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Isolation of Chlamydia trachomatis from the male urethra.

Chlamydia trachomatis was isolated from 26% of urethral swabs taken from 509 men with urethritis. The highest yield of 68% was obtained from a selected group of men with nonspecific urethritis (NSU) who had a frank urethral discharge. This is a higher than in previous reports, and is significantly higher than the isolation of C. trachomatis from men with less severe urethritis. The higher yield was similar to C. trachomatis isolation rates reported among patients with severe trachoma in hyperendemic areas. Men with a previous history of NSU had low isolation rates. Overall, 30% of 385 men with NSU had positive chlamydial culture results, 7% of 59 men with gonococcal urethritis alone were Chlamydia-positive, 15% of 59 men with gonorrhoea followed by NSU (post-gonococcal urethritis) were Chlamydia-positive, and only 3% of 61 men without urethritis harboured Chlamydia. Swabs taken from the cervical os of 28 of 108 female contacts of men with NSU had a positive result for C. trachomatis. Significantly more pairs of sexual partners had the same chlamydial culture result than had different results. The chlamydial isolation rate was higher among men admitting a casual sexual contact than in men claiming only regular partnerships. The findings provide further evidence for the sexual transmission of C. trachomatis and for its aetiological role in NSU.

Chlamydia Infections

[An isolation procedure of Chlamydia pneumoniae and Chlamydia trachomatis].

The author devised a method which permits simultaneous isolation and identification of Chlamydia using a slide chamber with 8 wells. Contaminating bacteria were eliminated by filtration with the membrane filter. The procedure allowed isolation of Chlamydia pneumoniae and Chlamydia trachomatis from 11 (10.1%) out of 109 and 10 (9.2%) out of 109 otolaryngologic clinical specimens, respectively. The use of HL cells together with Hela-229 cells had been considered essential to isolate Chlamydia from specimens in this field. The conditions for isolating Chlamydia pneumoniae were similar to those for Chlamydia trachomatis. The slide chamber procedure with membrane filter treated specimens was suitable for simultaneous isolation and culture of various species of Chlamydia and allowed easy differentiation of Chlamydia pneumoniae from Chlamydia trachomatis with identification by the indirect fluorescent-antibody technique. Routine examination of clinical specimens using this procedure should be required in the future in order to better understand chlamydial infections.

Bacteriological Techniques

Antibodies to Chlamydia trachomatis in sera of women with recurrent spontaneous abortions.

OBJECTIVE: The relationship between high-titer immunoglobulin G antibodies to Chlamydia trachomatis and recurrent spontaneous abortions was evaluated. STUDY DESIGN: Sera from the female partners of 258 couples with unexplained infertility, no history of chlamydial infection, and negative cervical cultures were diluted 1:128 and tested for immunoglobulin G antibodies to Chlamydia trachomatis. A subset of patients was also tested for antibodies to cytomegalovirus, cardiolipin, nuclear antigens, lactoferrin, and spermatozoa. RESULTS: Seven (41%) of 17 women with three abortions and 6 (60%) of 10 women with four abortions had chlamydial antibodies as opposed to 20 (13.5%) of 148 with no abortions, 6 (12.8%) of 47 with one abortion, and 4 (12.1%) of 33 with two abortions (p < 0.01). The incidence of > or = 3 spontaneous abortions was 31.8% among women with high-titer chlamydial antibodies and 7.5% among women who had seronegative results (p < 0.001). There was no relation between any of the other antibodies and > or = 3 abortions or antibodies to Chlamydia trachomatis. CONCLUSION: High-titer immunoglobulin G antibody to Chlamydia trachomatis was associated with recurrent spontaneous abortions. The mechanism may involve reactivation of a latent chlamydial infection, endometrial damage from a past chlamydial infection, or an immune response to an epitope shared by a chlamydial and a fetal antigen.

Abortion, Habitual

Evaluation of a chemiluminometric immunoassay for detection of Chlamydia trachomatis in the urine of male and female patients.

A chemiluminometric immunoassay (Magic Lite Chlamydia) for detection of Chlamydia trachomatis antigens in first-void urine samples was compared with cell culture using urogenital swabs from 221 men and 242 women. The rate of isolation of Chlamydia trachomatis was 23.5% in men, nearly 80% of whom had symptoms of urethritis, and 8.3% in women, in whom both cervix and urethra samples were tested. In urine sediments from men and women respectively the chemiluminometric assay showed a sensitivity of 80.8% and 70%, a specificity of 97% and 95%, a positive predictive value of 89.4% and 58.3%, and a negative predictive value of 94.3% and 97.2%. Discrepancies between results obtained with the chemiluminometric assay and cell culture were resolved using two polymerase chain reaction techniques to test urogenital samples. The detection of Chlamydia trachomatis in urine samples with the chemiluminometric assay was confirmed to be superior for screening symptomatic men with urogenital infections than women as a lower prevalence population.

Adolescent

[Antibodies against Chlamydia trachomatis in patients with non-gonococcal urethritis and in the healthy Italian population].

The Authors report the results of a study on the prevalence of serum antibodies against Chlamydia trachomatis among patients with non-gonococcal urethritis caused by Chlamydia trachomatis and diagnosed on the basis of the isolation of the microorganism in cell cultures, among patients with non-gonococcal urethritis of unknown etiology and in groups of healthy population, in Italy. The search for antibodies was performed both with complement-fixation tests in micro-titer system, using an antigen prepared from chicken embryo yolk sacs infected with the 6BC strain of Chlamydia psittaci, and with indirect immunofluorescence tests. The indirect immunofluorescence tests were carried out using as antigen the whole chlamydial inclusion developed in IUDR pre-treated McCoy cell cultures, grown on coverslips, and infected with the BU/434 strain of the LGV2 immunotype of Chlamydia trachomatis. The immunofluorescence tests proved to be much more sensitive than the complement fixation tests in detecting the presence of anti-chlamydial antibody both in patients with non-gonococcal urethritis and in the healthy population groups. The percentage of subjects possessing anti-chlamydial antibodies among the healthy population suggests a diffuse circulation of Chlamydia trachomatis infection. The possibility of employing the serological data in the diagnosis of the etiology of non-gonococcal urethritis is briefly discussed.

Adolescent

Chlamydia trachomatis in gonococcal and postgonococcal urethritis.

Chlamydia trachomatis was isolated from the urethra of 38 (28.6%) out of 133 men with gonococcal urethritis (GU). During the follow up of 72 men postgonococcal urethritis (PGU) was diagnosed in 50 (69.5%) patients. More than half (30 out of 50) of these patients with PGU were Chlamydia-positive. Out of 31 patients with Chlamydia 30 developed PGU whether or not procaine penicillin, spectinomycin, or gentamicin were used. These findings are discussed in relation to present recommendations for the treatment and follow up of patients with GU.

Adult

Isolation of Chlamydia trachomatis from women attending a clinic for sexually transmitted diseases.

Attempts were made to isolate Chlamydia trachomatis from the cervix of 300 women attending a clinic for sexually transmitted diseases in Leeds. The women were divided into four groups; (1) 130 were consorts of men suffering from non-specific urethritis; (2) 66 were suffering from gonorrhoea, or were consorts of men suffering from this disease; (3) 56 were suffering from other sexually transmitted diseases; (4) 48 had no evidence of STD. The overall isolation rate of Chlamydia trachomatis was 20%. Positive results were obtained in 30%. of Group 1, in 27-3%. of Group 2, in 3-6%. of Group 3, and in 2-1%. of Group 4. No pathogenic sign or symptom of Chlamydia trachomatis infection of the cervix was detected.

Adolescent

Chlamydia trachomatis in non-specific urethritis.

Chlamydia trachomatis was isolated from 58.5% of 159 patients with non-specific urethritis (NSU) using irradiated McCoy cell cultures. Patients with persistent Chlamydia-positive NSU remained Chlamydia-positive each time they were examined before treatment and patients with Chlamydia-negative NSU remained Chlamydia-negative during the course of the illness. Neither the duration of symptoms of urethritis nor a history of previous urethritis affected the chlamydial isolation rate significantly. Of 40 patients with severe discharge 30 (75%) harboured C. trachomatis. One-third of the Chlamydia-positive patients had a severe urethral discharge, while this was present in only 15% of Chlamydia-negative patients. Complications--such as conjunctivitis, arthritis, and epididymitis--were more severe in men with Chlamdia-positive NSU than in those with Chlamydia-negative NSU. Of 64 men matched for sexual promiscuity but without urethritis, none harboured C. trachomatis in his urethra. This differs significantly (P less than 0.001) when compared with patients with NSU. C. trachomatis was isolated from the urogenital tract in 24 (42%) out of 57 female sexual contacts of patients with NSU. The presence of C. trachomatis in the women correlated significantly (P less than 0.001) with the isolation of the agent from their male contacts. These findings give further evidence for the aetiological role of C. trachomatis in non-specific urethritis and its sexual transmission.

Adult

Separation and partial characterization of a type-specific antigen from Chlamydia trachomatis.

Type-specific antigens of Chlamydia trachomatis have been demonstrated by the mouse toxicity prevention test and a variety of immunofluorescent techniques. In addition, biologic activity has been associated with these antigens in terms of type-specific immunity to trachoma infections. This report is the first to describe the detection of a soluble type-specific antigen of C. trachomatis and its separation from those antigens that cross-react among different immunotypes. Test antigens were prepared by labeling the surface components of purified, yolk sac grown organisms with a radioiodinated intermediate (Bolton-Hunter reagent, 125I). The organisms were solubilized with Triton X-100 and gel filtered through Sepharose 6B. All fractions were then tested in radioimmunoassay for binding with rabbit antisera raised against solubilized immunogens prepared from homologous and heterologous strain organisms propagated in BHK-21 cells. A fraction demonstrating homologous binding only was used in subsequent modified procedures for the preparation of quantities of type-specific antigen sufficient for analysis. The antigen appears to be a heat labile, cell surface protein associated with apparent immunogenic activity during the course of actual chlamydial eye infection.

Antigen-Antibody Complex

Isolation of Chlamydia trachomatis from eye secretion (tears).

Shedding of Chlamydia trachomatis in the eye secretion (tears) of patients with either hyperendemic trachoma or paratrachoma was studied. The method of collection of eye secretion with cellulose sponges is proved to be simple, faster, and more practicable and yielded a higher rate of chlamydial isolation than aspiration. The chlamydial isolation rates in eye secretion in chlamydia-positive paratrachoma patients in London or trachoma patients in Iran was 84 and 49% respectively. It was found that the chlamydial isolation rate from eye secretion is directly related to the number of inclusions present in the conjunctival swabbings. The results of this study indicated that patients with moderate to severe hyperendemic trachoma or paratrachoma are the main reservoir of infection. In the developing countries of the Middle East and Africa the shedding of chlamydia in the eye secretion of persons with these diseases is a major factor in the transmission of them by means of flies, fingers, towels, or bed clothes.

Chlamydia trachomatis

Detection of Chlamydia trachomatis by the polymerase chain reaction in young patients with acute epididymitis.

Specimens from 11 patients presenting with acute epididymitis were tested for the presence of Chlamydia trachomatis by an enzyme immunoassay (EIA), growth in McCoy cells and the polymerase chain reaction (PCR), and for other microorganisms by standard laboratory techniques. Chlamydia trachomatis urethral infection was detected in four patients by tissue culture, in three patients by EIA and in nine patients by PCR. These findings confirm the usually low detection rate of Chlamydia trachomatis by conventional tissue culture and EIA. Detection by PCR indicated both the diagnostic value of this technique and the importance of this organism in epididymitis.

Acute Disease

[Seroepidemiologic study of sexually transmitted diseases caused by Chlamydia trachomatis in Casablanca (Morocco)].

Screening 579 sera specimens obtained in Casablanca (Morocco) we have performed a retrospective seroepidemiological survey with regard to the prevalence of Chlamydia trachomatis involved in genital tract infections. The surveyed populations are divided into 3 groups: 177 patients affected with sexually transmitted diseases (STD), 319 reference patients, 83 maghrebian patients affected with STD but living in France. The study was performed by the indirect microimmunofluorescence technique. The prevalence of Chlamydia trachomatis ranging from 50% in the moroccan reference groupe to about 70% among patients with STD both in Morocco and Bordeaux indicates that Chlamydia trachomatis takes a significant part in STD observed in moroccan populations.

Adolescent

[Genital infections with Chlamydia trachomatis in pregnant women in New Caledonia].

Chlamydia trachomatis was researched from 400 pregnant women. 76 of them were found infected and 129 carried serological signs of infection. We purpose a detection at the end of pregnancy interesting women with sexually transmitted diseases background and those with serological positive results (greater than 1/64). Then, treatment of the mother will be an useful method of prevention against neonatal infection.

Adult

[Prevalence of Chlamydia trachomatis in genital samples from Abidjan].

A study of direct genital swabs achieved in Abidjan, on 116 men and 131 women consulting for urogenital complaints, has revealed that the men show a prevalence of 28.4% Chlamydia trachomatis, and of 18.1% Neisseria gonorrhoeae. Concerning the women the prevalence of the same germs are 13.7% for Chlamydia trachomatis, and 4.6% for Neisseria gonorrhoeae. These results show the importance of Chlamydia trachomatis as a sexually transmitted disease in Abidjan (Côte-d'Ivoire). No differences were observed according to age in the two groups.

Chlamydia Infections

Neutralization of Chlamydia trachomatis in cell culture.

Neutralization of Chlamydia trachomatis was assayed by the decrease in inclusion-forming units in baby hamster kidney cells grown in culture. Five percent fresh guinea pig sera increased neutralization titers of rabbit antisera 100- to 1,000-fold but had no effect when normal rabbit sera were tested. Neutralization of a type A or B trachoma isolate was strain specific. Neutralization by human eye secretions and sera also was demonstrated when guinea pig sera were included in the test. All of the six human sera tested showed strain specificity against types A or B, in agreement with typing by the fluorescent antibody technique.

Animals

Chlamydia trachomatis genital infections.

The prevalence and clinical features of Chlamydia trachomatis infection were studied in men with nongonococcal urethritis (NGU), in their female sexual partners, and in other women. Of 92 patients with NGU, 36 (39%) were chlamydia-positive; although all had symptoms of urethritis, fewer than half had evident discharge. Clinical features of chlamydia-positive and chlamydia-negative NGU were indistinguishable. Most female contacts of chlamydia-positive patients with NGU were infected with C. trachomatis; contacts of chlamydia-negative patients with NGU seldom harboured chlamydia. Inflammatory and erosive changes were equally common in the uterine cervix of chlamydia-positive and chlamydia-negative women, although almost half of infected cases had no clinical signs of infection and no specific symptoms. In such women the present unavailability of sensitive screening techniques is a major obstacle to the effective control of chlamydial infection.

Adult

Immediate cytotoxicity of Chlamydia trachomatis for mouse peritoneal macrophages.

The toxicity of Chlamydia trachomatis was studied with mouse peritoneal macrophage culture. Inoculation of 30 inclusion-forming units of trachoma B/TW-5/OT organisms and 250 inclusion-forming units of lymphogranuloma venereum L2/434/Bu organisms per cell caused immediated toxicity, with the killing of 40 to 90% of the macrophages within 6 h after inoculation. Inhibition of phagocytosis by adsorption at 0 degrees C or by NaF pretreatment of macrophages prevented the toxicity, indicating that chlamydiae must be phagocytized to induce toxicity. Infectivity and toxicity could be dissociated, since ultraviolet-inactivated chlamydiae were still toxic. However, the toxicity was destroyed by heating the organisms at 56 degrees C for 10 min. Tetracycline, and antichlamydial drug, did not prevent toxicity, indicating that multiplication of the organisms was not required to induce toxicity. Toxicity was not prevented by treatment of macrophages with hydrocortisone. The toxicity of trachoma TW-5 was reduced by the rabbit immune serum of trachoma TW-5 but not by the rabbit immune serum of psittacosis meningopneumonitis.

Animals

[Chlamydia trachomatis infection with symptoms and signs of the central nervous system damage--a case report].

A 32-year-old woman developed myalgia, fever, consciousness disturbance, mental disorder, pyramidal tract signs and meningeal irritation signs at about 2 months after a normal labor. Laboratory examination showed hypopituitarism (decreased ACTH, TSH), renal dysfunction and hypercalcemia. A variety of antibiotics, acyclovir and gamma-globulin failed to improve her symptoms. A diagnosis of Chlamydia trachomatis infection was considered from the elevated antibody titers. In this case, minocycline was very effective. Rarely Chlamydia trachomatis infection involved general organs, including the central nervous system. It was interesting that she had endocrine disorders. We must take a look for Chlamydia trachomatis infection because this infection infrequently involves general organs, including the central nervous system and minocycline is very effective for this infection.

Adult