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Background: Chlamydia trachomatis is a common sexually transmitted disease that is associated with considerable morbidity and harmful sequelae, including pelvic inflammatory disease and infertility. Strategies for prevention and treatment of infertility in women with C. trachomatis infection require further investigation. There is evidence suggesting that vitamin D could be a potential treatment. This study aimed to investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels, chlamydia seropositivity, and the risk of infertility in women., Methods: We conducted this cross-sectional study using 2013-2016 National Health and Nutrition Examination Survey data. Women aged 18-39 years with complete serum 25(OH)D and chlamydia Pgp3Ab multiplex bead/enzyme-linked immunosorbent assay data available were included. The correlation between 25(OH)D level, chlamydia seropositivity, and infertility was evaluated using the weighted chi-squared test and the t-test with multivariate logistic regression and moderation effect models., Results: Among the 1424 women who met our eligibility criteria, the weighted chlamydia seropositivity rate was 36.8%. The 25(OH)D level was significantly lower in the seropositive group compared with seronegative control. (P = 0.009). After adjusting for ethnicity, the effect of 25(OH)D was no longer significant (P = 0.693). Further analysis in the chlamydia-seropositive subset revealed that the vitamin D level was lower in the infertile group (P = 0.024). In an interaction model, 25(OH)D was found to antagonizes the positive relationship between chlamydia and infertility (OR = 0.985, 95% CI: 0.971-0.999, P = 0.040)., Conclusion: The serum vitamin D level may be more related to the prognosis in terms of infertility than to the risk of chlamydia infection. This finding may reveal a possible treatment strategy for chlamydia infection., Competing Interests: Declarations Ethics approval and consent to participate This work was based on the public available NHANES data. All NHANES protocols are approved by the CDC’s National Center for Health Statistics Ethics Review Board, and all survey respondents provide written informed consent. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

This study explored the clinical characteristics of Chlamydia trachomatis (C. trachomatis) pneumonia in children and the risk factors for severe C. trachomatis pneumonia. This retrospective case-control study included children with C. trachomatis pneumonia who were admitted to the Department of Pediatrics, Women and Children's Hospital, School of Medicine, Xiamen University (Xiamen, China) between January 2018 and December 2021. Among 117 children, 33 (28.2%) had severe C. trachomatis pneumonia and 84 children had mild-to-moderate C. trachomatis pneumonia. According to the results of the binary logistic regression analysis, congenital heart disease [odds ratio (OR) = 0.09, 95% confidence interval (CI): 0.01-0.74, P-value = .024], mixed infection (OR = 0.17, 95%CI: 0.05-0.51, P-value = .002), white blood cell count greater than 15 000 cells/dl (OR = 1.20, 95%CI: 1.03-1.40, P-value = .022), and partial pressure of carbon dioxide (PaCO2) (OR = 1.14, 95%CI: 1.02-1.26, P-value = .016) were found as independent predictive factors for severe C. trachomatis pneumonia in children. This study explored key risk factors for severe C. trachomatis pneumonia, a condition underreported in tropical regions where pediatric respiratory infections are a leading cause of morbidity and mortality. By identifying risk factors, such as congenital heart disease, mixed infections, and elevated PaCO2, this research may guide early intervention strategies in resource-limited settings, potentially reducing pediatric pneumonia deaths., (© The Author(s) [2024]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Chlamydia trachomatis (C. trachomatis) infection has been implicated in various cancers, yet its association with breast cancer remains unexplored. This infection triggers a cascade of immune responses primarily regulated by Interleukins-12 (IL-12). Thus, the objective of this case-control study was to investigate the link between C. trachomatis infection and breast cancer risk, as well as the modification effect of IL-12., Methods: We assessed IgG levels against C. trachomatis in serum of 1,121 women with breast cancer (861 with estrogen receptor-positive (ER+) and 260 with estrogen receptor-negative (ER-) tumors) and 400 controls in Guangzhou, China. Logistic regression models were applied to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for breast cancer risk in association with C. trachomatis infection. The interaction between C. trachomatis infection and IL-12 on breast cancer risk was estimated by the product terms in the logistic regression models., Results: Seropositivity of C. trachomatis IgG showed a slight association with an increased risk of breast cancer (OR = 1.20; 95% CI: 0.86∼1.78). This association was more pronounced among women with a higher (OR = 5.82; 95% CI: 1.31∼25.94) than a lower (OR = 0.73; 95% CI: 0.41∼1.30) level of IL-12, with a statistically significant interaction observed (P interaction = 0.013). In addition, C. trachomatis IgG seropositivity was related to an increased risk of breast cancer among PR+ patients (OR = 1.53; 95% CI: 1.04∼2.23)., Conclusions: C. trachomatis infection may contribute to the development of hormone-responsive breast cancer in women with high levels of IL-12. Further studies are needed to uncover the underlying mechanisms., Competing Interests: Disclosure The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Epstein-Barr virus (EBV) is a major cause of infectious mononucleosis (IM), characterized by fever, fatigue, sore throat, lymphadenopathy, atypical lymphocytosis, and elevated liver enzymes. However, ascites is a rare complication associated with IM. We present a rare case of IM with ascites and peritonitis in a patient who underwent a peritoneal biopsy. A 20-year-old woman presented with fatigue and abdominal distension. Laboratory examination revealed atypical lymphocytes in peripheral blood (54%) and elevated liver enzymes. EBV serological tests revealed a recent primary infection (EBV VCA IgM 1:160). Computed tomography revealed moderate ascites and peritonitis. Adenocarcinoma was suspected based on the ascites' cytology. Considering possible complications of IM and adenocarcinoma, a laparoscopic biopsy was performed. Histological findings of biopsy specimens from the peritoneum, omentum, and fimbria of the fallopian tube demonstrated severe inflammatory cell infiltration and focal aggregation of large EBV-encoded RNA-1 (EBER1)-positive B cells, mimicking EBV-positive polymorphous B-cell lymphoproliferative disorder. Furthermore, intracytoplasmic inclusion bodies of Chlamydia trachomatis were observed by immunohistochemistry. Real-time polymerase chain reaction detected C. trachomatis in cervical secretions. Two months after laparoscopy, ascites decreased, and the diagnosis was IM-associated peritonitis with C. trachomatis infection. IM should be considered as a differential diagnosis in young patients with ascites., (© 2024 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.)

Background: Chlamydia abortus, as a pathogen of atypical pneumonia, is rare in humans, especially in HIV infection patients., Case Presentation: We present the case of a 48-year-old man with a history of HIV infection who started high fever and developed pneumonia. The pathogen-targeted next-generation sequencing (ptNGS) results of bronchial lavage fluid showed Chlamydia abortus infection., Conclusion: This is the first report of Chlamydia abortus infection presented as atypical pneumonia in an AIDS patient., (© 2024. The Author(s).)

Infectious mononucleosis (IM) is suspected to be associated with inflammatory bowel disease (IBD) development. Using a Danish nationwide cohort of people developing severe IM and their age-, sex-, and socioeconomic (SES) index-matched counterparts, we investigated the subsequent risk of IBD, Crohn's disease (CD), or ulcerative colitis (UC) development from 1977 to 2021. Among 39,684 severe IM patients we find a sex-, age-, and SES index-adjusted HR for IBD of 1.35 (95% CI: 1.22-1.49). This significantly increased risk was seen for both CD (HR: 1.56; 95% CI: 1.34-1.83) and to a lesser extent UC (HR: 1.23; 95% CI: 1.08-1.40) and remains following negative control matching with a cohort diagnosed with Chlamydia trachomatis infection (HR: 1.39; 95% CI: 1.01-1.91). Those with severe IM at 0-9 years had a particularly increased risk for CD (HR: 1.77; 95% CI: 1.26-2.49). Here we show an increased risk for IBD diagnosis following IM hospitalisation, indicating an association between severe EBV disease and later IBD development. Further exploration of the potential factors contributing to IBD susceptibility following EBV disease is warranted., (© 2024. The Author(s).)

Background: Syndromic management is widely used to treat symptomatic sexually transmitted infections in settings without aetiologic diagnostics. However, underlying aetiologies and consequent treatment suitability are uncertain without regular assessment. This systematic review estimated the distribution, trends, and determinants of aetiologies for vaginal discharge, urethral discharge, and genital ulcer in sub-Saharan Africa (SSA)., Methods and Findings: We searched Embase, MEDLINE, Global Health, Web of Science, and grey literature from inception until December 20, 2023, for observational studies reporting aetiologic diagnoses among symptomatic populations in SSA. We adjusted observations for diagnostic test performance, used generalised linear mixed-effects meta-regressions to generate estimates, and critically appraised studies using an adapted Joanna Briggs Institute checklist. Of 4,418 identified records, 206 reports were included from 190 studies in 32 countries conducted between 1969 and 2022. In 2015, estimated primary aetiologies for vaginal discharge were candidiasis (69.4% [95% confidence interval (CI): 44.3% to 86.6%], n = 50), bacterial vaginosis (50.0% [95% CI: 32.3% to 67.8%], n = 39), chlamydia (16.2% [95% CI: 8.6% to 28.5%], n = 50), and trichomoniasis (12.9% [95% CI: 7.7% to 20.7%], n = 80); for urethral discharge were gonorrhoea (77.1% [95% CI: 68.1% to 84.1%], n = 68) and chlamydia (21.9% [95% CI: 15.4% to 30.3%], n = 48); and for genital ulcer were herpes simplex virus type 2 (HSV-2) (48.3% [95% CI: 32.9% to 64.1%], n = 47) and syphilis (9.3% [95% CI: 6.4% to 13.4%], n = 117). Temporal variation was substantial, particularly for genital ulcer where HSV-2 replaced chancroid as the primary cause. Aetiologic distributions for each symptom were largely the same across regions and population strata, despite HIV status and age being significantly associated with several infection diagnoses. Limitations of the review include the absence of studies in 16 of 48 SSA countries, substantial heterogeneity in study observations, and impeded assessment of this variability due to incomplete or inconsistent reporting across studies., Conclusions: In our study, syndrome aetiologies in SSA aligned with World Health Organization guidelines without strong evidence of geographic or demographic variation, supporting broad guideline applicability. Temporal changes underscore the importance of regular aetiologic re-assessment for effective syndromic management., Prospero Number: CRD42022348045., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Michalow et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Tubal factor infertility (TFI) is common in sub-Saharan Africa and often secondary to pelvic inflammatory disease (PID). Anaerobes associated with bacterial vaginosis (BV) are also found in PIDs widely dominated by Chlamydia trachomatis (C. trachomatis), whose role in TFI is better demonstrated than that of BV., Objectives: To determine the prevalence of BV and C. trachomatis and to investigate the association between BV, C. trachomatis and TFI., Methods: We included 137 patients treated for infertility between January 2020 and November 2021. Cases were defined as women with infertility aged 18-45 years presenting with TFI (n = 52), and controls as infertile women in the same age groups without TFI (n = 85). Data on social habits, life style and infertility parameters were collected, and we performed screening for BV and C. trachomatis. Multiple regression was used to measure associations., Results: The prevalence of BV and C. trachomatis was 42.3% (58/137) and 23.4% (32/137), respectively. BV (61.5% vs 30.6%, p<0.001) and C. trachomatis (48.1 vs 8.2%, p<0.001) were more frequent in cases of TFI. BV and C. trachomatis increased the risk of TFI approximately 4-fold [aOR: 3.77 (1.61-8.83), p=0.002] and 14-fold [aOR: 13.77 (4.59-41.27), p<0.001], respectively., Conclusion: BV and C. trachomatis infection are strongly associated with TFI in Bukavu. Prevention and screening should be implemented to reduce the risk of TFI., (© 2024. The Author(s).)

Background: Reproductive age female individuals comprise the fastest-growing segment of Veterans Health Administration patients, but little is known about rates of reproductive health outcomes among those with chlamydia or gonorrhea infections. Our aim was to estimate the risk of pelvic inflammatory disease, ectopic pregnancy, infertility, and pelvic pain in female veterans tested for chlamydia or gonorrhea., Methods: We performed a retrospective cohort analysis of female veterans tested for chlamydia or gonorrhea between January 1, 2010, and December 31, 2020. We calculated rates of pelvic inflammatory disease, ectopic pregnancy, infertility, and pelvic pain per 100,000 person-years and used Cox proportional hazards regression models to estimate the risk of these reproductive health conditions according to infection status after adjustment for age, race, ethnicity, military sexual trauma, mental health diagnoses, and substance use disorder., Results: Of female veterans, 232,614 were tested at least once for chlamydia or gonorrhea, with a total of 1,665,786 person-years of follow-up. Of these, 12,971 had positive chlamydia or gonorrhea results (5.8%, 796 cases per 100,000 person-years). Compared with people who tested negative, those testing positive had double the risk of pelvic inflammatory disease (adjusted hazard ratio [aHR], 1.94; 95% confidence interval [CI], 1.81-2.07), 11% increased risk of infertility (aHR, 1.11; 95% CI, 1.04-1.18), 12% increased risk of pelvic pain (aHR, 1.12; 95% CI, 1.08-1.17), and 21% increased risk of any of these conditions (aHR, 1.21; 95% CI, 1.17-1.25). People with positive chlamydia or gonorrhea testing tended to have an increased risk of ectopic pregnancy (aHR, 1.14; 95% CI, 1.0-1.30). Among those with a positive test result, 2218 people (17.1%) had 1 or more additional positive test results. Compared with those with 1 positive test result, people with more than 1 positive test result had a significantly increased risk of pelvic inflammatory disease (aHR, 1.37; 95% CI, 1.18-1.58), infertility (aHR, 1.20; 95% CI, 1.04-1.39), and pelvic pain (aHR1.16; 95% CI, 1.05-1.28), but not ectopic pregnancy (aHR, 1.09; 95% CI, 0.80-1.47)., Conclusions: Female veterans with positive chlamydia or gonorrhea results experience a significantly higher risk of pelvic inflammatory disease, infertility, and pelvic pain, especially among those with repeat infection., Competing Interests: Conflict of interest and Sources of Funding: None declared., (Copyright © 2024 American Sexually Transmitted Diseases Association. All rights reserved.)

Background: Sexually transmitted infections (STIs) have a high incidence in the US Armed Forces and can adversely impact service members' ability to perform their duties. Better knowledge of Mycoplasma genitalium (MG) epidemiology in the military is needed to understand the potential impact of this emerging pathogen on force readiness., Methods: We conducted cross-sectional analyses of data from US Army service members and other Military Health System beneficiaries participating in a trial of an STI/HIV behavioral intervention at Fort Liberty, NC, and Joint Base Lewis-McChord, WA. At enrollment, participants completed questionnaires and provided biological specimens for nucleic acid amplification testing for MG, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG). We used principal component analysis and robust Poisson regression to examine associations between participant characteristics and prevalent urogenital MG., Results: Among 432 participants enrolled between November 2020 and February 2023, 43 had MG (prevalence, 10.0%), of whom 13 had coinfection with another bacterial STI (all 13 were positive for CT, with 1 also positive for NG). The prevalence of MG was significantly higher among female (13.5%) versus male (7.6%; P = 0.048) participants and non-Hispanic Black (14.9%) versus non-Hispanic White participants (6.6%; P = 0.045). Single relationship status and increased number of recent sexual partners were correlated, and their component was associated with higher MG prevalence (adjusted prevalence ratio, 2.11; 95% confidence interval, 1.29-3.48)., Conclusions: The high prevalence of urogenital MG among Military Health System beneficiaries highlights the importance of understanding the potential clinical sequelae of MG and conducting additional epidemiologic research in military settings., Competing Interests: Conflict of Interest and Sources of Funding: The authors declare no conflict of Interest. This work was supported by a cooperative agreement (W81XWH-18-2-0040) between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the US Department of Defense. The views expressed are those of the authors and should not be construed to represent the positions of the US Army, the Department of Defense, or the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. The investigators have adhered to the policies for protection of human subjects as prescribed in AR 70-25., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association.)

Men having sex with men (MSM) represent a key population, in which sexually transmitted rectal infections (STIs) caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and high-risk HPV (HR-HPV) are very common and linked to significant morbidity. Investigating the anorectal microbiome associated with rectal STIs holds potential for deeper insights into the pathogenesis of these infections and the development of innovative control strategies. In this study, we explored the interplay at the rectal site between C. trachomatis, N. gonorrhoeae, HR-HPV infection, and the anorectal microbiome in a cohort of 92 MSM (47 infected by CT and/or NG vs 45 controls). Moreover, we assessed the presence of Torquetenovirus (TTV), a non-pathogenic endogenous virus, considered as a possible predictor of immune system activation. We found a high prevalence of HR-HPV rectal infections (61%), especially in subjects with a concurrent CT/NG rectal infection (70.2%) and in people living with HIV (84%). In addition, we observed that TTV was more prevalent in subjects with CT/NG rectal infections than in non-infected ones (70.2% vs 46.7%, respectively). The anorectal microbiome of patients infected by CT and/or NG exhibited a reduction in Escherichia, while the presence of TTV was significantly associated with higher levels of Bacteroides. We observed a positive correlation of HR-HPV types with Escherichia and Corynebacterium, and a negative correlation with the Firmicutes phylum, and with Prevotella, Oscillospira, Sutterella. Our findings shed light on some of the dynamics occurring within the rectal environment involving chlamydial/gonococcal infections, HPV, TTV, and the anorectal microbiome. These data could open new perspectives for the control and prevention of STIs in MSM., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ceccarani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The human papillomavirus (HPV) is one of the most frequently diagnosed viruses in developing countries. Chlamydia trachomatis (CT) is an important cofactor in HPV-induced cervical cancer. Cervico-uterine smears were taken for cytology, and a total of 131 samples were analysed. HPV prevalence and CT were detected using specific primers (L1 gene and omp-1 gene). 23 (17.5 %) HPV-only samples were detected, CT-only positives were 10 (7.6 %). And HPV/CT co-infection was 13 (9.9 %). Identified risk factors associated with HPV/CT co-infection were risky sexual behaviour and cytology status. The prevalence of HPV and CT and their co-infection rates being high in our study population, may be an indicator of cervical cancer risk. Consequently, there is an urgent need to raise awareness and take appropriate precautions., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier Masson SAS.)

Introduction: Sexually transmitted diseases such as cervicitis, proctitis and urethritis are associated with high rates of HIV infection. When these pathologies are suspected, HIV serology should be requested., Material and Methods: A retrospective study was performed during 2018 at the Hospital Costa del Sol (Marbella, Málaga, Spain). HIV serologies requested in patients who were asked for PCR for Chlamydia trachomatis and Neisseria gonorrhoeae were reviewed., Results: A total of 1818 patients were evaluated, in which HIV serology was performed in 44.7%, of which 14 (1.7%) were positive. The remaining 55.3% were missed diagnostic opportunities., Conclusions: C. trachomatis and N. gonorrhoeae infections are associated with a high rate of occult HIV infection. The degree of suspicion of HIV in this population remains low and it is essential that it be reinforced in the presence of the possibility of infection by these pathologies., (Copyright © 2023 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)

Reactive arthritis is included in the spectrum of seronegative spondyloarthritides, occurring secondary to triggers of genitourinary and gastrointestinal tract infections. We describe two cases of sexually acquired reactive arthritis secondary to genital infection by Chlamydia trachomatis, diagnosed by in-house polymerase chain reaction performed on the first void urine. Both patients were managed with a combined approach of short course antibiotics, immunosuppressive agents, biologicals and surgical intervention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Chlamydia trachomatis (CT) is the most common sexually transmitted infections globally, and CT infection can enhance HPV persistence. Epidemiological analysis has shown that patients with CT/HPV coinfection have a higher risk of developing cervical cancer and exhibit more rapid progression to cervical cancer than patients with HPV infection alone. However, the mechanism has not been fully elucidated. Here, we report that CT infection supports HPV persistence by further suppressing the functions of Langerhans cells (LCs); in particular, CT further activates the PI3K pathway and inhibits the MAPK pathways in LCs, and these pathways are frequently involved in the regulation of immune responses. CT/HPV coinfection also impairs LC functions by reducing the antigen-presenting ability and density of LCs. Moreover, CT/HPV coinfection can alter T-cell subsets, resulting in fewer CD4 + and CD8 + T cells and more infiltrating Tregs. Moreover, CT/HPV coinfection decreases the CD4 + /CD8 + T cell ratio to below 1, coinfection also induces greater T lymphocytes' apoptosis than HPV infection, thus impairing cell-mediated immunity and accelerating the progress to cervical cancer., (© 2024. The Author(s).)

Problem: Increased oxidative stress (OS) and inflammatory responses are major underlying factors behind Chlamydia trachomatis-associated recurrent spontaneous abortion (RSA). miRNAs are known to regulate inflammation and OS and their dysregulation has been associated with compromised pregnancies. Therefore, aim of this study was to investigate the expression/correlation of OS biomarkers, cytokines and miRNAs in C. trachomatis-associated RSA., Method of Study: Urine and non-heparinized blood samples were collected from RSA patients with history of >3 consecutive abortions (cases) and non-pregnant women with history of >2 successful deliveries (controls) attending Department of Obstetrics and Gynaecology, Safdarjung hospital, New Delhi. C. trachomatis detection was done in urine by PCR. miRNA expression was studied by microarray analysis and validated by real time-PCR. Evaluation of cytokines and antioxidant genes expression were done by real-time PCR. Level of OS biomarkers 8-hydroxy guanosine (8-OHdG) and 8-isporostane (8-IP) were measured by ELISA., Results: Fifty circulating miRNAs were differentially expressed in infected patients compared with controls. Of these, four were overexpressed and 46 downregulated. Thirteen differentially expressed circulating miRNAs were selected to validate microarray results. miRs-8069, -3663-3p showed maximum upregulation/downregulation in infected versus control group. Expression of cytokines (IL-8, TNF-α, IFN-γ), antioxidant genes SOD2 and OS biomarkers (8-OHdG,8-IP) were increased while SOD1 was decreased in infected patients. miR-8069 showed significant positive correlation with cytokines, SOD2, 8-OHdG and 8-IP. miR-3663-3p showed significant positive correlation with SOD1., Conclusions: Overall results indicate circulating miRNAs are involved in pathogenesis of C. trachomatis-associated RSA and are potential modulators of cytokine signalling and OS in infected RSA., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Sexually transmitted infection is a frequent cause of tubal factor abnormality. Chlamydia trachomatis is a common causative organism for sexually transmitted infection. There are studies indicating association of chlamydial antibodies in serum with tubal abnormalities. In many centers chlamydial antibody test is done as part of routine work up for infertility. The objective of the study was to evaluate the sensitivity and specificity of chlamydial antibody test in screening infertile women for tubal factor infertility. This cross-sectional observational study was performed for one year from January 2019 to December 2019 in the Department of Reproductive Endocrinology and Infertility of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. The infertile women having laparoscopy as part of infertility work up were enrolled in the study. The women had their serum tested for chlamydial antibody IgG by enzyme linked immune-sorbent assay. The sero-positivity for chlamydial antibody was tested against the findings of laparoscopy and dye test as gold standard for diagnosing tubal factor infertility. Statistical analysis was done to find out the sensitivity and specificity of the chlamydial antibody test in screening infertile women for tubal factor infertility. The study population included 163 infertile women with mean age 29.8±5.8 years. The tubal factor infertility was present in 56.4% of the women. The sero-positivity of Chlamydia trachomatis IgG was 36.6%. Sensitivity and specificity of Chlamydial antibody test (IgG positive) in detecting tubal factor infertility is 47.8% and 70.4% respectively. Positive predictive value of chlamydial antibody test in detecting tubal factor infertility is 41.5% and negative predictive value is 72.4%. Positive likelihood ratio is 1.59. Negative likelihood ratio is 0.74. Accuracy is 57.67%. In conclusion, the chlamydial antibody test may not be an appropriate screening test for tubal factor infertility in women of Bangladesh because of low sensitivity and moderately high specificity.

Abstract: The contribution of chlamydia to secondary infertility in women is poorly understood. Among 404 female participants enrolled in a previous study in Cameroon, 142 had secondary infertility (cases) and 262 were pregnant with no history of infertility (controls) , Chlamydia trachomatis seropositivity was 92%. Seropositivity did not significantly differ by case/control status., Competing Interests: Conflict of Interest and Sources of Funding: None declared., (Copyright © 2023 American Sexually Transmitted Diseases Association. All rights reserved.)

Objective: The magnitude of infertile couples worldwide was found to be 60-80 million. Genital infection due to Chlamydia trachomatis (C. trachomatis) is one of the most prevalent sexually transmitted infections (STIs) which may present as PID, leading to ectopic pregnancy, infertility or other adverse health outcomes. This study was done to assess the prevalence of C. trachomatis infections among female patients with infertility using real time PCR (RT-PCR) and to compare the findings of molecular testing with hysterosalpingography (HSG) and ultrasonography (USG)., Material and Methods: 50 endocervical swabs were collected from women of reproductive age group attending infertility clinic and stored at -80 ºC. DNA extraction was done with Helini bacterial mini spin kit and tested for C. trachomatis DNA by RT-PCR kit., Results: Of the 50 patients, 43 (86%) had primary infertility, and 7 (14%) had secondary infertility. Three (6%) were positive for C. trachomatis by RT-PCR. Two had primary infertility and one had secondary infertility., Conclusion: Routine screening of C. trachomatis even in high-risk populations is not available in developing countries like India. The World Health Organization recommends syndromic approach for case management. Hence, a cost-effective, highly sensitive and specific test is the pressing priority in resource poor settings., (© 2023 Aparnna Vaikundam Subramanian et al., published by Sciendo.)

This review summarizes and examines research in the area of salpingitis animal modeling in the last 40 years, focusing primarily on Chlamydia trachomatis animal models, which are the most numerous in the literature. Early animal models are examined, followed by a discussion of study parameters and their impact on modeling success, subsequent considerations of fertility measures in modeling, explorations of treatment options, and finally exploring recent directions with a brief discussion of models using other bacterial pathogens., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Up to 26% of urogenital Chlamydia trachomatis infections spontaneously resolve between detection and treatment. Mechanisms governing natural resolution are unknown. We examined whether bacterial vaginosis (BV) was associated with greater chlamydia persistence versus spontaneous clearance in a large, longitudinal study., Methods: Between 1999 and 2003, the Longitudinal Study of Vaginal Flora followed reproductive-age women quarterly for 1 year. Baseline chlamydia screening and treatment were initiated after ligase chain reaction testing became available midstudy, and unscreened endocervical samples were tested after study completion. Chlamydia clearance and persistence were defined between consecutive visits without chlamydia-active antibiotics (n = 320 persistence/n = 310 clearance). Associations between Nugent score (0-3, no BV; 4-10, intermediate/BV), Amsel-BV, and chlamydia persistence versus clearance were modeled with alternating and conditional logistic regression., Results: Of chlamydia cases, 48% spontaneously cleared by the next visit (310/630). Nugent-intermediate/BV was associated with higher odds of chlamydia persistence (adjusted odds ratio [aOR] = 1.89; 95% confidence interval [CI], 1.30-2.74), and the findings were similar for Amsel-BV (aOR 1.39; 95% CI, .99-1.96). The association between Nugent-intermediate/BV and chlamydia persistence was stronger in a within-participant analysis of 67 participants with both clearance/persistence intervals (aOR = 4.77; 95% CI, 1.39-16.35). BV symptoms did not affect any results., Conclusions: BV is associated with greater chlamydia persistence. Optimizing the vaginal microbiome may promote chlamydia clearance., Competing Interests: Potential conflicts of interest. S. T. has been a consultant for Biofire Diagnostics, Roche Molecular Diagnostics, and Luca Biologics; receives royalties from UPTODATE; and has received speaker honoraria from Roche Molecular Diagnostics and Medscape. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The role of infectious agents, including Chlamydia pneumoniae (Cpn), in the development of multiple sclerosis (MS), is still a matter of major contention., Objective: This meta-analysis study aimed to assess the actual involvement of Cpn in MS development., Methods: We undertook a search of international scientific databases to identify eligible studies. We used a random-effects meta-analysis model (REM) to generate the pooled odds ratio (OR) and 95% confidence intervals (CIs). Heterogeneity was calculated using the I 2 statistic. Sensitivity and subgroup analyses were applied to assess the effects of study characteristics and socio-demographic variables on the pooled OR., Results: We identified 37 studies comprising 51 datasets that satisfied the inclusion criteria. Considering diagnostic methods for Cpn, 26 and 25 datasets used PCR- and serological-based methods, respectively. In PCR-based datasets, REM showed a significant positive association between Cpn infection and the development of MS (OR, 5.29; 95% CI, 3.12-8.97), while a non-significant positive association was achieved in serological-based datasets (OR, 1.34; 95% CI, 0.88-2.03). In subgroup analyses on PCR-based datasets, results were significant for both CSF (OR, 5.70) and serum (OR, 4.84) samples; both healthy (OR, 16.11) and hospital-based (OR, 2.88) controls; and both moderate (OR, 5.14) and high (OR, 5.48) quality studies. In serological-based datasets, only those that used CSF samples yielded significant results (OR, 3.41)., Conclusions: Our findings verify the significant positive relationship between Cpn infection and MS. We advocate prospective cohort studies with lifelong follow-ups and also experimental studies to better understand the role of Cpn in MS development., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: This study was designed to investigate the seroepidemiology of and identify factors associated with exposure to Chlamydia trachomatis ( C. trachomatis ) in fertility treatment-seeking patients in Abu Dhabi Emirate, United Arab Emirates., Methods: A total of 308 fertility treatment-seeking patients were surveyed. Seroprevalence of past (IgG positive), current/acute (IgM positive), and active infection (IgA positive) with C. trachomatis was quantified. Factors associated with exposure to C. trachomatis were identified., Results: Overall, 19.0%, 5.2%, and 1.6% found to have past, acute/recent, and ongoing active infection with C. trachomatis , respectively. Overall, 22.0% of the patients were seropositive to any of the 3 to C. trachomatis antibodies. Male compared with female patients (45.7% vs. 18.9%, P < 0.001) and current/ex-smokers compared with nonsmokers (44.4% vs. 17.8%) had higher seropositivity. Patients with a history of pregnancy loss had higher seropositivity compared with other patients (27.0% vs. 16.8%), particularly recurrent pregnancy losses (33.3%). Current smoking (adjusted odds ratio [aOR], 3.8; 95% confidence interval, 1.32-11.04) and history of pregnancy loss (adjusted odds ratio [aOR], 3.0; 95% confidence interval, 1.5-5.8) were significantly associated with higher odds of exposure to C. trachomatis ., Conclusions: The observed high seroprevalence of C. trachomatis , particularly in patients with a history of pregnancy loss, possibly indicates the contribution of C. trachomatis to the growing burden of infertility in the United Arab Emirates., Competing Interests: Conflict of Interest and Sources of Funding: The authors report no conflicts of interest. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This study was funded by the Zayed Center for Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University (grant no. 31R181)., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association.)

Chlamydia trachomatis infection is a major cause of sexually transmitted diseases and adverse pregnancy outcomes such as recurrent spontaneous abortion (RSA). Micro-RNAs (miRNAs) have been known to be upregulated/downregulated in various reproductive-associated diseases such as ectopic pregnancy, preterm birth and pre-eclampsia. However, there is paucity of literature on miRNA profile in C. trachomatis-infected RSA. The present study aimed to determine the profile of serum miRNAs followed by their validation in C. trachomatis-infected RSA and to find target genes involved in biological pathways. Non-heparinized blood and first void urine were collected from 30 non-pregnant women with RSA and 30 non-pregnant women with ≥2 successful deliveries (controls) attending Department of Obstetrics and Gynaecology, Safdarjung hospital, New Delhi, India. C. trachomatis detection was done in urine by PCR and chlamydial load was determined by quantitative real-time PCR (qRT-PCR). miRNA expression was studied by microarray analysis followed by in vitro validation by qRT-PCR. Analysis of target genes/pathways was characterized in silico. 06 RSA patients were infected with C. trachomatis, while chlamydial load was found to be 6000-12,000 copies/ml. 110 circulating miRNAs were expressed differentially in infected RSA patients compared with controls. Of these, 16 were overexpressed and 94 downregulated. 06 differentially expressed circulating miRNAs were selected to validate the microarray results. qRT-PCR data confirmed the reliability of the microarray results: miR-4443, -5100, -7975 showed statistically significant upregulation, while miR-6808-5p, -3148, -6727-5p were significantly downregulated in infected RSA patients versus controls. Chlamydial load was positively correlated with these upregulated miRNAs. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that target genes of miRNAs in RSA are involved in AMPK, Akt and mTOR signaling pathways. Overall results indicate that differentially expressed circulating miRNAs are involved in pathogenesis of C. trachomatis-associated RSA and have the potential to be used as biomarkers for predicting RSA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Chlamydia trachomatis (CT) infection has an increased risk for fertility-related and pregnancy adverse outcomes partly due to mechanisms related to a pro-inflammatory response to CT-, or cHSP60-induced delayed hypersensitivity. This study aimed to assess the evidence on the association between CT serology and adverse outcomes., Methods: PubMed/Medline, Embase and Web of Science databases were searched for observational studies on the association of CT-specific antibodies (e. g. IgG, IgA, IgM, etc.) with infertility, tubal factor infertility (TFIF), ectopic pregnancy (EP), spontaneous abortion (SA), or preterm labor (PL) that were published from database inception to 31 August 2022. Pooled adjusted odds ratios or relative risks with corresponding 95% confidence intervals were calculated using a random effects model. This study was registered with PROSPERO (CRD42022368366)., Findings: We identified 128 studies that met the inclusion criteria, comprising 87 case-control, 34 cross-sectional and 7 cohort studies, for a total of 167 records involving 128,625 women participants included into the meta-analyses. Based on the adjusted estimates, it was found that CT-specific IgG was significantly associated with TFIF (pooled adjusted OR = 2.09, 95% CI 1.33-3.27, I 2  = 63.8%) or EP (pooled adjusted OR = 3.00, 95% CI 1.66-5.40, I 2  = 93.0%). Analyses of the unadjusted estimates indicated significant associations between CT-specific IgG and infertility, TFIF, EP or SA (four pooled unadjusted ORs ranging between 1.60 and 5.14, I 2 ranging between 40% and 83%); IgA and infertility, TFIF, EP (three pooled unadjusted ORs ranging between 3.64 and 4.91, I 2 ranging between 0% and 74%); IgM and TFIF (pooled unadjusted OR = 5.70, 95% CI 1.58-20.56, I 2  = 56%); or cHSP60 and TFIF (pooled unadjusted OR = 7.83, 95% CI 5.42-11.31, I 2  = 49%)., Interpretation: A broad range of CT-specific antibodies have been studied in association with fertility-related and pregnancy adverse outcomes. However, our study identified a low- or moderate-quality evidence for an association of CT serology with the outcomes. There are substantial research gaps in relation to the clinical implications of CT serological biomarkers., Funding: The work was supported by the Chinese Academy of Medical Sciences Initiative for Innovative Medicine (2016-I2M-3-021)., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective： This study aimed to assess the impact of urogenital ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), and Chlamydia trachomatis (Ct) infections on semen quality in men.Methods： In this study, 1022 males were enrolled at the Department of Reproductive Medicine, Rizhao People's Hospital, Shandong Province from October 2014 to January 2023. The participants included 393 in the infertility group, 139 in the recurrent miscarriage group, and 490 in the control group. Based on age, 852 cases were < 36 years old, and 170 cases were ≥ 36 years old. All patients underwent routine semen analysis and tests for Uu, Mh, and Ct, with results statistically analyzed for their impact on semen quality and compared among different age groups. Results: Among the 1022 patients, 344 (33.6%) were Uu-positive, 49 (4.7%) were Mh-positive, and 31 (3.0%) were Ct positive. The sperm concentration, total sperm count, forward sperm motility rate (PR), sperm motility rate (PR+NP) and normal sperm morphology rate of Uu Mh and/or Ct-positive patients were significantly lower than those of the negative group, and the overall difference between the two groups was statistically significant (P<0.05). The positive rate of Uu infection was 41.7% in the infertility group, 30.2% in the recurrent miscarriage group and 28.2% in the control group, and the overall positive rate of the three groups was statistically significant(P<0.05). The positive rate of Mh infection was 6.9% in the infertility group, 8.6% in the recurrent miscarriage group and 2.0% in the control group, and the overall positive rate of the three groups was statistically significant (P<0.001). The positive rate of Ct infection was 6.1% in the infertility group, 2.9% in the recurrent miscarriage group and 0.6% in the control group, and the overall positive rate of the three groups was statistically significant (P<0.001). The positivity rate of Uu infection was 35.8% at the age of <36 years and 22.9% at the age ≥ 36 years, and there was a statistically significant difference in the positivity rate between the two groups (P<0.05). Conclusion: The prevalence of Uu infection in the male urogenital tract is significantly higher than that of Mh and Ct, which is the main pathogen of urogenital tract infection in men. Uu, Mh and Ct infections have adverse effects on sperm concentration, total sperm count, sperm forward motility rate (PR), sperm motility rate (PR+NP) and normal sperm morphology rate, which will lead to a decrease in semen quality and affect male fertility. Genital tract infections are closely related to age, and the prevalence of Uu infection is higher in the younger age group.

The aim of this study was to investigate the frequency of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium in men living with HIV in terms of sociodemographic characteristics and behavioral risk factors. In this cross-sectional, single center study, all HIV-infected male patients, aged ≥ 18 years, including those being followed-up (n= 142) and the new admissions (n= 16) at Hacettepe University, Department of Infectious Diseases between March 1st, 2017 and May 1st, 2018 were included. After obtaining the informed consent form; age, follow-up days in STI-clinic, marital status, education, employment status; STI-related sign and symptoms, prior STI diagnosis, multiple sexual partners during the last year, exchanging sex for money, sexual orientation, drug use, condom use with regular and casual partner and also risk factors regarding partners were inquired as behavioural risk factors. A sample of first-voided urine of each participant was tested for the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium by using nucleic acid amplification test (NAAT) (BD-MAX system, BD Diagnostics, USA) and BD MAX Mycoplasma-Ureaplasma-OSR for BioGX, (BD Diagnostics, The Netherlands). All participants living with HIV, men who have sex with men (MSM) and heterosexual men were grouped as STI-positive and STI-negative and compared. For all statistical analysis, SPSS 24 software was used. During the period of 14 months; the data was determined as follows: median follow-up time was 1138 (IQR= 159.5- 1494.5) days, median age was 35 (IQR= 28-42) years, 73.3% were single, 68.3% were at least college graduates or had higher educational attainment, 78.1% were currently employed. Of the participants, 26.9% reported STI-related sign and symptoms, 50.0% at least one STI episode in the past. Nine (5.6%) M.genitalium, five (3.1%) N.gonorrhoeae, and four (2.5%) C.trachomatis were detected in the urine samples of 17 (10.7%) individuals. N.gonorrhoeae and C.trachomatis were detected simultaneously in only one patient's urine sample. STI-positive patients (n= 17) were determined to be younger compared to STI-negative group [(p= 0.02; 27 years (IQR= 24-37) vs 35 years (IQR= 28-42)], had prominent STI-related signs and symptoms (p< 0.001) and had more multiple sexual partners (p= 0.03). The median CD4+ T lymphocyte count were relatively lower (p= 0.03) in STI-positive patients and plasma HIV RNA level was higher compared to the STI-negative participants (p= 0.05). STI-positive MSM group were younger [p= 0.01; 26 years (IQR= 23.5-29) vs 33 years, (IQR= 28-40)], STI-related signs and symptoms were more prominent (p= 0.02), the frequency of exchanging sex for money/drugs among their partners (p= 0.03) was higher compared to their STI-negative counterparts. Among STI-positive heterosexual patients, the presence of STI-related signs and symptoms (p= 0.04), drug use among their partners (p= 0.04) and plasma HIV RNA level (p<0.01) were significantly higher. STI was identified as an important health problem in this series of men living with HIV, 63.0% of whom had MSM and had a relatively high education level and socioeconomic status. Young age, having multiple partners, drug use, exchanging sex for money/drugs were prominent among the participants and their partners. Public health studies should focus on preventing STIs in young people living with HIV who have behavioral risk factors.

The aim of this study was to classify the diversity of anal HPV and non-HPV sexually transmitted infections (STIs) and compare the concordance between anal and genital infections in HIV-infected and uninfected women living in the Tapajós region, Amazon, Brazil. A cross-sectional study was performed with 112 HIV-uninfected and 41 HIV-infected nonindigenous women. Anal and cervical scrapings were collected and analyzed for HPV, Chlamydia trachomatis (CT) , Neisseria gonorrheae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), and Human alphaherpesvirus 2 (HSV-2). The Kappa test evaluated the concordance between anal and genital infections. The overall prevalence of anal HPV infection was 31.3% in HIV-uninfected and 97.6% in HIV-infected women. The most frequent anal high-risk HPV (hrHPV) types were HPV18 and HPV16 in HIV-uninfected women and HPV51, HPV59, HPV31, and HPV58 in HIV-infected women. Anal HPV75 Betapapillomavirus was also identified. Anal non-HPV STIs were identified in 13.0% of all participants. The concordance analysis was fair for CT, MG, and HSV-2, almost perfect agreement for NG, moderate for HPV, and variable for the most frequent anal hrHPV types. Thus, a high prevalence of anal HPV infection with moderate and fair concordance between anal and genital HPV and non-HPV STIs was observed in our study.

Background: Chlamydia trachomatis ( C. trachomatis ) and Neisseria gonorrhoeae ( N. gonorrhoeae ) are curable sexually transmitted infections (STIs) that cause adverse pregnancy and neonatal outcomes. Most countries, including Botswana, do not offer C. trachomatis or N. gonorrhoeae screening during antenatal care (ANC) and instead use a syndromic approach for management of STIs., Methods: The Maduo Study is a prospective, cluster-controlled trial in Botswana evaluating the impact of diagnostic screening for antenatal C. trachomatis and N. gonorrhoeae infections to prevent adverse neonatal outcomes. Using baseline data from the Maduo Study (March 2021-March 2022), we determined the prevalence of C. trachomatis and N. gonorrhoeae infection among asymptomatic pregnant women in Botswana and correlates of infection using multivariable logistic regression., Results: Of 251 women who underwent C. trachomatis and N. gonorrhoeae screening at first ANC visit, 55 (21.9%, 95%CI 17.0-27.5) tested positive for C. trachomatis , 1 (0.4%, 95%CI 0-2.2) for N. gonorrhoeae ; and 2 (0.8%, 95%CI 0-2.8) for dual C. trachomatis and N. gonorrhoeae infection. Older age was associated with lower odds (aOR 0.93; 95%CI 0.88-0.98; p = 0.011) while any alcohol use during pregnancy was associated with higher odds (aOR = 3.53; 95%CI 1.22-10.16; p = 0.020) of testing positive for C. trachomatis or N. gonorrhoeae ., Conclusions: A high frequency of C. trachomatis infections was detected among asymptomatic pregnant women in Botswana indicating that many antenatal STIs are missed by the syndromic management approach. Our results highlight the need for diagnostic C. trachomatis screening during ANC in Botswana and other low- and middle-income countries that rely solely on the syndromic approach for management of STIs.

Objective: Professional guidelines and state law require screening for sexually transmitted infections (STI) during pregnancy. Our objective was to evaluate adherence to these recommendations. Methods: This is a retrospective cohort study of patients initiating prenatal care before 20 weeks' gestation. Demographic characteristics and STI screening were abstracted from prenatal records. Tests of interest included initial syphilis, human immunodeficiency virus (HIV), hepatitis B, chlamydia, and gonorrhea tests, as well as repeat (third trimester) syphilis and HIV tests. All patients were eligible for initial screening. Patients were eligible for analysis of whether they received adherent repeat third trimester screening for syphilis (mandated by state law) and HIV (institutional protocol) if they delivered at or after 32 weeks' gestation. Adherent screening was defined as performance of all recommended screening. Results: Of 2370 patients, 1816 (76.6%) received adherent initial STI screening and 181 (7.8% of 2308 patients who delivered at or after 32 weeks' gestation) received adherent repeat third trimester STI screening. After adjusting for covariates, private insurance (adjusted odds ratio [aOR] 1.45, confidence interval [95% CI] 1.12-1.95) was associated with adherent initial screening, whereas being non-Hispanic Black or Hispanic were associated with lower odds of adherent initial screening. Factors associated with adherent repeat third trimester STI screening were younger age (aOR 0.93, 95% CI 0.90-0.97) and non-Hispanic Black race (aOR 3.24, 95% CI 1.94-5.42). Those with private insurance (aOR 0.10, 95% CI 0.06-0.15) were less likely to receive adherent repeat third trimester screening. Conclusion: STI screening rates remain suboptimal. Multiple disparities exist in performance both of initial and repeat third trimester screening.

Background: To analyse the correlation between vaginal flora and cervical immune function of HPV-infected patients with cervical cancer., Methods: Six hundred females with genital tract infections treated in Xuzhou Hospital of Traditional Chinese Medicine from January 2014 to December 2016 were selected and divided into a high-risk HPV group (n=246) and a control group (n=354). The vaginal flora and human T lymphocyte subsets (CD3+, CD4+, CD8+) were detected. Multivariate logistic regression analysis was performed to explore the risk factors for HPV infection., Results: The numbers of CD4+ and CD4+/CD8+ T cells of the high-risk HPV group were significantly lower than those of the control group (P<0.05). The two groups had similar numbers of CD3+ and CD8+ T cells. In the high-risk HPV group, the positive rates of Lactobacillus, Chlamydia trachomatis, Mycoplasma hominis, mycetes, Ureaplasma urealyticum and bacterial vaginosis were significantly higher than those of the control group (P<0.05). There was no significant difference in the positive rates of trichomonads between the two groups. Multivariate logistic regression analysis revealed that C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection (P<0.05)., Conclusion: High-risk HPV infection in patients with cervical cancer was associated with vaginal flora and immune function. C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection., Competing Interests: The authors report no conflicts of interest., (© 2023 Wang Q et al.)

Background: Oxidative stress generated by Chlamydia trachomatis infection is associated with reproductive complications such as recurrent spontaneous abortion. Aim of prospective study was to evaluate whether single nucleotide polymorphisms (SNPs) of SOD1 and SOD2 gene are associated with C. trachomatis-infected recurrent spontaneous abortion (RSA)., Methods: 150 patients with history of RSA and 150 patients with history of successful deliveries were recruited from Department of Obstetrics and Gynecology, Safdarjung hospital, New Delhi, India. Urine and non-heparinized blood samples were collected and C. trachomatis was detected by polymerase chain reaction (PCR). Using qualitative real time PCR, SNPs rs4998557 (SOD1) and rs4880 (SOD2) were screened in enrolled patients. Level of 8-hydroxyguanosine (8-OHdG), 8-isoprostane (8-IP), progesterone and estrogen was determined by enzyme-linked immunosorbent assays and correlated with SNPs., Results: Significant differences were found in frequency of AA genotype of SOD1 gene among RSA patients versus controls, (82% and 54.66%, respectively; p = 0.02; OR 0.40; CI 95%). Frequency of AA genotype of SOD1 gene among RSA patients with C. trachomatis infection was 87.33%, while in uninfected RSA patients was 71.33% (p < 0.0001; OR 8; CI 95%). No significant relation was found between SOD2 (rs4880) genotype and RSA. Furthermore, significant increase in 8-OHdG, 8-IP and estrogen and significant decrease in progesterone was observed among patients carrying AA genotype., Conclusions: Findings suggest the clinical importance of AA genotype along with 8-OHdG, 8-IP and estrogen and progesterone in screening C. trachomatis-infected RSA women., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Young men who have sex with men (YMSM) are disproportionately affected by HIV and bacterial sexually transmitted infections (STI) including gonorrhea, chlamydia, and syphilis; yet research into the immunologic effects of these infections is typically pursued in siloes. Here, we employed a syndemic approach to understand potential interactions of these infections on the rectal mucosal immune environment among YMSM. We enrolled YMSM aged 18-29 years with and without HIV and/or asymptomatic bacterial STI and collected blood, rectal secretions, and rectal tissue biopsies. YMSM with HIV were on suppressive antiretroviral therapy (ART) with preserved blood CD4 cell counts. We defined 7 innate and 19 adaptive immune cell subsets by flow cytometry, the rectal mucosal transcriptome by RNAseq, and the rectal mucosal microbiome by 16S rRNA sequencing and examined the effects of HIV and STI and their interactions. We measured tissue HIV RNA viral loads among YMSM with HIV and HIV replication in rectal explant challenge experiments among YMSM without HIV. HIV, but not asymptomatic STI, was associated with profound alterations in the cellular composition of the rectal mucosa. We did not detect a difference in the microbiome composition associated with HIV, but asymptomatic bacterial STI was associated with a higher probability of presence of potentially pathogenic taxa. When examining the rectal mucosal transcriptome, there was evidence of statistical interaction; asymptomatic bacterial STI was associated with upregulation of numerous inflammatory genes and enrichment for immune response pathways among YMSM with HIV, but not YMSM without HIV. Asymptomatic bacterial STI was not associated with differences in tissue HIV RNA viral loads or in HIV replication in explant challenge experiments. Our results suggest that asymptomatic bacterial STI may contribute to inflammation particularly among YMSM with HIV, and that future research should examine potential harms and interventions to reduce the health impact of these syndemic infections., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Van Doren et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Chlamydia is the most common bacterial sexually transmitted infection worldwide and it is widely acknowledged that controlling the rampant community transmission of this infection requires vaccine development. In this study, for the first time, we elucidate the long-term response to male mouse chlamydial vaccination with chlamydial major outer membrane protein (MOMP) and ISCOMATRIX (IMX) both prophylactically and in a novel therapeutic setting. Vaccination significantly reduced and, in some cases, cleared chlamydial burden from the prostates, epididymides, and testes, which correlates with high IgG and IgA tires in tissues and serum. Important markers of sperm health and fertility were protected including sperm motility and proteins associated with fertility in men. Within splenocytes, expression of IFNγ, TNFα, IL17, IL13, IL10, and TGFβ were changed by both infection and vaccination within CD4 and CD8 T cells and regulatory T cells. Within the testicular tissue, phenotypic and concentration changes were observed in macrophages and T cells (resident and transitory). This revealed some pathogenic phenotypes associated with infection and critically that vaccination allows maintenance of testicular homeostasis, likely by preventing significant influx of CD4 T cells and promoting IL10 production. Finally, we demonstrated the testes contained immature (B220+) B cells and mature (CD138+) Chlamydia-specific plasma cells. Thus, through vaccination, we can maintain the healthy function of the testes, which is vital to protection of male fertility., (© The Author(s) 2023. Published by Oxford University Press behalf of Society for the Study of Reproduction.)

The aim of our study was to investigate correlation between socio-Economic conditions and prevalence of Sexually Transmitted Infections among gay individuals (men who have sex with men, MSM) in Georgia. The study was conducted in 5 main cities in different regions of Georgia (Tbilisi, Batumi, Kutaisi, Zugdidi, and Telavi). During 2015-2019, social workers, LGBT community and non-governmental organizations (NGOs), conducted screening of MSM for STI, which was achieved by disseminating required information through electronic and print media, resulting in maximum involvement of MSM in screening programs for STI disseminating. A specially designed questionnaire/survey has been used to investigate the correlations between the following parameters, such as: age, educational attainment (non-completed secondary, secondary, non-completed High School, completed High School), economic income (extremely low, low, middle, high), awareness of STI (yes/no), sources of information (healthcare worker, internet/media, sex partner, social workers and/or NGOs (supporters of LGBT community, others), residence type (urban/rural); frequency of safe sex (using condoms for the last 6 months), number of sexual partners (>3) and etc., among the persons involved in the study. The following prevalence rates of STIs among the MSM population in Georgia during 2015-2019 were defined: for syphilis it appeared to be approximately 25.76%; for gonorrhea - 18.63%, and for chlamydia - 21.98%, respectively. The results of current study indicated that low-income levels and educational attainment are the key socioeconomic risk factors leading to high rates of STI prevalence among MSM. On the contrary, STI rates were inversely correlated with the level of education of the studied population. The odds ratio (OR) for syphilis between with the low and high incomes groups was 1.18 (p=0.023); for gonorrhea, the OR between the above stated groups s was 1.32 (p=0.001); for chlamydia OR was not significant - 0.89 (p=0.118). OR for syphilis between informed and uninformed about STI groups was 1.92 (p<0.001); the OR between the same groups was 2.24 (p<0.001), and in the case of chlamydia - 1.59 (p<0.001). Analysis of information obtained MSM from the selected sources over years showed that the contribution of the social and electronic media was decreased (50.5% to 38.1%, p<0.001) as well as the contribution of the social workers and/or non-governmental (LGBT community supporters) organizations (24,2% to 15.5%, p<0.001); that was mainly due to the acquisition of qualified information from medical workers (from 12.0% to 25.0%, p<0.001) and the high level of reliability of sexual partnership (from 13.2% to 21.1%, p<0.001). The OR for syphilis cases between the Rural/Urban groups was OR=1.60 (p=0.002); for gonorrhea, the OR between the same groups was 1.74 (p<0.001); and for chlamydiosis, the OR was 1.80 (p<0.001). Low-income levels and educational attainment are considered as main socio-economic risk-factors for high STI prevalence observed among the MSM. Healthcare workers and sexual partners are viewed as the main and reliable sources of sexual health information in MSM group. Although the obtained findings need further investigation and confirmation, preliminary results show that screening and prevention programs together with extensive dissemination of sexual health information may decrease prevalence of STI among MSM. And all are of great importance.

Background: Comprehensive evaluation of the quality-adjusted life-years (QALYs) lost attributable to chlamydia, gonorrhea, andtrichomoniasis in the United States is lacking., Methods: We adapted a previous probability-tree model to estimate the average number of lifetime QALYs lost due to genital chlamydia, gonorrhea, and trichomoniasis, per incident infection and at the population level, by sex and age group. We conducted multivariate sensitivity analyses to address uncertainty around key parameter values., Results: The estimated total discounted lifetime QALYs lost for men and women, respectively, due to infections acquired in 2018, were 1541 (95% uncertainty interval [UI], 186-6358) and 111 872 (95% UI, 29 777-267 404) for chlamydia, 989 (95% UI, 127-3720) and 12 112 (95% UI, 2 410-33 895) for gonorrhea, and 386 (95% UI, 30-1851) and 4576 (95% UI, 13-30 355) for trichomoniasis. Total QALYs lost were highest among women aged 15-24 years with chlamydia. QALYs lost estimates were highly sensitive to disutilities (health losses) of infections and sequelae, and to duration of infections and chronic sequelae for chlamydia and gonorrhea in women., Conclusions: The 3 sexually transmitted infections cause substantial health losses in the United States, particularly gonorrhea and chlamydia among women. The estimates of lifetime QALYs lost per infection help to prioritize prevention policies and inform cost-effectiveness analyses of sexually transmitted infection interventions., Competing Interests: Potential conflicts of interest. M.M.R. reports contract from World Health Organization, not related to the manuscript, and grant from Harvard University Center for AIDS Research Developmental Grant, not related to the manuscript. S.Y. reports doctoral stipend from New York University Grossman School of Medicine, not related to the manuscript. All other authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Introduction: Chlamydia trachomatis is the most reported bacterial sexually transmitted infection and if not properly treated may lead to tubal blockage. Tubal factor infertility is the most common form of infertility in Nigeria. This study was designed to determine the usefulness of chlamydia antibody testing in diagnosis of tubal factor infertility., Methods: this was a comparative cross-sectional study conducted in Olabisi Onabanjo University Teaching Hospital Sagamu. One hundred and forty-seven women with tubal blockage on hysterosalpingography and confirmed with laparoscopy, and pregnant control were recruited using convenience sampling method. Information obtained and chlamydia assay results were entered into a computer and analyzed using SPSS version 21. Chi-square was used to determine association between categorical variables. Logistic regression analysis was used to determine the risk factors associated with chlamydia infection., Results: ninety-four (63.9%) of the women with tubal factor infertility were positive for chlamydia IgG antibodies while 37(25.2%) women in the control group had positive results for IgG antibody. This was statistically significant (P=0.001). Analysis using multivariate logistic regression shows early age of coitarche, presence of multiple sexual partners and previous sexually transmitted infection were significantly associated with chlamydia infection (P=0.001)., Conclusion: there was a strong association between chlamydia seropositivity and tubal blockage. Early age at coitarche, previous sexually transmitted infection and multiple sexual partners are significant risk factors for chlamydial infection. Chlamydia trachomatis antibody testing could be used as marker for tubal blockage when evaluating infertile patient., Competing Interests: The authors declare no competing interests., (Copyright: Oluwaseyi Isaiah Odelola et al.)

Background: Methamphetamine (MA) use is associated with sexual risk behavior as well as systemic and mucosal inflammation, suggesting parallel biological and behavioral mechanisms of HIV transmission among men who have sex with men (MSM) who use MA. Data evaluating the combined biological effects of MA use with concomitant rectal gonococcal and/or chlamydial (GC/CT) infection on inflammation are limited., Setting: Secondary analysis of stored rectal and plasma specimens from 100 MSM participating in an NIDA-funded longitudinal cohort in Los Angeles, CA., Methods: This cross-sectional analysis evaluated systemic and rectal inflammatory markers under 2 conditions: (1) recent MA use (by urine drug screen) and (2) rectal GC/CT infection. We evaluated 50 participants with recent MA use (25 with and 25 without rectal GC/CT) and 50 MSM without MA use (25 with and 25 without rectal GC/CT). Log-transformed plasma and rectal immune markers were regressed on MA exposure and rectal GC/CT, controlling for HIV status and age., Results: Median age was 32 (range 19-45) years, and 58% of participants were living with HIV. Plasma tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-1ß, and rectal IL-6 were associated with rectal GC/CT and MA use, independent of HIV status. Higher levels of rectal TNF-α, IL-1ß, and IL-17a were associated with rectal GC/CT., Conclusions: Systemic and rectal inflammation was positively associated with rectal GC/CT and MA use. Condomless sex in the setting of GC/CT- and MA-induced immune activation may provide a basis for synergistic biobehavioral mechanisms that promote HIV/STI transmission among MSM who use MA., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Mycoplasma genitalium (MG) is associated with urethritis in men and weakly associated with pelvic inflammatory disease in women. Mycoplasma genitalium coinfections with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) are commonly reported; however, little is known about their interaction. One study suggested that MG/NG coinfections might increase the bacterial load of NG, which has been shown to have a higher transmission potential. As even less is known about the impact of a simultaneous MG/CT infection, we assessed whether patients with urogenital MG/CT coinfections have a higher bacterial load than patients with a single infection., Methods: There were 1673 urogenital samples from patients from a population-based chlamydia study, and our sexually transmitted infection clinic tested for both CT and MG. When positive, the load was quantified. Nonparametric tests compared the CT and MG load, and linear regression analyses tested the association of the CT and MG load within a patient., Results: In 60 MG-positive patients, MG load ranged from 1.7 to 6.0 log10 copies/ml, similar to the CT load distribution. Only 6 patients were MG-positive and CT-negative, but the MG load distribution was similar to that of CT-positive patients (n.s.). The MG and CT load was unrelated in coinfected persons (n.s.)., Conclusions: We found no correlation between the CT and MG load in urogenital samples, and the MG load distribution was similar in CT-positive and CT-negative patients. These results could have implications for the transmission risk of these infections., Competing Interests: Conflict of Interest and Sources of Funding: None declared., (Copyright © 2022 American Sexually Transmitted Diseases Association. All rights reserved.)

Background: Men having sex with men (MSM) are at increased risk of acquiring sexually transmitted infections (STIs), including extra-urethral infections. This study aimed to provide information on the presence of genital and extra-genital non-viral STIs and associated risk factors among MSM in the Tshwane district of South Africa., Method: Samples were collected from 200 MSM in the North-western area of Tshwane. After the completion of a questionnaire including demographics and sexual history and an HIV test, three swabs (pharyngeal, rectal, and urethral) were collected and tested for the presence of Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV)., Results: Data were collected from 199 participants and 77/199 (38.7%) participants had at least one infection regardless of specimen site. Of these 34 (17.1%) were infected with NG; 36 (18.1%) with CT, 16 (8.1%) with MG and 14 (7.0%) with TV. NG and CT were most frequently detected in rectal specimens. The HIV prevalence in this study was 66.8% (133/199), with 56 (28.1%) of participants both STI and HIV positive . Being between 18 and 20 years, and difficulty having safe sex (more sex partners and more often condomless anal sex) when high/drunk were significantly associated with having an STI. Factors with increased odds of having an STI were being HIV positive, having two or more sexual partners, depending on partner financially, performing and receiving rimming, or receiving anal sex., Conclusions: This study has highlighted the high burden of STIs in MSM in the local community, especially the prevalence of these pathogens in extra-genital sites.

Background: The impact of Chlamydia trachomatis on semen quality has been studied with varied results., Aim: To determine the prevalence of antichlamydial antibodies and their relationship with sperm quality among male partners of infertile couples in Enugu, South-East Nigeria., Materials and Methods: It was a cross-sectional study of infertile male partners of couples attending infertility clinics at the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu, Nigeria. Their sera were assayed for antichlamydial antibodies, and semen analysis and culture were done for each participant., Results: Two hundred and eighty-two (282) male partners of infertile couples were studied. Infertility was commoner among participants aged 40 years or more (45.1%) and was mainly of the "primary type" (62.1%). Antichlamydia antibody was detected in 156 (55.3%) participants and was significantly associated with sperm quality (P = 002; OR = 2.294; 95% CI = 1.36-3.88). Overall, 81 (28.7%) had abnormal sperm quality. The sperm count, progressive motility, and vitality were significantly lower in participants with abnormal sperm quality than those with normal sperm quality (P < 0.001) while morphology, volume, and liquefaction time did not differ significantly (P > 0.05). Staphylococcus aureus was the predominant organism isolated from culture (122/282, 43.3%) while Streptococcus species were the least (4/262, 1.4%). There was significantly more Staphylococcus aureus isolated from the semen of participants that were seropositive to antichlamydial antibodies than those that were seronegative (80/156, 51.3% vs. 42/126, 33.3%; OR = 2.105; 95% CI = 1.30-3.42; P = 0.003)., Conclusion: The prevalence of antichlamydial antibodies among male partners of infertile couples in Enugu, Nigeria is high and there is a significant association with sperm quality, sperm count, and bacterial isolates in seminal culture. Male partners of infertile couples in Enugu should be screened for antichlamydial antibodies and appropriate treatment offered wherever indicated. There is a need for increased public awareness and advocacy campaigns on the impact of Chlamydia infection on male factor infertility. This primary preventive measure may help in reducing the burden of Chlamydia infection and male factor infertility., Competing Interests: None

Introduction: Ectopic pregnancy(EP) is the implantation of a fertilized ovum outside of the uterine cavity. The incidence of EP has steadily increased around the world. The present umbrella review evaluated risk factors prior to conception associated with EP based on meta-analyses and systematic reviews., Methods: We searched PubMed, Scopus, and Web of Science until June 25, 2021. All meta-analyses that had focused on assessing the risk factors associated with EP were included. We calculated summary effect estimates, 95% CI, heterogeneity I², 95% prediction interval, small-study effects, excess significance biases, and sensitive analysis. The quality of the meta-analyses was evaluated with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2)., Results: Two risk factors including chlamydia trachomatis (OR: 3.03) and smoking (OR: 1·77) were graded as suggestive evidence (class III). IUD with pregnant control (OR: 10.63) and endometriosis for case-control studies (OR: 2·66) and tubal ligation with pregnant control (OR: 9.3) were graded as risk factors with weak evidence (class IV). Tubal ligation with non-pregnant control was a protective factor (class IV). IUD with non-pregnant control and endometriosis for cohort studies were not as risk factors for EP., Conclusion: Two risk factors including chlamydia trachomatis and smoking were graded as suggestive evidence. IUD with pregnant control and endometriosis for case-control studies and tubal ligation with pregnant control were graded as risk factors with weak evidence. Strong evidence for risk factors of EP was not achieved, indicating the degree of uncertainty and bias, which bring an emergency to conduct further no-bias studies., Systematic Review Registration: PROSPERO (CRD42021281632)., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Purpose: Evidence indicates that human papillomavirus (HPV) and Chlamydia trachomatis (CT) co-infection increases the risk of developing cervical pathogenesis. This study aims to assess the prevalence and possible risk factors of CT and HPV/CT co-infection in women from South of Morocco with normal and abnormal cytology., Methods: Participants were recruited after signing an informed consent. Cervical samples were collected and analysed for the presence of HPV or CT. Detection of genomic DNA of both pathogens was performed by nested polymerase chain reaction. HPV genotypes defined by Sanger sequencing method. The association between demographic features and co-infection status was determined using a logistic regression model. A possible association between the presence of HPV and CT and cytological abnormality patterns was also investigated., Results: We recruited n = 438 women, aged between 18 and 86 years. Around 59% of participants underwent a pap smear test for the first-time. Genomic DNA of HPV, CT and HPV/CT co-infection was detected in 32.3%, 17.7%, and 13.4% of the total samples, respectively. The identified risk factors associated with CT infection were history of sexually transmitted infections and marital status. By contrast, only smoking was found to be associated with HPV/CT co-infection. Evidence showed that co-infection was associated with an increased risk of developing cervical abnormalities (OR 3.18, 95% CI 0.96-9.21; p = 0.040)., Conclusion: HPV and CT rates were high among the studied population. Evidence suggests that HPV/CT co-infected women were more susceptible to developing abnormal cytology., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The rise in sexually transmitted infections and chemsex has led to syndemy with HIV, partly due to common routes of transmission and clustered transmissions. Despite this, barriers to STI care and PrEP still remain. We sought to determine whether MSM at low risk for HIV infection were also at low risk for other STIs., Methods: The study group was tested for HIV, HCV, and Treponema pallidum , as well as had urethral, rectal, and oropharyngeal smears performed for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) six months apart. The control group was tested once to define the background incidence., Results: Treponema pallidum , CT, and NG prevalence was very high at both time points and was similar to the control group. CT was especially common in the control group (20.58%) and the study group at the rectal site at the second time point (9.37%). NG dominated the oropharyngeal site (15.87%), with urethral site sparing. NG infection was associated with an increased number of partners, not condom use (OR, 1.082 [95% CI; 1.009-1.171]). Risk behavior did not change between the time points. Treponema pallidum , CT, and NG incidence was exceptionally high (12.5/100PY, 25.39/100PY, 34.92/100PY, respectively; pooled 87.5/100PY) and was comparable to other studies of high-risk MSM., Conclusions: Despite a lower risk for HIV acquisition, the study group was at a very high risk for other STIs, and this risk remained high throughout the study. Patients and medical professionals should be aware of syphilis, gonorrhea, and chlamydiosis transmission risks, and screening should be performed accordingly. Prophylactic programs need to be updated to specifically include lower-risk individuals.

Background: Chlamydia trachomatis infection is one of the most common sexually transmitted diseases. There is widespread evidence in recent years that indicate C. trachomatis infection plays a role in sperm dysfunction and poor sperm quality. However, some controversial documents have argued the role of infection with this bacterium in male infertility., Methods: A full comprehensive electronic search was performed using the online databases Web of Science, PubMed, Scopus, Embase, and Google Scholar, without considering the time limits., Results: In the present study, 56 articles were finally found to be eligible. The prevalence of C. trachomatis infection in the infertile males was estimated at 20.6% (19.8-21.5 with 95% CIs; p- Value: 0.01; I2: 97.77; Q-Value: 237.8; p-Value: 0.01; Begg's p-Value: 0.09; Egger's p-Value: 0.01) in overall. We have also shown that infection with C. trachomatis can significantly increase the risk of infertility in men (OR: 2.28; 1.90-2.72 with 95% CIs; p-Value: 0.001; I2: 81.61; QValue: 59.81; p-Value: 0.01; Begg's p-Value: 0.73; Egger's p-Value: 0.61)., Conclusion: We showed a high prevalence of C. trachomatis in the sperm and semen samples of infertile men, and C. trachomatis infection is associated with a significantly higher risk of infertility in men., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: In a guinea pig herd with 26 breeding animals, several individuals of all age categories died (16/26) after three animals had been newly introduced from another herd. Furthermore, the population suffered of apathy, anorexia, severe weight loss and conjunctivitis, as well as abortions and stillbirths. At the same time, the owner experienced a SARS-CoV-2 infection with pneumonia, which was confirmed by taking a PCR test. Chlamydia caviae was detected from the conjunctiva and vagina/uterus in one juvenile animal together with an intestinal Cryptosporidium wrairi infection. Oocysts were found histologically in the small intestine, which was confirmed by PCR. C. wairi is a parasite adapted to guinea pigs with zoonotic potential, which causes diarrhoea with frequent deaths in larger guinea pig herds. C. caviae is also a zoonotic pathogen and often the cause of conjunctivitis, pneumonia and abortions in guinea pigs and can lead to upper respiratory tract disease, conjunctivitis but also severe pneumonia in humans. The increased death cases and the clinical signs could be traced back to an infection with Cryptosporidium wrairi, complicated by a co-infection of C. caviae. We suspect that the abortions were caused by C. caviae, but since the population was treated with various antibiotics effective against chlamydial infections, it was no longer possible to verify this by PCR testing. Unfortunately, more animals succumbed and finally only two animals of the originally 26 were left. With this case report, we would like to point out to veterinarians that guinea pigs can be an important source of zoonotic infections for various pathogens, especially since they are popular pets and often come into close contact with children where hygiene might not always be strictly followed.

Urethritis is mainly caused by sexually transmitted pathogens, such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) [1]. Close to 90 million adults are infected annually with NG [2]. Treatment shall be performed according to national guidelines and resistance profiles [2, 3]. Enterobius vermicularis (EV) is the most common helminth in humans with 1 billion people globally infected [4-6]. Symptoms include anal pruritus; however, many infections are asymptomatic [4-7]. A case of urethritis due to simultaneous infection with NG and EV is reported., (© 2022. The Author(s).)