[Is the frequency of Chlamydia infections in Sweden increasing and is it time for a new strategy against Chlamydia infections?].
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Adolescent↗
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Results for “Chlamydia Infections”
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[Multifocal study of human chlamydia infections due to Chlamydia trachomatis. Initial descriptive study and deductions apropos of a survey conducted at Sidi-Okba (South Algeria)].
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Adult↗
Association of uterine and salpingeal fibrosis with chlamydial hsp60 and hsp10 antigen-specific antibodies in Chlamydia-infected koalas.
Infection by Chlamydia pneumoniae or Chlamydia pecorum commonly causes chronic, fibrotic disease of the urogenital tracts of female koalas. Studies of humans have associated titers of serum immunoglobulin G (IgG) against chlamydial hsp60 and hsp10 antigens with chronic infection, salpingeal fibrosis, and tubal infertility. To determine whether a similar relationship exists in Chlamydia-infected koalas, samples were collected opportunistically from 34 wild female koalas and examined by gross pathology and histopathology, PCR, and immunohistochemistry for Chlamydia spp. and enzyme-linked immunosorbent assay for serological responses to chlamydial hsp10 and hsp60 antigens. Greater anti-hsp titers occurred in Chlamydia-infected koalas with fibrous occlusion of the uterus or uterine tube than in other Chlamydia-infected koalas (for hsp10 IgG, P = 0.005; for hsp60 IgG, P = 0.001; for hsp10 IgA, P = 0.04; for hsp60 IgA, P = 0.09). However, as in humans, some koalas with tubal occlusion had low titers. Among Chlamydia-infected koalas with tubal occlusion, those with low titers were more likely to have an active component to their ongoing uterine or salpingeal inflammation (P = 0.007), such that the assay predicted, with 79% sensitivity and 92% specificity, tubal occlusion where an active component of inflammation was absent. Findings of this study permit advancement of clinical and epidemiological studies of host-pathogen-environment interactions and pose intriguing questions regarding the significance of the Th1/Th2 paradigm and antigen-presenting and inflammation-regulating capabilities of uterine epithelial cells and the roles of latency and reactivation of chlamydial infections in pathogenesis of upper reproductive tract disease of koalas.
Animals↗
[Chlamydia infections and pelviscopic findings].
Contact infections by chlamydia trachomatis have been observed more frequently in the last years, may be by better isolation methods. 1985 in all pelviscopies a cervical swab and cul-de-sac secretion have been examined using immunofluorescent test for chlamydia. In non selected 80 patients a positive cervical test could be found in 11 cases (13.8 per cent). In cul-de-sac secretions only 3 cases (3.8 per cent) in result was positive. We saw wide spread adhesions near the adnexa, which could be the reason of sterility, in 3 chlamydia positive cases and in 6 chlamydia negative cases. Results of chlamydia examinations are discussed with regard to sterility and the necessity of treatment with tetracyclines or erythromycin including the sexual partner.
Chlamydia Infections↗
The Preterm Prediction Study: association of second-trimester genitourinary chlamydia infection with subsequent spontaneous preterm birth.
OBJECTIVE: This study was undertaken to determine the association between genitourinary tract infection with Chlamydia trachomatis and spontaneous preterm birth. STUDY DESIGN: Genitourinary tract infection with C trachomatis was determined with a ligase chain reaction assay of voided urine samples collected at 24 weeks' gestation (22 weeks' to 24 weeks 6 days' gestation) and 28 weeks' gestation (27 weeks' to 28 weeks 6 days' gestation). Case patients (spontaneous preterm birth at <37 weeks' gestation; n = 190) and control subjects (delivery at >/=37 weeks' gestation, matched for race, parity, and center; n = 190) were selected from 2929 women enrolled in the Preterm Prediction Study of the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. RESULTS: Genitourinary C trachomatis infection (11% overall) was significantly more common among the case patients than among the control subjects at 24 weeks' gestation (15.8% vs 6.3%; P =.003) but not at 28 weeks' gestation (12.6% vs 10.9%; P =.61). Women with chlamydia infection were more likely to have bacterial vaginosis (57.1% vs 32.9%; P =.002) and a short cervical length (</=25 mm; 33.0% vs 17.9%; P =.02) but not a body mass index <19.8 kg/m(2) (35.0% vs 23.9%; P =.17) or a positive fetal fibronectin test result (7.1% vs 9.5%; P =.62). After adjustment for risk factors for spontaneous preterm birth, women with C trachomatis infection at 24 weeks' gestation were 2 times as likely as uninfected women to have a spontaneous preterm birth at <37 weeks' gestation (odds ratio, 2.2; 95% confidence interval, 1.03-4.78) and 3 times as likely to have a spontaneous preterm birth at <35 weeks' gestation (odds ratio, 3.2; 95% confidence interval, 1.08-9.57). CONCLUSION: Genitourinary C trachomatis infection at 24 weeks' gestation was associated with a 2-fold to 3-fold increased risk of subsequent spontaneous preterm birth.
Adolescent↗
Characterization of gamma interferon-mediated cytotoxicity to chlamydia-infected fibroblasts.
Addition of murine recombinant gamma interferon (IFN-gamma) to mouse fibroblast cultures infected with Chlamydia psittaci was found to induce a cytotoxic response that was dependent on the concentration of IFN-gamma added and the multiplicity of infection given. No cytotoxicity was observed for uninfected cells treated with IFN-gamma, nor did infection alone elicit cytotoxicity. Cytotoxicity was detected only if IFN-gamma was present for at least the first 18 h of a 30-h incubation period. Cytotoxic activity was not observed when infected cells were treated with 50 micrograms of chloramphenicol per ml, a drug which inhibits differentiation of infectious elementary bodies to noninfectious reticulate bodies. Cytotoxic activity was restored if addition of chloramphenicol was delayed until 18 h postinfection. Addition of 100 U of penicillin per ml to infected host cells reduced but did not abolish cytotoxic activity. Treatment of host cells with as little as 0.2 microgram of cycloheximide per ml inhibited cytotoxicity without interfering with chlamydial growth. When addition of cycloheximide was delayed until 12 h after infection and IFN-gamma treatment, cytotoxicity was restored. These data indicate that IFN-gamma functions as a cytotoxic cytokine against chlamydia-infected fibroblasts. Cytotoxicity was found to be dependent on chlamydial multiplicity of infection, differentiation of chlamydiae to the metabolically active form, and host cell protein synthesis.
Animals↗
[Chlamydia infections in gynecology and obstetrics].
Urogenital infections with Chlamydia trachomatis belong to the most prevalent sexual transmitted diseases worldwide. In women, Chlamydia trachomatis can cause an infection of the cervix, the urethra, the endometrium and the Fallopian tubes. As potential sequelae, tubal infertility and ectopic pregnancies are associated with urogenital infections caused by this pathogen. An infection of the cervix in pregnancy can lead to neonatal and maternal complications. Therefore, by April 1st, 1995 a cervical swab for Chlamydia trachomatis has been included in the German antenatal care guide lines. The significance of these infections in health care is in contrast to its often hardly symptomatic or asymptomatic course. New diagnostic methods facilitate the detection of the pathogen and allow a specific antibiotic therapy. The aim of this review is a presentation of the clinical significance, diagnosis and therapy of urogenital infections with Chlamydia trachomatis in obstetrics and gynaecology to contribute to the prevention of potentially severe sequelae.
Anti-Bacterial Agents↗
Distinct homing pathways direct T lymphocytes to the genital and intestinal mucosae in Chlamydia-infected mice.
Immunity to genital tract infection with Chlamydia trachomatis is mediated by type 1 CD4+ T lymphocytes. To define the signals that govern lymphocyte trafficking to the genital mucosa, integrins expressed by infiltrating T cells and endothelial addressins displayed on local vasculature were characterized during the course of infection. All T cells expressed the alphaLbeta2 heterodimer that binds vascular ICAM-1, and most displayed enhanced levels of the alpha4beta1 integrin that interacts with VCAM-1. AlphaE and beta7(low) integrin chains were detected on approximately 15 and 30% of infiltrating T cells, respectively. Lymphocytes derived from the spleen or draining lymph nodes expressed this same integrin profile, suggesting that cells are recruited to the genital mucosa from the systemic circulation without significant selection pressure for these markers. Immunofluorescent staining for the corresponding vascular addressins revealed intense expression of VCAM-1 on small vessels within Chlamydia-infected genital tracts and up-regulation of ICAM-1 on endothelial, stromal, and epithelial cells. Mucosal addressin cell adhesion molecule-1 was not detected within genital tissues. These results indicate that T lymphocyte homing to the genital mucosa requires the interaction of alphaLbeta2 and alpha4beta1 with endothelial ICAM-1 and VCAM-1, respectively, which is the same pathway that directs lymphocytes to systemic sites of inflammation. Homing pathways defined for the intestinal mucosa and assumed to be relevant to all mucosal sites are not well represented in the genital tract. The identification of T lymphocyte trafficking pathways shared between systemic and mucosal tissues should facilitate vaccine strategies aimed at maximizing immune responses against Chlamydia and other pathogens of the urogenital tract.
Animals↗
[The role of Chlamydia infection in the development of infectious inflammatory diseases in premature newborn infants].
It is highly probable that neonates may be infected with chlamydiae provided their mothers are chlamydia carriers, especially in disease exacerbation before delivery. Parallelism was noted between the intensity of antigen demonstration in the mother and the child. Infection with chlamydiae potentiates secondary infectious inflammatory diseases in premature neonates. However, diseases of chlamydia etiology developed only in 20.5% of children of all the infected and manifested themselves by pneumonias or total toxicosis without any localized focus of infection.
Adult↗
[Human chlamydia infections (authors' transl)].
Human Chlamydia infections have diverse clinical presentations and various biological methods are used for their diagnosis. Despite progress in laboratory techniques, theses methods are relatively slow: inoculation of chick embryos requires 4 to 12 days, cell culture from 2 to 3 days and indirect immunofluorescence a whole morning. Counter immunoelectrophoresis seems to have a future, as it is rapid (45 minutes), easy to perform, highly sensitive and applicable to routine examinations.
Adult↗
Improving services for sex partners of chlamydia-infected patients in an HMO.
OBJECTIVE: To improve services for sex partners of chlamydia-infected patients (ie, chlamydia partner services [CPS]) at an HMO. STUDY DESIGN: Assessment of current CPS policy, practices, and opinions in Kaiser Permanente Northwest Region (KPNW) and in local health departments, and design, implementation, and evaluation of 4 CPS interventions. METHODS: We reviewed KPNW policy documents, conducted focus groups with KPNW clinicians, and did phone interviews with KPNW chlamydia-infected patients and health department disease intervention specialists. We then implemented 3 informational interventions: CPS information was added to the after-visit summary given to patients tested for chlamydia; information on how to test, treat, and counsel chlamydia-infected patients was added to KPNW's electronic clinical-decision tool; and CPS information and a direct link to KPNW's chlamydia screening and treatment guidelines were added to KPNW's Web site. We also organized training for KPNW clinicians to review the roles of CPS and disease intervention specialists. We evaluated intervention uptake and impact by reviewing electronic medical charts, Web site "hits," and posttraining evaluations. RESULTS: Clinicians and disease intervention specialists reported that KPNW's CPS policy and the roles of disease intervention specialists regarding KPNW patients were unclear. Clinicians and patients wanted more CPS information. Clinicians commonly used the after-visit summary and Web-based CPS information and reported that training improved CPS knowledge. However, none used the clinical-decision tool. CONCLUSIONS: Several simple, centralized informational interventions to improve CPS were feasible and used by KPNW clinicians. These interventions could potentially be used in other settings structured like KPNW.
Chlamydia Infections↗
Asymptomatic Chlamydia infection in pregnant women.
Chlamydia trachomatis infection is currently among the most prevalent sexually transmitted diseases in the United States. A review of three textbooks of obstetrics reveals that none of them recommend routine chlamydia screening in prenatal patients, although two recommend routine screening for gonorrhea. A study was done at the Barberton Citizens Hospital Family Practice Residency Program to determine the incidence of asymptomatic chlamydia infection in pregnant women and to compare this to the incidence of asymptomatic Neisseria gonorrhoeae infection in the same population. A total of 69 patients were screened for Neisseria gonorrhoeae and Chlamydia trachomatis as part of their routine prenatal evaluations at the first prenatal visit and the visit of 36 weeks gestation. Neisseria gonorrhoeae was detected by growth on standard Martin-Lewis culture plates. Chlamydia trachomatis was detected by positive immunofluorescence using a standardized specimen kit (Syva Company, Palo Alto, California). The data were collected over a 12-month period from July of 1987 through July of 1988. There were no positive cultures for Neisseria gonorrhoeae (0%) in this group of patients. On the other hand, five patients tested positive for Chlamydia trachomatis (7.2%). The results of this study indicate that routine screening for Chlamydia trachomatis should be considered as part of the routine prenatal care. A larger, multi-centered study could be done in the future to confirm these results, as well as to determine if any regional differences exist.
Chlamydia Infections↗
[Diagnosis of Chlamydia infections].
Tissue culture for Chlamydiae requires facilities that are not generally available, are costly and require 3 to 7 days for completion. With the introduction of specific monoclonal antibodies Chlamydia trachomatis can be recognized within 30 minutes. Therefore the direct specimen test should be performed as the method of choice. In complicated, ascending forms of the disease requiring special methods for sample collection (e.g. laparoscopy), serology may aid in the diagnosis of a Chlamydia trachomatis infection.
Chlamydia Infections↗
Screening and diagnostic practices for chlamydia infections in New Zealand.
AIMS: To identify screening and diagnostic practices for chlamydia infection in New Zealand. METHODS: Postal survey of doctors and nurses at all sexual health, family planning, youth and student clinics, and randomly selected general practitioners (GPs). RESULTS: Most respondents recognised chlamydia infection as a cause of pelvic inflammatory disease and infertility in females, and epididymitis and non-gonococcal urethritis in males. Ectopic pregnancy and conjunctivitis were less commonly recognised by GPs and student and youth centre doctors. Sterile pyuria and arthritis were well recognised only by sexual health doctors. Female doctors were significantly more likely to recognise signs and symptoms than male doctors. GPs were less likely than other respondents to screen for chlamydia infection. Sexual health doctors and nurses were more likely to remove cervical secretions prior to taking endocervical specimens. Contact tracing was regarded as very important by only a quarter of family planning respondents, compared with over 80% of other respondents. CONCLUSIONS: While respondents recognised most signs, symptoms, and sequelae of chlamydia infection, some important features were not well recognised. Screening practices varied, and many endocervical specimens were taken incorrectly. Given the long-term health consequences and cost of chlamydia infection sequelae, screening guidelines are urgently required.
Adolescent↗
Relationship of cervical ectopy to chlamydia infection in young women.
OBJECTIVE: Genital Chlamydia trachomatis infection is the most common bacterial sexually transmitted infection (STI) in the UK. Behaviours including multiple sex partners and inconsistent condom use, and biological factors such as cervical ectopy, may increase susceptibility to STIs. Cervical ectopy is thought to increase risk of chlamydia infection by exposing columnar epithelium to a potential infectious inoculum. This study aimed to determine whether chlamydia was more prevalent in young women with cervical ectopy. METHODS: Clinical notes of women aged 16-24 years attending the Portsmouth Genitourinary Medicine Clinic for an STI screen during the period May-July 2003 were reviewed retrospectively. Information collected included the presence or absence of cervical ectopy, smoking habits, methods of contraception, number of sexual partners in the previous 3 months, and previous STIs. Chlamydia infection was diagnosed by using strand displacement amplification on cervical swabs. RESULTS: A total of 231 women were included in the study. The mean age was 19.8 years. Evidence of cervical ectopy was found in 107 women. Chlamydial infection was detected in 37.4% (40/107) of those women with cervical ectopy and 21.8% (27/124) in those without cervical ectopy. This difference was statistically significant (p = 0.009). The significance remained even when accounting for confounding variables. CONCLUSIONS: Cervical ectopy is a common physiological process in young women. Recognition of cervical ectopy should alert the clinician to the possibility of a genital chlamydia infection. Opportunistic screening for chlamydia in young people should be offered to reduce the prevalence of infection and its sequelae.
Adolescent↗
Intracellular location of inapparently infecting Chlamydia in synovial tissue from patients with Reiter's syndrome.
Culture of Chlamydia trachomatis from synovial tissues/fluids from Reiter's syndrome (RS) patients frequently yields negative results. However, we have identified chlamydial RNA at that site in such patients, suggesting that viable organisms may be present. Here we define the cellular location of chlamydia within the synovium via in situ hybridization. Using a chlamydial ribosomal RNA-directed probe, we show that synovial tissue from culture-negative RS patients gives strong hybridization which is often localized to a subsynovial cell layer, rather than to the synovial lining; in some cases, hybridizing cells are dispersed through the synovium. All hybridization signal is located within host cells, indicating that infectious extracellular elementary bodies are rare or absent. These data confirm the extensive intracellular presence of inapparent chlamydia in the synovia of RS patients and provide some insight into the usual culture negativity of synovial tissues for the organism.
Adult↗
Lack of Chlamydia infection of the central nervous system in multiple sclerosis.
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Central Nervous System Bacterial Infections↗
[Demonstration of urogenital Chlamydia infection by means of the Chlamydiazyme test].
Abbott's recently introduced Chlamydiazyme test which is based on the Elisa principal and cell culture technique was employed with the object of demonstrating urogenital infection with Chlamydia trachomatis in 150 persons. Neither of the methods were optimal. The Chlamydiazyme test had a lower sensitivity and specificity than the cell culture method.
Chlamydia Infections↗