Urogenital Chlamydia trachomatis serovars in men and women with a symptomatic or asymptomatic infection: an association with clinical manifestations?

To determine whether certain Chlamydia trachomatis serovars are preferentia lly associated with a symptomatic or an asymptomatic course of infection, C . trachomatis serovar distributions were analyzed in symptomatically and as ymptomatically infected persons. Furthermore, a possible association betwee n C. trachomatis serovars and specific clinical symptoms was investigated. C. trachomatis-positive urine specimens from 219 asymptomatically infected men and women were obtained from population-based screening programs in Ams terdam. Two hundred twenty-one C. trachomatis-positive cervical and urethra l swabs from symptomatically and asymptomatically infected men and women we re obtained from several hospital-based departments. Serovars were determin ed using PCR-based genotyping, i.e., restriction fragment length polymorphi sm analysis of the nested-PCR-amplified omp1 gene. The most prevalent C. tr achomatis serovars, D, E, and F, showed no association with either a sympto matic or asymptomatic course of infection. The most prominent differences f ound were (i) the association of serovar Ga with symptoms in men (P = 0.002 7), specifically, dysuria (P < 0.0001), and (ii) detection of serovar Ia mo re often in asymptomatically infected people (men and women) (P = 0.035), F urthermore. in women, serovar K was associated with vaginal discharge (P = 0.002) and serovar variants were found only in women (P = 0.045).