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Molecular epidemiology of genital Chlamydia trachomatis infection in Shenzhen, China
  1. Juan-Juan Zhang1,2,
  2. Guang-Lu Zhao1,
  3. Feng Wang1,
  4. Fu-Chang Hong1,
  5. Zhen-Zhou Luo3,
  6. Li-Na Lan1,
  7. Chun-Lai Zhang1,
  8. Yi Peng1,
  9. Xiao-Li Liu1,
  10. Tie-Jian Feng1,2,
  11. Xiang-Sheng Chen4
  1. 1Shenzhen Center for Chronic Disease Control, Shenzhen, China
  2. 2School of Public Health, Sun Yat-sen University, Guangzhou, China
  3. 3Shenzhen Nanshan Center For Chronic Disease Control, Shenzhen, China
  4. 4National Center for STD Control, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Dermatology, Nanjing, China
  1. Correspondence to Dr Tie-Jian Feng, Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen 518020, China; tiejian.feng{at}


Objective To investigate molecular epidemiology of Chlamydia trachomatis infection among patients recruited from different clinic settings in Shenzhen, China.

Methods A total of 2534 patients from the sexually transmitted disease (STD) clinics, obstetrics and gynaecology (OBGYN) clinics and genitourinary medicine (GUM) clinics in 34 hospitals participated in the study. The C trachomatis infection was determined using COBAS Amplicor system. DNA extracted in C trachomatis-positive samples was amplified using a nested PCR based on ompA gene and then genotyped using a microsphere suspension array.

Results The overall prevalence of genital C trachomatis infection was 17.7%. The prevalence in patients at STD or GUM clinics was significantly higher than that in patients at OBGYN clinics. Being male (adjusted OR (AOR) 2.5, 95% CI 1.8 to 3.4), having no consistent use of a condom with casual partners in the past 3 months (AOR 1.7, 95% CI 1.1 to 2.8) and having any STD symptoms (AOR 3.3, 95% CI 2.0 to 5.4) were independently associated with C trachomatis infection. Eight genotypes were identified. The most prevalent genotypes were F (22.3%), E (22.0%) and D/Da (12.7%). Other genotypes were G/Ga (8.0%), J (7.3%), K (2.7%), H (2.7%) and I/Ia (0.4%). Eighty-two samples (18.3%) were infected with multiple genotypes. Genotype D/Da among patients from GUM clinics was more common than those from STD or OBGYN clinics. Infections with genotypes G and F were statistically associated with abnormal vaginal discharge (p=0.001) and being married (p=0.014), respectively. Infection with multiple genotypes was more common among patients with a higher income (p=0.011).

Conclusion A substantial prevalence of genital C trachomatis infection in Shenzhen suggests the importance of detection and treatment of the infection in high-risk groups.

  • Chlamydia trachomatis
  • molecular epidemiology
  • genotype
  • chlamydia infection
  • chlamydia serology
  • infectious diseases
  • systematic reviews
  • antibiotic sensitivity
  • gonorrhoea
  • diagnosis

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  • J-JZ and G-LZ contributed equally to this paper.

  • Funding This work was supported by the funds from the Health, Population and Family Planning Commission of Shenzhen Municipality and the grants from the Mega Project of China National Science Research for the 11th Five-Year Plan (2008ZX10001-005) and the Unicef/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (A70578).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The research ethics committees of Shenzhen Center for Chronic Disease Control.

  • Provenance and peer review Not commissioned; externally peer reviewed.