Improvement of laboratory diagnostics of urogenital chlamydial infection in patients with impaired reproductive functions found to be infected with Chlamydia trachomatis

Cover Page
  • Authors: Fedorova V.A.1,2,3, Sultanakhmedov E.S.4, Saltykov Y.V.1,2,3, Utz S.R.4, Motin V.L.5
  • Affiliations:
    1. State Science Institution National Research Institute of Veterinary Virology and Microbiology
    2. Federal Research Center of Virology and Microbiology, the Branch in Saratov
    3. Saratov State Agrarian University named after N. I. Vavilov
    4. Saratov State Medical University named after V. I. Rasumovsky
    5. University of Texas Medical Branch
  • Issue: Vol 93, No 2 (2017)
  • Pages: 34-44
  • Section: LITERATURE REVIEW
  • URL: https://www.vestnikdv.ru/jour/article/view/306
  • DOI: https://doi.org/10.25208/0042-4609-2017-93-2-34-44

Abstract


The dominant role in human infertility has been attributed to sexually transmitted infections (STIs) with a leading contribution of urogenital chlamydial infection (UGCI) caused by Chlamydia trachomatis (CT). the two variants of this pathogen are represented by the wild-type (wtCT) and new Swedish (nvCT) strains containing 377 bp deletion within the cryptic plasmid orf1 gene. Objective. The purpose of the study was investigation of the clinical specimens obtained from the urogenital tract of couples coping with infertility for the presence of genetic material of wtCT and nvCT. Material and methods. Clinical samples (scrapings from the urethra and cervix) obtained from 25 to 41 years old couples (n = 14) were tested for the presence of identifiable wtCT and nvCT chlamydia DNA by monoplex and duplex PCR, specific antigens C. trachomatis in elementary bodies by using immunofluorescence analysis (IFA), while detection of anti-chlamydia antibodies in sera was determined by immunoenzymatic assay (IEA). Results. The nvCT variant with typical deletion of 377 bp within the orf1 gene that belongs to the genovar e subtype E1 was detected in 100% of couples with infertility. The negative results of DNA testing for wtcT were registered in 87.5% of patients from this group, while one individual (12.5%) was likely coinfected with nvCT and wtCT of E1 and D genovars, respectively. The wtCT strains of genovar E (subtypes E1, E2, E6), g (subtypes G1, G2), F (subtypes F1), and K were identified in control group among patients with UGCI. The study revealed difficulties in detection of nvCT by nucleic acid amplification test (NAAT), IFA, and IEA; data on comparison of the efficacy of these methods are presented. Conclusion. Chronic UGCI in patients with reproductive dysfunctions can be caused by nvCT alone or as result of co-infection with nvCT and wtCT. The negative results in NAAT may not 100% correlate with the absence of UGCI that requires further confirmation in tests allowing detection of all known variants of C. trachomatis.

About the authors

V. A. Fedorova

State Science Institution National Research Institute of Veterinary Virology and Microbiology; Federal Research Center of Virology and Microbiology, the Branch in Saratov; Saratov State Agrarian University named after N. I. Vavilov

Author for correspondence.
Email: feodorovav@mail.ru

Russian Federation

E. S. Sultanakhmedov

Saratov State Medical University named after V. I. Rasumovsky

Email: noemail@neicon.ru

Russian Federation

Y. V. Saltykov

State Science Institution National Research Institute of Veterinary Virology and Microbiology; Federal Research Center of Virology and Microbiology, the Branch in Saratov; Saratov State Agrarian University named after N. I. Vavilov

Email: noemail@neicon.ru

Russian Federation

S. R. Utz

Saratov State Medical University named after V. I. Rasumovsky

Email: noemail@neicon.ru

Russian Federation

V. L. Motin

University of Texas Medical Branch

Email: noemail@neicon.ru

Russian Federation

References

  1. Указ Президента РФ № 1351 от 09.10.2007 «Об утверждении Концепции демографической политики Российской Федерации на период до 2025 года». Собрание законодательства Российской Федерации от 15.10.2007. № 42, ст. 5009 с изменениями и дополнениями от 1 июля 2014 г.
  2. Kubanova A. A., Melekhina L. E., Kubanov A. A., Bogdanova E. V. Resources and activities of dermatovenereological medical organizations in Russian Federation in 2013. Vestnik Dermatol Venerol 2014; (3): 16-36. [Кубанова А. А., Мелехина Л. Е., Кубанов А. А., Богданова Е. В. Ресурсы и деятельность медицинских организаций дерматовенерологического профиля в Российской Федерации в 2013 году. Вестник дерматологии и венерологии 2014; (3):16-36.]
  3. Murzabayeva S.Sh. The importance of primary preventive measures in reproductive health preservation of Russian Federation population. Pediatric and Adolescent Reproductive Health 2014; (2): 15-19. [Мурзабаева С. Ш. Первичная профилактика - приоритетное направление в сохранении репродуктивного здоровья населения в Российской Федерации. Репродукт здоровье детей и подростков 2014; (2): 15-19.]
  4. Domeyka M., Savicheva A. M., Sokolovskiy E., Ballard R., Ünemo M. Guidelines for the laboratory diagnosis of infections of the urogenital tract. Spb: Izd-vo N-L 2012: 10-47. [Домейка М., Савичева А. М., Соколовский Е., Баллард Р., Унемо М. Руководство по лабораторной диагностике инфекций урогенитального тракта. Спб: Изд-во Н-Л 2012: 10-47.]
  5. Torrone E., Papp J., Weinstock H. Prevalence of Chlamydia trachomatis Genital Infection Among Persons Aged 14-39 Years - United States, 2007-2012. CDC, MMWR https:// www.cdc.gov/mmwr/preview/mmwrhtml/ mm6338a3.htm (26 September 2014)
  6. Chiaradonna C. The Chlamydia cascade: enhanced STD prevention strategies for adolescents. J Pediatr Adolesc Gynecol 2008;21(5):233-41.
  7. WHO. Laboratory diagnosis of sexually transmitted infections, including human immunodeficiency virus. Geneva: World Health Organization, 2013.
  8. Shipitsyna E., Zolotoverkhaya E., Agné-Stadling I., Krysanova A., Savicheva A., Sokolovsky E., Domeika M., Unemo M. First evaluation of six nucleic acid amplification tests widely used in the diagnosis of Chlamydia trachomatis in Russia. J Eur Acad Dermatol Venereol. 2009 Mar;23(3):268-76.
  9. Emmadi R., Boonyaratanakornkit J. B., Selvarangan R., Shyamala V., Zimmer B. L., Williams L., Bryant B., Schutzbank T., Schoonmaker M. M., Amos Wilson J. A., Hall L., Pancholi P., Bernard K. Molecular methods and platforms for infectious diseases testing a review of FDA-approved and cleared assays. J Mol Diagn 2011; 13(6): 583-604.
  10. Shipitsyna E., Hadad R., Ryzhkova O., Savicheva A., Domeika M., Unemo M. First reported case of the Swedish new variant of Chlamydia trachomatis (nvCT) in Eastern Europe (Russia), and evaluation of Russian nucleic acid amplification tests regarding their ability to detect nvCT. Acta Derm Venereol. 2012; 92(3):330- 1.
  11. Ripa T., Nilsson P. A variant of Chlamydia trachomatis with deletion in cryptic plasmid: implications for use of PCR diagnostic tests. Euro Surveill 2006; 9;11(11):E061109.2.
  12. Ripa T., Nilsson P. A. A Chlamydia trachomatis strain with a 377-bp deletion in the cryptic plasmid causing false-negative nucleic acid amplification tests. Sex Transm Dis 2007;34(5):255 6
  13. Pedersen L. N., Herrmann B., Moller J. K. Typing Chlamydia trachomatis: from egg yolk to nanotechnology. FEMS Immunol Med Microbiol. 2009;55(2):120-30
  14. Антибактериальная терапия урогенитальной хламидийной инфекции у взрослых: позиция европейских экспертов. Гинекология 2012. 2-10 стр
  15. Persson K., Hammas B., Janson H., Bjartling C., Dillner J., Dillner L. Decline of the new Swedish variant of Chlamydia trachomatis after introduction of appropriate testing. Sex Transm Infect 2012;88(6):451-5.
  16. Feodorova V. A., Sultanakhmedov E. S., Saltykov Yu.V., Polyanina T. I., Utz S. R., Zaitsev S. S., Bogoutdinov N.Sh., Motin V. L. The first case of the Swedish new variant Chlamydia trachomatis in the Southeastern European region of Russia. Proceeding Book, IUSTI Europe Scientific Meeting in St Julian. Malta. 2014; 106.
  17. [Савичева А. M., Соколовский Е. В., Домейка М.З. Улучшение качества лабораторной диагностики инфекций урогенитального тракта. Практическая медицина 2009;5(37)24.]
  18. fedorova V. A., Bannikova V. A., Alikberov Sh.A., Eliseev Iu.Iu., Grashkin V. A. Comparative efficiency of detection of the causative agent of urogenital chlamydiasis by immunofluorescence, polymerase chain reaction, and dot immunoassay. Klin Lab Diagn 2007; (7): 30-35. [Федорова В. А., Банникова В. А., Аликберов Ш. А., Елисеев Ю. Ю., Грашкин В. А. Сравнительная эффективность обнаружения возбудителя урогенитального хламидиоза методами иммунофлюоресценции, ПЦР и Дот-иммуноанализа. клин Лаб Диагн 2007; (7): 30-35.]
  19. WHO laboratory manual for the examination and processing of human semen. 5th edition, 2010.
  20. Catsburg A. TaqMan Assay for Swedish Chlamydia trachomatis Variant / A. Catsburg, L. van Dommelen, V. Smelov, H. J. C. de Vries, A. Savitcheva, M. Domeika, B. Herrmann, S. Ouburg, C. J. P. A. Hoebe, A. Nilsson, P. H. M. Savelkoul, S. A. Morré // Emerg. Infect. Dis. 2007. Vol. 13(9). P. 1432-1434.
  21. Quint K. D., van Doorn L. J., Kleter B., de Koning M. N., van den Munckhof H. A., Morre S. A., ter Harmsel B., Weiderpass E., Harbers G., Melchers W. J., Quint W. G. A highly sensitive, multiplex broad-spectrum PCR- DNA-enzyme immunoassay and reverse hybridization assay for rapid detection and identification of Chlamydia trachomatis serovars. J Mol Diagn 2007; 9:631-638.
  22. Lysén., Osterlund A., Rubin C. J., Persson T., Persson I., Herrmann B. Characterization of ompA genotypes by sequence analysis of DNA from all detected cases of Chlamydia trachomatis infections during 1 year of contact tracing in a Swedish County. J Clin Microbiol 2004;42(4):1641-7.
  23. Feodorova V. A., Konnova S. S., Saltykov Y. V., Zaitsev S. S., Polyanina T. I., Druzhkin I. V., Fedotov E. A., Gaydos C. A., Quinn T. C. and Motin V. L. Chlamydia trachomatis isolate Saratov E6/61.35-B1 major outer membrane protein (ompA) gene, partial cds 1,156 bp linear DNA Accession: KU963177.1
  24. Bjartling C., Osser S., Johnsson A., Persson K. Clinical manifestations and epidemiology of the new genetic variant of Chlamydia trachomatis. Sex Transm Dis. 2009; 36(9):529-35.
  25. Seth-Smith H.M., Harris S.R., Persson K., Marsh P., Barron A., Bignell A., Bjartling C., Clark L., Cutcliffe L.T., Lambden P.R., Lennard N., Lockey S.J., Quail M.A., Salim O., Skilton R. J., Wang Y., Holland M. J., Parkhill J., Thomson N. R., Clarke I. N. Co-evolution of genomes and plasmids within Chlamydia trachomatis and the emergence in Sweden of a new variant strain. BMC Genomics 2009; 10:239.
  26. Unemo M., Clarke I.N. The Swedish new variant of Chlamydia trachomatis. Curr Opin Infect Dis. 2011; 24: 62-9.

Statistics

Views

Abstract - 446

PDF (Russian) - 342

PlumX

Dimensions


Copyright (c)



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies