Skip to main content
SpringerLink
Log in

Rectale chlamydia bij vrouwen onbekend en onbehandeld

  • Beschouwing
  • Published:
Huisarts en wetenschap Aims and scope

Samenvatting

Chlamydia-infecties verlopen vaak symptoomloos en zijn voor de huisarts lastig op te sporen. Bovendien keren ze vaak terug na een behandeling. Bij vrouwen met een genitale chlamydia-infectie wordt vaak ook rectale chlamydia gevonden zonder dat de anamnese daartoe aanleiding geeft. Herbesmetting van de vagina vanuit een onvoldoende behandelde rectale infectie is een plausibele verklaring, maar huisartsen aarzelen vrouwen te vragen naar anale seks en doen weinig rectale tests. Een zevendaagse kuur doxycycline is effectiever tegen rectale chlamydia dan de standaard therapie, eenmalig azitromycine. Nog effectiever, maar veel duurder, is standaard testen van vrouwen met genitale chlamydia op rectale chlamydia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatuur

  1. Ahmadi MH, Mirsalehian A, Bahador A. Association of Chlamydia trachomatis with infertility and clinical manifestations: a systematic review and meta-analysis of case-control studies. Infect Dis 2016;48:517-23.

  2. Visser M, Van Aar F, Op de Coul ELM, Slurink IAL, Van Wees DA, Hoenderboom BM, et al. Sexually transmitted infections in the Netherlands in 2017. Bilthoven: RIVM, 2018.

  3. European Centre for Disease Prevention and Control. Chlamydia control in Europe: literature review. Stockholm: ECDC, 2015.

  4. Koldenhof A. Seksueel overdraagbare aandoeningen in Noord-Nederland van 2010- 2014: Een retrospectieve database studie. Groningen: UMCG, 2016.

  5. Trienekens SC, Van den Broek IV, Donker GA, Van Bergen JE, Van der Sande MA. Consultations for sexually transmitted infections in the general practice in the Netherlands: an opportunity to improve STI/HIV testing. BMJ Open 2013;3:e003687.

  6. Dukers-Muijrers NHTM, Van Liere GAFS, Hoebe CHPA. Re-screening Chlamydia trachomatis positive subjects: a comparison of practices between an STI clinic, general practitioners and gynaecologists. Sex Transm Infect 2013;89:25-7.

  7. De Vries HJ. The enigma of lymphogranuloma venereum spread in men who have sex with men: does ano-oral transmission plays a role? Sex Transm Dis 2016;43:420-2.

  8. Rank RG, Yeruva L. ‘Hidden in plain sight:’ Chlamydial gastrointestinal infection and its relevance to ‘persistence’ in human genital infections. Infect Immun 2014;82:1362-71.

  9. Van Bergen JEAM, Dekker JH, Boeke AJP, Kronenberg EHA, Van der Spruit R, Burgers JS, et al. NHG-Standaard Het soa-consult (Eerste herziening). Huisarts Wet 2013;56:450-63.

  10. Donker G, Van den Broek I. Seksuele anamnese cruciaal bij soa-consult. Huisarts Wet 2013;56:464.

  11. Den Heijer CDJ, Van Liere GAFS, Hoebe CJPA, Van Bergen JEAM, Cals JWL, Dukers-Muijrers NHTM. Who tests whom? A comprehensive overview of Chlamydia trachomatis test practices in a Dutch region among different STI care providers for urogenital, anorectal and oropharyngeal sites in young people: a cross- sectional study. Sex Transm Infect 2016;92:211-7.

  12. Van Liere GAFS, Hoebe CJPA, Wolffs PFG, Dukers-Muijrers NHTM. High co-occurrence of anorectal chlamydia with urogenital chlamydia in women visiting an STI clinic revealed by routine testing in an observational study; a recommendation towards a better anorectal chlamydia control in women. BMC Infect Dis 2014;14:274.

  13. Dukers-Muijrers HTM, Schachter J, Van Liere GAFS, Wolffs PFG, Hoebe CJPA. Wat is needed to guide testing of anorectal and pharyngeal Chlamydia trachomatis and Neisseria gonorrrhoeae in women and men? Evidence and opinion. BMC Infect Dis 2015;15:533.

  14. Peters RPH, Dubbink JH, Van der Eem L, Verweij SP, Bos ML, Ouburg S, et al. Cross-sectional study of genital, rectal, and pharyngeal chlamydia and gonorrhoea in women in rural South Africa. Sex Transm Dis 2014;41:564-9.

  15. Gratrix J, Singh AE, Bergman J, Egan C, Plitt SS, McGinnis J, et al.Evidence for increased Chlamydia case finding after the introduction of rectal screening among women attending 2 Canadian sexually transmitted infection clinics. Clin Infect Dis 2015;60:398-404.

  16. Kong FY, Tabrizi SN. Fairley CK, Vodstrcil LA, Huston WM, Chen M, et al. The efficacy of azithromycin and doxycycline for the treatment of rectal chlamydia infection: a systematic review and meta-analysis. J Antimicrob Chemother 2015;70;1290-7.

  17. Geisler WM, Uniyal A, Lee JY, Lensing SY, Johnson S, Pery RCW, et al. Azithromycin versus doxycycline for urogenital chlamydia trachomatis infection. N Engl J Med 2015;373:2512-21.

  18. Craig AP, Kong FY Yeruva L, Hocking JS, Rank RG, Wilson DP, et al. Is it time to switch to doxycycline from azithromycin for treating genital chlamydial infections in women? Modelling the impact of autoinoculation from the gastrointestinal tract to the genital tract. BMC Infect Dis 2015;15:200.

  19. Heijne JC, Van Liere GA, Hoebe CJ, Bogaards JA, Van Benthem BH, Dukers-Muijrers NH. What explains anorectal chlamydia infection in women? Implications of a mathematical model for test and treatment strategies. Sex Transm Infect 2017;93:270-5.

  20. Dukers-Muijrers NH, Wolffs PF, Eppings L, Götz HM, Bruisten SM, Schim van der Loeff MF, et al. Design of the FemCure study: prospective multicentre study on the transmission of genital and extra-genital Chlamydia trachomatis infections in women receiving routine care. BMC Infect Dis 2016;16:381.

Download references

Author information

Authors and Affiliations

  1. Huisarts, UMCG, afdeling Huisartsgeneeskunde, Groningen, Nederland

    Liesbeth AB

  2. Huisarts, Universitair hoofddocent, huisarts, Groningen, Nederland

    Janny Dekker

Authors
  1. Liesbeth AB
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Janny Dekker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Liesbeth AB.

Additional information

AB E, Dekker JH. Rectale chlamydia bij vrouwen: onbekend, onbehandeld. Huisarts Wet 2019;62(1):31-7. DOI:10.1007/s12445-018-0356-0.

Mogelijke belangenverstrengeling: niets aangegeven.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

AB, L., Dekker, J. Rectale chlamydia bij vrouwen onbekend en onbehandeld. Huisarts Wet 62, 31–37 (2019). https://doi.org/10.1007/s12445-018-0356-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12445-018-0356-0

Search

Navigation