WHAT IS ALREADY KNOWN ON THIS TOPIC
Chlamydia trachomatis (CT) is a prevalent STI with recognised rectal involvement in women, including those who do not report receptive anal intercourse. Standard nucleic acid amplification tests detect CT DNA but cannot distinguish between viable and non-viable bacteria, which may mislead the interpretation of positive rectal tests.
WHAT THIS STUDY ADDS
Rectal sampling with a paediatric proctoscope is feasible, acceptable and improves viable CT detection. Many rectal CT infections occurred without reported anal sex, and multi-locus typing showed discordant CT strains between anatomical sites, suggesting complex infection dynamics and a possible independent gastrointestinal reservoir.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
Viability PCR can help differentiate active infection from residual DNA, supporting more precise treatment and the role of gastrointestinal reservoirs and possibly fellatio in transmission.
Introduction
Chlamydia trachomatis (CT) is the most prevalent bacterial STI, with anorectal manifestations increasingly recognised as relevant…