| Background:Chlamydia trachomatis(CT),the most common etiological agent of bacterial sexually transmitted infections worldwide,can invade the conjunctiva,endocervical epithelium,urethra and rectum.Previous work has shown that chlamydial infections in the genital tract of mice are naturally cleared,but could persist in the gut.Whether Chlamydia infection of the female genital tract has the same characteristics has been of interest to numerous academics.Objective;The aim of this study was to investigate the characteristics of CT infection and its genotype distribution at different exposure sites in women and their serum antibody levels;to Identify the differences between genital and intestinal infections;and to understand migration of female genital CT infections to the rectum.Methods:4206 cervical samples,rectal samples and serum samples were collected from women attending Chenzhou First People’s hospital from september 2021 to June 2022.Mega7 and snapgene was used to compare the CT omp1 VS1-VS2 fragments and to analyze mutations of gene locus;the human IFN-y ELISA kit was used to detect IFN-y levels and liquid chromatography was used to detect tryptophan levels in cervical secretions.A luciferase immunosorbent assay(LISA)with high throughput antibodies was used to detect the level of CT Pgp3 and Hsp60 antibodies.After 6 months of standard treatment,positive patients were followed up with questionnaires and collected specimens from both the genital tract and the intestinal tract.Results:In this study,CT screening tests were performed on 4206 women with cervical and rectal specimens,and the percentages of CT infection in single-site genital tract,single-site rectum,and both genital and rectum were 1.69%(72/4206),0.21%(9/4206)and 1.24%(52/4206),respectively,genotypes J(30.68%,27/88)and E(23.86%,21/88)being the most common genotypes in the genital tract samples,genotypes G(25.45%,14/55)and J(21.81%,12/55)are the most common genotypes in the intestine.Cervical IFN-γ levels were significantly higher in CT-positive patients than in CT-negative patients[108.08(65.88,110.45)ng/L vs 60.59(60.07,62.05)ng/L,P<0.001].Cervical secretion tryptophan levels were significantly higher in CTpositive patients than in CT-negative patients[12.12(6.39,18.72)μmol/L vs 3.83(2.42,8.17)μmol/L,P<0.001].A total of 306 serum specimens were collected in this study.The overall positive rates of serum CT Pgp3 and Hsp60 antibodies were 32.7%(100/306)and 30.1%(92/306);the positive rate of serum Pgp3 antibodies was higher in CT-positive patients than in negative patients[58.82%(40/68)vs 25.21%(60/238),P<0.001].serum Hsp60 antibody positivity was higher in CT-positive patients than in negative patients[51.47%(35/68)vs 23.95%(57/238),P<0.001].With regard to the results of 78 questionnaires,first sexual intercourse time,the number of sexual encounters,number of pregnancies and births,and direction of wiping were not associated with site of infection or genotype.21 patients with CT infection were followed up.12 patients had cleared their infection and another 9 patients still had infection.Patients with genital and intestinal CT infections were more likely to have a longer duration of infection than genital infection.Conclusion:The prevalence of CT DNA in the female genital tract is higher than that of CT DNA in the intestinal tract;Genital CT infection can migrate to the intestine by the internal route,female intestinal CT infections can persist longer than genital tract infections. |
