O18.6 Persistence of Pharyngeal Chlamydia Trachomatis For 1–2 Weeks is Common Among Clients at the Amsterdam STI Clinic. (13th July 2013)

• Record Type: Journal Article
• Authors: Rooijen, M S van; Loeff, M F Schim van der; Dam, A P van; Speksnijder, A G C L; Vries, H J C de
• Is Part Of: Sexually transmitted infections. Volume 89(2013)Supplement 1
• Page Start: A62
• Page End: A62
• Publication Date: 2013-07-13
• Subjects: chlamydia -- persistence -- pharyngeal; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2013-051184.0190
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background: Pharyngeal Chlamydia trachomatis (PCt) must persist to contribute to ongoing transmission. We examined the prevalence, persistence and determinants of PCt among STI clinic clients. Methods: All men having sex with men (MSM) and women with a high risk profile were screened for anogenital and pharyngeal Ct with the APTIMA Combo 2 assay. After one week, clients with PCt were recalled for treatment, a follow-up pharyngeal swab and a questionnaire. Clients who used antibiotics since first visit were excluded from the analysis. Results: Between January 2011 and July 2012, we detected 148 PCt in MSM (13, 111 visits; prevalence 1.1%) and 160 PCt in women (6, 915 visits; 2.3%). In both groups, PCt was associated with being notified for STI, concurrent urogenital Ct and > 10 partners, but not with pharyngeal symptoms. Women reporting sex work had a lower risk, while women with pharyngeal gonorrhoea and MSM with anorectal Ct had a higher risk for PCt. 53% of MSM and 32% of women with PCt had no concurrent anogenitial Ct. Of 43 (29%) MSM and 55 (34%) women, follow-up swabs and questionnaire data were available. The median time between both visits was 10 days. PCt persisted in 27 (63%) MSM and in 35 (64%) women. In both groups 50% had unprotected active oral sex between first and second visit, but this did not affect persistence. Among MSM no determinants for persistence were detected; among women being notified for STI, younger age and urogenital Ct were significantly associated with persistence in univariate analysis. Among clients (n = 16) whose second visit was more than 3 weeks after the first visit, 11 (69%) had PCt at second visit. Discussion: The prevalence of PCt is low among STI clinic clients, but persistence is common. Therefore, the pharynx is a potential reservoir for ongoing Ct transmission.