Skip to main content
Log in

Screening for asymptomatic urogenital Chlamydia trachomatis infection at a large Dublin maternity hospital: results of a pilot study

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

There are currently no Irish guidelines on screening for Chlamydia trachomatis infection in pregnancy. Prevalence rates in the antenatal population are not known which has prevented the development of screening recommendations for this group.

Aims

The objective of this study was to determine the prevalence of asymptomatic urogenital C. trachomatis infection in young women attending for care at a large maternity hospital.

Methods

All patients aged 25 years and under attending the Hospital between December 2011 and December 2013 were offered screening for urogenital C. trachomatis infection. Nucleic acid amplification testing of the C. trachomatis cryptic plasmid was performed on either endocervical swabs or first void urine samples.

Results

There were 2687 women tested for C. trachomatis infection, 83.4 % (2241/2687) through the antenatal clinics, 7.1 % (193/2687) through the gynaecology clinic, and 9.4 % (253/2687) through the emergency department. The rate of a positive test result was 5.6 % (151/2687) overall. The rates in women ages 16–18, 19–21 and 22–25 years were 9.1 % (31/340), 6.5 % (50/774) and 4.4 % (69/1561), respectively. A positive test result was more likely in those who were unemployed (p = 0.04), those who were Irish (p = 0.03) and those who were unmarried (p < 0.01). There were no cases of neonatal C. trachomatis infection in babies born to mothers who were screened in early pregnancy.

Conclusions

The prevalence rate of detected C. trachomatis infection was 5.6 % in the study population. Screening of antenatal patients may have a role in preventing vertical transmission of infection to the neonate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Health Protection Surveillance Centre, Health Services Executive (2011) Trends in Sexually Transmitted Infection (STI) notifications, 1995–2009. Health Services Executive, Dublin

  2. Health Protection Surveillance Centre, Health Services Executive (2012) Quarterly report in sexually transmitted infections in Ireland, 2011, quarter 4. Health Services Executive, Dublin

  3. European Centre for Disease Prevention and Control (2009) Chlamydia control in Europe. European Centre for Disease Prevention and Control, Stockholm

  4. Health Protection Surveillance Centre, Health Services Executive (2005) The need for Chlamydia screening in Ireland. Health Services Executive, Dublin

  5. Baud D, Goy G, Jaton K et al (2011) Role of Chlamydia trachomatis in miscarriage. Emerg Infect Dis 17:1630–1635

    Article  PubMed  PubMed Central  Google Scholar 

  6. Thorne C (2011) Chlamydia screening in pregnancy: an evidence review. UK National Screening Committee Policy Review, London

    Google Scholar 

  7. LeFevre ML (2014) Screening for chlamydia and gonorrhea: US preventive services task force recommendation statement. Ann Intern Med 161:902–910

    Article  PubMed  Google Scholar 

  8. Rotunda Hospital (2015) Annual clinical report 2014. Rotunda Hospital, Dublin

  9. McMillan HM, O’Carroll H, Lambert JS et al (2006) Screening for Chlamydia trachomatis in asymptomatic women attending outpatient clinic in a large maternity hospital in Dublin, Ireland. Sex Transm Infect 82:503–505

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Keegan H, Ryan F, Malkin A et al (2009) Chlamydia trachomatis detection in cervical PreservCyt specimens from an Irish urban female population. Cytopath 20:111–116

    Article  CAS  Google Scholar 

  11. Health Protection Surveillance Centre and Health Research Board (2012) Chlamydia screening in Ireland: a pilot study if opportunistic screening for genital Chlamydia trachomatis infection in Ireland (2007–2009). Health Research Board, Dublin

  12. O’Connell E, Brennan W, Cormican M et al (2009) Chlamydia trachomatis infection and sexual behaviour among female students attending higher education in the Republic of Ireland. Pub Health 9:397–403

    Google Scholar 

  13. Heijne JCM, Tao G, Kent CK et al (2010) Uptake of regular chlamydia testing by US women: a longitudinal study. Am J Prev Med 39:243–250

    Article  PubMed  Google Scholar 

  14. National Chlamydia Screening Programme (2013) Annual Chlamydia diagnosis rate. National Chlamydia Screening Programme, London

  15. World Health Organization (2011) Prevalence and incidence of selected sexually transmitted infections, Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis and Trichomonas vaginalis: methods and results used by WHO to generate 2005 estimates. World Health Organization, Geneva

  16. Batteiger BE, Fujie Xu, Johnson RE et al (2010) Protective immunity to Chlamydia trachomatis genital infection: evidence from human studies. J Infect Dis 201(S2):S178–S189

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Shiely F, Horgan M, Hayes K (2010) Increased sexually transmitted infection incidence in a low risk population: identifying the risk factors. Eur J Public Health 2:207–212

    Article  Google Scholar 

  18. Gottleib SL, Berman SM, Low N (2010) Screening and treatment to prevent sequelae in women with Chlamydia trachomatis genital infection? How much do we know? J Infect Dis 201:S156–S167

    Article  Google Scholar 

  19. Molano M, Meijer CJLM, Weiderpass E et al (2005) The natural course of Chlamydia trachomatis infection in asymptomatic Colombian women: a 5-year follow-up study. J Infect Dis 191:907–916

    Article  PubMed  Google Scholar 

  20. Morré SA, van den Brule AJ, Rozendaal L et al (2002) The natural course of asymptomatic Chlamydia trachomatis infections: 45 % clearance and no development of clinical PID after 1-year of follow-up. Int J STD AIDS 13(S2):12–18

    Article  PubMed  Google Scholar 

  21. Geisler WM (2010) Duration of untreated, uncomplicated Chlamydia trachomatis genital infection and factors associated with chlamydia resolution: a review of human studies. J Infect Dis 201(S2):S104–S113

    Article  PubMed  Google Scholar 

  22. Herzog SA, Althaus CL, Heijne JCM et al (2012) Timing of progression of Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study. Infect Dis 12:187–195

    Google Scholar 

  23. Johnson HL, Ghanem KG, Zenilman JM et al (2011) Sexually transmitted infections and adverse pregnancy outcomes among women attending inner city public sexually transmitted diseases clinic. Sex Transm Dis 38:167–171

    Article  PubMed  Google Scholar 

  24. Silva MJPMA, Florencio GLD, Gabiatti JRE et al (2011) Perinatal morbidity and mortality associated with chlamydial infection: a meta-analysis study. Braz J Infect Dis 15:533–539

    Article  PubMed  Google Scholar 

  25. Rours GI, Duijts L, Moll HA et al (2011) Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study. Eur J Epidemiol 26:493–502

    Article  PubMed  PubMed Central  Google Scholar 

  26. Blas MM, Canchihuaman FA, Alva IE et al (2007) Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State. Sex Transm Infect 83:314–318

    Article  PubMed  PubMed Central  Google Scholar 

  27. Andrews WW, Goldenberg RL, Mercer B et al (2000) The Preterm Prediction Study: association of second-trimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. Am J Obstet Gynecol 183:662–668

    Article  CAS  PubMed  Google Scholar 

  28. Andrews WW, Klebanoff MA, Thom EA et al (2006) Mid-pregnancy genitourinary tract infection with Chlamydia trachomatis: association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis. Am J Obstet Gynecol 194:493–500

    Article  PubMed  Google Scholar 

  29. Silveira MF, Ghanem KG, Erbelding et al (2009) Chlamydia trachomatis infection during pregnancy and the risk of preterm birth: a case–control study. Int J STD AIDS 20:465–469

    Article  CAS  PubMed  Google Scholar 

  30. Ong JJ, Chen M, Hocking J et al (2015) Chlamydia screening for pregnant women aged 16–25 years attending an antenatal service: a cost-effectiveness study. BJOG. doi:10.1111/1471-0528.13567

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. C. O’Higgins.

Ethics declarations

Funding

No funding was received for this work.

Conflict of interest

AOH declares that she has no conflict of interest. VJ declares that she has no conflict of interest. ML declares that she has no conflict of interest. DLB declares that he has no conflict of interest. GC declares that she has no conflict of interest. ME declares that she has no conflict of interest. JSL declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

O’Higgins, A.C., Jackson, V., Lawless, M. et al. Screening for asymptomatic urogenital Chlamydia trachomatis infection at a large Dublin maternity hospital: results of a pilot study. Ir J Med Sci 186, 393–397 (2017). https://doi.org/10.1007/s11845-016-1429-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-016-1429-3

Keywords

Navigation