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Viability of Chlamydia trachomatis in Different Anatomical Sites-a Systematic Review and Meta-analysis
Arthur Wong1,2, Nicole Lima3, Tanya L Applegate2
1Sydney Sexual Health Centre, Sexual Health & Bloodborne Viruses, Population & Community Health, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
Summary
A significant portion of Chlamydia trachomatis (CT) detected by nucleic acid amplification testing (NAAT) is non-viable. This finding impacts STI screening programs and the evaluation of new antimicrobial treatments.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Modern Chlamydia trachomatis (CT) detection relies on nucleic acid amplification testing (NAAT).
- NAAT can detect both viable and non-viable CT.
- Various laboratory techniques exist to assess CT viability.
Purpose of the Study:
- To systematically review and meta-analyze studies measuring CT viability in NAAT-positive samples.
- To determine the proportion of non-viable CT across different anatomical sites.
Main Methods:
- A comprehensive literature search was conducted in PubMed, EMBASE, Scopus, and Dimensions from January 2000 to May 2023.
- Studies measuring CT viability in NAAT-positive samples were included.
- Viability assays included cell culture, DFA, mRNA detection (ddPCR), V-PCR, and RDR (RNA-to-DNA ratio).
- A meta-analysis was performed on the proportions of non-viable CT by anatomical site.
Main Results:
- 16 studies were included from 31,342 screened records.
- Pooled proportions of non-viable CT were: 33% in rectal swabs, 17% in cervical swabs, 15% in vaginal swabs, and 11% in urine/urethral swabs.
- Significant variation in non-viable CT proportions was observed across anatomical sites.
Conclusions:
- A substantial proportion of NAAT-detected CT is non-viable.
- These findings have critical implications for Chlamydia screening programs.
- The results are important for studies evaluating new STI tests and antimicrobial therapies.
