Suchland Robert J, Dimond Zoe E, Putman Timothy E, Rockey Daniel D
Department of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle.
College of Veterinary Medicine and Molecular and Cellular Biology Program, Oregon State University, Corvallis.
J Infect Dis. 2017 Jun 1;215(11):1657-1665. doi: 10.1093/infdis/jix155.
The biology of recurrent or long-term infections of humans by Chlamydia trachomatis is poorly understood. Because repeated or persistent infections are correlated with serious complications in humans, understanding these processes may improve clinical management and public health disease control.
We conducted whole-genome sequence analysis on C. trachomatis isolates collected from a previously described patient set in which individuals were shown to be infected with a single serovar over a lengthy period.
Data from 5 of 7 patients showed compelling evidence for the ability of these patients to harbor the same strain for 3-5 years. Mutations in these strains were cumulative, very uncommon, and not linked to any single protein or pathway. Serovar J strains isolated from 1 patient 3 years apart did not accumulate a single base change across the genome. In contrast, the sequence results of 2 patients, each infected only with serovar Ia strains, revealed multiple same-serovar infections over 1-5 years.
These data demonstrate examples of long-term persistence in patients in the face of repeated antibiotic therapy and show that pathogen mutational strategies are not important in persistence of this pathogen in patients.
沙眼衣原体对人类的反复感染或长期感染的生物学机制尚未得到充分了解。由于反复感染或持续性感染与人类的严重并发症相关，了解这些过程可能会改善临床管理和公共卫生疾病控制。
我们对从先前描述的一组患者中收集的沙眼衣原体分离株进行了全基因组序列分析，在这组患者中，个体在很长一段时间内被证明感染了单一血清型。
7名患者中有5名的数据显示了令人信服的证据，证明这些患者能够在3至5年内携带同一菌株。这些菌株中的突变是累积性的，非常罕见，并且与任何单一蛋白质或途径均无关联。从1名患者相隔3年分离出的血清型J菌株在整个基因组中没有积累一个碱基变化。相比之下，2名仅感染血清型Ia菌株的患者的序列结果显示，在1至5年期间发生了多次相同血清型感染。
这些数据证明了在反复进行抗生素治疗的情况下患者长期携带病原体的实例，并表明病原体的突变策略在该病原体在患者体内的持续存在中并不重要。
