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Analyses of multiple-site and concurrent Chlamydia trachomatis serovar infections, and serovar tissue tropism for urogenital versus rectal specimens in male and female patients
  1. C J Bax1,2,
  2. K D Quint3,
  3. R P H Peters4,
  4. S Ouburg5,
  5. P M Oostvogel6,
  6. J A E M Mutsaers6,
  7. P J Dörr1,
  8. S Schmidt6,
  9. C Jansen6,
  10. A P van Leeuwen4,
  11. W G V Quint3,
  12. J B Trimbos7,
  13. C J L M Meijer8,
  14. S A Morré5
  1. 1Department of Obstetrics and Gynaecology, MC Haaglanden, The Hague, The Netherlands
  2. 2Department of Obstetrics, Academic Medical Center, Amsterdam, The Netherlands
  3. 3DDL Diagnostic Laboratory, Voorburg, The Netherlands
  4. 4The Hague Municipal Health Service, The Hague, The Netherlands
  5. 5Laboratory of Immunogenetics, Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
  6. 6Department of Medical Microbiology, MC Haaglanden, The Hague, The Netherlands
  7. 7Department of Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
  8. 8Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr C J Bax, Academic Medical Center, Department of Obstetrics, H4-205, Postbus 22660, 1100 DD Amsterdam, The Netherlands; c.j.bax{at}


Objectives The aims of this study were: to determine the incidence of concurrent infections on a serovar level; to determine the incidence of multiple anatomical infected sites on a detection and genotyping level and analyse site-specific serovar distribution; to identify tissue tropism in urogenital versus rectal specimens.

Methods Chlamydia trachomatis-infected patients in two populations were analysed: 75 visiting the outpatient department of obstetrics and gynaecology of the MC Haaglanden, and 358 visiting the outpatient sexually transmitted disease clinic, The Hague, The Netherlands. The PACE 2 assay (Gen-Probe) was used to detect C trachomatis from urethral, cervical, vaginal, oropharyngeal and anorectal swabs. C trachomatis genotyping was performed on all C trachomatis positive samples, using the CT-DT genotyping assay.

Results Samples from 433 patients (256 female and 177 male) with confirmed C trachomatis infection were analysed. In 11 patients (2.6%), concurrent serovars in one anatomical sample site were present. In 62 (34.1%) female and four (9.3%) male patients, multiple sample site infections were found. A substantial percentage of women tested at the cervical/vaginal and rectal site were found to be positive at both sites (36.1%, 22/61). In men, D/Da and G/Ga serovars were more prevalent in rectal than urogenital specimens (p=0.0081 and p=0.0033, respectively), while serovar E was more prevalent in urogenital specimens (p=0.0012).

Conclusions The prevalence of multiple serovar infections is relatively low. Significant differences in serovar distribution are found in rectal specimens from men, with serovar G/Ga being the most prominent, suggesting tissue tropism.

  • Chlamydia trachomatis
  • Serovar
  • prevalence
  • sampling site
  • tissue tropism

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  • CJB and KDQ contributed equally to this work.

  • Funding The aims of this work are in part in line with the European EpiGenChlamydia Consortium which is supported by the European Commission within the Sixth Framework Program through contract No LSHG-CT-2007-037637. See for more details about this consortium.

  • Competing interests None.

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

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