PMID- 28934342
OWN - NLM
STAT- MEDLINE
DCOM- 20171018
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 9
DP  - 2017
TI  - Monitoring therapy success of urogenital Chlamydia trachomatis infections in
      women: A prospective observational cohort study.
PG  - e0185295
LID - 10.1371/journal.pone.0185295 [doi]
AB  - INTRODUCTION: The use of a nucleic acid amplification test (NAAT) as a test of
      cure after treatment is subject to discussion, as the presence of C. trachomatis 
      nucleic acids after treatment may be prolonged and intermittent without presence 
      of infectious bacteria. We used cell culture to assess if a positive RNA- or
      DNA-based NAAT after treatment indicates the presence of viable C. trachomatis.
      METHODS: We included women with asymptomatic urogenital C. trachomatis infection 
      visiting the Amsterdam STI clinic from September 2015 through June 2016.
      Endocervical swabs were collected prior to treatment with azithromycin, and
      during three follow-up visits 7, 21 and 49 days after treatment. Collected swabs 
      were subjected to C. trachomatis culture and a RNA- and DNA-based NAAT.
      High-resolution multilocus sequence typing (hr-MLST) was used to further
      differentiate potential re-infections. RESULTS: We included 90 women with a
      positive RNA-test prior to receiving treatment of whom 81 (90%) were also
      DNA-positive, and 69 (76.7%) culture-positive. Prolonged and intermittent
      positive RNA and DNA results over time were observed. Three women had culture
      positive results at the second visit, but all were negative at the third visit.
      Five women had NAAT-positive results at the fourth visit of whom three women were
      also culture-positive indicating a viable infection. All five women reported
      unprotected sexual contact since the first visit. From 2, hr-MLST sequence types 
      were obtained. One had a different sequence type indicating a new infection the
      other was identical to the previously found indicating a potentially persisting
      infection. CONCLUSION: Most RNA- or DNA-positive results after treatment of
      urogenital C. trachomatis may be caused by non-viable molecular remnants since
      they cannot be confirmed by culture. In a minority viable C. trachomatis was
      found in culture at the second visit, indicating that patients may remain
      infectious at least 7 days after treatment.
FAU - Versteeg, Bart
AU  - Versteeg B
AUID- ORCID: http://orcid.org/0000-0003-2606-8057
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
FAU - Bruisten, Sylvia M
AU  - Bruisten SM
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
AD  - Amsterdam Infection and Immunity Institute, Academic Medical Center, University
      of Amsterdam, Amsterdam, the Netherlands.
FAU - Heijman, Titia
AU  - Heijman T
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
FAU - Vermeulen, Wilma
AU  - Vermeulen W
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
FAU - van Rooijen, Martijn S
AU  - van Rooijen MS
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
FAU - van Dam, Alje P
AU  - van Dam AP
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
AD  - Department of Medical Microbiology, OLVG General Hospital, Amsterdam, the
      Netherlands.
FAU - Schim van der Loeff, Maarten F
AU  - Schim van der Loeff MF
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
AD  - Amsterdam Infection and Immunity Institute, Academic Medical Center, University
      of Amsterdam, Amsterdam, the Netherlands.
FAU - de Vries, Henry J C
AU  - de Vries HJC
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
AD  - Amsterdam Infection and Immunity Institute, Academic Medical Center, University
      of Amsterdam, Amsterdam, the Netherlands.
AD  - Department of Dermatology, Academic Medical Center, University of Amsterdam,
      Amsterdam, the Netherlands.
FAU - Scholing, Maarten
AU  - Scholing M
AD  - Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam,
      the Netherlands.
AD  - Department of Medical Microbiology, OLVG General Hospital, Amsterdam, the
      Netherlands.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170921
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (DNA, Bacterial)
RN  - 0 (RNA, Bacterial)
SB  - IM
MH  - Chlamydia Infections/*therapy
MH  - Chlamydia trachomatis/genetics/*physiology
MH  - DNA, Bacterial/metabolism
MH  - Female
MH  - Humans
MH  - Microbial Viability
MH  - Prospective Studies
MH  - RNA, Bacterial/metabolism
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5608402
EDAT- 2017/09/22 06:00
MHDA- 2017/10/19 06:00
CRDT- 2017/09/22 06:00
PHST- 2017/06/08 00:00 [received]
PHST- 2017/09/08 00:00 [accepted]
PHST- 2017/09/22 06:00 [entrez]
PHST- 2017/09/22 06:00 [pubmed]
PHST- 2017/10/19 06:00 [medline]
AID - 10.1371/journal.pone.0185295 [doi]
AID - PONE-D-17-22019 [pii]
PST - epublish
SO  - PLoS One. 2017 Sep 21;12(9):e0185295. doi: 10.1371/journal.pone.0185295.
      eCollection 2017.