Ding Alvin, Challenor Rachel
GUM Department, Derriford Hospital, Plymouth, UK
GUM Department, Derriford Hospital, Plymouth, UK.
Int J STD AIDS. 2014 Jul;25(8):587-92. doi: 10.1177/0956462413515637. Epub 2013 Dec 18.
The aim of this study was to observe the proportion of concurrent rectal Chlamydia (RCt) infection in women who have cervical Chlamydia (CCt) and to observe whether there was any correlation with receptive anal intercourse (RAI). Untreated CCt-positive women were invited to take part. Women chose either to have a physician-collected or self-taken rectal swab. Treatment was then commenced. 17 samples were physician-collected and 80 were self-collected. 75/97 (77.3%, 95% Confidence Interval [95%CI] 69.0-85.7%) were RCt positive. 25/97 (25.8%, 95%CI 17.1-34.5%) reported RAI. There was no difference in the positivity rate whether RAI was reported (80%) or not (76%) (P = 0.71); or whether swabs were physician-collected (65%) or self-taken (80%) (P = 0.17). Only one of those with RCt reported rectal symptoms. One woman had concurrent gonococcal infection. 34/97 (35%) had a history of past sexually transmitted infections. Verified contact attendance was 0.52 and 72% of verified contacts were Chlamydia positive. Reported RAI may not be helpful in guiding RCt testing. RCt infection in women may be more prevalent than previously thought. We do not know whether RCt infections are clinically significant or whether they may act as a reservoir for re-infection. RCt infections in women require further study.
本研究的目的是观察患有宫颈衣原体（CCt）的女性中同时感染直肠衣原体（RCt）的比例，并观察其与接受式肛交（RAI）是否存在关联。未接受治疗的CCt阳性女性受邀参与研究。女性可选择由医生采集或自行采集直肠拭子。随后开始治疗。17份样本由医生采集，80份由自行采集。97份样本中75份（77.3%，95%置信区间[95%CI]为69.0 - 85.7%）RCt呈阳性。97份样本中有25份（25.8%，95%CI为17.1 - 34.5%）报告有接受式肛交。报告有接受式肛交的患者阳性率（80%）与未报告的患者阳性率（76%）之间无差异（P = 0.71）；拭子由医生采集的患者阳性率（65%）与自行采集的患者阳性率（80%）之间也无差异（P = 0.17）。RCt阳性患者中仅1人报告有直肠症状。1名女性同时感染了淋球菌。97份样本中有34份（35%）有既往性传播感染史。核实的性伴侣就诊率为0.52，72%的核实性伴侣衣原体呈阳性。报告的接受式肛交情况可能无助于指导RCt检测。女性中的RCt感染可能比之前认为的更为普遍。我们尚不清楚RCt感染是否具有临床意义，或者它们是否可能成为再次感染的储存源。女性中的RCt感染需要进一步研究。
