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Evaluation of antimicrobial resistance and
treatment failures for Chlamydia trachomatis: A meeting report.
Journal of Infectious Diseases 2005;191(6):917-923.
Wang SA, Papp JR, Stamm WE, Peeling RW, Martin DH, Holmes KK.
Abstract
Each year, Chlamydia trachomatis causes ~3 million new infections and results
in more than 1 billion dollars in medical costs in the United States. Repeat
or persistent infection occurs in 10%-15% of women who are treated for C.
trachomatis infection. However, the role played by antimicrobial resistance
in C. trachomatis treatment failures or persistent infection is unclear.
With researchers in the field, we reviewed current knowledge and available
approaches for evaluating antimicrobial resistance and potential clinical
treatment failures for C. trachomatis. We identified key research questions
that require further investigation. To date, there have been no reports of
clinical C. trachomatis isolates displaying in vitro homotypic resistance
to antimicrobials, but in vitro heterotypic resistance in C. trachomatis
has been described. Correlation between the results of existing in vitro
antimicrobial susceptibility tests and clinical outcome after treatment for
C. trachomatis infection is unknown. Animal models may provide insight into
chlamydial persistence, since homotypic resistance against tetracycline has
been described for Chlamydia suis in pigs. Evaluating C. trachomatis clinical
treatment failures, interpreting laboratory findings, and correlating the
2 clearly remain extremely challenging undertakings.