Date Published: May 31, 2019
Publisher: Public Library of Science
Author(s): Ana Ximena Kiguen, Marcela Marramá, Susana Ruiz, Patricia Estofan, Raúl Fernando Venezuela, Jessica Paola Mosmann, Marina Soledad Monetti, Virginia Rivero, Cecilia Gabriela Cuffini, Guangming Zhong.
Chlamydia trachomatis causes the most prevalent bacterial Sexual Transmitted Infection. In pregnant women, untreated chlamydial infections are associated with abortions, premature rupture of membranes, postpartum endometritis, low birth weight and transmission to the newborn. In Córdoba, Argentina, there is little knowledge about the prevalence of Chlamydia trachomatis in women in their third trimester of pregnancy, so, the aim of this study was to evaluate Chlamydia trachomatis prevalence and genotypes present in Cordovan pregnant women with different age and socioeconomic status.
Design: prospective study.
A prevalence of 6.9% (35/509) for Chlamydia trachomatis infection was detected, with 32/295 and 3/214 from pregnant women with low or better economic resources respectively (p = 0,0001). Results showed a significantly increased rate of 11.6% (30/258) in women under 25 years compared with 2% (5/251) in patients over that age (p = 0,00003). Genotype E was the most prevalent.
With these results, we can say that pregnant women under 25 years old and low economic resources are one of the populations in which the screening programs of Chlamydia trachomatis should focus.
Chlamydia trachomatis (C. trachomatis) is an obligate intracellular Gram negative bacterium causing the most prevalent bacterial Sexual Transmitted Infection (STI) throughout the world. The World Health Organization (WHO) estimated that annually some 357 million people get one STI include: chlamydia, gonorrhea, syphilis or trichomoniasis . According to ompA gene molecular differences, C. trachomatis could be divided into different genotypes that are responsible for various diseases: genotypes A, B, Ba and C causing trachoma; genotypes D, Da, E, F, G, H, I, Ia, J and K responsible for urogenital infections in adults and respiratory and conjunctival infections in neonates and genotypes L1, L2, L2a and L3 causing Lymphogranuloma venereum [2, 3]. The most important characteristic of C. trachomatis is the ability to produce acute complications and long-term sequelae in upper genital tract, thus affecting the reproductive health.
We studied patients from 14 to 43 years of age with a median of 25 years. From 509 samples analyzed in the present work, 35 were positive for C. trachomatis DNA, revealing a total prevalence of 6.9% in the pregnant population included in our study.
In our knowledge this is the first report of C. trachomatis prevalence in women in their third trimester of pregnancy from Cordoba, Argentina. According to published studies, the prevalence of this bacterium differs greatly around the world, with values between 0.1% and 25.7% depending on the particular characteristics of the pregnant population and the methodology used in the study [20, 21]. In Latin America, there are a few studies regarding C. trachomatis prevalence in pregnant women and values reported are 5.9%, 10% and 11% for pregnant women from Chile, Peru and Brazil respectively [22, 12, 23]. In the present study we found a prevalence of 6.9%, which is within the range expected for the region. Highest percentages of positivity were found in women between 21 to 25 years and with limited financial resources. Young women are a vulnerable group of the population with regard to sexually transmitted diseases. This is thought to be because of the relative immaturity of the genital tract, making it prone to both trauma and infection, particularly in the developing transformation zone of the cervix [6–7].