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PubMed1990

Laboratory survey of Chlamydia trachomatis ocular infections.

The authors used immunofluorescence and immunoperoxidase tests to study a group of 101 patients with acute or chronic conjunctivitis, etiologically unrelated to conventional bacterial pathogens, and a control group of 30 healthy adults. Positive titers of IgG in serum and of IgA in lacrimal secretions against Chlamydia, detected by IPA, correlated with the identification of microorganisms by direct immunofluorescence. The use of both tests allows a precise evaluation of the stage of the infection and of its evolutive pattern.

Adult↗
PubMed1996

Evaluation of two nonculture antigen tests and three serotests for detection of anti-chlamydial antibodies in the diagnosis of ocular chlamydial infections.

BACKGROUND: Diagnosis of chlamydial conjuctivitis is difficult in chronic diseases because chlamydial elementary bodies are mostly undetectable in conjunctival scrapings by cell culture. We therefore compared two nonculture antigen tests and three different serotests for anti-chlamydial antibodies with McCoy cell culture, the "gold standard" of chlamydial diagnosis. Conjunctival scrapings and serum samples of 93 patients attending the outpatient eye clinic in Graz because of chronic follicular conjunctivitis were tested. METHODS: A total of 558 conjunctival scrapings and 93 serum samples were investigated. Chlamydial antigen detection was done by McCoy cell culture, polymerase chain reaction (PCR; Amplicor, Roche), and direct immunofluorescence assay (DFA; Microtrak, Syva). Antichlamydial IgA and IgG antibodies in the sera were detected by an immunoperoxidase assay (IPAzyme, Savyon) and two different enzyme-linked immunosorbent assays (SeroELISA, Savyon and rELISA, medac). RESULTS: Cell culture and PCR yielded identical results. The positivity rate for chlamydial conjunctivitis was 8.6% (8 of 93 patients). PCR proved most sensitive and most specific. IPAzyme was 75% sensitive for IgA and 100% for IgG; SeroELISA and rELISA were less sensitive. IPAzyme was 81% specific for IgA and 47.3% for IgG. SeroELISA and rELISA were less specific for IgA, but more specific for IgG. Post-test likelihood of disease was greatest in IPAzyme. CONCLUSIONS: PCR proved to be a good alternative to cell culture; DFA is useful for quick diagnosis. Genus-specific serotests cannot compete with chlamydial antigen detection. They differ in sensitivity and specificity because of the antigen type they present. They are still of only supportive value in cases where chlamydial antigen detection is not possible. Recently introduced species-specific antibody tests should be of greater value.

Adolescent↗
PubMed1982

Chlamydia trachomatis and clinical genital infections: a general review.

Genital infections caused by Chlamydia trachomatis (immunotypes D to K) are briefly reviewed. Urethritis is not only the most important chlamydial infection in men, but is also the most common sexually transmitted disease. The complication of this form of nongonococcal or postgonococcal urethritis include prostatitis, epididymitis and arthritis. Urethritis and cervicitis are the primary infections in women, and may lead to salpingitis, peritonitis or perihepatitis. Chlamydial infection is transmitted to the infant at birth, causing conjunctivitis or pneumonia. The diagnosis and treatment of genital chlamydial infections are briefly reviewed. Finally, some general recommendations on genital chlamydial infections are presented.

Arthritis↗
PubMedDate not supplied

Perinatal transmission of Chlamydia trachomatis. The use of serological tests in detecting infected women.

A study is presented on the use of serological tests for the detection of Chlamydia trachomatis in 273 pregnant women. 166 were cultured for C. trachomatis and nine (5.4%) were positive. Three culture-positive babies, all born to culture-positive women, had conjunctivitis. Elevated IgG and IgA antibody levels were seen in six (67%) and three (33%) of the infected women, respectively. Three (2.4%) of IgG antibody-negative mothers (n = 126) were positive by culture. Compared to serology culture of the microorganism appears as the most reliable way of detecting infected women.

Adult↗
PubMed1990

Use of blocking reagent to confirm enzyme immunoassay results in chlamydial conjunctivitis.

A blocking reagent (Abbott) was used to test 153 conjunctival and nasopharyngeal samples from children with signs of early trachoma and from neonates and adults with conjunctivitis caused by Chlamydia trachomatis in whom positive results had been obtained on at least one occasion in an enzyme immunoassay (EIA) (Abbott). EIA and cycloheximide-treated McCoy cell cultures of the eye sample were equally often positive in the non-trachoma cases (70 versus 71), the EIA results being confirmed by the blocking reagent test in these cases. The corresponding figures for the nasopharyngeal samples were 31 versus 25. There was full agreement between the results of the EIA and blocking reagent tests, except in two eye samples and one nasopharyngeal sample where the blocking reagent test was negative. Three EIA results were within the equivocal zone around the cutoff point, two of which were positive and one negative in the blocking test.

Adolescent↗
PubMed2007

[Chlamydial diseases of the eye. A short overview].

In this short review, new data on the taxonomy of Chlamydia and the association of these pathogens with various ocular diseases are presented. Clinical diagnosis and laboratory tests for ocular C. trachomatis infection are discussed. The actual therapy consists in oral azithromycin.

Administration, Oral↗
PubMed1999

Diagnosis of chlamydial infection by direct enzyme-linked immunoassay and polymerase chain reaction in patients with acute follicular conjunctivitis.

BACKGROUND: Acute follicular conjunctivitis is a clinical diagnosis common to multiple etiologies, of which chlamydial infection requires specific antibiotic treatment. PURPOSE: This prospective study was designed to evaluate Chlamydia trachomatis as the cause of acute follicular conjunctivitis by two sensitive tests: direct enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). METHODS: Conjunctival scrapings from patients presented with untreated acute follicular conjunctivitis were examined by ELISA and PCR, and patients were followed up for prolongation of the disease course. RESULTS: All 36 consecutive patients presented with acute follicular conjunctivitis were negative for Chlamydia trachomatis by ELISA and PCR. None of the patients had a prolonged course of more than 4 weeks or required treatment with systemic antibiotics as would be expected from chlamydial infection. CONCLUSIONS: Chlamydia trachomatis was probably not responsible for the acute follicular conjunctivitis in this series, and ELISA and PCR may not be cost effective for evaluation of acute follicular conjunctivitis due to chlamydial infection. Further evaluation of the cost effectiveness of these tests is required in chronic follicular conjunctivitis.

Acute Disease↗
PubMed1980

Electrocardiographic exercise testing and ambulatory monitoring to identify patients with ischemic heart disease at high risk of sudden death.

Prognostic significance of ambulatory electrocardiographic monitoring and exercise testing was studied in 144 patients with established ischemic heart disease. A follow-up study showed that 10 sudden deaths occurred within 2 years. The univariates most strongly associated with the subsequent occurrence of sudden death included reduced maximal exercise heart rate, exercise-induced frequent ventricular arrhythmias, complex ventricular arrhythmias revealed by 24 hour ambulatory electrocardiographic monitoring and onset of S-T segment depression during exercise testing. Groups of patients at very high and very low risk of sudden death were identified using conjunction and inclusive disjunction of the foregoing variable. The presence of bivariate and trivariate combinations was associated with an increase up to 20-fold in the incidence of sudden death. Patients with the poorest prognosis were those who stopped exercise before achieving a high heart rate and who exhibited either pronounced electrocardiographic abnormalities during stress testing or complex ventricular arrhythmias during ambulatory monitoring. Combinations of exercise variables identified patients at a very high risk of sudden death, whereas combinations of monitoring variables appeared to be preferable for defining groups of patients at very low risk. The results obtained suggest that the two methods carry different prognostic information and, therefore, may complement each other in identifying potential victims of sudden cardiac death.

Adult↗