Oral Chlamydia trachomatis in a dental clinic population with established periodontitis.

Abstract

Chlamydia trachomatis is an intracellular pathogen of mucosal epithelial cells lining the ocular, nasopharyngeal, and uro-genital tracts. C. trachomatis causes trachoma the leading cause of preventable blindness and the most common bacterial sexually transmitted disease in the United States. Because of some similarities between the natural history of C. trachomatis infections and periodontitis, it was hypothesized that C. trachomatis would be found in the lining epithelium of periodontal sites diagnosed as having periodontitis. The purpose of this study was to assess oral epithelial cell specimens for the presence of C. trachomatis. Participants were dental clinic patients (n = 87) aged 18-50 years with no history of systemic disease associated with neutrophil disorders and who had not taken antibiotics indicated for C.trachomatis treatment in the previous three months. Participants needed to have at least three teeth which satisfied the definition for established periodontitis and also at least three teeth which were considered periodontally healthy. Pooled cell specimens were made for each participant from three locations; the diseased periodontal sites, the healthy periodontal sites, and a general mucosal site which included the lining of the cheeks, floor of mouth and tongue. For cell collection a periodontal probe was wiped against the lining epithelium at the periodontal sites and a cytobrush was brushed against the general mucosal tissue. Microslide cell specimens were prepared using the Behring Diagnostic MicroTrak$\sp\circler$ Chlamydia trachomatis Direct Specimen Test for direct immunofluorescence technique. Cross-reactivity of the commercial monoclonal antibody was tested with twenty microorganisms including fourteen dental plaque microorganisms, e.g. Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Bacteroides forsythus. This study found six participants (6.9%) positive for C. trachomatis in oral specimens. C. trachomatis was detected in the diseased periodontal sites in four participants, in the healthy periodontal sites in one participant and from the general mucosal site of another. All tests for cross-reactivity were negative. The discovery of C. trachomatis in the lining epithelium of the periodontal sulci generates many questions concerning its role in periodontitis. Also, whether or not the oral cavity is a reservoir for C. trachomatis is important for transmission, treatment, and prevention issues.