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PubMed1988

Sensitive immune dot blot test for diagnosis of Chlamydia trachomatis infection.

The sensitivity and specificity of an immune dot blot test (IDBT), which relies on a 125I-labeled genus-specific monoclonal antibody to detect the Chlamydia lipopolysaccharide (LPS) antigen, were improved by pretreatment of specimens with proteinase K. This enzyme destroys protein A and therefore eliminates false-positive reactions caused by the presence of Staphylococcus aureus. Proteinase K treatment also improved the ability of the assay to detect the Chlamydia LPS antigen. When the improved IDBT was compared with culture for detection of C. trachomatis in 1,394 urogenital specimens obtained from a genitourinary medicine clinic, the overall sensitivity was 96%, and LPS antigen was detected in 76 of 83 (92%) specimens that yielded less than 10 inclusions in culture. The specificity and positive and negative predictive values of the test were 97, 81.5, and 99%, respectively. Of 123 conjunctival swabs, 7 were positive by both tests and 4 swabs were positive only by IDBT. This improved IDBT provides a simple, reliable alternative to culture for the detection of C. trachomatis in urogenital and conjunctival specimens.

Adult↗
PubMed1978

Cell-mediated immune responses in owl monkeys (Aotus trivirgatus) with trachoma to soluble antigens of Chlamydia trachomatis.

The first temporal study of the cell-mediated immune responses (CMI) following ocular infections with Chlamydia trachomatis is presented. We examined the CMI of owl monkeys infected with trachoma to soluble antigens of C. trachomatis by leucocyte migration inhibition (LIF) and delayed hypersensitivity skin testing. Delayed hypersensitivity of a systemic nature developed after a local eye infection in owl monkeys; clearance of inclusions from conjunctival cells coincided with the onset of this response. The association of eye secretion and circulating antibodies with recovery from primary infection was not so striking. Both cellular and humoral immune responses persisted for at least 2 months, at which time all test animals were completely resistant to re-infection. The elicitation of cell-mediated immune reactions with solubilized chlamydial antigens may permit the isolation of specific antigens involved in the generation of protective immunity in the owl monkey model.

Animals↗
PubMed1991

Seroprevalence of Chlamydia trachomatis types in children with clinical trachoma in New Delhi, India.

Micro-immunofluorescence test with type specific antigens of ocular Chlamydial infection types A-D was used for serotyping the causative C. trachomatis serotypes in 32 inclusion positive school children suffering from trachoma. Single serotype associated infection was seen in six of the patients. The rest of them had antibodies against more than one serotype indicating simultaneous or previous infection by more than one serotype. By geometric mean titre determination, type C appeared to be the most prevalent serotype. However the highest antibody titres in individual cases were most frequently observed for serotype A. The use of geometric mean titre versus highest titre against specific serotype observed in individual cases for population survey is discussed. Isolation of organism for absolute determination of causative serotype from each patient is emphasised.

Antibodies, Bacterial↗
PubMed1995

Murine model of ocular infection by a human biovar of Chlamydia trachomatis.

PURPOSE: A human biovar of Chlamydia trachomatis was used to develop a murine model of ocular chlamydial infection. The inbred mouse model will allow detailed immunologic studies during ocular infection, and use of a human biovar for infection may aid in identification of appropriate vaccine strategies against chlamydial infections. METHODS: BALB/c, C3H/HeN, and C57B1/6J mice (n = 5 to 10 mice/group) were topically infected in the conjunctiva with C serovar of C. trachomatis. The effects were tested of single and repeated infection with 5000 inclusion-forming units (IFU) in 5 microliters and different inoculum doses. Conjunctival surfaces of both eyes were swabbed for microbiologic signs (isolation culture or direct fluorescent antibody staining) of infection over 4 to 6 weeks. Conjunctivae were removed for histopathologic study, and lymphocytes from draining cervical lymph nodes and spleens were tested for chlamydia-specific proliferative responses. Serum was obtained from all mice and tested for anti-chlamydial antibodies. RESULTS: BALB/c and C3H/HeN mice developed dose-dependent microbiologic, histopathologic, and immunologic evidence of ocular infection. Eyes of mice were culture-positive from day 7 through at least day 21, with the peak of infection at days 10 to 14 after infection. Histopathologically, the development of conjunctival subepithelial mononuclear infiltration, exudate, and loss of goblet cells occurred within 1 week. Dose-dependent lymphoproliferative responses to whole chlamydial elementary bodies were observed; anti-chlamydial antibody was detected by immunoblotting only in infected mice. CONCLUSIONS: Several strains of inbred mice are susceptible to human chlamydial biovars and may provide a useful alternative disease model in which to study the immunopathogenesis of ocular chlamydial infection and test of vaccine candidates derived from clinically relevant human biovars.

Animals↗
PubMed1977

Conjunctival impression cytology.

A new technique is presented using impression of the conjunctiva with a plastic device to study the conjunctival response in various conjunctival disease states. When used with a rapid acting stain the impression technique proved to be accurate, reproducible, and nondestructive when compared to the standard spatula scraping of the conjunctiva using Giemsa stain.

Conjunctiva↗
PubMed1981

Chlamydia trachomatis infection in mothers and infants. A prospective study.

The incidence of chlamydia trachomatis infection of the cervix during pregnancy was found to be 18% in a group of 1,327 women attending the prenatal clinic of a large urban hospital. There were no statistically significant differences between infected and uninfected women in the type or frequency of complications of pregnancy. Chlamydial infection was demonstrated in 27 (28%) of 95 infants born vaginally to infected mothers. Conjunctival infection in these infants was detected earlier than nasopharyngeal infection and the conjunctivae appeared to be the usual portal of entry for the organism. Infants were observed through the age of 12 weeks. Conjunctivae, but the chlamydial pneumonia syndrome occurred in only three (17%) of 18 infants with nasopharyngeal infection.

Chlamydia Infections↗
PubMed1982

Oral v topical erythromycin therapies for chlamydial conjunctivitis.

Results of oral and topical erythromycin therapy in 41 infants under 4 months of age with chlamydial conjunctivitis were evaluated in randomized clinical trial. After three weeks of treatment, relapse or reinfection of the eye occurred in four of 19 patients (21%) in the topical therapy group and in three of 22 patients (13.6%) in the oral therapy group (p less than .69). In the topical therapy group, chlamydiae were isolated from nasopharyngeal cultures of eight patients (42%) during or after therapy. Chlamydiae were eradicated from the nasopharynx of the six colonized patients treated with oral erythromycin. All relapses responded to a course of oral erythromycin therapy. We conclude that both modes of therapy are comparable for treatment of chlamydial conjunctivitis, but that oral therapy has the advantage of eradicating nasopharyngeal colonization.

Administration, Oral↗
PubMed1985

Topical sulfacetamide vs oral erythromycin for neonatal chlamydial conjunctivitis.

Conjunctival and nasopharyngeal cultures for Chlamydia trachomatis were obtained from infants 30 days of age or younger with purulent conjunctivitis. Conjunctival specimens were also tested for other bacterial pathogens and for viruses. Most of the infants studied were black and came from a low-income, urban population. By random assignment infants received either topical treatment with 10% sulfacetamide sodium ophthalmic solution or systemic treatment with oral erythromycin estolate (50 mg/kg/day). Treatment was continued for 14 days if C trachomatis was isolated from the conjunctivae. Treatment was considered to be effective if conjunctivitis resolved and if follow-up chlamydial cultures of the conjunctivae and nasopharynx were negative at completion of therapy and two to four weeks later. Chlamydia trachomatis was isolated in the absence of other pathogens from the eyes of 37 (73%) of 51 infants with conjunctivitis. Other bacterial pathogens were isolated from four infants (8%) and viruses from none. Chlamydial infection was eradicated from 14 (93%) of 15 infants treated orally. In contrast, persistent conjunctival infection was detected in eight infants (57%) and nasopharyngeal colonization in three (21%) of 14 infants after topical treatment. It was concluded that C trachomatis is the most frequent cause of neonatal conjunctivitis in the low-income, urban population studied; that erythromycin estolate administered orally for 14 days eradicates chlamydial conjunctival and nasopharyngeal infection; and that topical sulfacetamide therapy may result in persistent conjunctival infection and nasopharyngeal colonization.

Administration, Oral↗
PubMed2004

Feasibility of eliminating ocular Chlamydia trachomatis with repeat mass antibiotic treatments.

CONTEXT: Mass antibiotic administrations for ocular chlamydial infection play a key role in the World Health Organization's trachoma control program. Mathematical models suggest that it is possible to eliminate trachoma locally with repeat mass treatment, depending on the coverage level of the population, frequency of mass treatments, and rate that infection returns into a community after each mass treatment. Precise estimates of this latter parameter have never been reported. OBJECTIVE: To determine the rate at which chlamydial infection returns to a population after mass treatment and to estimate the treatment frequency required for elimination of ocular chlamydia from a community. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal cohort study of 24 randomly selected villages from the Gurage Zone in Ethiopia conducted February 2003 to October 2003. A total of 1332 children aged 1 to 5 years were monitored for prevalence of ocular chlamydial infection pretreatment and 2 and 6 months posttreatment. INTERVENTIONS: All individuals older than 1 year were eligible for single-dose oral azithromycin treatment. Pregnant women were offered tetracycline eye ointment. MAIN OUTCOME MEASURES: Prevalence of ocular chlamydial infection, measured by polymerase chain reaction, in children aged 1 to 5 years, in each of 24 villages at each time point was used to estimate the rate of return of infection and the treatment frequency necessary for elimination. RESULTS: The prevalence of infection was 56.3% pretreatment (95% confidence interval [CI], 47.5%-65.1%), 6.7% 2 months posttreatment (95% CI, 4.2%-9.2%), and 11.0% 6 months posttreatment (95% CI, 7.3%-14.7%). Infection returned after treatment at an exponential rate of 12.3% per month (95% CI, 4.6%-19.9% per month). The minimum treatment frequency necessary for elimination was calculated to be once every 11.6 months (95% CI, 7.2-30.9 months), given a coverage level of 80%. Thus, biannual treatment, already being performed in some areas, was estimated to be more than frequent enough to eventually eliminate infection. CONCLUSION: The rate at which ocular chlamydial infection returns to a community after mass treatment suggests that elimination of infection in a hyperendemic area is feasible with biannual mass antibiotic administrations and attainable coverage levels.

Anti-Bacterial Agents↗