Detection of chlamydial antigenic material in ovarian, prostatic, ectopic pregnancy and semen samples of culture-negative subjects

PROBLEM: The pathogenesis of long-term sequelae in Chlamydia trachomatis in fection is poorly understood. While serology indicates previous chlamydial infection, culture studies are frequently negative. We wanted to know wheth er in chronic cases the bacterium is absent or persists in a dormant state where it evades detection. METHODS OF STUDY: Using immunoperoxidase (IP) staining and in situ hybridiz ation (ISH), we examined tissues of culture-negative subjects. Ovarian biopsy specimens from 19 culture-negative women with pelvic adhesio ns and/or tubal infertility were analyzed by both methods. Samples of prost ates from 10 culture-negative men undergoing prostatectomy for benign hyper trophy, two sets of semen samples from culture-negative sexual partners of 28 women with PID and/or bacterial vaginosis (BV), and ten endometrium-tube sample-pairs from ectopic pregnancies (EPs) were examined by IP only. RESULTS: Seven of the nineteen ovarian specimens tested positive for Chlamy dia antigen or deoxyribonucleic acid (DNA) (36%). Of the 10 hypertrophic pr ostates examined, 4 (40%) were positive. Of the 28 semen samples examined, 10 (35%) tested positive. Tissue samples of 3 cases of EP were positive by IF. CONCLUSIONS: 1. C. trachomatis antigen and nucleic acid can be frequently d emonstrated in asymptomatic, culture-negative men and women with chronic in fection. 2. Chlamydia antigens may have an etiologic role in benign prostat e hypertrophy and EP. 3. Antigenic material may be sexually transmissible. 4. IP and ISH identify temporarily inactive bacteria that may continue to a ct as immunostimulants and potentially reactivate as Chlamydia infection.