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PubMed1975

Chlamydial eye disease.

In the United States, chlamydial (TRIC) agents cause a small but important segment of infectious ocular disease. Elsewhere in the world, trachoma still represents the single greatest cause of blindness. The description of these diseases in this chapter is a brief introduction to a subject about which volumes have been and will continue to be written. Barring unforeseen developments, these agents will continue to plague humankind beyond the end of the twentieth century.

Chlamydia Infections↗
PubMed1982

Paranoid-nonparanoid schizophrenic distinctions in implementing external conceptual constraints.

Using procedures originated by Bruner et al. (Bruner, J. S., Goodnow, J. J., and Austin, G. A Study of Thinking. John Wiley & Sons, New York, 1956), paranoid and nonparanoid schizophrenics and nonpatients were compared on performance in identifying rules for organizing multidimensional items. Successive item selections were accompanied by feedback as to whether or not each corresponded to the rule currently in effect (either conjunctive, inclusive-disjunctive, or biconditional). The most pronounced aspects of deficit associated with paranoid status were related to performance latency. Examination of results in the light of component operations underlying the present task indicated that paranoids' lower performance stemmed from difficulties in initially translating stimulus properties into a task-facilitative format. Findings were related to earlier paranoid distinctives in (choice) reaction time latencies, as well as to earlier findings on rule definition learning involving procedures closely related to the present ones. As well, inferences were drawn as to conditions of rule acquisition where differential latency aspects of performance are likely to be most pronounced among paranoids.

Adolescent↗
PubMed1989

Failure of erythromycin ointment for postnatal ocular prophylaxis of chlamydial conjunctivitis.

Chlamydia trachomatis is the most common pathogen associated with conjunctivitis during early infancy in the United States. During a 13-month interval at our medical center 4834 infants were born, 311 of whom (6.4%) had conjunctival specimens tested for chlamydial antigen before the age of 12 weeks. In 44 (14% of all tested infants, 0.9% of live births) chlamydial antigen was present. Because the rate of asymptomatic maternal chlamydial endocervical colonization is estimated to be 26% at our institution (previous prospective study), we calculated a minimal failure rate for erythromycin ocular prophylaxis of from 7 to 19.5%. A subsequent case-control study revealed that mothers of infants with chlamydial conjunctivitis were more likely to be primiparous (P = 0.03) and experience longer duration of rupture of membranes before delivery (P = 0.046). We conclude that a substantial percentage of infants exposed to Chlamydia develop chlamydial conjunctivitis despite receiving erythromycin ocular prophylaxis.

Administration, Topical↗
PubMed1997

Use of polymerase chain reaction for the detection of Chlamydia trachomatis in ocular and nasopharyngeal specimens from infants with conjunctivitis.

BACKGROUND: Chlamydia trachomatis is the most common identifiable infectious cause of neonatal conjunctivitis. Nonculture tests including enzyme immunoassays and direct fluorescent antibody tests have been shown to perform well for the diagnosis of chlamydial conjunctivitis with sensitivities and specificities > or = 90%. However, the performance with respiratory specimens has been less than satisfactory. METHODS: We compared a new, commercially available polymerase chain reaction (PCR) assay, Roche AMPLICOR (Roche Diagnostic Systems, Branchburg, NJ) with culture for the detection of C. trachomatis in conjunctival and nasopharyngeal specimens from infants with conjunctivitis. We also evaluated AMPLICOR for the detection of C. trachomatis in the urine of mothers of positive infants. RESULTS: Ocular and nasopharyngeal specimens from 75 infants with conjunctivitis were obtained for culture and PCR. AMPLICOR was equivalent to culture for eye specimens and more sensitive than culture for nasopharyngeal specimens. The sensitivity, specificity and positive and negative predictive values of PCR compared with culture for conjunctival specimens were 92.3, 100, 100 and 98.4%, respectively. The sensitivity, specificity and positive and negative predictive values for nasopharyngeal specimens were 100, 97.2, 60 and 100%, respectively. We also detected C. trachomatis by PCR in the urine of 12 mothers of culture positive infants. CONCLUSIONS: PCR performed comparably to culture for detection of C. trachomatis in conjunctival and nasopharyngeal specimens from infants with conjunctivitis.

Bacteriological Techniques↗
PubMedDate not supplied

Dual infection of the conjunctiva with herpes simplex virus and Chlamydia trachomatis.

We describe a homosexual man with simultaneous infection of the conjunctiva by Herpes simplex virus and Chlamydia trachomatis. This dual infection was associated with a genital and disseminated Herpes simplex virus infection as well as asymptomatic chlamydial infection of the rectum and "nonspecific" urethritis. The findings in this case show the importance of laboratory investigation in cases of conjunctivitis associated with genital infection.

Acyclovir↗
PubMedDate not supplied

Genital infection with Chlamydia trachomatis in patients with chlamydial conjunctivitis: unexplained results.

It is generally believed that a chlamydial eye infection in adults is the result of autoinoculation of the eye by infected genital secretion. Genital samples of 60 microbiologically verified, adult, non-trachomatous chlamydial conjunctivitis cases were investigated. Only two of the 38 men and none of the 22 women tested had symptoms of genital infection when the sampling was made for establishing the diagnosis of chlamydial infection. Of the men, 23 (61%), 20 (53%), 19 (50%), and 20 (53%) were positive in urethral samples by culture, ELISA (Chlamydiazyme, Abbott, USA), and immunofluorescence tests (Chlamyset, Orion, Finland and MicroTrak, Syva, Finland), respectively. The corresponding figures for the female urethral samples were 12 (55%), 11 (50%), 9 (41%), and 12 (55%) and for the cervical samples 15 (68%), 15 (68%), 14 (64%), and 14 (64%), respectively. Thirty-nine mothers to neonates with chlamydial conjunctivitis were also studied. In 34 (87%) of the mothers, a genital chlamydial infection could be verified. It has been a general belief that the eye in chlamydial conjunctivitis in adults is generally infected by autoinoculation of infected genital secretion. Different means to explain the discrepancy between the results of the diagnostic tests for the eye and genital samples are considered.

Adolescent↗
PubMed1983

Amino acid requirements of strains of Chlamydia trachomatis and C. psittaci growing in McCoy cells: relationship with clinical syndrome and host origin.

The effects of omission of individual amino acids from growth medium on the multiplication of a range of Chlamydia trachomatis and C. psittaci strains in cycloheximide-treated McCoy cells have been assessed. Differences in requirements were revealed which for C. trachomatis strains correlated with clinical syndrome and for C. psittaci with host origin. All 11 strains of C. trachomatis examined showed a requirement for addition of histidine to the medium; this was not shown by any of four C. psittaci strains. Among the strains of C. trachomatis, three from cases of trachoma, representing serotypes A, B and C, showed a distinctive requirement for the addition of tryptophan to the medium, whilst six strains of oculogenital origin, representing serotypes D-I, exhibited no requirement for tryptophan or methionine; a lymphogranuloma venereum and a 'fast variant' strain both showed a requirement for methionine. Of the four C. psittaci strains from different hosts, three showed distinct patterns of amino acid requirements. All chlamydiae required the addition of valine to medium and the majority required leucine, phenylalanine and also glutamine.

Amino Acids↗
PubMed1991

Lymphocyte proliferative responses to chlamydial antigens in human chlamydial eye infections.

In order to study the relationship between cell-mediated immune responses to Chlamydia trachomatis and the pathogenesis of human chlamydial eye disease, we have measured the peripheral blood lymphocyte proliferative responses to whole chlamydial elementary bodies in 40 subjects with oculogenital chlamydial infection of varying severity, 13 subjects with genital chlamydial infections and 12 healthy seronegative controls. The mean stimulation index was significantly higher in those with oculogenital infections than in controls. There was a strong correlation between the response to C. trachomatis serotypes B and L1. We studied the relationship between proliferative responses and four clinical parameters: follicular conjunctivitis, papillary hypertrophy, corneal pannus and epithelial punctate keratitis, but were unable to show a significant association with any of these. Nor was there any association between proliferative response and serum antibody titre to C. trachomatis (pooled serotypes D-K), duration of disease or quantitative isolation of chlamydia from the conjunctiva. The depletion of CD8+ cells had no consistent effect on proliferative responses to serotype L1 in 13 subjects.

CD8 Antigens↗
PubMed1989

Chlamydia trachomatis infection in late pregnancy: a prospective study.

During a 1-year period, 3309 women were screened in pregnancy for Chlamydia trachomatis infection. A cervical swab was taken and chlamydial antigen was detected, using a monoclonal antibody ELISA technique, in 198 women (6%). The prevalence of chlamydial infection was high in women under 20 years (14.5%), single women (14.2%) and black women (16.8%). Binomial regression of these data estimates a relative risk of 2.9 for women under 20 years compared with women aged 25 and over. There was an interaction between race and marital status with a high risk in single white and single asian women (2.3, 4.5 respectively) but a similar risk in black single and black married women (3.0, 4.0 respectively). Parity and social class did not effect the prevalence of antigen carriage. There was no demonstrable effect of maternal antigen carriage on outcome of pregnancy, gestation or admission to neonatal unit. Infants of 174 antigen-positive mothers were followed-up. Tissue culture for Chlamydia trachomatis was positive in 43 (24%) infants. Complications occurred in 23 (53%): 17 had conjunctivitis, three had lower respiratory tract infection and three both complications. Amongst 131 chlamydia-negative infants, complications occurred in 21 (16%). Since this infection, in infants, responds promptly to erythromycin therapy, screening and treatment in pregnancy will convey little benefit in prevention of perinatal morbidity or perinatal mortality.

Adult↗