{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:36:35Z","timestamp":1777926995065,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T00:00:00Z","timestamp":1370044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:p>In vivo antimicrobial resistance has yet to be documented in Chlamydia trachomatis; however, there have been anecdotal reports of persistent infection. The purpose of this case series was to describe a group of patients who have persistent chlamydia infection despite adequate treatment and where re-infection was considered unlikely. Patients were selected using a clinical questionnaire. For inclusion patients had to have tested positive for C. trachomatis, at least twice, using a nucleic acid amplification test despite having been fully compliant with at least two rounds of recommended therapy and be deemed to be at low risk of re-infection. Patients were grouped into categories based on sexual behaviour. Twenty-eight patients are included in this case series; 46% declared no sexual contact since initial diagnosis (category 1), a further 36% declaring contact that was considered low risk of re-infection (categories 2\u20134); 61% showed signs and symptoms at initial presentation increasing to 75% at re-attendance. Thirty-nine percent of patients received azithromycin only while 48% received doxycycline also. This case series identifies patients with persistent chlamydia despite receiving treatment. There is a need for a case definition of clinical treatment failure, development of susceptibility testing methods and guidance on appropriate treatment for patients with persistent infection.<\/jats:p>","DOI":"10.1177\/0956462412472815","type":"journal-article","created":{"date-parts":[[2013,7,4]],"date-time":"2013-07-04T23:56:00Z","timestamp":1372982160000},"page":"469-475","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Presentation of clinically suspected persistent chlamydial infection: a case series"],"prefix":"10.1177","volume":"24","author":[{"given":"R A","family":"Pitt","sequence":"first","affiliation":[{"name":"Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Alexander","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P J","family":"Horner","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C A","family":"Ison","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,7,4]]},"reference":[{"key":"bibr1-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2005.019158"},{"key":"bibr2-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318227a366"},{"key":"bibr3-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2011-050385"},{"key":"bibr4-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.7.2865-2873.2005"},{"key":"bibr5-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1086\/315372"},{"key":"bibr6-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.4.1347-1349.2004"},{"key":"bibr7-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2011.03.015"},{"key":"bibr8-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1159\/000314998"},{"key":"bibr9-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.11.3001-3008.2001"},{"key":"bibr10-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00962-07"},{"key":"bibr11-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00477-09"},{"key":"bibr12-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/JB.01592-07"},{"key":"bibr13-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/JB.00845-06"},{"key":"bibr14-0956462412472815","unstructured":"BASHH. UK National Guideline for the Mangament of Genital Tract Infection with\n                      Chlamydia trachomatis\n                      . 2006, http:\/\/www.bashh.org\/guidelines (2006, accessed 15 February 2013)"},{"key":"bibr15-0956462412472815","unstructured":"Chlamydia trachomatis Reference Service Enhanced Surveillance Forms\n                      . 2009. See http:www.hpa.org.uk\/web\/HPAweb&HPAwebStandard\/HPAweb_C\/1195733785206, (2009, accessed 15 February 2013)."},{"key":"bibr16-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1086\/648427"},{"key":"bibr17-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2214"},{"key":"bibr18-0956462412472815","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.2.636-642.2003"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462412472815","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0956462412472815","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462412472815","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:31:52Z","timestamp":1777674712000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0956462412472815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2013,6]]}},"alternative-id":["10.1177\/0956462412472815"],"URL":"https:\/\/doi.org\/10.1177\/0956462412472815","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6]]}}}