title: Analyses of multiple-site and concurrent Chlamydia trachomatis serovar infections, and serovar tissue tropism for urogenital versus rectal specimens in male and female patients.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Obstetrics and Gynaecology, MC Haaglanden, The Hague, The Netherlands. c.j.bax@amc.uva.nl
authors.forename: C J
authors.initials: CJ
authors.lastname: Bax
authors.forename: K D
authors.initials: KD
authors.lastname: Quint
authors.forename: R P H
authors.initials: RP
authors.lastname: Peters
authors.forename: S
authors.initials: S
authors.lastname: Ouburg
authors.forename: P M
authors.initials: PM
authors.lastname: Oostvogel
authors.forename: J A E M
authors.initials: JA
authors.lastname: Mutsaers
authors.forename: P J
authors.initials: PJ
authors.lastname: Dörr
authors.forename: S
authors.initials: S
authors.lastname: Schmidt
authors.forename: C
authors.initials: C
authors.lastname: Jansen
authors.forename: A P
authors.initials: AP
authors.lastname: van Leeuwen
authors.forename: W G V
authors.initials: WG
authors.lastname: Quint
authors.forename: J B
authors.initials: JB
authors.lastname: Trimbos
authors.forename: C J L M
authors.initials: CJ
authors.lastname: Meijer
authors.forename: S A
authors.initials: SA
authors.lastname: Morré
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002690:Chlamydia Infections / Q000150:complications* / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000145:classification*; D005260:Female; D005784:Gene Amplification; D005838:Genotype; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012002:Rectal Diseases / Q000150:complications* / Q000453:epidemiology; D012703:Serotyping / Q000379:methods; D055815:Young Adult