Chlamydia: What Do We Know?

Chlamydia is a sexually transmitted disease (STD) caused by infection with the bacteria Chlamydia trachomatis. It is the most frequently reported infectious disease in the United States with over 2.2 million diagnosed cases in 2020. The majority of infections are among young women aged 15-24 years. Other factors, including race and ethnicity, are associated with a disproportionate number of cases in particular groups. For example, the reported chlamydia rates among African American/Black groups were six times greater than those of White groups in 2020.

The “Silent” Infection of Chlamydia

Much like other STDs, chlamydia is not usually associated with symptoms, nor does it present upon physical examination. In fact, symptoms may take several weeks to appear in those who do present with them. Depending on the location of the bacterial infection, chlamydia may cause signs and symptoms of cervicitis, urethritis, and pelvic inflammatory disease (PID) in women.

For those who do not receive treatment, infection with chlamydia can lead to PID, which may cause long term damage to the reproductive tract (chronic pelvic pain, infertility, and ectopic pregnancy). Additionally, pregnant women can infect their baby with chlamydia during childbirth, resulting in conjunctivitis and pneumonia in some infants. For those who do receive treatment, chlamydial infection is successfully cured with antibiotics.

Occasionally, those who test positive for chlamydia can present with a lower bacterial load upon initial screening. As a result, these individuals may clear the infection without treatment. However, studies(1) have shown that not all individuals with a lower bacterial load can be cured spontaneously. In other words, it is still important to seek out and follow through with treatment.

The take-home message: chlamydia is commonly asymptomatic; therefore, sexually active women younger than 25 and older women with risk factors should be annually screened for all STDs in order to prevent complications linked to undetected infection.

Bibliography

van Liere GAFS, Hoebe CJPA, Dirks JAMC, et al. Sex Transm Infect Epub ahead of print:
doi:10.1136/sextrans-2018-053825