AUTHOR=Zhao Jianhui , Shui Jingwei , Luo Lipei , Ao Cailing , Lin Hongqing , Liang Yuanhao , Wang Li , Wang Haiying , Chen Hongliang , Tang Shixing 

TITLE=Identification and characterization of mixed infections of Chlamydia trachomatis via high-throughput sequencing

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.1041789

DOI=10.3389/fmicb.2022.1041789

ISSN=1664-302X

ABSTRACT=<p>Precise genotyping is necessary to understand epidemiology and clinical manifestations of <italic>Chlamydia trachomatis</italic> infection with different genotypes. Next-generation high-throughput sequencing (NGHTS) has opened new frontiers in microbial genotyping, but has been clinically characterized in only a few settings. This study aimed to determine <italic>C. trachomatis</italic> genotypes in particular mixed-genotype infections and their association with clinical manifestations and to characterize the sensitivity and accuracy of NGHTS. Cervical specimens were collected from 8,087 subjects from physical examination center (PEC), assisted reproductive technology center (ART) and gynecology clinics (GC) of Chenzhou Hospital of China. The overall prevalence of <italic>C. trachomatis</italic> was 3.8% (311/8087) whereas a prevalence of 2.8, 3.7 and 4.8% was found in PEC, ART and GC, respectively. The most frequent three <italic>C. trachomatis</italic> genotypes were E (27.4%, 83/303), F (21.5%, 65/303) and J (18.2%, 55/303). Moreover, NGHTS identified 20 (6.6%, 20/303) mixed-genotype infections of <italic>C. trachomatis</italic>. Genotype G was more often observed in the subjects with pelvic inflammatory disease than genotype E (adjusted <italic>OR</italic> = 3.61, 95%<italic>CI</italic>, 1.02–12.8, <italic>p</italic> = 0.046). Mixed-genotype infection was associated with severe vaginal cleanliness (degree IV) with an adjusted <italic>OR</italic> of 5.17 (95%<italic>CI</italic> 1.03–25.9, <italic>p</italic> = 0.046) whereas mixed-genotype infection with large proportion of minor genotypes was associated with cervical squamous intraepithelial lesion (SIL) with an adjusted <italic>OR</italic> of 5.51 (95%<italic>CI</italic> 1.17–26.01, <italic>p</italic> = 0.031). Our results indicated that NGHTS is a feasible tool to identity <italic>C. trachomatis</italic> mixed-genotype infections, which may be associated with worse vaginal cleanliness and cervical SIL.</p>