Detection of Chlamydia trachomatis in Pap Smear Samples from South Khorasan Province of Iran

Objective Chlamydia trachomatis (CT) is the most common sexually transmitted infection (STI) and can lead to pelvic inflammatory disease, infertility, and chronic pelvic pain in women and increased risk of vertical transmission, conjunctivitis, and pnuemonitis in infants. It may also be a co-factor along with HPV in cervical cancer progression. The current study aimed to determine the prevalence of CT genotypes in genital specimens of women in Southern Khorasan, Iran and the association of CT with cytology stats. MaterialsAndMethods The presented project was a cross-sectional study of 248 Pap smear samples from women who visited a gynecologist for routine Pap smear test in Southern Khorasan province. Nested PCR was used to check the residual fluids of Pap smears for CT- DNA after cytological examinations. Direct sequencing, alignment, and phylogenic analyses were performed to identify genotypes. Results The mean age of patients was 37.54 ± 5.21 years. Most of the samples had a normal cytology (214 cases, 86.29%). Overall, 31 samples were positive for CT infection (12.5%) including 20 samples (9.34 %) of normal group and 11 cases (32.35%) on the abnormal group with the difference being significant (P-value=0.022). The co-infection of CT/ HPV in total was identified in 14 cases (5.6%) of which 45.16% were among CT-infected patients. The results of sequencing of 8 samples out of the 31 Ct positive samples and their and phylogenic analyses revealed the detection of genotypes D and E each in 4 cases. Conclusion The results of this study revealed a high prevalence of genital CT infection in both women with normal cytology and those with abnormal cytology. Genital CT infection was significantly more prevalent among women in the abnormal group, which indicates it may be involved in cervical neoplasia.