Epidemiological and microbiologic correlates of chlamydia trachomatis infection in sexual partnerships.
Around the world, an estimated 50 million new cases of Chlamydia trachomatis infection occur each year. Chlamydia infections are associated with a spectrum of clinical diseases, including pelvic inflammatory disease, which can lead to infertility and ectopic pregnancy. Previous studies, using culture to detect C trachomatis infection, have suggested that male-to-female transmission is more efficient than female-to-male transmission. However, it may be the case that lower infection rates in males may reflect the possibility that Chlamydia cultures are less sensitive in males than in females.
The primary objective of the Quinn et al. study was to determine the frequency of C trachomatis infection within sexual partnerships by using highly sensitive polymerase chain reaction (PCR) amplification to detect infection. The study sample consisted of 494 sexual partnerships who attended STD clinics in Baltimore, Maryland. Study subjects filled out a questionnaire related to partner-specific sexual and contraceptive practices and other relevant factors. Both partners in each relationship were tested, using both culture and PCR, for C trachomatis.
Using culture, the researchers detected C trachomatis in 12.9% of females and 8.5% of males. Eighty-four (17%) of the 494 couples in the study had at least one infected partner. Of these 84 couples, in 27 (32.1%) cases both partners were infected. Using PCR, the researchers detected C trachomatis in 15.8% of females and 14.2% of males. PCR detection indicated that 101 (20.4%) of the 494 couples had at least one infected partner, and in 53 (52.5%) of these couples, both partners were infected.
In the 78 couples that included female partners who tested positive for C trachomatis by PCR, 53 male sexual partners (68%) also tested positive by PCR. In the 76 couples with male partners who tested positive by PCR, 53 female sexual partners (70%) also tested positive by PCR. Thus, there was no significant difference in the probability of transmission either by the sex of the infected individual or by the presence of symptoms (p. 1739-1740).
The Quinn et al. study suggests that compared to culture, PCR may be a more sensitive test for detecting C trachomatis in both males and females, and that contrary to previous studies which used culture, there is no significant difference between the efficiency of female-to-male and male-to-female transmission. Among other things, the authors suggest that these findings highlight "[...] the importance of routine screening, contact tracing, and treatment of all sexual partners of chlamydia-infected individuals" (p. 1742).
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|Author:||T. Quinn, and others|
|Publication:||The Canadian Journal of Human Sexuality|
|Date:||Jan 1, 1996|
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