沙眼衣原体在城市内儿童和青少年中的血清流行率——对疫苗开发的启示。

Seroprevalence of Chlamydia trachomatis in Inner-City Children and Adolescents-Implications for Vaccine Development.

机构信息

From the *Department of Pediatrics, State University of New York Downstate Medical Center; †Department of Family Medicine, New York University, Lutheran Medical Center; and ‡Department of Epidemiology & Biostatistics, State University of New York, Downstate Medical Center, Brooklyn, NY.

出版信息

Sex Transm Dis. 2017 Dec;44(12):717-721. doi: 10.1097/OLQ.0000000000000683.

DOI:10.1097/OLQ.0000000000000683

PMID:28876302

Abstract

BACKGROUND

Prevention of Chlamydia trachomatis infection is an ideal application for a vaccine program, which should optimally be administered before sexual debut. However, there are limited epidemiologic studies of C. trachomatis infection in an unselected pediatric population since routine screening and treatment of pregnant women was implemented in the United States in 1993.

METHODS

Anonymized serum samples were obtained from children younger than 21 years in 2 medical centers in Brooklyn, New York, from 2013 to 2015. Anti-C. trachomatis IgG antibody was determined by a validated enzyme immunoassay. Infants younger than 1 year were excluded from the final analysis due to interference of maternal antibody.

RESULTS

One thousand two sera were included in the final analysis. Fifty-seven percent were females. No antibody was detected at younger than 11 years. Anti-C. trachomatis IgG antibody was detected in 11.4% and 5.6% of female and male subjects, respectively, older than 11 years (P = 0.0027), and seropositivity increased with age. There was no significant difference in the distribution of age at infection between the centers (P = 0.432), but a difference was detected between genders (P = 0.012) with a higher percentage of female subjects testing positive.

CONCLUSIONS

Antibody was first detected at 11 years of age, likely coinciding with sexual debut. The prevalence of antibody was higher and appeared earlier in females, mirroring national surveillance trends based on nucleic acid amplification testing. The delay in male antibody detection may be due to biological or behavioral differences between genders. These data are critical in informing potential C. trachomatis vaccine strategies.

摘要

背景

预防沙眼衣原体（Chlamydia trachomatis）感染是疫苗计划的理想应用，该计划应在首次性行为之前最佳实施。然而，自从 1993 年美国开始对孕妇进行常规筛查和治疗以来，针对未选择的儿科人群中沙眼衣原体感染的流行病学研究有限。

方法

从 2013 年至 2015 年，在纽约布鲁克林的 2 家医疗中心，从 21 岁以下的儿童中获得了匿名血清样本。通过经过验证的酶免疫测定法测定抗沙眼衣原体 IgG 抗体。由于母体抗体的干扰，1 岁以下的婴儿未纳入最终分析。

结果

最终分析共纳入 1200 份血清。其中 57%为女性。11 岁以下的儿童均未检测到抗体。11 岁以上的女性和男性受试者中分别有 11.4%和 5.6%检测到抗沙眼衣原体 IgG 抗体（P = 0.0027），且抗体阳性率随年龄增加而增加。2 个中心的感染年龄分布无显著差异（P = 0.432），但在性别之间存在差异（P = 0.012），女性受试者的阳性比例更高。