Development of PCR assays for detection of Trichomonas vaginalis in urine specimens.

Trichomonas vaginalis infections are usually asymptomatic or can result in nonspecific clinical symptoms, which makes laboratory-based detection of this protozoan parasite essential for diagnosis and treatment. We report the development of a battery of highly sensitive and specific PCR assays for detection of T. vaginalis in urine, a noninvasive specimen, and development of a protocol for differentiating among Trichomonas species that commonly infect humans.

Distribution of Chlamydia trachomatis genovars among youths and adults in Brazil.

Despite a high prevalence of sexually transmitted Chlamydia trachomatis infections in Brazil and other countries in South America, very little is known about the distribution of C. trachomatis genovars. In this study, we genotyped C. trachomatis strains from urine or endocervical specimens collected from 163 C. trachomatis-positive female and male youths, and female adults, residing in two different regions of Brazil, the city of Goiânia located in the central part of Brazil, and the city of Vitória in the south-east region. C. trachomatis strains were genotyped by amplifying and sequencing the ompA gene encoding the chlamydial major outer-membrane protein, which is genovar specific. We found nine different C. trachomatis genovars: E (39.3%), F (16.6%), D (15.9%), I (8.6%), J (7.4%), G (4.9%), K (3.1%), H (2.4%) and B (1.8%). The distribution of the C. trachomatis genovars in the two regions of Brazil was similar, and there was no statistically significant association of serovars with age, gender, number of sexual partners or clinical symptoms. The overall distribution of C. trachomatis genovars in Brazil appears similar to that found in other regions of the world, where E, D and F are the most common. This supports the notion that, during the last few decades, the overall distribution of C. trachomatis genovars throughout the world has been relatively stable.

Evaluation of the rapid BioStar optical immunoassay for detection of Chlamydia trachomatis in adolescent women.

We evaluated the performance of the BioStar Chlamydia OIA (optical immunoassay) in adolescent females (n = 261) from an inner city population. With a reference standard of two different nucleic acid amplification tests, the sensitivity and specificity of the BioStar Chlamydia OIA were 59.4 and 98.4%, respectively. Due to its relatively low sensitivity, the BioStar Chlamydia OIA should only be used in conjunction with more sensitive laboratory tests unless laboratory tests are unavailable or timely return for treatment is unlikely.

The natural history of untreated Chlamydia trachomatis infection in the interval between screening and returning for treatment.

BACKGROUND: Studies of the natural history of genital chlamydial infections in humans are sparse and have had study design limitations. An improved understanding of chlamydial natural history may influence recommendations for elements of control efforts such as chlamydia screening frequency or time parameters for partner notification. METHODS: Addressing limitations of prior studies in part, we are prospectively studying chlamydial natural history in sexually transmitted diseases clinic patients in the interval between screening and returning for treatment of positive chlamydial tests. Results of repeat chlamydial testing and clinical outcomes and their associated predictors are being evaluated. RESULTS: In the initial 129 subjects, 89% were female, 88% were black, median age was 21 years, and the median interval between screening and treatment was 13 days. Based on nucleic acid amplification testing at treatment, spontaneous resolution of chlamydia occurred in 18%. Resolution was somewhat more common in subjects with longer intervals between screening and treatment. Persisting infections more often progressed to develop clinical signs at the time of treatment (e.g., urethritis or cervicitis). Two women and one man developed chlamydial complications between screening and treatment. CONCLUSIONS: Our findings demonstrate that although spontaneous resolution of chlamydia is common, many persons with persisting chlamydia progress to develop signs of infection and some develop complications.

Chlamydia trachomatis serovars among strains isolated from members of rural indigenous communities and urban populations in Australia.

We genotyped Chlamydia trachomatis strains from 45 women or men living in either a rural indigenous community or in urban heterosexual communities. We found six different C. trachomatis serovars: E (n = 22; 48.9%), F (n = 10; 22.2%), J/Ja (n = 5; 11.1%), D/Da (n = 4; 8.9%), G (n = 3; 6.7%), and K (n = 1; 2.2%). The distribution of C. trachomatis serovars among members of the indigenous rural and the urban Australian communities appears similar to that in other Western countries.