Time to clearance of Chlamydia trachomatis RNA and DNA after treatment in patients coinfected with Neisseria gonorrhoeae – a prospective cohort studyReport as inadecuate




Time to clearance of Chlamydia trachomatis RNA and DNA after treatment in patients coinfected with Neisseria gonorrhoeae – a prospective cohort study - Download this document for free, or read online. Document in PDF available to download.

BMC Infectious Diseases

, 16:554

Sexually transmitted diseases

Abstract

BackgroundPerforming a test of cure TOC could demonstrate success or failure of antimicrobial treatment of Chlamydia trachomatis infection, but recommendations for the timing of a TOC using nucleic acid amplification tests NAATs are inconsistent. We assessed time to clearance of C. trachomatis after treatment, using modern RNA- and DNA-based NAATs.

MethodsWe analysed data from patients with a C. trachomatis and Neisseria gonorrhoeae coinfection who visited the STI Clinic Amsterdam, The Netherlands, from March through October 2014. After treatment with ceftriaxone plus either azithromycin or doxycycline, patients self-collected anal, vaginal or urine samples during 28 consecutive days. Samples were analysed using an RNA-based NAAT Aptima Combo 2 and a DNA-based NAAT Cobas 4800 CT-NG. We defined clearance as three consecutive negative results, and defined -blips- as isolated positive results following clearance.

ResultsWe included 23 patients with C. trachomatis and N. gonorrhoeae coinfection. All patients cleared C. trachomatis during follow-up, and we observed no reinfections. The median time to clearance range was 7 days 1–13 for RNA, and 6 days 1–15 for DNA. Ninety-five per cent of patients cleared RNA at day 13, and DNA at day 14. The risk of a blip after clearance was 4.4 % RNA and 1.7 % DNA.

ConclusionsIf a TOC for anogenital chlamydia is indicated, we recommend performing it at least 14 days after initiation of treatment, when using modern RNA- and DNA-based assays. A positive result shortly after 14 days probably indicates a blip, rather than a treatment failure or a reinfection.

KeywordsChlamydia trachomatis Neisseria gonorrhoeae Antimicrobial resistance Nucleic acid amplification test Test of cure Abbreviations95 %-CI95 % confidence interval

CtCycle threshold

DNADeoxyribonucleic acid

GEEGeneralized estimated equation

HIVHuman immunodeficiency virus

IQRInterquartile range

MSMMen who have sex with men

NAATNucleic acid amplification test

OROdds ratio

PCRPolymerase chain reaction

RNARibonucleic acid

STISexually transmitted infection

TOCTest of cure

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Author: Carolien M. Wind - Maarten F. Schim van der Loeff - Magnus Unemo - Rob Schuurman - Alje P. van Dam - Henry J. C. de Vri

Source: https://link.springer.com/







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