Presentation of clinically suspected persistent chlamydial infection: A case series

R. A. Pitt, S. Alexander, P. J. Horner, C. A. Ison

Research output: Contribution to journalArticle (Academic Journal)peer-review

12 Citations (Scopus)


In vivo antimicrobial resistance has yet to be documented in Chlamydia trachomatis; however, there have been anecdotal reports of persistent infection. The purpose of this case series was to describe a group of patients who have persistent chlamydia infection despite adequate treatment and where re-infection was considered unlikely. Patients were selected using a clinical questionnaire. For inclusion patients had to have tested positive for C. trachomatis, at least twice, using a nucleic acid amplification test despite having been fully compliant with at least two rounds of recommended therapy and be deemed to be at low risk of re-infection. Patients were grouped into categories based on sexual behaviour. Twenty-eight patients are included in this case series; 46% declared no sexual contact since initial diagnosis (category 1), a further 36% declaring contact that was considered low risk of re-infection (categories 2-4); 61% showed signs and symptoms at initial presentation increasing to 75% at re-attendance. Thirty-nine percent of patients received azithromycin only while 48% received doxycycline also. This case series identifies patients with persistent chlamydia despite receiving treatment. There is a need for a case definition of clinical treatment failure, development of susceptibility testing methods and guidance on appropriate treatment for patients with persistent infection.

Original languageEnglish
Pages (from-to)469-475
Number of pages7
JournalInternational Journal of STD and AIDS
Issue number6
Publication statusPublished - Jan 2013


  • antibiotics
  • Chlamydia trachomatis
  • persistent infection
  • sexually transmitted infection
  • therapy
  • treatment failure


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