ReviewInfection and immunity2014
Hidden in plain sight: chlamydial gastrointestinal infection and its relevance to persistence in human genital infection.
Review in Infection and immunity, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 90 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized, Open-label, Multicenter Study of Azithromycin Compared With Doxycycline for Treating Anorectal Chlamydia Trachomatis Infection Concomitant to a Vaginal Infection
Are Rectal and Genital Chlamydia Trachomatis Infections in Women Related to Anal Sex, Autoinoculation / Contamination
Who cites it
90 citing papers in PubMed, 1 synthesis or guideline pooled it, 181 citations in OpenAlex.
- Prevalence of Rectal Chlamydial and Gonococcal Infections: A Systematic Review.Sexually transmitted diseases · 2018Pooled it
- Trial
- Influence of Chlamydia suis on reproductive outcome in farms with and without tetracycline treatment of sows.Veterinary research · 2026Article
- Positive Nucleic Acid Amplification Test Results Are Rarely Indicative of a Viable Rectal Chlamydia trachomatis Infection Among Men With Anal Exposures Other Than Receptive Anal Sex.Sexually transmitted diseases · 2026Article
- Pathobiont-triggered induction of goblet cell response drives regional susceptibility to inflammatory bowel disease.The Journal of clinical investigation · 2026Article
- Pathogenicity and virulence ofVirulence · 2025Review
- Highly viable gastrointestinal Chlamydia trachomatis in women abstaining from receptive anal intercourse.Scientific reports · 2025Article
- Intestinal IL-22RA1 signaling regulatesFrontiers in microbiology · 2025Article
- First assessment of the health status of pregnant women, detection of prevalence and risk factors associated with enzootic ovine abortion disease among pregnant women in southern Benin.Frontiers in public health · 2025Article
- Chlamydia muridarum Causes Persistent Subclinical Infection and Elicits Innate and Adaptive Immune Responses in C57BL/6J, BALB/cJ, and J:ARC(S) Mice Following Exposure to Shedding Mice.Comparative medicine · 2024Article
- Epidemiology, Transmission Mode, and Pathogenesis ofAnimals : an open access journal from MDPI · 2024Review
- Article
- Sexually Transmitted Infections in People with Human Immunodeficiency Virus.Infectious disease clinics of North America · 2024Review
- Infection of human organoids supports an intestinal niche for Chlamydia trachomatis.PLoS pathogens · 2024Article
- Advances inMicroorganisms · 2024Review
- Regulation of chlamydial spreading from the small intestine to the large intestine by IL-22-producing CD4Infection and immunity · 2024Article
- Prognostic Value of Anti-Journal of inflammation research · 2024Article
- IL-23 receptor signaling licenses group 3-like innate lymphoid cells to restrict a live-attenuated oral Chlamydia vaccine in the gut.Infection and immunity · 2023Article
- Article
- Review
30 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although the concept of persistence in chlamydial infections has been recognized for about 80 years, there is still very little known about the mechanism by which this occurs. In this review, we revisit an old paradigm, long known to chlamydiologists and veterinarians, that in virtually all hosts of chlamydiae, including mammals and birds, chlamydiae reside in the gastrointestinal tract for long periods of time in the absence of clinical disease. Thus, if gastrointestinal infection occurs in most hosts, then it is very likely that gastrointestinal infection occurs in humans as well. We demonstrate that gastrointestinal infection does indeed occur in humans and propose that this anatomical site is the source of persistent infection in humans. The data in ruminants and animal models demonstrate that the immune system is unable to clear chlamydiae from the gut, so they can remain indefinitely, with continual shedding in feces. Clearly, many women become reinfected from an untreated partner; however, we propose that women, cured of genital infection, remain at risk for autoinoculation from the lower gastrointestinal tract. Moreover, there are substantial data demonstrating treatment failure of chlamydial infections, particularly with azithromycin. New data in the mouse model have shown that azithromycin is far less effective against chlamydial gastrointestinal infection than against genital infections. Therefore, it is possible that women cured of genital infection by antibiotics remain infected in the gastrointestinal tract and can become reinfected by autoinoculation from that site.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.