Value of screening for oro-pharyngeal Chlamydia trachomatis infection

J Clin Pathol. 1995 Jul;48(7):658-61. doi: 10.1136/jcp.48.7.658.

Abstract

Aims: To determine whether oro-pharyngeal colonisation by Chlamydia trachomatis occurs in patients at risk of genital chlamydia infection; to determine whether screening pharyngeal specimens by polymerase chain reaction (PCR) increases detection of C trachomatis compared with isolation and the immune dot blot test; and to correlate the detection of C trachomatis and Neisseria gonorrhoeae in the pharynx with a history of oro-genital contact.

Methods: Thirteen homosexuals and 11 heterosexuals were included in the study. Urogenital and pharyngeal specimens were tested for C trachomatis and N gonorrhoeae using standard clinical diagnostic procedures. Two different PCR methodologies were also used to detect C trachomatis in the pharyngeal specimens. Results were correlated with the mode of sexual practice.

Results: Oro-genital sexual contact was practised by 64.9% (72/111) of heterosexuals in addition to penetrative penovaginal intercourse. Additionally, 62.1% (77/124) of all patients did not use any form of barrier protection. Of those who admitted to oro-genital sexual contact, 17.6% of patients with a genital chlamydial infection and 36.4% of those with genital gonorrhoea also had asymptomatic pharyngeal colonisation. C trachomatis was detected in three of 124 (2.4%) pharyngeal specimens by PCR which were reported as negative by chlamydial culture; one was positive by the immune dot blot test.

Conclusion: The majority of patients practised unprotected oro-genital contact and significant pharyngeal colonisation by C trachomatis and N gonorrhoeae occurred if genital infection was present. Despite the use of PCR in a population at high risk of sexually transmitted disease, the prevalence of chlamydia in the pharynx was very low. This indicates that transmission of C trachomatis to the oro-pharynx does not pose a serious health risk and that screening of patients for oro-pharyngeal C trachomatis is not worthwhile.

MeSH terms

  • Adolescent
  • Adult
  • Base Sequence
  • Chlamydia Infections / prevention & control
  • Chlamydia Infections / transmission*
  • Chlamydia trachomatis / isolation & purification*
  • Female
  • Homosexuality, Male
  • Humans
  • Male
  • Mass Screening
  • Molecular Sequence Data
  • Oropharynx / microbiology*
  • Pharyngeal Diseases / microbiology*
  • Polymerase Chain Reaction
  • Prospective Studies
  • Sexual Behavior*
  • Urogenital System / microbiology