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The following is a summary of “Diagnostic-avoiding Chlamydia trachomatis variants detected in cervical and endometrial specimens from women during 16S microbiome profiling,” published in the March 2025 issue of BMC Infectious Diseases by Jeong et al. 

The cervicovaginal microbiome influences reproductive and infectious health, with 16S rRNA sequencing enabling the detection of bacterial DNA, including pathogens missed by standard tests. 

Researchers conducted a retrospective study analyzing the cervicovaginal microbiome of 220 participants of T Cell Response against Chlamydia (TRAC) using 16S rRNA sequencing and compared the findings with standard diagnostic test results for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). 

They performed targeted PCR amplification followed by sequencing to analyze the chlamydial 23S ribosomal RNA (rRNA) locus and qPCR was used to detect gonococcal DNA in residual diagnostic swab eluates or DNA utilized for generating 16S rRNA libraries.  

The results showed that discrepant specimens with chlamydial DNA carried a G1523A nucleotide polymorphism in the 23S rRNA locus, identical to variants found in Finland, Denmark, and the UK. The PCR confirmed gonococcal DNA in all participants with negative test results, with stochastic effects indicating infection levels near the diagnostic assay’s detection limit.  

Investigators concluded that a probe-avoidant CT mutant existed in the northeastern US before 2019, potentially causing false negatives. 

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10689-w