Source of Chlamydia Reinfections May be GI Tract

Article

The current standard of care treatment for chlamydia sometimes fails to eradicate the disease, according to a review published ahead of print in Infection and Immunity, and the culprit may be in the gut.

Chlamydia trachomatis not only infects the reproductive tract, but abides persistentlythough benignlyin the gastrointestinal tract. There it remains even after eradication from the genitals by the antibiotic azithromycin, says first author Roger Rank, of the Arkansas Children's Research Institute, Little Rock. And that reservoir is likely a source of the all-too-common reinfections that follow treatment.

The source of the reinfections has long been a conundrum. Some are blamed on continued intercourse with an infected partner. This is not surprising since chlamydia is usually asymptomatic in men.

Chlamydiae have long been assumed often to persist within the genital tract in a non-replicating form, but Rank says there is no evidence for this. "While all agree that chlamydiae may persist in a patient for long periods of time, and that recurrent infections do develop, there has been no agreement on how and where and in what form chlamydiae persist," says Rank.

In a recent study, coauthor and Arkansas colleague Laxmi Yeruva showed in mice that azithormycin eradicated the genital infection, but not the GI infection.

Rank showed furtheralso in micethat chlamydial infection of the GI does not elicit an inflammatory response, and never resolves, unlike in the genital tract.

"However, we found that GI infection does produce a strong immune response that can actually be effective against a genital infection, but that is unable to cure the GI infection," says Rank.

While chlamydial persistence in the GI tract has largely escaped notice of late, it was documented in the veterinary literature in numerous animals as early as the 1950s, says Rank. His reading of that early literature was a major factor motivating his and Yeruva's studies, and this review, Rank says.

Chlamydia trachomatis is the most common cause of sexually transmitted disease in the world. In the US, approximately 1.4 million cases occur annually, according to the Centers for Disease Control and Prevention. Adolescents are most affected, and 6.8 percent of sexually active females ages 14-19 become infected annually.

Source: American Society for Microbiology (ASM)

Recent Videos
Mark Wiencek, PhD
Rebecca Crapanzano-Sigafoos, DrPH, CIC, AL-CIP, FAPIC
The CDC’s updated hospital respiratory reporting requirement has added new layers of responsibility for infection preventionists. Karen Jones, MPH, RN, CIC, FAPIC, clinical program manager at Wolters Kluwer, breaks down what it means and how IPs can adapt.
Studying for the CIC using a digital tablet and computer (Adobe Stock 335828989 by NIKCOA)
Infection Control Today's Conversations with the HSPA President, Arlene Bush, CRCST, CER, CIS, SME, DSMD, CRMST
Infection Control Today's Conversations with the HSPA President, Arlene Bush, CRCST, CER, CIS, SME, DSMD, CRMST
Cheron Rojo, BS, FCS, CHL,  CER, CFER, CRCST
Matthias Tschoerner, Dr Sc
Standardizing Cleaning and Disinfection
Concept images of Far-UVC  (Adobe Stock 316993517 by hopenv)
Related Content