沙眼衣原体细菌负荷，通过 Cq 值估计，在男性和女性就诊于普通诊所、医院或性传播感染门诊的泌尿生殖样本中。
Chlamydia trachomatis bacterial load, estimated by Cq values, in urogenital samples from men and women visiting the general practice, hospital or STI clinic.
机构信息
Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), AZ Maastricht, the Netherlands.
Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Heerlen, the Netherlands.
出版信息
PLoS One. 2019 Apr 19;14(4):e0215606. doi: 10.1371/journal.pone.0215606. eCollection 2019.
BACKGROUND
The bacterial load of Chlamydia trachomatis (CT) is assumed to play a role in transmission and sequelae. We assessed urogenital CT cycle quantification (Cq) values, as an indicator for CT load, of men and women diagnosed by general practitioners (GPs), hospital physicians and the STI clinic.
METHODS
Urogenital CT-positive samples (n = 2,055 vaginal swabs, n = 77 cervical swabs, n = 1,519 urine samples and n = 19 urethral swabs) diagnosed by GPs, hospital physicians and the STI clinic from the Maastricht Medical Microbiology Laboratory were included (2012-2016). The outcome measure 'urogenital Cq values' was used as an inversely proportional measure for CT load. Among all patients, multivariate linear regression analyses were used to assess primary determinants for mean urogenital Cq values, stratified by sex. Additional clinical determinants were assessed among STI clinic patients.
RESULTS
In men, mean urogenital Cq values were similar between GPs, hospital physicians and the STI clinic (32.7 and 33.5 vs. 32.7; p>0.05). Women visiting the GP had lower urogenital Cq values than women visiting the STI clinic (30.2 vs. 30.9; p = <0.001). Women visiting the hospital had higher urogenital Cq values than women visiting the STI clinic (32.4 vs. 30.9; p = <0.001). Among STI clinic women, urogenital Cq values were lower in women with concurrent anorectal CT and in rectally untested women compared to anorectal CT-negative women (30.7 and 30.6 vs. 33.9; p = <0.001).
CONCLUSION
Men visiting different STI care providers had similar urogenital Cq values, which could be an indicator for similar CT loads. The lower Cq values of women visiting the GP compared to women visiting the STI clinic could be an indicator for higher CT loads and likely higher transmission potential. Notably, urogenital Cq values of STI clinic women were much lower (>3 Cq) when STI clinic women also had anorectal CT. This finding could indicate higher urogenital CT loads and likely higher chances of transmission and sequelae.
背景
沙眼衣原体（CT）的细菌载量被认为在传播和后遗症中起作用。我们评估了由全科医生（GP）、医院医生和性传播感染（STI）诊所诊断的男性和女性的泌尿生殖道 CT 循环定量（Cq）值，作为 CT 负荷的指标。
方法
纳入了 2012 年至 2016 年期间马斯特里赫特医学微生物学实验室由全科医生、医院医生和 STI 诊所诊断的 CT 阳性泌尿生殖道样本（n=2055 例阴道拭子、n=77 例宫颈拭子、n=1519 例尿液样本和 n=19 例尿道拭子）。将“泌尿生殖道 Cq 值”作为 CT 负荷的反比测量指标。对所有患者进行多变量线性回归分析，按性别分层，评估泌尿生殖道 Cq 值的主要决定因素。在 STI 诊所患者中评估其他临床决定因素。
结果
在男性中，GP、医院医生和 STI 诊所之间的平均泌尿生殖道 Cq 值相似（32.7 和 33.5 比 32.7；p＞0.05）。与 STI 诊所就诊的女性相比，GP 就诊的女性泌尿生殖道 Cq 值较低（30.2 比 30.9；p＜0.001）。与 STI 诊所就诊的女性相比，医院就诊的女性泌尿生殖道 Cq 值较高（32.4 比 30.9；p＜0.001）。在 STI 诊所就诊的女性中，与直肠未检测的女性和同时患有直肠 CT 的女性相比，直肠 CT 阴性的女性泌尿生殖道 Cq 值较低（30.7 和 30.6 比 33.9；p＜0.001）。
结论
不同 STI 护理提供者就诊的男性具有相似的泌尿生殖道 Cq 值，这可能是 CT 负荷相似的指标。与 STI 诊所就诊的女性相比，GP 就诊的女性 Cq 值较低，这可能表明 CT 负荷较高，传播潜力也较高。值得注意的是，当 STI 诊所就诊的女性同时患有直肠 CT 时，其泌尿生殖道 Cq 值低得多（＞3 Cq）。这一发现可能表明泌尿生殖道 CT 负荷较高，传播和后遗症的几率也较高。
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