Skip to main content
SpringerLink
Log in

Chlamydia trachomatis Infection

  • Chapter
  • First Online:
Sexually Transmitted Infections in HIV-Infected Adults and Special Populations

Abstract

Chlamydia trachomatis (‘chlamydia’) is the most commonly diagnosed bacterial sexually transmitted infection (STI) worldwide and an important cause of reproductive complications in women and epididymitis in men. Different serovars (types) of chlamydia are associated with different types of infections: A–C cause ocular infections (‘trachoma’), D–K anogenital infections, and the serovars L1–L3 cause lymphogranuloma venereum (LGV). Chlamydia infection is common among HIV-infected individuals, but there is little evidence that the infection differs between HIV-infected and noninfected individuals. However, there is some evidence that chlamydia infection increases the risk of HIV transmission and acquisition. Chlamydia is most common in young heterosexual adults aged ≤26 years and among men who have sex with men (MSM) with high rates observed among HIV-infected MSM. Most infections are asymptomatic, although rectal infection with LGV is more likely to be symptomatic and clinically severe. Annual screening for young sexually active women is widely recommended and annual or more frequent screening is recommended for MSM, HIV-infected men and women, incarcerated men and women, sex workers, and those considered at high risk based on the sexual history. Chlamydia is easily diagnosed using provider as well as self-collected specimens from a variety of anatomic sites. For infection with non-LGV-associated serovars, azithromycin 1 g as a single dose or doxycycline 100 mg twice daily for 7 days are the recommended treatments. There is no evidence that treatment efficacy differs by HIV status.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Schachter J, Stephens RS. Biology of Chlamydia trachomatis. In: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, et al., editors. Sexually transmitted diseases. 4th ed. New York: McGraw-Hill; 2008. p. 555–74.

    Google Scholar 

  2. Adbelrahman YM, Belland RJ. The chlamydial developmental cycle. FEMS Microbiol Rev. 2005;29:949–59.

    Article  CAS  Google Scholar 

  3. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Inf. 1999;75(1):3–17.

    Article  CAS  Google Scholar 

  4. Johnson LF, Lewis DA. The Effect of Genital Tract Infections on HIV-1 Shedding in the Genital Tract: a systematic review and meta-analysis. Sex Transm Dis. 2008;35(11):946–59.

    Article  PubMed  Google Scholar 

  5. Taylor MM, Newman DR, Gonzalez J, Skinner J, Khurana R, Mickey T. HIV status and viral loads among men testing positive for rectal gonorrhoea and chlamydia, Maricopa County, Arizona, USA, 2011-2013. HIV Med. 2015;16(4):249–54.

    Article  CAS  PubMed  Google Scholar 

  6. Cohen MS, Hoffman IF, Royce RA, Kazembe P, Dyer JR, Daly CC, Zimba D, Vernazza PL, Maida M, Fiscus SA, et al. Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi research group. Lancet. 1997;349(9069):1868–73.

    Article  CAS  PubMed  Google Scholar 

  7. McClelland RS, Wang CC, Mandaliya K, Overbaugh J, Reiner MT, Panteleeff DD, Lavreys L, Ndinya-Achola J, Bwayo JJ, Kreiss JK. Treatment of cervicitis is associated with decreased cervical shedding of HIV-1. AIDS. 2001;15(1):105–10.

    Article  CAS  PubMed  Google Scholar 

  8. Grosskurth H, Mosha F, Todd J, Mwijarubi E, Klokke A, Senkoro K, Mayaud P, Changalucha J, Nicoll A, ka-Gina G. Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial. Lancet. 1995;346(8974):530–6.

    Article  CAS  PubMed  Google Scholar 

  9. Wawer MJ, Sewankambo NK, Serwadda D, Quinn TC, Paxton LA, Kiwanuka N, et al. Control of sexually transmitted diseases for AIDS prevention in Uganda: a randomised community trial. Rakai project study group. Lancet. 1999;353(9152):525–35.

    Article  CAS  PubMed  Google Scholar 

  10. van de Wijgert JHHM, Morrison CS, Brown J, Kwok C, Van Der Pol B, Chipato T, et al. Disentangling contributions of reproductive tract infections to HIV acquisition in African Women. Sex Transm Dis. 2009;36(6):357–64.

    Article  PubMed  Google Scholar 

  11. Adachi K, Klausner JD, Bristow CC, Xu J, Ank B, Morgado MG, et al. Chlamydia and Gonorrhea in HIV-infected pregnant women and infant HIV transmission. Sex Transm Dis. 2015;42(10):554–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Bernstein KT, Marcus JL, Nieri G, Philip SS, Klausner JD. Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion. JAIDS. 2010;53(4):537–43.

    PubMed  Google Scholar 

  13. Jin F, Prestage GP, Imrie J, Kippax SC, Donovan B, Templeton DJ, et al. Anal sexually transmitted infections and risk of HIV infection in homosexual men. JAIDS. 2010;53(1):144–9.

    PubMed  Google Scholar 

  14. Pathela P, Braunstein SL, Blank S, Schillinger JA. HIV incidence among men with and those without sexually transmitted rectal infections: estimates from matching against an HIV case registry. Clin Inf Dis. 2013;57(8):1203–9.

    Article  Google Scholar 

  15. Kimani J, Maclean IW, Bwayo JJ, MacDonald K, Oyugi J, Maitha GM, et al. Risk factors for Chlamydia trachomatis pelvic inflammatory disease among sex workers in Nairobi, Kenya. J Infect Dis. 1996;173(6):1437–44.

    Article  CAS  PubMed  Google Scholar 

  16. Brunham RC, Kimani J, Bwayo J, Maitha G, Maclean I, Yang C, et al. The epidemiology of Chlamydia trachomatis within a sexually transmitted diseases core group. J Infect Dis. 1996;173(4):950–6.

    Article  CAS  PubMed  Google Scholar 

  17. Newman L, Rowley J, Hoorn SV, Wijesoorita N, Unemo M, Low N, et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS One. 2015;10(12):e0143304.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Owusu-Edusei K Jr, Chesson HW, Gift TL, Tao G, Mahajan R, Ocfemia MCB, et al. The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sex Transm Dis. 2013;40(3):197–201.

    Article  PubMed  Google Scholar 

  19. Redmond SM, Alexander-Kisslig K, Woodhall SC, van den Broek IVF, van Bergen J, Ward H, et al. Genital chlamydia prevalence in Europe and non-European high income countries: systematic review and meta-analysis. Plos One. 2015;10(1):e0115753.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. Mimiaga MJ, Helms DJ, Reisner SL, Grasso C, Bertrand T, Mosure DJ, et al. Gonococcal, chlamydia, and syphilis infection positivity among MSM attending a large primary care clinic, Boston, 2003 to 2004. Sex Transm Dis. 2009;36(8):507–11.

    Article  PubMed  Google Scholar 

  21. Baker J, Plankey M, Josayma Y, Elion R, Chiliade P, Shahkolahi A, et al. The prevalence of rectal, urethral, and pharyngeal Neisseria gonorrheae and Chlamydia trachomatis among asymptomatic men who have sex with men in a prospective cohort in Washington, D.C. AIDS Patient Care STDs. 2009;23(8):585–8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Guy RJ, Wand H, Franklin N, Fairley CK, Chen MY, O’Connor CC, et al. Chlamydia trends in men who have sex with men attending sexual health services in Australia, 2004-–2008. Sex Transm Dis. 2011;38(4):339–46.

    PubMed  Google Scholar 

  23. van Liere GAFS, Hoebe CJPA, Dukers-Muijrers NHTM. Evaluation of the anatomical site distribution of chlamydia and gonorrhoea in men who have sex with men and in high-risk women by routine testing: cross-sectional study revealing missed opportunities for treatment strategies. Sex Transm Inf. 2014;90(1):58–60.

    Article  Google Scholar 

  24. Lewis D, Newton D, Guy R, Ali H, Chen MY, Fairley CK, Hocking JS. The prevalence of Chlamydia trachomatis infection in Australia: a systematic review and meta-analysis. BMC Infect Dis. 2012;12. doi:10.1186/1471-2334-1112-1113.

  25. Crichton J, Hickman M, Campbell R, Batista-Ferrer H, Macleod J. Socioeconomic factors and other sources of variation in the prevalence of genital chlamydia infections: a systematic review and meta-analysis. BMC Public Health. 2015;15(729):015-2069.

    Google Scholar 

  26. Datta SD, Torrone E, Kruszon-Moran D, Berman S, Johnson R, Satterwhite CL, et al. Chlamydia trachomatis trends in the United States among persons 14 to 39 years of age, 1999–2008. Sex Transm Dis. 2012;39(2):92–6.

    Article  PubMed  Google Scholar 

  27. Op de Coul EL, Gotz HM, van Bergen JE, Fennema JS, Hoebe CJ, Koekenbier RH, et al. Who participates in the Dutch Chlamydia screening? A study on demographic and behavioral correlates of participation and positivity. Sex Transm Dis. 2012;39(2):97–103.

    Google Scholar 

  28. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2014. Atlanta: U.S. Department of Health and Human Services; 2015.

    Google Scholar 

  29. Dukers-Muijrers NHTM, Schachter J, van Liere GAFS, Wolffs PFG, Hoebe CJPA. What is needed to guide testing for anorectal and pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae in women and men? Evidence and opinion. BMC Infect Dis. 2015;15:533.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Chan PA, Robinette A, Montgomery M, Almonte A, Cu-Uvin S, Lonks JR, et al. Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature. Infect Dis Obstet Gynecol. 2016;2016:5758387.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Liu AY, Cohen SE, Vittinghoff E, Anderson PL, Doblecki-Lewis S, Bacon O, et al. Preexposure prophylaxis for HIV infection integrated with municipal- and community-based sexual health services. JAMA Intern Med. 2016;176(1):75–84.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Volk JE, Marcus JL, Phengrasamy T, Blechinger D, Nguyen DP, Follansbee S, et al. No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clin Inf Dis. 2015;61(10):1601–3.

    Article  Google Scholar 

  33. Zablotska I. STI rates among gay men taking daily antiretrovirals for pre-exposure prophylaxis of HIV: the NSW demonstration project prelude. In: World STI and AIDS congress. Brisbane: ISSTDR; 2015.

    Google Scholar 

  34. Kojima N, Davey DJ, Klausner JD. Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men. AIDS. 2016;30(14):2251–2.

    Article  PubMed  Google Scholar 

  35. Foschi C, Marangoni A, D’Antuono A, Nardini P, Compri M, Bellavista S, et al. Prevalence and predictors of Lymphogranuloma venereum in a high risk population attending a STD outpatients clinic in Italy. BMC Res Notes. 2014;7:225.

    Google Scholar 

  36. Hughes G, Alexander S, Simms I, Conti S, Ward H, Powers C, et al. Lymphogranuloma venereum diagnoses among men who have sex with men in the U.K.: interpreting a cross-sectional study using an epidemic phase-specific framework. Sex Transm Inf. 2013;89(7):542–7.

    Google Scholar 

  37. Gotz HM, van Doornum G, Niesters HG, den Hollander JG, Thio HB, de Zwart O. A cluster of acute hepatitis C virus infection among men who have sex with men–results from contact tracing and public health implications. AIDS. 2005;19(9):969–74.

    Article  PubMed  Google Scholar 

  38. Macdonald N, Sullivan AK, French P, White JA, Dean G, Smith A, et al. Risk factors for rectal lymphogranuloma venereum in gay men: results of a multicentre case-control study in the U.K. Sex Transm Inf. 2014;90(4):262–8.

    Google Scholar 

  39. Bissessor M, Fairley CK, Read T, Denham I, Bradshaw C, Chen M. The etiology of infectious proctitis in men who have sex with men differs according to HIV status. Sex Transm Dis. 2013;40(10):768–70.

    Article  PubMed  Google Scholar 

  40. Haar K, Dudareva-Vizule S, Wisplinghoff H, Wisplinghoff F, Sailer A, Jansen K, et al. Lymphogranuloma venereum in men screened for pharyngeal and rectal infection, Germany. Emerg Infect Dis. 2013;19(3):488–92.

    Google Scholar 

  41. Rodriguez-Dominguez M, Puerta T, Menendez B, Gonzalez-Alba JM, Rodriguez C, Hellin T, et al. Clinical and epidemiological characterization of a lymphogranuloma venereum outbreak in Madrid, Spain: co-circulation of two variants. Clin Micro Inf. 2014;20(3):219–25.

    Google Scholar 

  42. Golden MR, Schillinger J, Markowitz L, Louis MES. Duration of untreated genital infections with Chlamydia trachomatis. a review of the literature. Sex Transm Dis. 2000;27(6):329–37.

    Article  CAS  PubMed  Google Scholar 

  43. Molano M, Meijer CJLM, Weiderpass E, Arslan A, Posso H, Franceschi S, et al. The natural course of Chlamydia trachomatis infection in asymptomatic Colombian women: a 5-year follow-up study. JID. 2005;191:907–16.

    Google Scholar 

  44. Fairley C, Walker J, Gurrin L, Hocking J. Doctor, how long has my chlamydia been there? Answer: years. Sex Transm Dis. 2007;34(9):727–8.

    Article  PubMed  Google Scholar 

  45. Althaus CL, Heijne JCM, Roellin A, Low N. Transmission dynamics of Chlamydia trachomatis affect the impact of screening programmes. Epidemics. 2010;2(3):123–31.

    Article  PubMed  Google Scholar 

  46. Valkengoed IGMv, Morre SA, Brule AJCvd, Meijer CJLM, Bouter LM, Boeke AJP. Overestimation of complication rates in evaluations of Chlamydia trachomatis screening programmes—implications for cost-effectiveness analyses. Int J Epidemiol. 2004;33:416–25.

    Google Scholar 

  47. Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F, Ness RB. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis. 2010;201(Suppl 2):S134–55.

    Article  PubMed  Google Scholar 

  48. Wallace LA, Scoular A, Hart G, Reid M, Wilson P, Goldberg DJ. What is the excess risk of infertility in women after genital chlamydia infection? A systematic review of the evidence. Sex Transm Inf. 2008;84(3):171–5.

    Article  CAS  Google Scholar 

  49. Land JA, Van Bergen JE, Morre SA, Postma MJ. Epidemiology of Chlamydia trachomatis infection in women and the cost-effectiveness of screening. Hum Reprod Update. 2010;16(2):189–204.

    Article  CAS  PubMed  Google Scholar 

  50. Risser W, Risser J. The incidence of pelvic inflammatory disease in untreated women infected with Chlamydia trachomatis: a structured review. Int J STD AIDS. 2007;18:727–31.

    Article  CAS  PubMed  Google Scholar 

  51. Price MJ, Ades AE, De Angelis D, Welton NJ, Macleod J, Soldan K, et al. Risk of pelvic inflammatory disease following Chlamydia trachomatis infection: analysis of prospective studies with a multistate model. Am J Epidemiol. 2013;178(3):484–92.

    Google Scholar 

  52. Kavanagh K, Wallace LA, Robertson C, Wilson P, Scoular A. Estimation of the risk of tubal factor infertility associated with genital chlamydial infection in women: a statistical modelling study. Int J Epidemiol. 2013;42(2):493–503.

    Article  PubMed  Google Scholar 

  53. Price MJ, Ades AE, Soldan K, Welton NJ, Macleod J, Simms I, et al. The natural history of Chlamydia trachomatis infection in women: a multi-parameter evidence synthesis. Health Tech Assess. 2016;20(22):1–250.

    Google Scholar 

  54. Davies B, Turner KM, Frolund M, Ward H, May MT, Rasmussen S, et al. Risk of reproductive complications following chlamydia testing: a population-based retrospective cohort study in Denmark. Lancet Infect Dis. 2016;8(16):30092–5.

    Google Scholar 

  55. Davies B, Ward H, Leung S, Turner KME, Garnett GP, Blanchard JF, et al. Heterogeneity in risk of pelvic inflammatory diseases after chlamydia infection: a population-based study in Manitoba, Canada. J Infect Dis. 2014;210(Suppl 2):S549–55.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Bakken IJ, Skjeldestad FE, Lydersen S, Nordbo SA. Births and ectopic pregnancies in a large cohort of women tested for Chlamydia trachomatis. Sex Transm Dis. 2007;34(10):739–43.

    PubMed  Google Scholar 

  57. Menon S, Timms P, Allan JA, Alexander K, Rombauts L, Horner P, et al. Human and pathogen factors associated with Chlamydia trachomatis-related infertility in women. Clin Micro Rev. 2015;28(4):969–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Rours GIJG, Duijts L, Moll HA, Arends LR, de Groot R, Jaddoe VW, et al. Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study. Eur J Epidemiol. 2011;26(6):493–502.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Rours GIJG, Hammerschlag MR, Van Doornum GJJ, Hop WCJ, de Groot R, Willemse HFM, et al. Chlamydia trachomatis respiratory infection in Dutch infants. Arch Dis Child. 2009;94(9):705–7.

    Article  CAS  PubMed  Google Scholar 

  60. Gimenes F, Souza RP, Bento JC, Teixeira JJ, Maria-Engler SS, Bonini MG, Consolaro ME. Male infertility: a public health issue caused by sexually transmitted pathogens. Nat Rev Urol. 2014;11(12):672–87.

    Article  PubMed  Google Scholar 

  61. Eley A, Pacey AA, Galdiero M, Galdiero F. Can Chlamydia trachomatis directly damage your sperm? Lancet Infect Dis. 2005;5(1):53–7.

    Article  PubMed  Google Scholar 

  62. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR. 2015;64(3):1–135.

    PubMed  Google Scholar 

  63. Mercer CH, Tanton C, Prah P, Erens B, Sonnenberg P, Clifton S, et al. Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). Lancet. 2013;382(9907):1781–94.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Bissessor M, Tabrizi SN, Bradshaw CS, Fairley CK, Hocking JS, Garland SM, et al. The contribution of Mycoplasma genitalium to the aetiology of sexually acquired infectious proctitis in men who have sex with men. Clin Microbiol Infect. 2016;22(3):260–5.

    Article  CAS  PubMed  Google Scholar 

  65. Saxon C, Hughes G, Ison C. Group ULC-F: asymptomatic lymphogranuloma venereum in men who have sex with men, United Kingdom. Emerg Infect Dis. 2016;22(1):112–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Pallawela SNS, Sullivan AK, Macdonald N, French P, White J, Dean G, et al. Clinical predictors of rectal lymphogranuloma venereum infection: results from a multicentre case-control study in the U.K. Sex Transm Inf. 2014;90(4):269–74.

    Article  CAS  Google Scholar 

  67. Van der Bij AK, Spaargaren J, Morre SA, Fennema HSA, Mindel A, Coutinho RA, et al. Diagnostic and clinical implications of anorectal lymphogranuloma venereum in men who have sex with men: a retrospective case-control study. Clin Inf Dis. 2006;42(2):186–94.

    Article  Google Scholar 

  68. Soni S, Srirajaskanthan R, Lucas SB, Alexander S, Wong T, White JA. Lymphogranuloma venereum proctitis masquerading as inflammatory bowel disease in 12 homosexual men. Aliment Pharmacol Ther. 2010;32(1):59–65.

    Article  CAS  PubMed  Google Scholar 

  69. de Vrieze NHN, van Rooijen M, van Schim van der Loeff MF, de Vries HJC. Anorectal and inguinal lymphogranuloma venereum among men who have sex with men in Amsterdam, The Netherlands: trends over time, symptomatology and concurrent infections. Sex Transm Inf. 2013;89(7):548–52.

    Article  Google Scholar 

  70. Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice (“The red book”). 8th ed. Melbourne. In.: Royal Australian College of General Practitioners; 2012.

    Google Scholar 

  71. Public Health Agency of Canada: Canadian Guidelines on Sexually Transmitted Infections. 2010.

    Google Scholar 

  72. Centers for Disease Control and Prevention: Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010, 59(RR-12).

    Google Scholar 

  73. Public Health England: National chlamydia screening programme standards. Edited by PHE. London: Public Health England; 2014.

    Google Scholar 

  74. van den Broek IV, Sfetcu O, van der Sande MA, Andersen B, Herrmann B, Ward H, et al. Changes in chlamydia control activities in Europe between 2007 and 2012: a cross-national survey. Eur J Public Health. 2016;26(3):382–8.

    Article  PubMed  Google Scholar 

  75. Australian STI Management Guidelines for use in Primary Care. http://www.sti.guidelines.org.au/.

  76. Aggarwal A, Spitzer RF, Caccia N, Stephens D, Johnstone J, Allen L. Repeat screening for sexually transmitted infection in adolescent obstetric patients. JOGC. 2010;32(10):956–61.

    PubMed  Google Scholar 

  77. Bissessor M, Fairley CK, Leslie D, Howley K, Chen MY. Frequent screening for syphilis as part of HIV monitoring increases the detection of early asymptomatic syphilis among HIV-positive homosexual men. JAIDS. 2010;55(2):211–6.

    PubMed  Google Scholar 

  78. Teague R, Mijch A, Fairley CK, Sidat M, Watson K, Boyd K, Chen MY. Testing rates for sexually transmitted infections among HIV-infected men who have sex with men attending two different HIV services. Int J STD AIDS. 2008;19(3):200–2.

    Article  PubMed  Google Scholar 

  79. Zou H, Fairley CK, Guy R, Chen MY. The efficacy of clinic-based interventions aimed at increasing screening for bacterial sexually transmitted infections among men who have sex with men: a systematic review. Sex Transm Dis. 2012;39(5):382–7.

    Article  PubMed  Google Scholar 

  80. Bissessor M, Fairley CK, Leslie D, Chen MY. Use of a computer alert increases detection of early, asymptomatic syphilis among higher-risk men who have sex with men. Clin Inf Dis. 2011;53(1):57–8.

    Article  Google Scholar 

  81. Renault CA, Israelski DM, Levy V, Fujikawa BK, Kellogg TA, Klausner JD. Time to clearance of Chlamydia trachomatis ribosomal RNA in women treated for chlamydial infection. Sex Health. 2011;8(1):69–73.

    Article  PubMed  Google Scholar 

  82. Centers for Disease C, Prevention. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae–2014. MMWR. 2014;63(RR-02):1–19.

    Google Scholar 

  83. Hosenfeld CB, Workowski KA, Berman S, Zaidi A, Dyson J, Mosure D, et al. Repeat infection with chlamydia and gonorrhea among females: a systematic review of the literature. Sex Transm Dis. 2009;36(8):478–89.

    Article  PubMed  Google Scholar 

  84. Fung M, Scott KC, Kent CK, Klausner JD. Chlamydial and gonococcal reinfection among men: a systematic review of data to evaluate the need for retesting. Sex Transm Inf. 2007;83(4):304–9.

    Article  Google Scholar 

  85. Khosropour CM, Dombrowski JC, Barbee LA, Manhart LE, Golden MR. Comparing azithromycin and doxycycline for the treatment of rectal Chlamydial Infection: a retrospective cohort study. Sex Transm Dis. 2014;41(2):79–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Steedman NM, McMillan A. Treatment of asymptomatic rectal Chlamydia trachomatis: is single-dose azithromycin effective? Int J STD AIDS. 2009;20(1):16–8.

    Article  CAS  PubMed  Google Scholar 

  87. Drummond F, Ryder N, Wand H, Guy R, Read P, McNulty AM, et al. Is azithromycin adequate treatment for asymptomatic rectal chlamydia? Int J STD AIDS. 2011;22(8):478–80.

    Article  CAS  PubMed  Google Scholar 

  88. Hathorn E, Opie C, Goold P. What is the appropriate treatment for the management of rectal Chlamydia trachomatis in men and women? Sex Transm Inf. 2012;88(5):352–4.

    Article  Google Scholar 

  89. Kong FYS, Tabrizi S, Fairley CK, Phillips S, Fehler G, Law M, et al. Higher organism load associated with failure of azithromycin to treat rectal chlamydia. Epidemiol Infect. 2016;. doi:10.1017/S0950268816000996.

    Google Scholar 

  90. Watson EJ, Templeton A, Russell I, Paavonen J, Mardh P-A, Stary A, Pederson BS. The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review. J Med Microbiol. 2002;51:1021–31.

    Article  PubMed  Google Scholar 

  91. Hocking JS, Guy R, Walker J, Tabrizi SN. Advances in sampling and screening for chlamydia. Future Microbiol. 2013;8:367–86.

    Article  CAS  PubMed  Google Scholar 

  92. Lanjouw E, Ouburg S, de Vries HJ, Stary A, Radcliffe K, Unemo M. 2015 European guideline for the management of Chlamydia trachomatis infections. Int J STD AIDS. 2015;27(5):333–48.

    Article  PubMed  Google Scholar 

  93. Knox J, Tabrizi SN, Miller P, Petoumenos K, Law M, Chen S, et al. Evaluation of self-collected samples in contrast to practitioner-collected samples for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis by polymerase chain reaction among women living in remote areas. Sex Transm Dis. 2002;29(11):647–54.

    Article  PubMed  Google Scholar 

  94. Masek BJ, Arora N, Quinn N, Aumakhan B, Holden J, Hardick A, et al. Performance of three nucleic acid amplification tests for detection of Chlamydia trachomatis and Neisseria gonorrhoeae by use of self-collected vaginal swabs obtained via an Internet-based screening program. J Clin Micro. 2009;47(6):1663–7.

    Article  CAS  Google Scholar 

  95. Doshi JS, Power J, Allen E. Acceptability of chlamydia screening using self-taken vaginal swabs. Int J STD AIDS. 2008;19(8):507–9.

    Article  CAS  PubMed  Google Scholar 

  96. van der Helm JJ, Hoebe CJPA, van Rooijen MS, Brouwers EEHG, Fennema HSA, Thiesbrummel HFJ, et al. High performance and acceptability of self-collected rectal swabs for diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in men who have sex with men and women. Sex Transm Dis. 2009;36(8):493–7.

    Article  PubMed  Google Scholar 

  97. Bachmann LH, Johnson RE, Cheng H, Markowitz LE, Papp JR, Hook EW 3rd. Nucleic acid amplification tests for diagnosis of Neisseria gonorrhoeae oropharyngeal infections. J Clin Micro. 2009;47(4):902–7.

    Article  CAS  Google Scholar 

  98. Bachmann LH, Johnson RE, Cheng H, Markowitz L, Papp JR, et al. Nucleic acid amplification tests for diagnosis of Neisseria gonorrheae and Chlamydia trachomatis rectal infections. J Clin Micro. 2010;48(5):1827–32.

    Article  Google Scholar 

  99. Schachter J. Point-of-care tests using enzyme detection to diagnose Chlamydia trachomatis infection do not work. But when they fail in clinical trials, they reappear under different names. Sex Transm Inf. 2016;92(6):406–7.

    Article  Google Scholar 

  100. Brook G. The performance of non-NAAT point-of-care (POC) tests and rapid NAAT tests for chlamydia and gonorrhoea infections. An assessment of currently available assays. Sex Transm Inf. 2015;91(8):539–44.

    Article  Google Scholar 

  101. Tabrizi SN, Unemo M, Golparian D, Twin J, Limnios AE, Lahra M, et al. Analytical evaluation of the GeneXpert(R) CT/NG, the first genetic point of care assay for simultaneous detection of Neisseria gonorrhoeae and Chlamydia trachomatis. J ClinMicrobiol. 2013;51(6):1945–7.

    Google Scholar 

  102. Golden MR, Whittington WL, Handsfield HH, Hughes JP, Stamm WE, Hogben M, et al. Effect of expedited treatment of sex partners on recurrent or persistent gonorrhoea or chlamydial infection. N Engl J Med. 2005;352:676–85.

    Article  CAS  PubMed  Google Scholar 

  103. Manhart LE, Gillespie CW, Lowens MS, Khosropour CM, Colombara DV, Golden MR, et al. Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial. Clin Inf Dis. 2013;56(7):934–42.

    Article  CAS  Google Scholar 

  104. Groups AE. Therapeutic guidelines: Antibiotic. Version 15. Melbourne: Therapeutic Guidelines Limited; 2014.

    Google Scholar 

  105. Australian STI management guidelines for use in primary care. http://www.sti.guidelines.org.au/sexually-transmissible-infections/chlamydia#management.

  106. Kong FYS, Tabrizi SN, Law M, Vodstrcil LA, Chen M, Fairley CK, et al. Azithromycin versus doxycycline for the treatment of genital chlamydia infection: a meta-analysis of randomized controlled trials. Clin Inf Dis. 2014;59(2):193–205.

    Article  CAS  Google Scholar 

  107. Geisler WM, Uniyal A, Lee JY, Lensing SY, Johnson S, Perry RCW, et al. Azithromycin versus doxycycline for urogenital Chlamydia trachomatis infection. New Engl J Med. 2015;373(26):2512–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. Hocking JS, Kong F, Timms P, Huston W, Tabrizi S. Treatment for rectal chlamydia infection may be more complicated than we originally thought. J Antimicrob Chemother. 2015;70(4):961–4.

    CAS  PubMed  Google Scholar 

  109. Kong FY, Hocking JS. Treatment challenges for urogenital and anorectal Chlamydia trachomatis. BMC Infect Dis. 2015;15(1):293.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  110. Kong FY, Tabrizi S, Fairley C, Vodstrcil L, Huston W, Chen M, et al. The efficacy of azithromycin and doxycycline for the treatment of rectal chlamydia infection: a systematic review and meta-analysis. J Antimicrob Chemother. 2015;70(5):1290–7.

    Article  CAS  PubMed  Google Scholar 

  111. Pitsouni E, Iavazzo C, Athanasiou S, Falagas ME. Single-dose azithromycin versus erythromycin or amoxicillin for Chlamydia trachomatis infection during pregnancy: a meta-analysis of randomised controlled trials. Int J Antimicrob Agents. 2007;30(3):213–21.

    Article  CAS  PubMed  Google Scholar 

  112. de Vries HJC, Zingoni A, Kreuter A, Moi H, White JA, et al. 2013 European guideline on the management of lymphogranuloma venereum. JEADV. 2015;29(1):1–6.

    PubMed  Google Scholar 

  113. White J, O’Farrell N, Daniels D. BASSH: 2013 UK National Guideline for the management of lymphogranuloma venereum: Clinical Effectiveness Group of the British Association for Sexual Health and HIV (CEG/BASHH) Guideline development group. Int J STD AIDS. 2013;24(8):593–601.

    Article  PubMed  Google Scholar 

  114. de Vries HJC, Smelov V, Middelburg JG, Pleijster J, Speksnijder AG, Morre SA. Delayed microbial cure of lymphogranuloma venereum proctitis with doxycycline treatment. CLin Inf Dis. 2009;48(5):e53–6.

    Article  CAS  Google Scholar 

  115. Waalboer R, van der Snoek EM, van der Meijden WI, Mulder PGH, Ossewaarde JM. Analysis of rectal Chlamydia trachomatis serovar distribution including L2 (lymphogranuloma venereum) at the Erasmus MC STI clinic. Rotterdam. Sex Transm Inf. 2006;82(3):207–11.

    Article  CAS  Google Scholar 

  116. Hill SC, Hodson L, Smith A. An audit on the management of lymphogranuloma venereum in a sexual health clinic in London. UK. Int J STD AIDS. 2010;21(11):772–6.

    Article  CAS  PubMed  Google Scholar 

  117. Foschi C, Filippini A, D’Antuono A, Compri M, Macca F, Banzola N, et al. Lymphogranuloma venereum in an Italian MSM: concurrent pharyngeal and rectal infection. New Microbiol. 2014;37(3):399–402.

    PubMed  Google Scholar 

  118. Cunningham SE, Johnson MD, Laczek JT. Lymphogranuloma venereum proctitis. Gastrointest Endosc. 2012;75(6):1269–70.

    Article  PubMed  Google Scholar 

  119. Mechai F, de Barbeyrac B, Aoun O, Merens A, Imbert P, Rapp C. Doxycycline failure in lymphogranuloma venereum. Sex Transm Inf. 2010;86(4):278–9.

    Article  Google Scholar 

  120. Castro R, Baptista T, Vale A, Nunes H, Prieto E, Araujo C, et al. Lymphogranuloma venereum serovar L2b in Portugal. Int J STD AIDS. 2010;21(4):265–6.

    Article  CAS  PubMed  Google Scholar 

  121. Vall-Mayans M, Isaksson J, Caballero E, Salles B, Herrmann B. Bubonic lymphogranuloma venereum with multidrug treatment failure. Int J STD AIDS. 2014;25(4):306–8.

    Article  PubMed  Google Scholar 

  122. Oud EV, de Vrieze NHN, de Meij A, de Vries HJC. Pitfalls in the diagnosis and management of inguinal lymphogranuloma venereum: important lessons from a case series. Sex Transm Inf. 2014;90(4):279–82.

    Article  Google Scholar 

  123. World Health Organization. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Geneva: WHO; 2012.

    Google Scholar 

  124. Wang SA, Papp JR, Stamm WE, Peeling RW, Martin DH, Holmes KK. Evaluation of antimicrobial resistance and treatment failures for Chlamydia trachomatis: A meeting report. J Infect Dis. 2005;191(6):917–23.

    Article  PubMed  Google Scholar 

  125. Sandoz KM, Rockey DD. Antibiotic resistance in Chlamydiae. Future Microbiol. 2010;5(9):1427–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  126. Horner P. The case for further treatment studies of uncomplicated genital Chlamydia trachomatis infection. Sex Transm Inf. 2006;82:340–3.

    Article  CAS  Google Scholar 

  127. Horner P, Saunders J. Should azithromycin 1 g be abandoned as a treatment for bacterial STIs? The case for and against. Sex Transm Inf. 2016;14(052414):2015-052414.

    Google Scholar 

  128. Horner PJ. Azithromycin antimicrobial resistance and genital Chlamydia trachomatis infection: duration of therapy may be the key to improving efficacy. Sex Transm Inf. 2012;88(3):154–6.

    Article  Google Scholar 

  129. Public Health Agency of Canada. Canadian sexually transmitted infections surveillance report. Can Commun Dis Rep. 2007;33(S1):1–69.

    Google Scholar 

  130. Public Health Agency of Canada. Report on sexually transmitted infections in Canada: 2012. Edited by Centre for Communicable Diseases and Infection Control IDPaCB: Public Health Agency of Canada; 2015.

    Google Scholar 

  131. Chlamydia infection—statistics. https://www.folkhalsomyndigheten.se/folkhalsorapportering-statistik/statistikdatabaser-och-visualisering/sjukdomsstatistik/klamydiainfektion/.

  132. Number of notifications of Chlamydial infections, Australia, 2012 by age group and sex. http://www1.health.gov.au/cda/Source/Rpt_5.cfm.

Download references

Acknowledgements

We thank Charussri Leeyaphan for providing references and Tim Read for a case report.

Author information

Authors and Affiliations

  1. Melbourne School of Population and Global Health, University of Melbourne, 3/207 Bouverie St, Carlton, VIC, 3053, Australia

    Jane S. Hocking

  2. School of Life Sciences, University of Technology Sydney, Building 4, City Campus, Thomas St, Broadway, Ultimo, NSW, 2007, Australia

    Wilhelmina M. Huston

  3. Alfred Health and Central Clinical School, Melbourne Sexual Health Centre, Monash University, 580 Swanston St, Carlton, VIC, 3053, Australia

    Marcus Chen

Authors
  1. Jane S. Hocking
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wilhelmina M. Huston
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcus Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jane S. Hocking .

Editor information

Editors and Affiliations

  1. Division of Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA

    Laura Hinkle Bachmann

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Hocking, J.S., Huston, W.M., Chen, M. (2017). Chlamydia trachomatis Infection. In: Bachmann, L. (eds) Sexually Transmitted Infections in HIV-Infected Adults and Special Populations. Springer, Cham. https://doi.org/10.1007/978-3-319-56694-8_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56694-8_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56692-4

  • Online ISBN: 978-3-319-56694-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation