Evaluation of a PGP3 ELISA for surveillance of the burden of Chlamydia infection in women from Australia and Samoa

ABSTRACT Serological assays can be used to investigate the population burden of infection and potentially sequelae from Chlamydia. We investigated the PGP3 ELISA as a sero-epidemiological tool for infection or sub-fertility in Australian and Samoan women. The PGP3 ELISA absorbance levels were compared between groups of women with infertility, fertile, and current chlamydial infections. In the Australian groups, women with chlamydial tubal factor infertility had significantly higher absorbance levels in the PGP3 ELISA compared to fertile women (P < 0.0001), but not when compared to women with current chlamydial infection (P = 0.44). In the Samoan study, where the prevalence of chlamydial infections is much higher there were significant differences in the PGP3 ELISA absorbance levels between chlamydial sub-fertile women and fertile women (P = 0.003). There was no difference between chlamydial sub-fertile women and women with a current infection (P = 0.829). The results support that the PGP3 assay is effective for sero-epidemiological analysis of burden of infection, but not for evaluation of chlamydial pathological sequelae such as infertility.

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MiR-378b Modulates Chlamydia-Induced Upper Genital Tract Pathology

Pathogens ◽

10.3390/pathogens10050566 ◽

2021 ◽

Vol 10 (5) ◽

pp. 566

Author(s):

Stephanie R. Lundy ◽

Kobe Abney ◽

Debra Ellerson ◽

Joseph U. Igietseme ◽

Darin Carroll ◽

...

Keyword(s):

Host Responses ◽

Chlamydia Infection ◽

Chlamydia Trachomatis Infection ◽

Host Immune Responses ◽

Tubal Factor Infertility ◽

Evolutionarily Conserved ◽

Duration Of Infection ◽

Tubal Factor ◽

Pathologic Lesions ◽

Mammalian Gene Expression

Genital Chlamydia trachomatis infection causes severe reproductive pathologies such as salpingitis and pelvic inflammatory disease that can lead to tubal factor infertility. MicroRNAs (miRNAs) are evolutionarily conserved regulators of mammalian gene expression in development, immunity and pathophysiologic processes during inflammation and infection, including Chlamydia infection. Among the miRNAs involved in regulating host responses and pathologic outcome of Chlamydia infection, we have shown that miR-378b was significantly differentially expressed during primary infection and reinfection. In this study, we tested the hypothesis that miR-378b is involved in the pathological outcome of Chlamydia infection. We developed miR-378b knockout mice (miR-378b−/−) using Crispr/Cas and infected them along with their wild-type (WT) control with Chlamydia to compare the infectivity and reproductive pathologies. The results showed that miR-378b−/− mice were unable to clear the infection compared to WT mice; also, miR-378b−/− mice exhibited a relatively higher Chlamydia burden throughout the duration of infection. However, gross pathology results showed that miR-378b−/− mice had significantly reduced uterine dilatations and pathologic lesions after two infections compared to WT mice. In addition, the pregnancy and fertility rates for infected miR-378b−/− mice showed protection from Chlamydia-induced infertility with fertility rate that was comparable to uninfected WT mice. These results are intriguing as they suggest that miR-378b is important in regulating host immune responses that control Chlamydial replication and drive the inflammation that causes complications such as infertility. The finding has important implications for biomarkers of Chlamydial complications and targets for prevention of disease.

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Where to go to in chlamydia control? From infection control towards infectious disease control

Sexually Transmitted Infections ◽

10.1136/sextrans-2021-054992 ◽

2021 ◽

pp. sextrans-2021-054992

Author(s):

Jan E A M van Bergen ◽

Bernice Maria Hoenderboom ◽

Silke David ◽

Febe Deug ◽

Janneke C M Heijne ◽

...

Keyword(s):

Chlamydia Infection ◽

Limited Evidence ◽

Future Directions ◽

Tubal Factor Infertility ◽

Effectiveness Analysis ◽

Population Prevalence ◽

Tubal Factor ◽

Health Relevance ◽

Asymptomatic Infections

ObjectivesThe clinical and public health relevance of widespread case finding by testing for asymptomatic chlamydia infections is under debate. We wanted to explore future directions for chlamydia control and generate insights that might guide for evidence-based strategies. In particular, we wanted to know the extent to which we should pursue testing for asymptomatic infections at both genital and extragenital sites.MethodsWe synthesised findings from published literature and from discussions among national and international chlamydia experts during an invitational workshop. We described changing perceptions in chlamydia control to inform the development of recommendations for future avenues for chlamydia control in the Netherlands.ResultsDespite implementing a range of interventions to control chlamydia, there is no practice-based evidence that population prevalence can be reduced by screening programmes or widespread opportunistic testing. There is limited evidence about the beneficial effect of testing on pelvic inflammatory disease prevention. The risk of tubal factor infertility resulting from chlamydia infection is low and evidence on the preventable fraction remains uncertain. Overdiagnosis and overtreatment with antibiotics for self-limiting and non-viable infections have contributed to antimicrobial resistance in other pathogens and may affect oral, anal and genital microbiota. These changing insights could affect the outcome of previous cost–effectiveness analysis.ConclusionThe balance between benefits and harms of widespread testing to detect asymptomatic chlamydia infections is changing. The opinion of our expert group deviates from the existing paradigm of ‘test and treat’ and suggests that future strategies should reduce, rather than expand, the role of widespread testing for asymptomatic chlamydia infections.

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Role of IgG Chlamydia antibody in tubal factor infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170464 ◽

2017 ◽

Vol 6 (3) ◽

pp. 837

Author(s):

Sheila Balakrishnan ◽

Anitha Malathi ◽

Geetha Raveendran ◽

Dolly Johnrose ◽

Sreekumari Radha

Keyword(s):

Chlamydial Infection ◽

Venous Blood ◽

Igg Antibody ◽

Infertile Women ◽

Tubal Factor Infertility ◽

Tubal Factor ◽

Tubal Disease ◽

The Difference ◽

Chlamydial Antibody ◽

The Relationship

Background: Chlamydial infection is considered to be one of the important causes of tubal factor infertility. This study will help to explore the relationship between positive Chlamydial infection and tubal damage in infertile women assessed by diagnostic laparoscopy. The results will help to determine whether a policy of routine screening for Chlamydia antibody is justifiable in infertile women to suspect tubal factor so that they can be taken up for laparoscopy earlier.Methods: A prospective study was performed on 158 consecutive patients who underwent laparoscopy as part of infertility evaluation. About 5 mL of venous blood was drawn preoperatively to detect Chlamydia IgG antibody in all the patients by ELISA. The laparoscopic findings were documented and the relationship to Chlamydial antibody evaluated.Results: Of the 158 patients who underwent laparoscopy, 95 patients had evidence of tubal disease as evidenced by unilateral or bilateral tubal block, peritubal adhesions, hydrosalpinx, beading of the tube and unhealthy shaggy appearance. Of the 95 patients with documented tubal disease at laparoscopy, 14 (14.7%) had antibodies to Chlamydia. Of the 63 patients with normal tubes, 12 (19%) had Chlamydial positivity. The difference is not statistically significant. However of the 26 patients who were positive for Chlamydia antibodies 14 patients (53.8%) had abnormal tubes. Out of the 158 patients who underwent laparoscopy 26 patients were positive for Chlamydia. Hence the prevalence in our study is 16.4% (26/158). The sensitivity is 14.7% and the specificity is 81%.Conclusions: This study showed no difference in Chlamydial positivity between infertile women with abnormal tubes and those with normal looking tubes in our population. The absence of Chlamydial antibodies cannot be taken as a marker for normal tubes. Hence screening for chlamydial antibody can neither be used as a screening test for tubal factor infertility nor to decide on the need for laparoscopy in the present population.

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Estimation of the risk of tubal factor infertility associated with genital chlamydial infection in women: a statistical modelling study

International Journal of Epidemiology ◽

10.1093/ije/dyt011 ◽

2013 ◽

Vol 42 (2) ◽

pp. 493-503 ◽

Cited By ~ 23

Author(s):

Kimberley Kavanagh ◽

Lesley A Wallace ◽

Chris Robertson ◽

Phil Wilson ◽

Anne Scoular

Keyword(s):

Chlamydial Infection ◽

Statistical Modelling ◽

Tubal Factor Infertility ◽

Tubal Factor ◽

Modelling Study

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Tubal factor infertility: an association with prior chlamydial infection and asymptomatic salpingitis**Supported by a grant from the Physicians Services’ Incorporated Foundation of Ontario.

Fertility and Sterility ◽

10.1016/s0015-0282(16)59772-6 ◽

1988 ◽

Vol 49 (3) ◽

pp. 451-457 ◽

Cited By ~ 78

Author(s):

John W. Sellors ◽

James B. Mahony ◽

Max A. Chernesky ◽

Darlyne J. Rath

Keyword(s):

Chlamydial Infection ◽

Tubal Factor Infertility ◽

Tubal Factor

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Detection of Chlamydia trachomatis antibodies by 2 novel tests: rELISA and peptide EIA

International Journal of STD & AIDS ◽

10.1258/0956462981921044 ◽

1998 ◽

Vol 9 (10) ◽

pp. 604-607 ◽

Cited By ~ 3

Author(s):

◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Membrane Protein ◽

Inflammatory Disease ◽

Chlamydial Infection ◽

Igg Antibodies ◽

Specific Antibodies ◽

Tubal Factor Infertility ◽

Iga Antibodies ◽

Tubal Factor ◽

Species Specific

The performance of 2 newly developed enzyme immunoassays (EIAs) intended for the routine serological diagnosis of chlamydial infections was evaluated. rELISA is based on a recombinant lipopolysaccharide antigen which detects chlamydia genus-specific antibodies, and Chlamydia trachomatis EIA is based on a peptide derived from major outer membrane protein and is therefore speciesspecific. Both tests distinguished patients with tubal factor infertility (TFI) or pelvic inflammatory disease (PID) from the controls. The prevalence of IgA antibodies was higher for the PID patients than for the TFI patients; the finding indicates a more active state of infections for the PID patients. Furthermore, C. trachomatis EIA detected more IgG antibodies in the TFI patients than in patients with non-tubal factor infertility. In conclusion, rELISA detected chlamydial antibodies in general, and C. trachomatis EIA detected species-specific antibodies. These EIA tests may be useful in the serodiagnosis of chlamydial infection.

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Faculty Opinions recommendation of Genome-wide identification of Chlamydia trachomatis antigens associated with tubal factor infertility.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13294040.14653180 ◽

2011 ◽

Author(s):

Steven Witkin

Keyword(s):

Chlamydia Trachomatis ◽

Tubal Factor Infertility ◽

Genome Wide ◽

Tubal Factor

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Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom

Journal of Infection Prevention ◽

10.1177/1757177420976798 ◽

2020 ◽

pp. 175717742097679

Author(s):

Kordo Saeed ◽

Emanuela Pelosi ◽

Nitin Mahobia ◽

Nicola White ◽

Christopher Labdon ◽

...

Keyword(s):

Real Time ◽

Healthcare Workers ◽

Healthcare Facility ◽

Rt Pcr ◽

Serum Samples ◽

The United Kingdom ◽

Key Issues ◽

Current Infection ◽

Polymerase Chain ◽

A Current

Background: We report an outbreak of SARS coronavirus-2 (SARS-CoV-2) infection among healthcare workers (HCW) in an NHS elective healthcare facility. Methodology: A narrative chronological account of events after declaring an outbreak of SARS-CoV-2 among HCWs. As part of the investigations, HCWs were offered testing during the outbreak. These were: (1) screening by real-time reverse transcriptase polymerase chain reaction (RT- PCR) to detect a current infection; and (2) serum samples to determine seroprevalence. Results: Over 180 HCWs were tested by real-time RT-PCR for SARS-CoV-2 infection. The rate of infection was 15.2% (23.7% for clinical or directly patient-facing HCWs vs. 4.8% in non-clinical non-patient-facing HCWs). Of the infected HCWs, 57% were asymptomatic. Seroprevalence (SARS-CoV-2 IgG) among HCWs was 13%. It was challenging to establish an exact source for the outbreak. The importance of education, training, social distancing and infection prevention practices were emphasised. Additionally, avoidance of unnecessary transfer of patients and minimising cross-site working for staff and early escalation were highlighted. Establishing mass and regular screening for HCWs are also crucial to enabling the best care for patients while maintaining the wellbeing of staff. Conclusion: To our knowledge, this is the first UK outbreak report among HCWs and we hope to have highlighted some key issues and learnings that can be considered by other NHS staff and HCWs globally when dealing with such a task in future.

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