Genital and anal Chlamydia trachomatis bacterial load in concurrently infected women: a cross-sectional study

Objectives Most international STI guidelines recommend Chlamydia trachomatis anorectal testing in women after self-reported sexual exposure or symptoms in women. However, it has been shown that the prevalence of anorectal C. trachomatis is as high (7%-17 %) in women who do not report anorectal intercourse (AI) as in women who do. This study assessed the correlation between the genital and anorectal C. trachomatis load in concurrently infected women for increased microbiological insight. Methods A convenience sample of 105 women with a concurrent (genital and anorectal) C. trachomatis infection was included from the STI clinic in South Limburg, the Netherlands. Women provided self-collected vaginal and anorectal swabs. The C. trachomatis load was quantified with qPCR and the human cell load was assessed to ensure sample adequacy. Genital and anorectal C. trachomatis loads were divided into tertiles for comparison. The chi(2) test and linear regression were used to compare genital and anorectal C. trachomatis loads and identify determinants associated with load. Results The overall median C. trachomatis load was higher in genital (median 5.3 log(10)C. trachomatis/ml) than anorectal samples (median 3.4, p