Frequency of co-infection with urogenital chlamydial infection and other sexually transmitted infections and assessment of associated risk factors
A.A. Abramov1, A.Yu. Brazhnikov1, K.I. Plakhova2,3, N.I. Briko1
1I.M. Sechenov First Moscow State Medical University (Sechenov University), 8 Trubetskaya St., build. 2, Moscow, 119048, Russian Federation
2State Scientific Center of Dermatovenereology and Cosmetology, 3 Korolenko St., build. 6, Moscow, 107076, Russian Federation
3Russian Medical Academy of Continuous Professional Education, 2/1 Barrikadnaya St., build. 1, 125993, Moscow, Russian Federation
Chlamydia trachomatis is one of the most common sexually transmitted infection (STI) pathogens worldwide. Co-infection with multiple STI pathogens increases the risk of complications and the spread of infections necessitating research of risk factors for effective prevention and control.
We analyzed 1,201 medical histories of patients who sought treatment at a specialized dermatovenereological center between 2005 and 2022. Logistic regression was used to assess the independent influence of each analyzed factor.
Co-infection with multiple pathogens was detected in 7.8 % of patients, more frequently among women (68.1 %) and indi-viduals aged 18–29 years (71.3 %). The main co-infections in patients with urogenital chlamydial infection were anogenital (venereal) warts (80.9 %), anogenital herpes infection (20.2 %), and gonococcal infection (14.8 %). Logistic analysis revealed that the likelihood of co-infection was higher among women (OR = 4.84), minors (OR = 3.26), individuals aged 18–29 years (OR = 1.97), those with regular sexual activity (OR = 1.56), and those not in a marital relationship (OR = 2.72).
This study identified factors associated with co-infection with multiple STI pathogens in patients with chlamydial infection, including female sex, age 18–29 years, being unmarried, and having regular sexual activity. The results emphasize the need for early screening for chlamydial infection and other STIs, as well as preventive measures for high-risk groups.
- Li C., Ong J., Tang W., Wang C. Editorial: Chlamydia trachomatis infection: Epidemiology, prevention, clinical, and basic science research. Front. Public Health, 2023, vol. 11, pp. 1167690. DOI: 10.3389/fpubh.2023.1167690
- Kubanov A.A., Bogdanova E.V. Performance results of medical organizations providing medical care in the field of dermatovenereology in 2019–2021 in the Russian Federation. Vestnik dermatologii i venerologii, 2022, vol. 98, no. 5, pp. 18–33. DOI: 10.25208/vdv1337 (in Russian).
- Fischer N., Peeters I., Klamer S., Montourcy M., Cuylaerts V., Van Beckhoven D., De Baetselier I., Van der Heyden J., Vanden Berghe W. Prevalence estimates of genital Chlamydia trachomatis infection in Belgium: results from two cross-sectional studies. BMC Infect. Dis., 2021, vol. 21, no. 1, pp. 947. DOI: 10.1186/s12879-021-06646-y
- Smelov V., Thomas P., Ouburg S., Morré S.A. Prevalence of genital Chlamydia trachomatis infections in Russia: sys-tematic literature review and multicenter study. Pathog. Dis., 2017, vol. 75, no. 7. DOI: 10.1093/femspd/ftx081
- Foschi C., Nardini P., Banzola N., D'Antuono A., Compri M., Cevenini R., Marangoni A. Chlamydia trachomatis in-fection prevalence and serovar distribution in a high-density urban area in the north of Italy. J. Med. Microbiol., 2016, vol. 65, no. 6, pp. 510–520. DOI: 10.1099/jmm.0.000261
- Gassowski M., Poethko-Müller C., Schlaud M., Sailer A., Dehmel K., Bremer V., Dudareva S., Jansen K., Chlamydia trachomatis laboratory sentinel team. Prevalence of Chlamydia trachomatis in the general population in Germany – a triangulation of data from two population-based health surveys and a laboratory sentinel system. BMC Public Health, 2022, vol. 22, no. 1, pp. 1107. DOI: 10.1186/s12889-022-13456-7
- Vladimirova E.V., Kovalyk V.P., Murakov S.V., Vladimirov A.A., Markova Yu.A. Analysis of the prevalence of STIs in Russia according to the Federal Laboratory Network. Klinicheskaya praktika, 2019, vol. 10, no. 3, pp. 35–41. DOI: 10.17816/clinpract10335–41 (in Russian).
- Mitchell C.M., Anyalechi G.E., Cohen C.R., Haggerty C.L., Manhart L.E., Hillier S.L. Etiology and diagnosis of pelvic inflammatory disease: looking beyond gonorrhea and chlamydia. J. Infect. Dis., 2021, vol. 224, no. 12, suppl. 2, pp. S29–S35. DOI: 10.1093/infdis/jiab067
- Tang W., Mao J., Li K.T., Walker J.S., Chou R., Fu R., Chen W., Darville T. [et al.]. Pregnancy and fertility-related adverse outcomes associated with Chlamydia trachomatis infection: a global systematic review and meta-analysis. Sex. Transm. Infect., 2020, vol. 96, no. 5, pp. 322–329. DOI: 10.1136/sextrans-2019-053999
- Zenilman J.M. Gonorrhea and Chlamydia. In book: Sexually transmitted infections: diagnosis, management, and treatment; J.M. Zenilman, M. Shahmanesh eds. US, Jones & Bartlett Learning Publ., 2011, pp. 31.
- Liu B., Guy R., Donovan B., Kaldor J.M. Chlamydia trachomatis re-infections in a population-based cohort of women. Sex. Transm. Infect., 2013, vol. 89, no. 1, pp. 45–50. DOI: 10.1136/sextrans-2011-050252
- Aung E.T., Chow E.P., Fairley C.K., Hocking J.S., Bradshaw C.S., Williamson D.A., Chen M.Y. International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017. Euro Surveill., 2019, vol. 24, no. 44, pp. 1900219. DOI: 10.2807/1560-7917.ES.2019.24.44.1900219
- Campaner A.B., De Castro M.A., Lucarelli A.P. Chlamydia trachomatis prevalence in females in São Paulo, Brazil: 11 years’ surveillance of the infection. Braz. J. Microbiol., 2023, vol. 54, no. 1, pp. 151–158. DOI: 10.1007/s42770-022-00865-4
- Shilling H.S., Garland S.M., Costa A.-M., Marceglia A., Fethers K., Danielewski J., Murray G., Bradshaw C. [et al.]. Chlamydia trachomatis and Mycoplasma genitalium prevalence and associated factors among women presenting to a pregnancy termination and contraception clinic, 2009–2019. Sex. Transm. Infect., 2022, vol. 98, no. 2, pp. 115–120. DOI: 10.1136/sextrans-2020-054695
- Hilmarsdóttir I., Arnardóttir E.M., Jóhannesdóttir E.R., Golparian D., Unemo M. Chlamydia trachomatis in Iceland: Prevalence, clinico-epidemiological features and comparison of Cobas 480 CT/NG and Aptima Combo 2 (CT/NG) for diagnosis. Acta Derm. Venereol., 2021, vol. 101, no. 2, pp. adv00393. DOI: 10.2340/00015555-3762
- Darville T. Pelvic inflammatory disease due to Neisseria gonorrhoeae and Chlamydia trachomatis: immune evasion mechanisms and pathogenic disease pathways. J. Infect. Dis., 2021, vol. 224, no. 12, suppl. 2, pp. S39–S46. DOI: 10.1093/infdis/jiab031
- Lee S.J., Jang T.S., Jeon J.-S., Kim J.K. Coinfections with multiple sexually transmitted pathogens in Republic of Ko-rea, 2018–2020. Journal of Clinical Laboratory Analysis, 2022, vol. 36, no. 10, pp. e24682. DOI: 10.1002/jcla.24682
- van Veen M.G., Koedijk F.D.H., van der Sande M.A.B., Dutch STD centres. STD coinfections in The Netherlands: specific sexual networks at highest risk. Sex. Transm. Dis., 2010, vol. 37, no. 7, pp. 416–422. DOI: 10.1097/OLQ.0b013e3181cfcb34
- Ghasemian E., Harding-Esch E., Mabey D., Holland M.J. When Bacteria and Viruses Collide: A Tale of Chlamydia trachomatis and Sexually Transmitted Viruses. Viruses, 2023, vol. 15, no. 9, pp. 1954. DOI: 10.3390/v15091954
- Gómez Castellá J., Díaz Franco A., Polo Rodríguez R., Del Amo Valero J. Approaches to STI Prevention and Control in a Highly Decentralized State: An Integrative Review. Front. Reprod. Health, 2022, vol. 4, pp. 725646. DOI: 10.3389/frph.2022.725646