Data indicate that NAAT performance on self-collected rectal swabs is comparable to clinician-collected rectal swabs, and this specimen collection strategy for rectal C. trachomatis at rectal and oropharyngeal sites ( 553, 800– 804), and certain NAAT platforms have been cleared by FDA for these anatomic sites ( 805). NAATs have been demonstrated to have improved sensitivity and specificity, compared with culture, for detecting C. trachomatis infection among persons engaging in receptive anal or oral intercourse can be diagnosed by testing at the anatomic exposure site. Previous evidence indicates that the liquid-based cytology specimens collected for Pap smears might be acceptable specimens for NAAT, although test sensitivity using these specimens might be lower than that associated with use of cervical or vaginal swab specimens ( 799) regardless, certain NAATs have been cleared by FDA for use on liquid-based cytology specimens. trachomatis testing might be a reasonable approach for men who are either unable to provide urine or prefer to collect their own meatal swab over providing urine. Patient collection of a meatal swab for C. Recent studies have demonstrated that among men, NAAT performance on self-collected meatal swabs is comparable to patient-collected urine or provider-collected urethral swabs ( 796– 798). Optimal urogenital specimen types for chlamydia screening by using NAAT include first-catch urine (for men) and vaginal swabs (for women) ( 553). Patient-collected vaginal swab specimens are equivalent in sensitivity and specificity to those collected by a clinician using NAATs ( 792, 793), and this screening strategy is highly acceptable among women ( 794, 795). NAATs that are FDA cleared for use with vaginal swab specimens can be collected by a clinician or patient in a clinical setting. NAATs are the most sensitive tests for these specimens and are the recommended test for detecting C. trachomatis urethral infection can be diagnosed by testing first-void urine or a urethral swab. trachomatis urogenital infection can be diagnosed by vaginal or cervical swabs or first-void urine. More frequent screening than annual for certain women (e.g., adolescents) or certain men (e.g., MSM) might be indicated on the basis of risk behaviors. Among women, the primary focus of chlamydia screening should be to detect and treat chlamydia, prevent complications, and test and treat their partners, whereas targeted chlamydia screening for men should be considered only when resources permit, prevalence is high, and such screening does not hinder chlamydia screening efforts for women ( 789– 791). trachomatis among sexually active young men because of certain factors (i.e., feasibility, efficacy, and cost-effectiveness), screening of sexually active young men should be considered in clinical settings with a high prevalence of chlamydia (e.g., adolescent clinics, correctional facilities, or STD specialty clinics) or for populations with a high burden of infection (e.g., MSM) ( 149, 788). Although evidence is insufficient to recommend routine screening for C. Although chlamydia incidence might be higher among certain women aged ≥25 years in certain communities, overall, the largest proportion of infection is among women aged <25 years ( 141).Ĭhlamydia screening programs have been demonstrated to reduce PID rates among women ( 786, 787). In a community-based cohort of female college students, incident chlamydial infection was also associated with BV and high-risk HPV infection ( 785). Annual screening of all sexually active women aged <25 years is recommended, as is screening of older women at increased risk for infection (e.g., women aged ≥25 years who have a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI) ( 149). To detect chlamydial infection, health care providers frequently rely on screening tests. ![]() Certain women who receive a diagnosis of uncomplicated cervical infection already have subclinical upper genital tract infection.Īsymptomatic infection is common among both men and women. trachomatis infection among women, the most serious of which include PID, ectopic pregnancy, and infertility. ![]() Chlamydial Infection Among Adolescents and AdultsĬhlamydial infection is the most frequently reported bacterial infectious disease in the United States, and prevalence is highest among persons aged ≤24 years ( 141, 784).
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