Jenab A, Roghanian R, Motamedi H, Golbang N, Golbang P, et al. Genotyping of Endocervical Chlamydia trachomatis strains and detection of serological markers of Acute and chronic inflammation in their host. Int J Fertil Steril. 2012;6:101–6.PubMedPubMedCentral
19.
go back to reference Shui J, Xie D, Zhao J, Ao C, Lin H, Liang Y, et al. Seroepidemiology of Chlamydia trachomatis infection in the General Population of Northern China: the Jidong Community Cohort Study. Front Microbiol. 2021;12:729016.CrossRefPubMedPubMedCentral Shui J, Xie D, Zhao J, Ao C, Lin H, Liang Y, et al. Seroepidemiology of Chlamydia trachomatis infection in the General Population of Northern China: the Jidong Community Cohort Study. Front Microbiol. 2021;12:729016.CrossRefPubMedPubMedCentral
20.
go back to reference Wang H, Cai Q, Liang Y, Shui J, Tang S. A simple and high-throughput luciferase immunosorbent assay for both qualitative and semi-quantitative detection of anti-HIV-1 antibodies. Virus Res. 2019;263:9–15.CrossRefPubMed Wang H, Cai Q, Liang Y, Shui J, Tang S. A simple and high-throughput luciferase immunosorbent assay for both qualitative and semi-quantitative detection of anti-HIV-1 antibodies. Virus Res. 2019;263:9–15.CrossRefPubMed
21.
go back to reference Yue X-a, Chen P, Tang Y, Wu X, Hu Z. The dynamic changes of vaginal microecosystem in patients with recurrent vulvovaginal candidiasis: a retrospective study of 800 patients. Arch Gynecol Obstet. 2015;292:1285–94.CrossRefPubMed Yue X-a, Chen P, Tang Y, Wu X, Hu Z. The dynamic changes of vaginal microecosystem in patients with recurrent vulvovaginal candidiasis: a retrospective study of 800 patients. Arch Gynecol Obstet. 2015;292:1285–94.CrossRefPubMed
22.
go back to reference Chen H, Wang L, Zhao L, Luo L, Min S, Wen Y, et al. Alterations of vaginal microbiota in women with infertility and Chlamydia trachomatis infection. Front Cell Infect Microbiol. 2021;11:698840.CrossRefPubMedPubMedCentral Chen H, Wang L, Zhao L, Luo L, Min S, Wen Y, et al. Alterations of vaginal microbiota in women with infertility and Chlamydia trachomatis infection. Front Cell Infect Microbiol. 2021;11:698840.CrossRefPubMedPubMedCentral
23.
go back to reference Zhao J, Shui J, Luo L, Ao C, Lin H, Liang Y, et al. Identification and characterization of mixed infections of Chlamydia trachomatis via high-throughput sequencing. Front Microbiol. 2022;13:1041789.CrossRefPubMedPubMedCentral Zhao J, Shui J, Luo L, Ao C, Lin H, Liang Y, et al. Identification and characterization of mixed infections of Chlamydia trachomatis via high-throughput sequencing. Front Microbiol. 2022;13:1041789.CrossRefPubMedPubMedCentral
24.
go back to reference de Oliveira ACA, Domingues MF, Neufeld PM, Fleury M, Nogueira Neto JF. Comparison between conventional cytology and liquid-based cytology in the tertiary Brazilian Navy Hospital in Rio De Janeiro. Acta Cytol. 2020;64:539–46.CrossRefPubMed de Oliveira ACA, Domingues MF, Neufeld PM, Fleury M, Nogueira Neto JF. Comparison between conventional cytology and liquid-based cytology in the tertiary Brazilian Navy Hospital in Rio De Janeiro. Acta Cytol. 2020;64:539–46.CrossRefPubMed
25.
go back to reference Brown E, Lo Monaco S, O’Donoghue B, Nolan H, Hughes E, Graham M et al. Improving the Sexual Health of Young People (under 25) in high-risk populations: a systematic review of behavioural and psychosocial interventions. Int J Environ Res Public Health. 2021; 18. Brown E, Lo Monaco S, O’Donoghue B, Nolan H, Hughes E, Graham M et al. Improving the Sexual Health of Young People (under 25) in high-risk populations: a systematic review of behavioural and psychosocial interventions. Int J Environ Res Public Health. 2021; 18.
26.
go back to reference Robbins A, Hanger J, Jelocnik M, Quigley BL, Timms P. Koala immunogenetics and chlamydial strain type are more directly involved in chlamydial disease progression in koalas from two south east Queensland koala populations than koala retrovirus subtypes. Sci Rep. 2020;10:15013.CrossRefPubMedPubMedCentral Robbins A, Hanger J, Jelocnik M, Quigley BL, Timms P. Koala immunogenetics and chlamydial strain type are more directly involved in chlamydial disease progression in koalas from two south east Queensland koala populations than koala retrovirus subtypes. Sci Rep. 2020;10:15013.CrossRefPubMedPubMedCentral
27.
go back to reference Takourt B, de Barbeyrac B, Fau - Khyatti M, Khyatti M, Fau - Radouani F, Radouani F, Fau - Bebear C, Bebear C, Fau - Dessus-Babus S, Dessus-Babus S, Fau - Bebear C, et al. Direct genotyping and nucleotide sequence analysis of VS1 and VS2 of the Omp1 gene of Chlamydia trachomatis from Moroccan trachomatous specimens. Microbes Infect. 2001;3(6):459–66.CrossRefPubMed Takourt B, de Barbeyrac B, Fau - Khyatti M, Khyatti M, Fau - Radouani F, Radouani F, Fau - Bebear C, Bebear C, Fau - Dessus-Babus S, Dessus-Babus S, Fau - Bebear C, et al. Direct genotyping and nucleotide sequence analysis of VS1 and VS2 of the Omp1 gene of Chlamydia trachomatis from Moroccan trachomatous specimens. Microbes Infect. 2001;3(6):459–66.CrossRefPubMed
28.
go back to reference Li JH, Yin Yp Fau - Zheng H-P, Zheng Hp Fau - Zhong M-Y, Zhong My Fau - Peng R-R, Peng Rr Fau -, Wang B, Wang B, Fau - Chen X-S et al. A high-resolution melting analysis for genotyping urogenital Chlamydia trachomatis. Diagn Microbiol Infect Dis. 2010; 68(4): 366– 74. Li JH, Yin Yp Fau - Zheng H-P, Zheng Hp Fau - Zhong M-Y, Zhong My Fau - Peng R-R, Peng Rr Fau -, Wang B, Wang B, Fau - Chen X-S et al. A high-resolution melting analysis for genotyping urogenital Chlamydia trachomatis. Diagn Microbiol Infect Dis. 2010; 68(4): 366– 74.
29.
go back to reference Sturm-Ramirez K, Brumblay H, Diop K, Gueye-Ndiaye A, Sankale JL, Thior I, et al. Molecular epidemiology of genital Chlamydia trachomatis infection in high-risk women in Senegal, West Africa. J Clin Microbiol. 2000;38:138–45.CrossRefPubMedPubMedCentral Sturm-Ramirez K, Brumblay H, Diop K, Gueye-Ndiaye A, Sankale JL, Thior I, et al. Molecular epidemiology of genital Chlamydia trachomatis infection in high-risk women in Senegal, West Africa. J Clin Microbiol. 2000;38:138–45.CrossRefPubMedPubMedCentral
30.
go back to reference Workowski KA, Bolan GA, Centers for Disease C. Prevention: Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015; 64: 1-137. Workowski KA, Bolan GA, Centers for Disease C. Prevention: Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015; 64: 1-137.
31.
go back to reference Horner PJ, Wills GS, Righarts A, Vieira S, Kounali D, Samuel D, et al. Chlamydia trachomatis Pgp3 antibody persists and correlates with self-reported infection and behavioural risks in a Blinded Cohort Study. PLoS ONE. 2016;11:e0151497.CrossRefPubMedPubMedCentral Horner PJ, Wills GS, Righarts A, Vieira S, Kounali D, Samuel D, et al. Chlamydia trachomatis Pgp3 antibody persists and correlates with self-reported infection and behavioural risks in a Blinded Cohort Study. PLoS ONE. 2016;11:e0151497.CrossRefPubMedPubMedCentral
32.
go back to reference Thompson SE, Washington AE. Epidemiology of sexually transmitted Chlamydia trachomatis infections. Epidemiol Rev. 1983;5:96–123.CrossRefPubMed Thompson SE, Washington AE. Epidemiology of sexually transmitted Chlamydia trachomatis infections. Epidemiol Rev. 1983;5:96–123.CrossRefPubMed
33.
go back to reference Zhong G. Chlamydia spreading from the genital tract to the gastrointestinal tract– a two-hit hypothesis. Trends Microbiol. 2018;26:611–23.CrossRefPubMed Zhong G. Chlamydia spreading from the genital tract to the gastrointestinal tract– a two-hit hypothesis. Trends Microbiol. 2018;26:611–23.CrossRefPubMed
Metadata
Title
Characterization of genital chlamydia trachomatis infection among women attending infertility and gynecology clinics in Hunan, China
Authors
Qianting Zhou
Jiayan Li
Lipei Luo
Shuling Min
Li Wang
Lixiu Peng
Yinglan Hou
Ping He
Song He
Shixing Tang
Hongliang Chen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2024
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-024-09254-8

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