Taking action to prevent silent transmission
The hidden costs of infection
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are among the most common sexually transmitted infections (STIs), with new cases in adults totaling 105.7 million and 106.1 million, respectively.1
These infections are caused by two different bacterial pathogens which initially invade host tissue in the urethra, anus, or throat strictly through sexual contact. Once inside the urethra the bacteria invade or attach to host tissue and cause an inflammatory response often proceeded by a purulent discharge, which can be seen by the patient. These bacteria then have the potential to spread upwards through the urogenital tract of males and females. This may lead to complications in women affecting the urethra, cervix, fallopian tubes, and uterus, or the prostate in men which may cause infertility for both sexes. Along with urogenital symptoms, patients may experience discomfort, bleeding, or discharge from the anus and sores, redness, or lesions in the mouth. However, the majority of patients do not experience any symptoms at all.1
The total direct medical cost for chlamydia in the US is estimated to be $516 million per year, while the total direct medical cost for gonorrhoea in the US is estimated at $162.1 million per year.2
On top of these monetary costs, the asymptomatic nature of CT/NG adds to the complexity of treatment and infection control, as carriers may transmit the bacteria unknowingly. Approximately 85% of women and 40% of men with chlamydia are asymptomatic,1,3 while 30–80% of women and 5% of men with genital gonorrhoea are asymptomatic.1,4
Unique and complex challenges
If left untreated, CT/NG infections can cause severe complications in both men and women. Possible sequelae include pelvic inflammatory disease, adverse pregnancy outcomes, and infertility.5 Antimicrobial resistance further complicates our efforts to reduce the impact of STIs globally, particularly in people infected with NG.5
Neisseria gonorrhoeae has shown decreased susceptibility to “last line” treatment options, including oral and injectable cephalosporins. Together with known resistances to penicillins, sulphonamides, tetracyclines, quinolones, and macrolides, NG is considered a multidrug-resistant organism.6
Clinical microbiology labs play a major role in solidifying infection control. Effective screening of both asymptomatic and symptomatic populations using diagnostic tools can help to contain the silent disease transmission of CT/NG, reduce prevalence, and further improve the understanding of these infections.
Paving the way for improved CT/NG testing
In 1993, Roche introduced its first ever FDA-cleared polymerase chain reaction (PCR) test—a molecular test for CT. Three years later, Roche introduced a CT/NG test with internal controls.
With every generation, Roche has continued to improve CT/NG testing. Through advances in automation and accuracy, Roche instruments and assays make it easier to deliver faster, more reliable, and more accurate answers.
- World Health Organization, Department of Reproductive Health and Research. Global incidence and prevalence of selected curable sexually transmitted infections – 2008. http://apps.who.int/iris/bitstream/10665/75181/1/9789241503839_eng.pdf. Published 2012. Accessed April 15, 2014.
- Owusu-Edusei K, Chesson HW, Gift TL, et al. The estimated direct medical cost of selected sexually transmitted infection in the United States, 2008. Sex Transm Dis. 2013; 40(3):197-201. doi:10.1097/OLQ.0b013e318285c6d2.
- Stamm WE, Holmes KK. Chlamydia trachomatis infections in the adult. In: Holmes KK, Mardh PA, Sparling PF, et al., eds. Sexually transmitted diseases. 2nd ed. New York, NY: McGraw-Hill; 1980:181-193.
- Judson FN. Gonorrhoea. Med Clin North Am. 1990; 1353-1367.
- World Health Organization. Sexually transmitted infections (STIs). http://www.who.int/mediacentre/factsheets/fs110/en/. Accessed April 15, 2014.
- World Health Organization, Department of Reproductive Health and Research. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. http://whqlibdoc.who.int/publications/2012/9789241503501_eng.pdf?ua=1. Published 2012. Accessed April 15, 2014.