Time to clearance of Chlamydia trachomatis RNA and DNA after treatment in patients coinfected with Neisseria gonorrhoeae: a prospective cohort study
2016 (English)In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 16, no 1, 554Article in journal (Refereed) Published
Background: Performing 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.
Methods We 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.
Results: We 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).
Conclusions: If 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.
Place, publisher, year, edition, pages
London, United Kingdom: BioMed Central, 2016. Vol. 16, no 1, 554
Chlamydia trachomatis, Neisseria gonorrhoeae, Antimicrobial resistance, Nucleic acid amplification test, Test of cure
Research subject Infectious Diseases
IdentifiersURN: urn:nbn:se:oru:diva-53044DOI: 10.1186/s12879-016-1878-3ISI: 000385445900001PubMedID: 27724878ScopusID: 2-s2.0-84990950512OAI: oai:DiVA.org:oru-53044DiVA: diva2:1038666
Public Health Service Amsterdam2016-10-192016-10-192016-11-15Bibliographically approved