澳大利亚北部和中部偏远地区泌尿生殖系统样本横断面研究中的沙眼衣原体基因型
Chlamydia trachomatis genotypes in a cross-sectional study of urogenital samples from remote Northern and Central Australia.
作者信息
Giffard Philip M, Brenner Nicole C, Tabrizi Sepehr N, Garland Suzanne M, Holt Deborah C, Andersson Patiyan, Lilliebridge Rachael A, Tong Steven Y C, Karimi Mahdad, Boylan Prudence, Ryder Nathan, Johns Tracy, Singh Gurmeet
机构信息
Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia.
Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia Forensic Science Branch-Biology, Northern Territory Fire and Emergency Services, Darwin, Northern Territory, Australia.
出版信息
BMJ Open. 2016 Jan 6;6(1):e009624. doi: 10.1136/bmjopen-2015-009624.
OBJECTIVES
The objective was to determine the frequency of trachoma genotypes of Chlamydia trachomatis-positive urogenital tract (UGT) specimens from remote areas of the Australian Northern Territory (NT).
SETTING
The setting was analysis of remnants of C. trachomatis positive primarily UGT specimens obtained in the course of clinical practice. The specimens were obtained from two pathology service providers.
PARTICIPANTS
From 3356 C. trachomatis specimens collected during May 2012-April 2013, 439 were selected for genotyping, with a focus on specimens from postpubescent patients, in remote Aboriginal communities where ocular trachoma is potentially present.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary outcome measure was the proportion of successfully genotyped UGT specimens that were trachoma genotypes. The secondary outcome measures were the distribution of genotypes, and the frequencies of different classes of specimens able to be genotyped.
RESULTS
Zero of 217 successfully genotyped UGT specimens yielded trachoma genotypes (95% CI for frequency=0-0.017). For UGT specimens, the genotypes were E (41%), F (22%), D (21%) and K (7%), with J, H and G and mixed genotypes each at 1-4%. Four of the five genotyped eye swabs yielded trachoma genotype Ba, and the other genotype J. Two hundred twenty-two specimens (50.6%) were successfully genotyped. Urine specimens were less likely to be typable than vaginal swabs (p<0.0001).
CONCLUSIONS
Unlike in some other studies, in the remote NT, trachoma genotypes of C. trachomatis were not found circulating in UGT specimens from 2012 to 2013. Therefore, C. trachomatis genotypes in UGT specimens from young children can be informative as to whether the organism has been acquired through sexual contact. We suggest inclusion of C. trachomatis genotyping in guidelines examining the source of sexually transmitted infections in young children in areas where trachoma genotypes may continue to circulate, and continued surveillance of UGT C. trachomatis genotypes.
目的
本研究旨在确定澳大利亚北领地（NT）偏远地区沙眼衣原体阳性泌尿生殖道（UGT）标本中沙眼基因型的出现频率。
背景
本研究是对临床实践中获得的沙眼衣原体阳性主要UGT标本的剩余部分进行分析。标本来自两家病理服务提供商。
参与者
在2012年5月至2013年4月期间收集的3356份沙眼衣原体标本中，选取了439份进行基因分型，重点关注青春期后患者的标本，这些标本来自可能存在眼沙眼的偏远原住民社区。
主要和次要观察指标
主要观察指标是成功进行基因分型的UGT标本中沙眼基因型的比例。次要观察指标是基因型的分布，以及能够进行基因分型的不同类别标本的频率。
结果
217份成功进行基因分型的UGT标本中，没有一份产生沙眼基因型（频率的95%置信区间为0 - 0.017）。对于UGT标本，基因型为E（41%）、F（22%）、D（21%）和K（7%），J、H、G以及混合基因型各占1 - 4%。五份进行基因分型的眼拭子中有四份产生了沙眼基因型Ba，另一份为基因型J。222份标本（50.6%）成功进行了基因分型。尿液标本比阴道拭子更不容易进行分型（p<0.0001）。
结论
与其他一些研究不同，在偏远的北领地，2012年至2013年期间未发现沙眼衣原体的沙眼基因型在UGT标本中传播。因此，幼儿UGT标本中的沙眼衣原体基因型对于该病原体是否通过性接触获得具有参考价值。我们建议在沙眼基因型可能继续传播的地区，将沙眼衣原体基因分型纳入检查幼儿性传播感染来源的指南中，并持续监测UGT沙眼衣原体基因型。
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