High Rates of Repeat Chlamydial Infections Among Young Women—Louisiana, 2000–2015

Cha, Susan; Newman, Daniel R.; Rahman, Mohammad; Peterman, Thomas A.

doi:10.1097/olq.0000000000000906

Cited by 11 publications

(13 citation statements)

References 31 publications

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“…early detection, treatment and prevention for repeat infections, C. trachomatis infections are rising. 21 The ongoing unmet need and 'mounting pressure' to develop chlamydia vaccines is visible in the patent landscape and is especially reflected in patenting activity for interventions in humans. 22 This study found clear technical and clinical differences between innovation efforts in the human and veterinary field.…”

Section: Discussionmentioning

confidence: 99%

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Identifying the gaps in human and veterinary chlamydia vaccine development

et al. 2020

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Background: Chlamydia infections in humans and animals pose a significant burden on health systems worldwide. While widespread screening, adequate treatment, and prevention programs are helpful to increase awareness and improve screening rates, infection rates are rising. A vaccine is necessary to slow increasing rates, manage negative consequences, and prevent possible antibiotic resistance. We present the current landscape regarding the innovations for commercial vaccine development in a “one-health” context.Methods: We developed a unique dataset containing data of patent documents intended for human and veterinary use, and clinical trials in order to provide a detailed description of the global chlamydia vaccine developments.Results: Analysis of patents and clinical trials intended for human use presented a vaccine field that is underdeveloped, with no commercial human chlamydia vaccine available, and two potential candidates in a phase 1 clinical trial. Comparing innovations concerning chlamydia vaccine developments for both human and veterinary patents, it was clear that these fields are very different and independent of each other. The field is small, and certain companies and researchers show repeated interest. Partnerships among applicants and those involved in chlamydia vaccine innovation would be an important step to take towards innovating and developing an effective vaccine.Conclusions: We have shown that North America is considered, by patent application, to hold the most potential for a chlamydia vaccine, specifically against the Chlamydia trachomatis strain. A new vaccine is likely to be a subunit vaccine with components of the major outer membrane protein antigen.

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Section: Discussionmentioning

confidence: 99%

“…All this indicates a high interest or high sense of urgency to solve the unmet need in the US. 21 In contrast, most veterinary vaccines are applied for by Chinese and Russian applicants. This interest by Chinese applicants can be explained by the economic burden that veterinary chlamydia serovars pose on Chinese livestock.…”

Section: Discussionmentioning

confidence: 99%

Identifying the gaps in human and veterinary chlamydia vaccine development

et al. 2020

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“…12,34 Rates of recurrent infection in nonpregnant women average 14%, and predictors of recurrence include age of <20 years and black race. 4,15,35 The current study shows that gonorrhea and syphilis coinfection in pregnancy is independently associated with persistent or recurrent chlamydia. This is consistent with studies in nonpregnant women.…”

Section: Resultsmentioning

confidence: 51%

“…1 Women between the ages of 15 and 24 years and women who reside in the southeastern United States, where the case rate is 744 cases per 100,000 persons, are disproportionally affected by chlamydia. 1 - 4 Untreated chlamydia in pregnancy has been associated with preterm delivery and low birthweight (LBW) infants. 5 - 9 Infection in women is usually asymptomatic, and timely screening and treatment in pregnancy can prevent adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

High rates of persistent and recurrent chlamydia in pregnant women after treatment with azithromycin

Dionne-Odom

Subramaniam

Aaron

et al. 2020

American Journal of Obstetrics & Gynecology MFM

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BACKGROUND: Chlamydia trachomatis is a common bacterial sexually transmitted infection that can persist or recur after antibiotic treatment. Universal screening for chlamydia in pregnancy is recommended to prevent adverse birth outcomes. Single-dose oral azithromycin has been the first-line therapy for chlamydia in pregnancy since 2006. OBJECTIVE: In the setting of limited data and rising sexually transmitted infection rates in the United States, our goal was to document rates and risk factors for persistent or recurrent chlamydia after azithromycin treatment in pregnancy. STUDY DESIGN: This retrospective cohort study included pregnancies with urogenital chlamydia and follow-up testing in women who delivered at an Alabama facility between November 2012 and December 2017. Pregnancies with prescribed azithromycin therapy and repeat chlamydia testing !21 days later were included. Chlamydia trachomatis nucleic acid amplification testing was performed on genital swab or urine samples. Descriptive characteristics and birth outcomes were compared for categories stratified by repeat test results: persistence (þ þ), recurrence (þ À þ), or clearance (þ À). Logistic regression models were used to identify demographic and clinical risk factors for persistent or recurrent chlamydia in pregnancy. RESULTS: Among 810 women with 840 pregnancies with repeat chlamydia testing after azithromycin treatment, 114 (14%) had persistence and an additional 72 (9%) had recurrence later in pregnancy. The median time to repeat testing was 30 days (interquartile range, 24e49 days). Concomitant gonorrhea or syphilis in pregnancy was independently associated with persistent or recurrent chlamydia (adjusted odds ratio, 1.6; 95% confidence interval, 1.1e2.4). CONCLUSION: Persistent or recurrent chlamydia after azithromycin treatment was detected in nearly 1 in 4 pregnancies with repeat testing in our urban center, highlighting the importance of performing a test of cure and ensuring partner therapy to reduce recurrent chlamydia risk.

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“…Rescreening fluctuated year to year but the overall trend was consistently suboptimal. The findings of higher positivity at rescreening compared with initial screening might be due to numerous factors, including high community prevalence, re-exposure to untreated sexual partners, and treatment compliance issues ( 33 , 34 ). Rescreening also might have been focused on the adolescent and young females who were identified as having a higher risk for reinfection, thus overestimating the prevalence of reinfection.…”

Section: Discussionmentioning

confidence: 99%