Monitoring therapy success of urogenital Chlamydia trachomatis infections in women: A prospective observational cohort study
The use of a nucleic acid amplification test (NAAT) as a test of cure after treatment is subject to discussion, as the presence of C. trachomatis nucleic acids after treatment may be prolonged and intermittent without presence of infectious bacteria. We used cell culture to assess if a positive RNA-...
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| creator | Versteeg, Bart Bruisten, Sylvia M Heijman, Titia Vermeulen, Wilma van Rooijen, Martijn S van Dam, Alje P Schim van der Loeff, Maarten F de Vries, Henry J C Scholing, Maarten |
| description | The use of a nucleic acid amplification test (NAAT) as a test of cure after treatment is subject to discussion, as the presence of C. trachomatis nucleic acids after treatment may be prolonged and intermittent without presence of infectious bacteria. We used cell culture to assess if a positive RNA- or DNA-based NAAT after treatment indicates the presence of viable C. trachomatis.
We included women with asymptomatic urogenital C. trachomatis infection visiting the Amsterdam STI clinic from September 2015 through June 2016. Endocervical swabs were collected prior to treatment with azithromycin, and during three follow-up visits 7, 21 and 49 days after treatment. Collected swabs were subjected to C. trachomatis culture and a RNA- and DNA-based NAAT. High-resolution multilocus sequence typing (hr-MLST) was used to further differentiate potential re-infections.
We included 90 women with a positive RNA-test prior to receiving treatment of whom 81 (90%) were also DNA-positive, and 69 (76.7%) culture-positive. Prolonged and intermittent positive RNA and DNA results over time were observed. Three women had culture positive results at the second visit, but all were negative at the third visit. Five women had NAAT-positive results at the fourth visit of whom three women were also culture-positive indicating a viable infection. All five women reported unprotected sexual contact since the first visit. From 2, hr-MLST sequence types were obtained. One had a different sequence type indicating a new infection the other was identical to the previously found indicating a potentially persisting infection.
Most RNA- or DNA-positive results after treatment of urogenital C. trachomatis may be caused by non-viable molecular remnants since they cannot be confirmed by culture. In a minority viable C. trachomatis was found in culture at the second visit, indicating that patients may remain infectious at least 7 days after treatment. |
| doi_str_mv | 10.1371/journal.pone.0185295 |
| format | Article |
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We included women with asymptomatic urogenital C. trachomatis infection visiting the Amsterdam STI clinic from September 2015 through June 2016. Endocervical swabs were collected prior to treatment with azithromycin, and during three follow-up visits 7, 21 and 49 days after treatment. Collected swabs were subjected to C. trachomatis culture and a RNA- and DNA-based NAAT. High-resolution multilocus sequence typing (hr-MLST) was used to further differentiate potential re-infections.
We included 90 women with a positive RNA-test prior to receiving treatment of whom 81 (90%) were also DNA-positive, and 69 (76.7%) culture-positive. Prolonged and intermittent positive RNA and DNA results over time were observed. Three women had culture positive results at the second visit, but all were negative at the third visit. Five women had NAAT-positive results at the fourth visit of whom three women were also culture-positive indicating a viable infection. All five women reported unprotected sexual contact since the first visit. From 2, hr-MLST sequence types were obtained. One had a different sequence type indicating a new infection the other was identical to the previously found indicating a potentially persisting infection.
Most RNA- or DNA-positive results after treatment of urogenital C. trachomatis may be caused by non-viable molecular remnants since they cannot be confirmed by culture. In a minority viable C. trachomatis was found in culture at the second visit, indicating that patients may remain infectious at least 7 days after treatment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0185295</identifier><identifier>PMID: 28934342</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Azithromycin ; Bacteria ; Biology and Life Sciences ; Care and treatment ; Cell culture ; Chlamydia ; Chlamydia infections ; Chlamydia Infections - therapy ; Chlamydia trachomatis ; Chlamydia trachomatis - genetics ; Chlamydia trachomatis - physiology ; Cohort analysis ; Condoms ; Demographic aspects ; Deoxyribonucleic acid ; Diagnosis ; DNA ; DNA, Bacterial - metabolism ; Female ; Genetic testing ; Health aspects ; Health services ; Humans ; Infections ; Infectious diseases ; Medicine and Health Sciences ; Mens health ; Microbial Viability ; Multilocus sequence typing ; Nucleic acids ; Nucleotide sequence ; Observational studies ; Polymerase chain reaction ; Prospective Studies ; Public health ; Research and Analysis Methods ; Ribonucleic acid ; RNA ; RNA, Bacterial - metabolism ; Sexually transmitted diseases ; STD ; Treatment Outcome ; Womens health ; Young Adult</subject><ispartof>PloS one, 2017-09, Vol.12 (9), p.e0185295-e0185295</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Versteeg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Versteeg et al 2017 Versteeg et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-f54a63a0ea9938bad479e2ef6faf14426260f5ddd0c0a2b9aedb0d0327c3a5853</citedby><cites>FETCH-LOGICAL-c692t-f54a63a0ea9938bad479e2ef6faf14426260f5ddd0c0a2b9aedb0d0327c3a5853</cites><orcidid>0000-0003-2606-8057</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608402/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608402/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28934342$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Versteeg, Bart</creatorcontrib><creatorcontrib>Bruisten, Sylvia M</creatorcontrib><creatorcontrib>Heijman, Titia</creatorcontrib><creatorcontrib>Vermeulen, Wilma</creatorcontrib><creatorcontrib>van Rooijen, Martijn S</creatorcontrib><creatorcontrib>van Dam, Alje P</creatorcontrib><creatorcontrib>Schim van der Loeff, Maarten F</creatorcontrib><creatorcontrib>de Vries, Henry J C</creatorcontrib><creatorcontrib>Scholing, Maarten</creatorcontrib><title>Monitoring therapy success of urogenital Chlamydia trachomatis infections in women: A prospective observational cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The use of a nucleic acid amplification test (NAAT) as a test of cure after treatment is subject to discussion, as the presence of C. trachomatis nucleic acids after treatment may be prolonged and intermittent without presence of infectious bacteria. We used cell culture to assess if a positive RNA- or DNA-based NAAT after treatment indicates the presence of viable C. trachomatis.
We included women with asymptomatic urogenital C. trachomatis infection visiting the Amsterdam STI clinic from September 2015 through June 2016. Endocervical swabs were collected prior to treatment with azithromycin, and during three follow-up visits 7, 21 and 49 days after treatment. Collected swabs were subjected to C. trachomatis culture and a RNA- and DNA-based NAAT. High-resolution multilocus sequence typing (hr-MLST) was used to further differentiate potential re-infections.
We included 90 women with a positive RNA-test prior to receiving treatment of whom 81 (90%) were also DNA-positive, and 69 (76.7%) culture-positive. Prolonged and intermittent positive RNA and DNA results over time were observed. Three women had culture positive results at the second visit, but all were negative at the third visit. Five women had NAAT-positive results at the fourth visit of whom three women were also culture-positive indicating a viable infection. All five women reported unprotected sexual contact since the first visit. From 2, hr-MLST sequence types were obtained. One had a different sequence type indicating a new infection the other was identical to the previously found indicating a potentially persisting infection.
Most RNA- or DNA-positive results after treatment of urogenital C. trachomatis may be caused by non-viable molecular remnants since they cannot be confirmed by culture. In a minority viable C. trachomatis was found in culture at the second visit, indicating that patients may remain infectious at least 7 days after treatment.</description><subject>Analysis</subject><subject>Azithromycin</subject><subject>Bacteria</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Cell culture</subject><subject>Chlamydia</subject><subject>Chlamydia infections</subject><subject>Chlamydia Infections - therapy</subject><subject>Chlamydia trachomatis</subject><subject>Chlamydia trachomatis - genetics</subject><subject>Chlamydia trachomatis - physiology</subject><subject>Cohort analysis</subject><subject>Condoms</subject><subject>Demographic aspects</subject><subject>Deoxyribonucleic acid</subject><subject>Diagnosis</subject><subject>DNA</subject><subject>DNA, Bacterial - metabolism</subject><subject>Female</subject><subject>Genetic testing</subject><subject>Health aspects</subject><subject>Health services</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Medicine and Health Sciences</subject><subject>Mens health</subject><subject>Microbial Viability</subject><subject>Multilocus sequence typing</subject><subject>Nucleic acids</subject><subject>Nucleotide sequence</subject><subject>Observational studies</subject><subject>Polymerase chain reaction</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Research and Analysis Methods</subject><subject>Ribonucleic acid</subject><subject>RNA</subject><subject>RNA, Bacterial - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Versteeg, Bart</au><au>Bruisten, Sylvia M</au><au>Heijman, Titia</au><au>Vermeulen, Wilma</au><au>van Rooijen, Martijn S</au><au>van Dam, Alje P</au><au>Schim van der Loeff, Maarten F</au><au>de Vries, Henry J C</au><au>Scholing, Maarten</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Monitoring therapy success of urogenital Chlamydia trachomatis infections in women: A prospective observational cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-09-21</date><risdate>2017</risdate><volume>12</volume><issue>9</issue><spage>e0185295</spage><epage>e0185295</epage><pages>e0185295-e0185295</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The use of a nucleic acid amplification test (NAAT) as a test of cure after treatment is subject to discussion, as the presence of C. trachomatis nucleic acids after treatment may be prolonged and intermittent without presence of infectious bacteria. We used cell culture to assess if a positive RNA- or DNA-based NAAT after treatment indicates the presence of viable C. trachomatis.
We included women with asymptomatic urogenital C. trachomatis infection visiting the Amsterdam STI clinic from September 2015 through June 2016. Endocervical swabs were collected prior to treatment with azithromycin, and during three follow-up visits 7, 21 and 49 days after treatment. Collected swabs were subjected to C. trachomatis culture and a RNA- and DNA-based NAAT. High-resolution multilocus sequence typing (hr-MLST) was used to further differentiate potential re-infections.
We included 90 women with a positive RNA-test prior to receiving treatment of whom 81 (90%) were also DNA-positive, and 69 (76.7%) culture-positive. Prolonged and intermittent positive RNA and DNA results over time were observed. Three women had culture positive results at the second visit, but all were negative at the third visit. Five women had NAAT-positive results at the fourth visit of whom three women were also culture-positive indicating a viable infection. All five women reported unprotected sexual contact since the first visit. From 2, hr-MLST sequence types were obtained. One had a different sequence type indicating a new infection the other was identical to the previously found indicating a potentially persisting infection.
Most RNA- or DNA-positive results after treatment of urogenital C. trachomatis may be caused by non-viable molecular remnants since they cannot be confirmed by culture. In a minority viable C. trachomatis was found in culture at the second visit, indicating that patients may remain infectious at least 7 days after treatment.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28934342</pmid><doi>10.1371/journal.pone.0185295</doi><tpages>e0185295</tpages><orcidid>https://orcid.org/0000-0003-2606-8057</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1941349306 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Analysis Azithromycin Bacteria Biology and Life Sciences Care and treatment Cell culture Chlamydia Chlamydia infections Chlamydia Infections - therapy Chlamydia trachomatis Chlamydia trachomatis - genetics Chlamydia trachomatis - physiology Cohort analysis Condoms Demographic aspects Deoxyribonucleic acid Diagnosis DNA DNA, Bacterial - metabolism Female Genetic testing Health aspects Health services Humans Infections Infectious diseases Medicine and Health Sciences Mens health Microbial Viability Multilocus sequence typing Nucleic acids Nucleotide sequence Observational studies Polymerase chain reaction Prospective Studies Public health Research and Analysis Methods Ribonucleic acid RNA RNA, Bacterial - metabolism Sexually transmitted diseases STD Treatment Outcome Womens health Young Adult |
| title | Monitoring therapy success of urogenital Chlamydia trachomatis infections in women: A prospective observational cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T11%3A59%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Monitoring%20therapy%20success%20of%20urogenital%20Chlamydia%20trachomatis%20infections%20in%20women:%20A%20prospective%20observational%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Versteeg,%20Bart&rft.date=2017-09-21&rft.volume=12&rft.issue=9&rft.spage=e0185295&rft.epage=e0185295&rft.pages=e0185295-e0185295&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0185295&rft_dat=%3Cgale_plos_%3EA505755342%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1941349306&rft_id=info:pmid/28934342&rft_galeid=A505755342&rft_doaj_id=oai_doaj_org_article_f63bcf80f9fd43e2addfffcfd5bdfbec&rfr_iscdi=true |