SPONTANEOUS CLEARANCE OF CHLAMYDIA-TRACHOMATIS INFECTION IN UNTREATEDPATIENTS

Background and Objectives: To assess the spontaneous clearance of untr eated Chlamydia trachomatis infections and factors correlated dth the process. Study Design: Spontaneous clearance was assessed through revi ew of laboratory database, chart review and laboratory testing using d irect immunofluorescence (DFA) and polymerase chain reaction (PCR) tes ts on C. trachomatis culture transport media from patients with negati ve chlamydial cultures. Specimens (C. trachomatis culture transport me dia) were obtained from patients attending a Birmingham, Alabama sexua lly transmitted diseases clinic. The study group consisted of patients with positive cultures for C. trachomatis who had repeat specimens ob tained for culture within 45 days of initial observation and who had n ot received recommended therapy for chlamydial infection in the interv al between the two tests. Results: Of 74 evaluable patients, 24 (32%) had negative follow-up cultures, Culture transport media for these 24 culture-negative patients were tested with DFA or PCR assays for chlam ydial infection, and 3 (13%) were positive, Culture positivity rates d eclined significantly with increasing age and duration of follow-up. I nterval treatment with benzanthine penicillin resulted in apparent res olution of infection in 9 of 10 patients. Neither a history of a C. tr achomatis-associated syndrome nor treatment with cefixime, metronidazo le, or antifungal agents was associated with clearance of infection. C onclusions: These results are consistent with host response-mediated r esolution of infection in a minority of patients and have implications regarding public health efforts to control chlamydial infection.