Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Clin Infect Dis. 2021 Aug 2;73(3):e629-e637. doi: 10.1093/cid/ciaa1879.
Chlamydia trachomatis is the most common nationally notifiable sexually transmitted infection in the United States; however, the seroprevalence of C. trachomatis infection is unknown.
This cross-sectional study was conducted among 1725 females aged 18 to 39 years who provided serum and urine samples in the 2013 through 2016 National Health and Nutrition Examination Surveys. Presence of anti-C. trachomatis Pgp3 immunoglobulin G (IgG) was determined using both an enzyme-linked immunosorbent assay (ELISA) and multiplex bead array (MBA). Weighted seroprevalence estimates were calculated. Correlates of seroprevalence were examined by multivariable Poisson regression.
In 2013 through 2016, overall seroprevalence of C. trachomatis Pgp3 IgG was 30.0% (95% confidence interval [CI], 25.5-35.0) as measured by ELISA and 29.4% (95% CI, 25.8-33.0) as measured by the MBA assay. Overall agreement between tests was 87.1% (1503/1725). There was a high positive agreement by the MBA assay with current detection of chlamydia in urine (86% [36/42]), a past-year diagnosis of chlamydia (81.8% [27/33]), and a history of treatment for pelvic inflammatory disease (60.7% [37/61]). Seroprevalence of C. trachomatis Pgp3 IgG, as measured by MBA, was significantly higher among non-Hispanic Blacks (68.0%; adjusted prevalence ratio (aPR) = 2.7 [95% CI, 2.3-3.3]), Mexican Americans (30.9%; aPR = 1.5 [95% CI, 1.2-1.9]), and other Hispanics (35.0%; aPR = 1.9 [95% CI, 1.4-2.5]) compared with non-Hispanic Whites (21.4%). A higher lifetime number of sexual partners and a younger age at sexual debut was also associated with higher seroprevalence.
Both the ELISA and MBA serologic assays revealed a high prevalence of antibodies to C. trachomatis Pgp3 in young adult females in the US household population. There were major racial/ethnic disparities in exposure to C. trachomatis, with increased vulnerability among non-Hispanic Black females.
沙眼衣原体是美国最常见的全国性传染病；然而，沙眼衣原体感染的血清流行率尚不清楚。
本横断面研究纳入了 1725 名年龄在 18 至 39 岁的女性，她们在 2013 年至 2016 年期间参加了国家健康和营养检查调查，提供了血清和尿液样本。使用酶联免疫吸附试验（ELISA）和多重 bead 阵列（MBA）同时检测抗沙眼衣原体 Pgp3 免疫球蛋白 G（IgG）的存在。计算加权血清流行率估计值。采用多变量泊松回归分析血清流行率的相关因素。
2013 年至 2016 年，ELISA 检测沙眼衣原体 Pgp3 IgG 的总血清流行率为 30.0%（95%置信区间[CI]，25.5-35.0），MBA 检测的流行率为 29.4%（95% CI，25.8-33.0）。两种检测方法的总体一致性为 87.1%（1503/1725）。MBA 检测法与当前尿液中衣原体的检测（86%[36/42]）、过去一年的衣原体诊断（81.8%[27/33]）和盆腔炎治疗史（60.7%[37/61]）具有高度阳性一致性。MBA 检测法检测到的沙眼衣原体 Pgp3 IgG 血清流行率在非西班牙裔黑种人（68.0%；调整后流行率比[aPR]为 2.7[95% CI，2.3-3.3]）、墨西哥裔美国人（30.9%；aPR 为 1.5[95% CI，1.2-1.9]）和其他西班牙裔（35.0%；aPR 为 1.9[95% CI，1.4-2.5]）中明显高于非西班牙裔白种人（21.4%）。一生中性伴侣的数量较多和性开始年龄较小也与血清流行率较高有关。
酶联免疫吸附试验和 MBA 血清学检测均显示，在美国普通人群中，年轻成年女性中存在针对沙眼衣原体 Pgp3 的高抗体流行率。非西班牙裔黑人女性中，沙眼衣原体感染的种族/民族差异很大，易感性增加。
