Chlamydia trachomatis anorectal infections by LGV (L1, L2 and L2b) and non-LGV serotypes in symptomatic patients in Buenos Aires, Argentina

Abstract

Background Chlamydia trachomatis (CT) can infect the anorectum producing various signs and symptoms. There is scarce literature regarding the differences between LGV and non-LGV CT anorectal manifestations. We compare the clinical spectrum of LGV and non-LGV infections. Methods Patients over 18 years with presumptive infectious anorectal symptoms were examined in two healthcare centres in Buenos Aires. The patients were studied and treated according to current sexually transmitted infection guidelines. Anorectal swabs were collected to detect and genotype CT. Results A three-year-long study on 317 patients with anorectal symptoms showed 45.11% CT infection (85% LGV strains). Of 140 samples, 92 were sequenced: 80/119 LGV (L2b 45%, L1 32.5% and L2 22.5%) and 12/21 non-LGV. Older age and HIV+ status were significantly higher in the LGV group. Anal discharge, bleeding, severe proctitis and anal ulcers were more common in the LGV group. Multivariate logistic regression analysis revealed that HIV infection, anorectal bleeding and oro-anal sex are independent predictors of LGV infection. Conclusions In patients with anorectal symptoms, LGV serovars predominate over non-LGV ones. Clinical manifestations are not pathognomonic of a specific biovar. If genotyping is not available, having clinical predictors may help to presume an LGV infection and define length of treatment.

Nanoparticle-Based Lateral Flow Biosensor Integrated With Loop-Mediated Isothermal Amplification for Rapid and Visual Identification of Chlamydia trachomatis for Point-of-Care Use

“…Genital infection with C. trachomatis is considered to be one of the most common bacterial STIs worldwide (Ramadhani et al, 2019 ; La Rosa et al, 2021 ). A distinguishing feature of C. trachomatis infection is that the patients are asymptomatic at the early stage of infection and usually delay or do not seek medical treatment, especially in less-developed regions, which brings about the continued transmission (Tadele et al, 2019 ; Caven and Carabeo, 2020 ).…”

ompA Sequencing and Multilocus Sequence Typing of Lymphogranuloma Venereum Cases in Buenos Aires Reveal New Chlamydia trachomatis Genotypes

“…Specifically, older age and HIV-positive status were significantly higher in the LGV group. Anal discharge, bleeding, severe proctitis, and anal ulcers were more commonly reported in the LGV group [ 9 ]. In this study, we delved deeper into the LGV group and utilized MLST data to conduct a comparative analysis of sequence types (STs) with associated symptoms.…”

“…Most cases presented symptomatic manifestations, demonstrating varying degrees of proctitis (mild, moderate, and severe), with associated clinical features such as straining, tenesmus, urgency for bowel movements, and mucous or purulent discharge. In addition to HIV co-infection, 40% of them were diagnosed with at least another associated STI [ 8 , 9 ].…”

“…Since the first description of the LGV outbreak in Buenos Aires, the detected strains of C. trachomatis showed unique characteristics. About half of the studied strains belonged to the L2b genotype, 20% to the L2 genotype, and one-third to the L1 genotype, which was absent in the European outbreak [ 9 , 11 , 12 , 13 ].…”

Resistencia antibiótica y aspectos clínicos de Neisseria gonorrhoeae anorrectal en un hospital de CABA, Argentina

“…Cuando se realiza tratamiento empírico en esta localización es preferible asociar doxiciclina debido a la frecuente coinfección con C. trachomatis. En CABA predomina el LGV como biovar responsable de los cuadros en pacientes sintomáticos, tal como se constató en esta serie, en que el 63% de las infecciones por C. trachomatis correspondieron a dicho biovar, en es-tos casos se sugiere la terapia combinada con doxiciclina 100 mg cada 12 hs por tres semanas (24,25).…”