{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:22:41Z","timestamp":1792664561200,"version":"4.5.0"},"reference-count":20,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,7,17]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>In recent years, studies have demonstrated frequent rectal<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) detection in women, irrespective of reported anal sex or rectal symptoms. However, the clinical relevance and public health implication of rectal CT detection in women remain under debate. Therefore, evaluating CT viability may provide more insight into the relevance of standard routine nucleic acid amplification test (NAAT)\u2013positive results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross-sectional explorative study, a convenience sample of female patients at our STI clinic aged 18 years or older, diagnosed with vaginal and\/or rectal CT, were invited to participate. On return for treatment, rectal CT-diagnosed women were instructed to self-collect rectal swab samples before being treated. Standard COBAS 4800 CT\/NG routine NAAT testing was applied for CT diagnosis. Rectal viable CT load was evaluated by using viability-PCR (V-PCR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>53 women with rectal CT were included in this study; 86.8% (46\/53) had a quantifiable rectal total CT load. Of women with quantifiable samples, 52.2% (24\/46) had viable CT detected from rectal swabs by V-PCR, with a mean rectal viable CT load of 3.31 log<jats:sub>10<\/jats:sub>CT\/mL (range 1.16\u20136.22). No statistically significant difference (p=0.73) was observed in the mean rectal viable CT load of women with an indication for rectal testing (n=9) and without (n=15), 3.20 log<jats:sub>10<\/jats:sub>CT\/mL (range 2.06\u20134.36) and 3.38 log<jats:sub>10<\/jats:sub>CT\/mL (range 1.16\u20136.22), respectively. CT culture yielded positive test results from rectal swabs in 22.6% (12\/53) of rectal CT NAAT-diagnosed women. Of women with viable rectal CT by V-PCR (n=24), 50% (12\/24) were positive by CT culture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, the detection of high rectal viable CT loads in this study indicates that rectal CT in some women might represent a currently ongoing infection rather than just the presence of remnant DNA from dead bacteria or only contamination from an active vaginal CT infection.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2019-054002","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T21:15:36Z","timestamp":1565039736000},"page":"85-88","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Assessment of rectal<i>Chlamydia trachomatis<\/i>viable load in women by viability-PCR"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-0521","authenticated-orcid":false,"given":"Kevin J H","family":"Janssen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Wolffs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayk","family":"Lucchesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole H T M","family":"Dukers-Muijrers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J P A","family":"Hoebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,5]]},"reference":[{"key":"2024092304051238000_96.2.85.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0143304","article-title":"Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting","volume":"10","author":"Newman","year":"2015","journal-title":"PLoS One"},{"key":"2024092304051238000_96.2.85.2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws583"},{"key":"2024092304051238000_96.2.85.3","first-page":"1","article-title":"Centers for Disease Control and Prevention (CDC). Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae\u20142014","volume":"63","author":"Papp","year":"2014","journal-title":"MMWR Recomm Rep"},{"key":"2024092304051238000_96.2.85.4","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415618837"},{"key":"2024092304051238000_96.2.85.5","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415615443"},{"key":"2024092304051238000_96.2.85.6","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1093\/cid\/cix243","article-title":"High proportion of anorectal Chlamydia trachomatis and Neisseria gonorrhoeae after routine universal urogenital and anorectal screening in women visiting the sexually transmitted infection clinic","volume":"64","author":"van Liere","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2024092304051238000_96.2.85.7","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053161"},{"key":"2024092304051238000_96.2.85.8","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dku574"},{"key":"2024092304051238000_96.2.85.9","doi-asserted-by":"publisher","DOI":"10.1177\/0956462413515637"},{"key":"2024092304051238000_96.2.85.10","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052786"},{"key":"2024092304051238000_96.2.85.11","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1080\/14737159.2018.1498785","article-title":"Review of Chlamydia trachomatis viability methods: assessing the clinical diagnostic impact of NAAT positive results","volume":"18","author":"Janssen","year":"2018","journal-title":"Expert Rev Mol Diagn"},{"key":"2024092304051238000_96.2.85.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0165920","article-title":"Viability-PCR shows that NAAT detects a high proportion of DNA from non-viable Chlamydia trachomatis","volume":"11","author":"Janssen","year":"2016","journal-title":"PLoS One"},{"key":"2024092304051238000_96.2.85.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2006.04.015"},{"key":"2024092304051238000_96.2.85.14","doi-asserted-by":"crossref","first-page":"804","DOI":"10.2144\/03344rr02","article-title":"Ethidium monoazide for DNA-based differentiation of viable and dead bacteria by 5\u2032-nuclease PCR","volume":"34","author":"Nogva","year":"2003","journal-title":"Biotechniques"},{"key":"2024092304051238000_96.2.85.15","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.44.1.206-213.2006"},{"key":"2024092304051238000_96.2.85.16","article-title":"Cultivation and laboratory maintenance of Chlamydia trachomatis","volume":"Chapter 11","author":"Scidmore","year":"2005","journal-title":"Curr Protoc Microbiol"},{"key":"2024092304051238000_96.2.85.17","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.01244-13"},{"key":"2024092304051238000_96.2.85.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-016-1721-x","article-title":"Design of the FemCure study: prospective multicentre study on the transmission of genital and extra-genital Chlamydia trachomatis infections in women receiving routine care","volume":"16","author":"Dukers-Muijrers","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2024092304051238000_96.2.85.19","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1111\/jsm.12961","article-title":"Correlates of heterosexual anal intercourse among women in the 2006\u20132010 national survey of family growth","volume":"12","author":"Benson","year":"2015","journal-title":"J Sex Med"},{"key":"2024092304051238000_96.2.85.20","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/81.2.237"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2019-054002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:06:39Z","timestamp":1727089599000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2019-054002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,5]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,17]]},"published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1136\/sextrans-2019-054002"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2019-054002","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,5]]}}}