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J Clin Microbiol. 2019 Nov 6. pii: JCM.01375-19. doi: 10.1128/JCM.01375-19. [Epub ahead of print]

Bacterial load of Chlamydia trachomatis in the posterior oropharynx, tonsillar fossae and saliva among gay and bisexual men with untreated oropharyngeal chlamydia.

Author information

1
Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia TPhillips@mshc.org.au.
2
Central Clinical School, Monash University, Melbourne, VIC, Australia.
3
Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
4
Murdoch Children's Research Institute, Parkville, VIC, Australia.
5
Centre for Women's Infectious Disease Research, The Royal Women's Hospital, Parkville, VIC, Australia.
6
Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
7
Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
8
Department of Obstetrics and Gynaecology, University of Melbourne, Grattan Street, Parkville, VIC, Australia.

Abstract

Background: The aim of this study was to determine whether Chlamydia trachomatis (CT) could be detected in saliva and if infection is specific to an anatomical site in the oropharynx.Methods: Men who have sex with men (MSM) who were diagnosed with oropharyngeal chlamydia at Melbourne Sexual Health Centre in 2017-2018 were invited to participate upon returning for treatment. Swabs at the tonsillar fossae, posterior oropharynx, and a saliva sample were collected. Throat samples were tested for CT by Aptima Combo 2 assay. The bacterial loads of CT in all samples were assessed by qPCR detecting the ompA gene. We calculated the positivity and bacterial load of CT for all samples.Results: Forty-two MSM were included. Median age was 28 (interquartile range [IQR]:24-33). 32 participants (76.2%; 95%CI:60.5% to 87.9%) had CT detected by qPCR at both the tonsillar fossae and the posterior oropharynx, followed by 9.5% (n=4; 95%CI:2.7% to 22.6%) positive at the posterior oropharynx only, and 4.8% (n=2; 95%CI:0.58% to 16.2%) positive at the tonsillar fossae only. Twenty-nine MSM had CT detected in saliva (69.0%; 95%CI:52.9% to 82.3%). The median CT load in saliva was 446 copies/ml (IQR:204-1,390), in the tonsillar fossae was 893 copies/swab (IQR:390-13,224), and in posterior oropharynx was 1,204 copies/swab (IQR:330-16,211). There was no significant difference in CT load between the tonsillar fossae and the posterior oropharynx (p=0.119).Conclusion: Among MSM with oropharyngeal chlamydia nearly three quarters had chlamydia DNA detected in saliva, although the viability and implications for transmission are unknown.

PMID:
31694973
DOI:
10.1128/JCM.01375-19

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