{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:33:14Z","timestamp":1761514394382,"version":"3.37.3"},"reference-count":29,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,4,18]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Most international STI guidelines recommend<jats:italic>Chlamydia trachomatis<\/jats:italic>anorectal testing in women after self-reported sexual exposure or symptoms in women. However, it has been shown that the prevalence of anorectal<jats:italic>C. trachomatis<\/jats:italic>is as high (7%\u201317 %) in women who do not report anorectal intercourse (AI) as in women who do. This study assessed the correlation between the genital and anorectal<jats:italic>C. trachomatis<\/jats:italic>load in concurrently infected women for increased microbiological insight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A convenience sample of 105 women with a concurrent (genital and anorectal)<jats:italic>C. trachomatis<\/jats:italic>infection was included from the STI clinic in South Limburg, the Netherlands. Women provided self-collected vaginal and anorectal swabs. The<jats:italic>C. trachomatis<\/jats:italic>load was quantified with qPCR and the human cell load was assessed to ensure sample adequacy. Genital and anorectal<jats:italic>C. trachomatis<\/jats:italic>loads were divided into tertiles for comparison. The \u03c7<jats:sup>2<\/jats:sup>test and linear regression were used to compare genital and anorectal<jats:italic>C. trachomatis<\/jats:italic>loads and identify determinants associated with load.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall median<jats:italic>C. trachomatis<\/jats:italic>load was higher in genital (median 5.3 log<jats:sub>10<\/jats:sub><jats:italic>C. trachomatis<\/jats:italic>\/ml) than anorectal samples (median 3.4, p \u2264 0.001), but both loads were within the same range. The genital and anal load categories were not related within one woman (p = 0.99), both in women with and without AI. The anorectal<jats:italic>C. trachomatis<\/jats:italic>load was in the same or higher load category than the genital load in 56% of women without AI, and 79% of women with AI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although no cut-off for clinical relevance is known, an anorectal<jats:italic>C. trachomatis<\/jats:italic>load in the same or higher load category than the genital<jats:italic>C. trachomatis<\/jats:italic>load is likely to be clinically relevant. Other measurements should also be taken into account, such as leucocytes or bacterial viability to distinguish infection from contamination or exposure.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053678","type":"journal-article","created":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T21:15:58Z","timestamp":1558041358000},"page":"317-321","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Genital and anal<i>Chlamydia trachomatis<\/i>bacterial load in concurrently infected women: a cross-sectional study"],"prefix":"10.1136","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1961-9589","authenticated-orcid":false,"given":"J A M C","family":"Dirks","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-4548","authenticated-orcid":false,"given":"Genevieve A F S","family":"van Liere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian J P A","family":"Hoebe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Wolffs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole H T M","family":"Dukers-Muijrers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,5,16]]},"reference":[{"key":"2024092304402302000_95.5.317.1","unstructured":"World Health Organisation . Who guidelines approved by the guidelines review Committee. Who guidelines for the treatment of Chlamydia trachomatis. 2016. Geneva: World Health Organization, 2016."},{"key":"2024092304402302000_95.5.317.2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31825159ff"},{"key":"2024092304402302000_95.5.317.3","unstructured":"Centers for Disease Control and Prevention (CDC) . Sexually transmitted diseases treatment guidelines. chlamydial infections, 2015. Available: http:\/\/www.cdc.gov\/std\/tg2015\/chlamydia.htm"},{"key":"2024092304402302000_95.5.317.4","unstructured":"International Union against Sexually Transmitted Infections (IUSTI) . European guideline for the organisation of a consultation for sexually transmitted infections, 2012. Available: http:\/\/iusti.org\/regions\/Europe\/pdf\/2012\/European_guideline_onSTIconsultation2012final.pdf"},{"key":"2024092304402302000_95.5.317.5","unstructured":"Australian STI management guidelines for use in primary care . Chlamydia. 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