Assessment of Chlamydia trachomatis infection in asymptomatic male partners of infertile couples

Abstract

Three specimens from 111 asymptomatic male partners of infertile couples attending the Department of Urology in Amiens, France, were examined by the PCR COBAS AMPLICOR test (Roche Molecular Diagnostics) for the presence of Chlamydia trachomatis. The specimens analysed were: first void urine (FVU), urine obtained after prostatic massage (UPM) and semen specimens. Serum from each patient was also obtained and analysed for the presence of IgG and IgA chlamydial antibodies by in-house microimmunofluorescence (MIF) and pELISA. C. trachomatis was detected by PCR in 5 . 4 % of FVU samples, 2 . 7 % of semen specimens and in 0 . 9 % of UPM samples. Two treatments for processing the samples (storage at À70 8C and heating to 95 8C) were routinely used before initial testing to reduce the effects of inhibitors of PCR. Despite these precautions, the PCR method revealed the presence of inhibitors in 7 . 3 % of semen specimens and 3 . 6 % of FVU samples. C. trachomatis was detected by PCR COBAS AMPLICOR in seven of 111 patients (6 . 3 %) and by serology in five of 111 patients (4 . 5 %). The detection of C. trachomatis in FVU, UPM and semen specimens can serve as a marker for the presence of this organism in the genital tract, and can be used as a reliable way of detecting asymptomatic carriers of infection. INTRODUCTIONChlamydia trachomatis is one of the most common sexually transmitted pathogens of humans, with an estimated 92 million new cases occurring worldwide each year (WHO, 2001). The number of cases is probably underestimated, particularly for men, who are less likely to seek diagnosis than women. C. trachomatis often causes asymptomatic genital tract infections in both men and women, and the high number of unrecognized infected individuals provides a reservoir for spreading the infection to men and women via sexual contact.Chlamydial infection in the male urethra can be complicated by inflammation of the epididymis (Stamm et al., 1984) and the prostate gland (Dan et al., 1991), but the role that C. trachomatis infection plays in male infertility is controversial.C. trachomatis can attach to spermatozoa (Hanssen & Mardh, 1984) and can be present in cytoplasmic droplets of spermatozoa (Villegas et al., 1991). Previous studies have found a correlation between genital chlamydial infection and sperm quality (Custo et al., 1989), although other studies have reported contradictory findings (Eggert- Kruse et al., 1996;Gdoura et al., 2001). It is important to resolve this issue, since chlamydiae present in semen could be transmitted by adhering to spermatozoa, which may serve as vectors, spreading the pathogen to the uterus and Fallopian tubes. In fact, studies have reported finding spermatozoa with adhering chlamydial bodies in the peritoneal fluid of women with salpingitis at laparoscopy (Friberg et al., 1987).The presence of C. trachomatis in semen emphasizes the potential risk of this route of transmission, and underlines the need for sensitive direct detection methods in this group of patients (Dieterle et al., 1995).Sc...

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

“…Nucleic acid amplification tests, which include N-PCR, are more typically used for screening and diagnosing chlamydial infections. The plasmid target DNA is present only in C. trachomatis and at 7 to 10 copies per genome; therefore, targeting it with PCR increases the sensitivity and specificity of the test (4,5,18). We targeted plasmid DNA using N-PCR, but chlamydial DNA was not detected in any of our 14 patients with ectopic pregnancy.…”

“…Four patients had only detectable IgG antibodies against chsp60. The MIF test has been considered the "gold standard" for the serological diagnosis of chlamydial infections, and the discrimination between the different species of chlamydia (18). The specificity of the MIF test can be estimated by the ability to discriminate between C. trachomatis and C. pneumoniae reactivity (5,18).…”

“…The MIF test was developed for typing the C. trachomatis strains in serotypes and for seroepidemiological studies. Until now, the MIF test has been considered the "gold standard" for the serological diagnosis of chlamydial infections (18).…”

Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia

“…Men can harbor subclinical infections in the genital tract over extended periods of time. Several viruses, including cytomegalovirus (CMV), Epstein-Barr virus (EBV), human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), herpes simplex virus type 2 (HSV-2), human herpes virus type 6 (HHV-6), and human immunodeficiency virus type 1 (HIV-1), as well as the intracellular bacterium, Chlamydia trachomatis (CT), have been detected in semen from asymptomatic men (5)(6)(7)(8).…”

Detection of Common Bacterial Causes of STIs among STD Clinic Attendees by Gram Stain and Culture versus the Microarray Nucleic Acid Hybridization Method

“…STIs often have no or mild symptoms and therefore, can go unrecognized and subsequently, untreated [3][4][5]. Unrecognized and untreated STIs can lead to serious adverse effects on an individual's sexual and reproductive health.…”