Chlamydia trachomatis

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What is it about ?

The Chlamydia trachomatis is a bacterium capable of causing infections in the genitals and urinary tracts of men and women. It is a sexually transmitted infection (STI), which is usually acquired from unprotected sex.

Chlamydia infection doesn’t always make you sick. Many infections do not trigger any symptoms. But that does not mean that they do not cause damage, quite the contrary. The Chlamydia bacteria attacks the cells of the mucous membranes, especially in the intimate areas such as the vagina, cervix, urethra, penis and anal area.

In humans, the bacteria also causes inflammation of the prostate and epididymis. It is also known to cause, in women, inflammations in the small pelvis, more specifically in the ovaries and fallopian tubes. These inflammations can lead to infertility and are associated with an increased risk of ectopic pregnancy.

Chlamydia can also infect the eyes of newborns during childbirth. Finally, after oral sex, Chlamydia can cause inflammation of the oral cavity and tonsils.

What is its frequency?

Chlamydia infection is the most common STI in Belgium and, in recent years, its frequency has steadily increased. This is in part due to the increasing number of screenings and the free speech about Chlamydia infections. Nevertheless, it is also presumed that there are more and more Chlamydia infections. Chlamydia infection is most often diagnosed in young women between the ages of 15 and 34. In Europe, it is estimated that between 3 and 6% of women of childbearing age are infected with Chlamydia. Chlamydia infection is diagnosed twice as often in women as in men. Again, this is believed to be due to the fact that women are screened more often than men. In 2014, there were 5,605 cases of Chlamydia infection in Belgium. And these are only people who have been screened and treated. This figure can therefore be underestimated. As we have already said, Chlamydia infection often does not cause problems, so infected individuals do not necessarily see a doctor.

How to recognize it?

In many cases, there are no symptoms. But, when there are complaints, they concern the infected part of the body. In women, it may be painful urination, increased or changed vaginal discharge, blood flow after sex, or loss of blood between two menstrual cycles (breakthrough bleeding). In the event of infection of the organs of the pelvis, diffuse or, on the contrary, intense abdominal pain or pain during sexual intercourse may appear. In men, Chlamydia infects the urethra, which can lead to a white, viscous discharge from the penis, pain in the scrotum, or an uncomfortable feeling when urinating. After anal intercourse, Chlamydia can infect the lining at the end of the large intestine, resulting in anal pain and discharge of blood or mucus.

Target group for screening for Chlamydia infection

The doctor will suggest a screening test to a group of women asymptomatic (this is called “opportunistic screening”). This group includes:

  • women under the age of 35 who have had more than one partner in the past year or who have a recent partner (for less than 6 months);
  • women for whom pregnancy termination is planned.

This is a simple test, performed on a sample of urine or vaginal mucus taken with a cotton swab. The patient can refuse this test. If the test is positive, further examination should confirm the diagnosis. This screening has been shown to reduce the number of late complications of the infection.

In another group, presenting symptoms potentially due to a Chlamydia infection, the doctor will actively screen for the infection with a diagnostic test. This group includes:

  • women with one or more of the following risk factors: blood loss after intercourse or between periods, pain when urinating that does not go away with conventional treatment, inflammation of the urethra in the partner;
  • men with pain when urinating or with viscous discharge from the urethra.

How is the diagnosis made?

The doctor will suspect a Chlamydia infection based on your story and your symptoms. He will examine the mucous membranes of the genitals, anus and mouth.
Chlamydia can be detected in different ways. Most often, a urine test will be performed. To do this, we collect the first 10 to 20 milliliters of a urine stream in a small sterile pot. It is not necessary to wash the intimate area beforehand. But it is advisable not to urinate during the hour before the sample. Urinalysis tests for the presence of Chlamydia DNA. Another method of testing is to use a swab taken from the vagina (or sometimes the cervix), urethra (in men), oral cavity, or anus. A positive test for Chlamydia DNA is always confirmed by another test.

What can you do ?

The safest way to avoid getting an STI is to use a condom every time you have sex. If you haven’t used a condom and you’re not sure your partner doesn’t have an STI, get tested. Ditto if you have pain or a burning sensation when you urinate, have more vaginal discharge, or find out that a partner has an STI.

Young people under the age of 20 who have a “risky behavior” (eg several partners in a short time) or who present signs of STIs can benefit from a screening test reimbursed by the INAMI (Institut national health and disability insurance). The laboratory invoice does not explicitly mention the name of the test that was performed.

If you are diagnosed with Chlamydia infection, it is very important to tell your partner. He (or she) can thus be tested and, if necessary, be treated.

In any case, it is important to share your uncertainties and questions with a doctor, your general practitioner or your gynecologist. Each doctor is, in any case, bound by medical confidentiality and will treat this information with the utmost discretion.

What can your doctor do?

Chlamydia infection is easily treated with antibiotics. In Belgium, the standard treatment for chlamydial infection is to take 1 g of azithromycin at one time or 100 mg of doxycycline 2 x daily for 7 days. The partner must also be treated. Amoxicillin can be an alternative in case of allergy or pregnancy, for example.

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Source

www.ebpnet.be