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Poster Presentations
PS02 – POSTER VIEWING SESSION – TUESDAY
Tuesday, July 16, 2019 5:45 PM – 7:00 PM
P469 Spontaneous resolution to negative and non-viable status of vaginal and rectal Chlamydia trachomatis infection (FemCure)
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  1. Nicole Dukers-Muijrers1,
  2. Kevin Janssen2,
  3. Hannelore Götz3,
  4. Maarten Schim Van Der Loeff4,
  5. Sylvia Bruisten4,
  6. Henry De Vries5,
  7. Christian Hoebe6,
  8. Petra Wolffs7
  1. 1Public Health Service South Limburg, Sexual Health, Infectious Diseases and Environmental Health, Heerlen, Netherlands
  2. 2Maastricht University Medical Centre (MUMC), Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands
  3. 3Public Health Service Rotterdam Rijnmond, Public Health/Sexual Health, Rotterdam, Netherlands
  4. 4Public Health Service Amsterdam, Amsterdam University Medical Center (UMC), Infectious Diseases, Infection and Immunity (AI and II), Amsterdam, Netherlands
  5. 5Public Health Service Amsterdam, Amsterdam University Medical Center (UMC), National Institute of Public Health and the Environment (RIVM), Infectious Diseases Infection and Immunity Institute (AI and II), Epidemiology and Surveillance Unit, Amsterdam, Netherlands
  6. 6Public Health Service South Limburg, Maastricht University Medical Center (MUMC), Sexual Health, Infectious Diseases and Environmental Health, Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Heerlen, Netherlands
  7. 7Maastricht University Medical Center (MUMC), Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands

Abstract

Background Spontaneous resolution (clearance) of Chlamydia trachomatis (CT) infections can occur between diagnosis by nucleic acid amplification assays (NAAT) and treatment. Moreover, viability polymerase chain reaction (V-PCR) techniques showed that part of non-resolved NAAT positives represent non-viable CT. This may impact clinic policies aiming to restrict antibiotic treatment (i.e. to viable CT only). We followed 560 CT diagnosed women to assess the proportion without viable CT at follow-up, and associated risk factors.

Methods Vaginal (vCT) or rectal (rCT) NAAT positive adult women, negative for HIV, syphilis and Neisseria gonorrhoeae, who not recently used antibiotics, were included at three STI outpatient-clinics (Netherlands, 2016–2017; FemCure). At clinic-diagnosis women were (a) vCT positive, rCT untested (n=351), (b) vCT, rCT positive (n=155), (c) vCT positive, rCT negative (n=25), (d) vCT negative, rCT positive (n=29). After a median of 8 [IQR:7–12] days, before treatment, samples were tested using NAAT and V-PCR. We present percentages of women without viable CT at follow-up, and tested which factors (group [a-d], age, education, non-western-background, symptoms, anal/vaginal sex, sexpartners) were associated, using logistic regression.

Results At follow-up, percentages of women NAAT negative at both anatomic sites were 5.4% (a), 0.6% (b), 32.0% (c), and 27.6% (d). Percentages of women without viable CT (i.e. NAAT negative or NAAT positive and V-PCR undetectable) at both anatomic sites were 9.4% (33/351, a), 3.9% (6/155, b), 52.0% (13/25, c), and 41.4% (12/29, d). Alongside group (p<0.001), older age was independently associated (odds ratio: 1.07 per year (95%CI: 1.01–1.13; p=0.029) with lack of viable CT.

Conclusion Less than ten percent of STI-clinic women diagnosed with vaginal and rectal CT (or were rectally untested) did not have viable CT one week after diagnosis (when they return for treatment). Yet, this percentage was higher in women with single vaginal or rectal infection and in older women; this may affect treatment-choices.

Disclosure No significant relationships.

  • chlamydia

https://doi.org/10.1136/sextrans-2019-sti.551

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