Chlamydia trachomatis in Iceland: Prevalence, Clinico-epidemiological Features and Comparison of Cobas 480 CT/NG and Aptima Combo 2 (CT/NG) for Diagnosis
DOI:
https://doi.org/10.2340/00015555-3762Keywords:
Chlamydia trachomatis, Neisseria gonorrhoeae, prevalence, risk factor, nucleic acid amplification, Iceland, sexually transmitted diseaseAbstract
The aims of this study were to assess the prevalence of, and risk factors for, Chlamydia trachomatis in attendees recruited prospectively from October 2018 to January 2019 at the only sexually transmitted infections clinic in Iceland (in Reykjavík), and to evaluate the cobas 4800 CT/NG Test and Aptima Combo 2 Assay for C. trachomatis detection in male urine and female vaginal swabs. Prevalence of C. trachomatis was 15.8% among 487 women and 13.6% among 491 men (no Neisseria gonorrhoeae positive patients were found). C. trachomatis detection was independently and positively associated with being tested for contact tracing, 18–24 years of age, and reporting ≥ 6 sexual partners within 12 months. Reporting sex with non-residents of Iceland was associated with a lower risk of C. trachomatis infection. Both assays had a high sensitivity in detection of C. trachomatis (Aptima Combo 2: 100%; cobas 4800 CT/NG: 95.1%) and high specificity (100% and 99.6%, respectively). The high local prevalence of C. trachomatis and increased acquisition risk following sex with residents are of public health concern.
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Lanjouw E, Ouburg S, de Vries HJ, Stary A, Radcliffe K, Unemo M. Background review for the '2015 European guideline on the management of Chlamydia trachomatis infections'. Int J STD AIDS 2015 Nov 24. [Online ahead of print].
DOI: https://doi.org/10.1177/0956462415618838
Nye MB, Osiecki J, Lewinski M, Liesenfeld O, Young S, Taylor SN, et al. Detection of Chlamydia trachomatis and Neisseria gonorrhoeae with the cobas CT/NG v2.0 test: performance compared with the BD ProbeTec CT Q(x) and GC Q(x) amplified DNA and Aptima AC2 assays. Sex Transm Infect 2019; 95: 87-93.
DOI: https://doi.org/10.1136/sextrans-2018-053545
Surveillance Atlas of Infectious Diseases Solna, Sweden: European Centre for Disease Prevention and Control; 2017 [cited 2020 Oct 29]. Available from: https://atlas.ecdc.europa.eu/public/index.aspx.
Redmond SM, Alexander-Kisslig K, Woodhall SC, van den Broek IV, van Bergen J, Ward H, et al. Genital chlamydia prevalence in Europe and non-European high income countries: systematic review and meta-analysis. PLoS One 2015; 10: e0115753.
DOI: https://doi.org/10.1371/journal.pone.0115753
de Coul EL, Warning TD, Koedijk FD, Dutch STIc. Sexual behaviour and sexually transmitted infections in sexually transmitted infection clinic attendees in the Netherlands, 2007-2011. Int J STD AIDS 2014; 25: 40-51.
DOI: https://doi.org/10.1177/0956462413491736
Velicko I, Ploner A, Sparen P, Marions L, Herrmann B, Kuhlmann-Berenzon S. Sexual and testing behaviour associated with Chlamydia trachomatis infection: a cohort study in an STI clinic in Sweden. BMJ Open 2016; 6: e011312.
DOI: https://doi.org/10.1136/bmjopen-2016-011312
Aung ET, Chow EP, Fairley CK, Hocking JS, Bradshaw CS, Williamson DA, et al. International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017. Euro Surveill 2019; 24: 1900219.
DOI: https://doi.org/10.2807/1560-7917.ES.2019.24.44.1900219
Steingrimsson O, Olafsson JH, Kristinsson KG, Geirsson RT, Thorsteinsson V, Ryan RW. Diagnostic efforts for the detection of chlamydia trachomatis infections in Iceland 1982-1994. Laeknabladid 1995; 81: 545-549.
Steingrimsson O, Jonsdottir K, Olafsson JH, Karlsson SM, Palsdottir R, Davidsson S. Comparison of Roche Cobas Amplicor and Abbott LCx for the rapid detection of Chlamydia trachomatis in specimens from high-risk patients. Sex Transm Dis 1998; 25: 44-48.
DOI: https://doi.org/10.1097/00007435-199801000-00009
Chernesky M, Jang D, Gilchrist J, Hatchette T, Poirier A, Flandin JF, et al. Head-to-head comparison of second-generation nucleic acid amplification tests for detection of Chlamydia trachomatis and Neisseria gonorrhoeae on urine samples from female subjects and self-collected vaginal swabs. J Clin Microbiol 2014; 52: 2305-2310.
DOI: https://doi.org/10.1128/JCM.03552-13
Taylor SN, Liesenfeld O, Lillis RA, Body BA, Nye M, Williams J, et al. Evaluation of the Roche cobas(R) CT/NG test for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in male urine. Sex Transm Dis 2012; 39: 543-549.
DOI: https://doi.org/10.1097/OLQ.0b013e31824e26ff
Van Der Pol B, Liesenfeld O, Williams JA, Taylor SN, Lillis RA, Body BA, et al. Performance of the cobas CT/NG test compared to the Aptima AC2 and Viper CTQ/GCQ assays for detection of Chlamydia trachomatis and Neisseria gonorrhoeae. J Clin Microbiol 2012; 50: 2244-2249.
DOI: https://doi.org/10.1128/JCM.06481-11
Gaydos CA, Quinn TC, Willis D, Weissfeld A, Hook EW, Martin DH, et al. Performance of the APTIMA Combo 2 assay for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in female urine and endocervical swab specimens. J Clin Microbiol 2003; 41: 304-309.
DOI: https://doi.org/10.1128/JCM.41.1.304-309.2003
Altman DG. Practical statistics for medical research. 1st edn. London: Chapman & Hall; 1995.
Klamydía (LGV) Reykjavík, Iceland: Icelandic Directorate of Health; 2019 [cited 2020 July 13]. Available from: https://www.landlaeknir.is/smit-og-sottvarnir/smitsjukdomar/sjukdomur/item12514/Klamydia-(C--trachomatis-og-C--venereu/LGV.
Unemo M, Salado-Rasmussen K, Hansen M, Olsen AO, Falk M, Golparian D, et al. Clinical and analytical evaluation of the new Aptima Mycoplasma genitalium assay, with data on M. genitalium prevalence and antimicrobial resistance in M. genitalium in Denmark, Norway and Sweden in 2016. Clin Microbiol Infect 2018; 24: 533-539.
DOI: https://doi.org/10.1016/j.cmi.2017.09.006
Hokynar K, Hiltunen-Back E, Mannonen L, Puolakkainen M. Prevalence of Mycoplasma genitalium and mutations associated with macrolide and fluoroquinolone resistance in Finland. Int J STD AIDS 2018; 29: 904-907.
DOI: https://doi.org/10.1177/0956462418764482
Lallemand A, Bremer V, Jansen K, Nielsen S, Munstermann D, Lucht A, et al. Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up? BMC Infect Dis 2016; 16: 610.
DOI: https://doi.org/10.1186/s12879-016-1915-2
Lekandi Reykjavík, Iceland: Icelandic Directorate of Health; 2019 [cited 2020 October 29th]. Available from: https://www.landlaeknir.is/smit-og-sottvarnir/smitsjukdomar/sjukdomur/item13054/Lekandi.
ECDC. Gonorrhoea - annual epidemiological report 2018. Stockholm: European Centre for Disease Prevention and Control; 2020.
Righarts AA, Morgan J, Horner PJ, Wills GS, McClure MO, Dickson NP. Chlamydia trachomatis incidence using self-reports and serology by gender, age period, and sexual behavior in a birth cohort. Sex Transm Dis 2017; 44: 344-350.
DOI: https://doi.org/10.1097/OLQ.0000000000000605
Decraene V, Kuhlmann Berenzon S, Andersson Franko M, Velicko I. Differences in travel-related incidence of chlamydia by age groups, gender and destination: Sweden 2000-2013. Travel Med Infect Dis 2018; 25: 42-49.
DOI: https://doi.org/10.1016/j.tmaid.2018.02.008
Icelandic Tourist Board. Numbers of foreign visitors Reykjavík, Iceland: Icelandic Tourist Board; 2020 [cited 2020 July 13th]. Available from: https://www.ferdamalastofa.is/en/recearch-and-statistics/numbers-of-foreign-visitors.
Icelandic Tourist Board. Tourism in Iceland in figures Reykjavík, Iceland: Icelandic Tourist Board; 2020 [cited 2020 October 30th]. Available from: https://www.ferdamalastofa.is/en/recearch-and-statistics/tourism-in-iceland-in-figures.
Kumamoto Y, Matsumoto T, Fujisawa M, Arakawa S. Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urogenital and oral specimens using the cobas(R) 4800, APTIMA Combo 2(R) TMA, and ProbeTec ET SDA assays. Eur J Microbiol Immunol (Bp) 2012; 2: 121-127.
DOI: https://doi.org/10.1556/EuJMI.2.2012.0001
Van Der Pol B, Taylor SN, Liesenfeld O, Williams JA, Hook EW, 3rd. Vaginal swabs are the optimal specimen for detection of genital Chlamydia trachomatis or Neisseria gonorrhoeae using the Cobas 4800 CT/NG test. Sex Transm Dis 2013; 40: 247-250.
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Copyright (c) 2021 Ingibjorg Hilmarsdóttir, Eva Mjöll Arnardóttir, Elísabet Reykdal Jóhannesdóttir, Daniel Golparian, Magnus Unemo
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