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1.
PLoS Comput Biol ; 17(9): e1009365, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34492008

RESUMEN

Chlamydia trachomatis is a common sexually transmitted infection that is associated with a range of serious reproductive tract sequelae including in women Pelvic Inflammatory Disease (PID), tubal factor infertility, and ectopic pregnancy. Ascension of the pathogen beyond the cervix and into the upper reproductive tract is thought to be necessary for these pathologies. However, Chlamydia trachomatis does not encode a mechanism for movement on its genome, and so the processes that facilitate ascension have not been elucidated. Here, we evaluate the factors that may influence chlamydial ascension in women. We constructed a mathematical model based on a set of stochastic dynamics to elucidate the moderating factors that might influence ascension of infections in the first month of an infection. In the simulations conducted from the stochastic model, 36% of infections ascended, but only 9% had more than 1000 bacteria ascend. The results of the simulations indicated that infectious load and the peristaltic contractions moderate ascension and are inter-related in impact. Smaller initial loads were much more likely to ascend. Ascension was found to be dependent on the neutrophil response. Overall, our results indicate that infectious load, menstrual cycle timing, and the neutrophil response are critical factors in chlamydial ascension in women.


Asunto(s)
Infecciones por Chlamydia/microbiología , Chlamydia trachomatis , Modelos Biológicos , Útero/microbiología , Carga Bacteriana , Cuello del Útero/microbiología , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/fisiopatología , Chlamydia trachomatis/patogenicidad , Biología Computacional , Simulación por Computador , Femenino , Humanos , Infertilidad Femenina/etiología , Ciclo Menstrual/fisiología , Neutrófilos/inmunología , Enfermedad Inflamatoria Pélvica/etiología , Peristaltismo/fisiología , Embarazo , Embarazo Ectópico/etiología , Procesos Estocásticos , Útero/inmunología , Útero/fisiopatología
2.
Pathog Dis ; 78(6)2020 09 26.
Artículo en Inglés | MEDLINE | ID: mdl-32901793

RESUMEN

Adverse reproductive health outcomes, such as pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility, have been associated with Chlamydia trachomatis and Neisseria gonorrhoea infections. These reproductive health outcomes could be complemented by measuring subsequent pregnancies to assess impact on fertility. The study design was a cohort study of women in Queensland (QLD), Australia, using data linkage methods to link chlamydia and/or gonorrhea testing records (including an unexposed group undergoing full blood count tests; 2000 and 2005) with the QLD Perinatal Registry (2000-2013). The cohort included 132 962 women, with 69 533 records of pregnancies. Women in the exposed group, with no prior pregnancy, had a reduced odds of a pregnancy during the follow up of the study (20-year-old (at 2005) aOR 0.91 95% CI 0.87-0.95, and 25-year-old aOR 0.71 95% CI 0.68-0.75). Women in the exposed group with a prior pregnancy had increased odds of pregnancy during the follow up of the study (20-year-old (at 2005) aOR 1.72 95% CI 1.59-1.86, and 25-year-old aOR 1.35 95% CI 1.26-1.45). Our data provides further evidence at a population level of the significant impact on reproductive outcomes associated with chlamydia and gonorrhea.


Asunto(s)
Infecciones por Chlamydia/complicaciones , Gonorrea/complicaciones , Complicaciones Infecciosas del Embarazo/microbiología , Salud Reproductiva , Adulto , Australia/epidemiología , Certificado de Nacimiento , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Femenino , Gonorrea/epidemiología , Humanos , Recién Nacido de Bajo Peso , Almacenamiento y Recuperación de la Información/métodos , Neisseria gonorrhoeae , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo , Nacimiento Prematuro , Estudios Retrospectivos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Adulto Joven
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