Studies on oculogenital TRIC agents isolated in Denmark.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Chlamydiae are small bacteria that have a unique life cycle. There are two species, Chlamydia psittaci and C. trachomatis, which cause a wide spectrum of clinical disease, including neonatal conjunctivitis and pneumonia, sexually transmitted disease, psittacosis, and trachoma. The importance of chlamydial disease in public health is being increasingly recognized, and the incidence in developed countries seems to be increasing. An understanding of chlamydial disease, its prevention and treatment, is essential for the infection control practitioner, who can play a significant role in patient education.
As a result of chlamydia epidemic in the adult population, the incidence of Chlamydia trachomatis in infants is increasing. Certain population groups are at risk for development of an infection. This article discusses the epidemiology, microbiology, symptomatology, and management of this problem.
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Cervical and ocular swabs from 100 mother/newborn pairs delivering on the clinic service were assayed for Chlamydia trachomatis with standard McCoy cell culture and with standard and biotinylated polymerase chain reaction techniques, using primers directed against the major outer membrane protein gene and C. trachomatis-specific cryptic plasmid, respectively. Using the polymerase chain reaction, 20 (20%) mothers and seven (7%) neonates were positive for Chlamydia. All neonates positive by polymerase chain reaction were from mothers positive by polymerase chain reaction, yielding a 35% transmission rate. Only five of 20 (25%) mothers and two of seven (28%) neonates positive by polymerase chain reaction were positive by cell culture. All cell culture samples were positive by polymerase chain reaction testing. Culture and polymerase chain reaction analysis two weeks after treatment with oral erythromycin were negative. The polymerase chain reaction assay appears to be equally specific and more sensitive than McCoy cell culture for the detection of C. trachomatis from ocular specimens.
Ocular swabs from 30 consecutive patients with follicular conjunctivitis were screened for Chlamydia trachomatis, herpes simplex virus, and adenovirus by a variety of laboratory techniques. For the detection of C. trachomatis, we compared two polymerase chain reaction methods, McCoy cell culture isolation, and the direct fluorescein-conjugated monoclonal antibody test. Four of 30 patients tested positive for C. trachomatis by using both conventional and biotinylated polymerase chain reaction methods. Two of the four patients were also McCoy cell culture-positive for C. trachomatis and one of four patients tested positive by using a fluorescein-conjugated chlamydial monoclonal antibody test. All four patients responded to oral antibiotic treatment. On follow-up testing, all four patients were polymerase chain reaction-negative, McCoy cell culture-negative, and fluorescein-conjugated antibody test-negative for C. trachomatis. The polymerase chain reaction appears to be an equally specific and more sensitive method than McCoy cell culture or fluorescein-conjugated antibody testing for the detection of C. trachomatis from ocular specimens.
PURPOSE: To evaluate type-specific antichlamydial antibody IgG in children with chronic follicular conjunctivitis. METHODS: A total of 90 serum samples from juvenile patients with chronic follicular conjunctivitis were collected in the Southeastern Anatolian region of Turkey where trachoma is still endemic. These samples were investigated regarding Chlamydia trachomatis pooled serotype-specific IgG by using the micro-immunofluorescence test. A titer of 1/32 or higher was considered positive. RESULTS: Specific IgG seropositivity to Chlamydia trachomatis titer was found in 33 (36.1%) of the 90 subjects. A higher titer was observed frequently in the serotypes pooled in BDE (21 subjects), CHIJ (10 subjects), and FGK (2 subjects), respectively. CONCLUSIONS: The presence of antichlamydial antibodies in blood should always be interpreted in accordance with the history of the patient, the clinical picture, and the course of the disease. In the diagnosis of Chlamydia trachomatis infections in a patient with chronic follicular conjunctivitis, not only genus-specific antibodies but also the presence of the subspeciespecific antibodies should be investigated.
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We assessed the microbial causes of neonatal conjunctivitis by comparing 55 infants with purulent conjunctivitis and 60 healthy control infants. A mean of greater than 5 leukocytes per 1000X microscopic field was seen in Gram-stained smears obtained from the more inflamed eye in 77% of 30 untreated patients but none of 57 controls. Pathogens isolated more often from untreated patients than from controls included Haemophilus spp. (17% vs 2%, P = 0.01), Staphylococcus aureus (17% vs 2%, P = 0.01), Chlamydia trachomatis (14% vs 0%, P = 0.01), enterococci (8% vs 0%, P = 0.05), and Streptococcus pneumoniae (11% vs 2%, P = 0.06). One or more of these pathogens were isolated from the conjunctivae in 58% of patients and 5% of controls (P less than 0.001). Bacterial morphology seen on smear correlated with the pathogens cultured. Isolation of Haemophilus spp. or S. pneumoniae was associated with dacryostenosis. We conclude that several microbial pathogens are implicated in neonatal conjunctivitis. These organisms have differing susceptibilities to antimicrobial agents, so culture and sensitivity testing are required as a guide to therapy.