title: Evidence for long-term cervical persistence of Chlamydia trachomatis by omp1 genotyping.
abstract: Recurrent Chlamydia trachomatis infections are common among sexually active women. Although recurrences with a new chlamydial serovar indicate reinfection, same-serovar recurrences may be due to persistence. Because persistence has important implications for pathogenesis and patient management, we identified 552 women with >3 recurrences over 2 years. Among these, 130 women (24%) had same-serovar recurrences; 58 (45%) were C class serovars (odds ratio, 2.4; 95% confidence interval, 1.7-3.5; P<.0001). Forty-five isolates from 7 women with 3-10 repeated, same-serovar infections over 2-5 years were studied. As determined by omp1 genotyping, 4 women had identical genotypes at each recurrence; 2 women had 1 or 2 amino acid changes following treatment, and one was persistently infected with a unique genotype, Ja. Many intervening culture-negative samples were positive when tested by ligase chain reaction, which suggests persistence. These data demonstrate that cervical infections with C class serovars can persist for years and may have specific biologic properties that allow for modulation of the major outer membrane protein in response to immune selection.
authors.affiliation: Children's Hospital Oakland Research Institute, Oakland, CA 94609, USA. ddean@chori.org
authors.forename: D
authors.initials: D
authors.lastname: Dean
authors.forename: R J
authors.initials: RJ
authors.lastname: Suchland
authors.forename: W E
authors.initials: WE
authors.lastname: Stamm
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017963:Azithromycin / Q000494:pharmacology; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics*; D001483:Base Sequence; D002690:Chlamydia Infections / Q000382:microbiology*; D002692:Chlamydia trachomatis; D004318:Doxycycline / Q000494:pharmacology; D005260:Female; D005838:Genotype; D006801:Humans; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D018272:Porins; D012189:Retrospective Studies; D002575:Uterine Cervicitis / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D001425:Bacterial Outer Membrane Proteins; D018272:Porins; C071677:omp1 protein, Chlamydia trachomatis; D017963:Azithromycin; D004318:Doxycycline