The relative importance of other infections. Chlamydiae.
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Chlamydia Infections↗
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[Chlamydia infection of swine. 1. Experimental chlamydia pneumonia of swine].
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Animals↗
[Detection of endocervical chlamydia infections by comparing the Papanicolaou staining test and direct immunofluorescence].
The association of infection with Chlamydia trachomatis and cytologic changes on Papanicolaou smear was examined in 453 sexually active postmenarcal female subjects attending the cytology service for routine Papanicolaou smear. We described inflammatory and epithelial cell patterns that permit the detection of group of women with and without cervicitis at high risk for cervical chlamydial infection. We confirmed the infection by direct immunofluorescence using monoclonal antibodies. Ninety-five of 453 women had cervicitis (20.9%) chlamydial inclusions were noted by Papanicolaou in 26 patients with cervicitis and in 61 without cervicitis. Direct stain with fluorescein-conjugated monoclonal antibodies demonstrated elementary bodies of C. trachomatis in 42/453 women, 24 had cervicitis and 18 without cervicitis. One of two patients with cervical smears with chlamydial inclusions as "changes suggestive of chlamydial infection" by Papanicolaou was confirmed by inmmunofluorescence. We calculated the efficay of the Papanicolaou smear as a diagnostic technique: the sensitivity was 0.27, the specificity was 0.80, the predictive value of o positive test was 0.29. In order to compare the efficiency with immunofluorescence the sensitivity was 0.25, specificity 0.94 and the positive predictive value was 0.57. Using the epithelial changes interpreted as inflammatory, we had the highest sensitivity with both tests, 0.76 to Papanicolaou and 0.90 to immunofluorescence, specificity is near 100% for both tests, cytology tended to be more efficient in identifying women without infection than in identifying those with infection.
Adult↗
[Chlamydia infection and salpingitis].
Chlamydia trachomatis is the most prevalent etiologic agent in women with uncomplicated salpingitis. This presentation reviews the current aspects of etiology, diagnosis, therapy, prevention and complications of this disease. The other clinical manifestations of chlamydial infection are also discussed.
Chlamydia Infections↗
Chlamydia infections in the neonatal period.
The paper presents current knowledge about the clinical course, diagnostic and treatment of chlamydial infections in the neonatal period. In the neonatal period, infections caused by Chlamydia trachomatis are in the majority of maternal origin. Chlamydia mother to child transmission occurs during vaginal birth. It can also occur but rarely, during caesarean section after premature rupture of membranes. Chlamydia trachomatis infection of the genitourinary system in pregnancy increases the danger of intrauterine growth restriction and foetal death. It rises the perinatal morbidity of foetuses and newborns and increases the risk of premature deliveries. Chlamydia trachomatis infection in newborns manifests as conjunctivitis and ophthalmia and less commonly as pharyngitis and otitis media. Erythromycin is applied in prophylaxis and treatment of Chlamydia infections.
Anti-Bacterial Agents↗
[Testing pattern and prevalence of Chlamydia infection among women].
BACKGROUND: Chlamydia notification rates have increased in Norway over the recent years. The increase in notification cannot be interpreted as an increase in chlamydia prevalence since knowledge of testing patterns and prevalence of chlamydia by sex and age is virtually absent. MATERIAL AND METHODS: A data set, applying the woman as unit for analyses, comprising all test activity in one Norwegian county, was created for the period 1990-2003 (women 15-59 years old, resident in Sør-Trøndelag County, n = 56,220). Tests registered within 60 days from the previous test were excluded. Outcome measures are age-specific testing rates (first test), cumulative incidence of first test and incidence of repeated testing, proportion of positive first tests and cumulative incidence of being diagnosed with chlamydia before the age of 25, and 12-month incidence of chlamydia. RESULTS: Testing rates were high among young women throughout the study period. By the age of 25, almost all women had been tested at least once for chlamydia (85-90%). By the end of the year following the first test, one in five women with a negative first test and one in three women with a positive first test had been tested for chlamydia at least once more. The proportion of positive tests was highest among the youngest women (9-11% for women 15-24 years from 2000). Cumulative incidence of diagnosed chlamydia by the age of 25 years was 15% for women born 1976-79. Incidence of chlamydia during the first year after the first test was 2-3%. The relative risk for being diagnosed with chlamydia after the first test was highest for women who initially tested positive, and for teenagers. INTERPRETATION: The prevalence of chlamydia is high among young women. However, many women are not tested within a reasonable time after their first intercourse. Increased testing rates among teenagers can be achieved by focusing on easily available tests implying self-sampling methods.
Adolescent↗
[Our experience in the serodetection of Chlamydia infections in tubal pathology].
Chlamydia appears to be an increasingly frequent cause of salpingitis and its complications (sterility, extra-uterine pregnancy). The difficulty of isolating Chlamydia in cell cultures has led us to study the value of serology in the form of immunofluorescence and ELISA. This study is based on 475 cases (206 controls and 269 women with tubal disease). Although it is difficult to interpret an isolated IgG level, the results nevertheless confirmed the value of serodetection: especially the comparison between the control group (18.44% positive) and the pathological group (62.08% positive) and the effectiveness obtained when cases of tubal sterility were treated with appropriate antibiotics, alone or in combination with surgery.
Animals↗
Associations between condom use and rectal or urethral chlamydia infection in men.
OBJECTIVE: To investigate the association of condom use with chlamydia infection in men attending a large sexually transmitted infection (STI) clinic in Australia. STUDY: Computerized records for all attendances between July 2002 and June 2003 were included and separate analyses were performed for men reporting male-to-male sexual contact (MSM) and for men reporting heterosexual contact only (non-MSM). Associations among age, condom use, and number of partners with chlamydia infection were assessed. RESULTS: Chlamydia was diagnosed at a rate of 8.6 cases per 100 consultations (95%CI: 7.1, 10.3) among MSM and at a rate of 6.8 cases per 100 consultations (95%CI: 5.9, 7.8) among non-MSM. Condom use was associated with a lower odds of rectal chlamydia but not urethral infection in MSM. Condom use was associated with lower odds of urethral chlamydia among non-MSM. CONCLUSIONS: The findings suggest that condoms do provide some protection against rectal chlamydia infection in MSM and chlamydial urethritis in non-MSM, but other factors may play an important role in the transmission of chlamydial urethritis in MSM.
Adult↗
Effects of a probiotic strain of Enterococcus faecium on the rate of natural chlamydia infection in swine.
Chlamydiae are obligately intracellular pathogens which cause infections associated with a broad range of diseases in both livestock and humans. In addition, a large proportion of animals may become persistently infected asymptomatic carriers and serve as reservoirs for other animals which also shed these potential zoonotic pathogens. Reducing the chlamydial load of animals is therefore of major importance, and since large-scale antibiotic treatment is neither desired nor feasible, alternative means of prevention are needed. Here we performed a study comparing the efficacy of a probiotic strain of Enterococcus faecium on the reduction of both the rate of natural infection and the shedding of chlamydiae in swine. The presence of Chlamydiaceae was detected by species-specific PCR of fecal samples of sows taken at three times prior to the birth of piglets. Piglets delivered from chlamydia-positive sows in either the control or the probiotic group were also examined for the frequency of chlamydiae at various ages. Eighty-five percent of the piglets from the control group were found to be chlamydia positive, whereas chlamydiae were found in only 60% of piglets from the probiotic group, results confirmed by fluorescence in situ hybridization and immunohistology, which showed higher rates of infection in the control group. In addition to the reduced frequency of chlamydia-positive piglets in the probiotic group, the time of appearance of positive samples was delayed. To our knowledge, these data show for the first time that a probiotic strain of E. faecium can reduce the rate of carryover infections of piglets by obligate intracellular pathogens.
Animals↗
Chlamydia-infected cells continue to undergo mitosis and resist induction of apoptosis.
Both anti- and proapoptotic activities have been reported to occur during chlamydial infection. To reconcile the apparent controversy, we compared host cell apoptotic responses to infection with 17 different chlamydial serovars and strains. None of the serovars caused any biologically significant apoptosis in the infected host cells. Host cells in chlamydia-infected cultures can continue to undergo DNA synthesis and mitosis. Chlamydia-infected cells are resistant to apoptosis induction, although the extent of the antiapoptotic ability varied between serovars. These observations have demonstrated that an anti- but not proapoptotic activity is the prevailing event in chlamydia-infected cultures.
Apoptosis↗
Is there a correlation between vaginal chlamydia infection and cervical smear abnormalities? A community-based study in the Al-Ain district, United Arab Emirates.
AIM: The purpose of this study was to determine the correlation between vaginal chlamydia infection and cervical abnormalities. The data on the prevalence of chlamydia infection and cervical abnormalities have been presented elsewhere and in this article we provide the results of a correlation analysis. METHODS: In this cross-sectional, community-based survey, women attending primary and secondary care in the Al-Ain medical district, United Arab Emirates, were offered cervical screening using the Papanicolaou smear, and chlamydia testing. A total of 793 women underwent cervical screening and 728 were tested for chlamydia. A commercially available kit was used to determine the prevalence of chlamydia. The correlation between cervical abnormalities and chlamydia infection was tested using the chi-squared test or Fisher's exact test, as appropriate. RESULTS: The prevalence of abnormal smears was 1.51% (95% confidence interval [CI], 0.66-2.4). Twelve subjects had abnormal smears, including smears showing atypical squamous cells of undetermined significance. The prevalence of chlamydia infection in this population was 2.5% (95% CI, 1.2-3.3). Statistical analysis showed no association (chi2 0.6, P = 0.4) between the prevalence of chlamydia infection and cervical abnormalities. CONCLUSION: Although there have been earlier reports of an association between vaginal chlamydia and cervical abnormalities, our study does not provide evidence to support this association.
Adolescent↗
[Morphological and morphogenetic characteristics of Chlamydia infection in sick animals].
Studies were carried out on the morphology and the morphogenesis of the Chlamydia organisms in animals with various Chlamydia infections. A total of 255 samples of placentae and parenchymal organs were investigated via the electron microscope, using the ultrathin section method and the negative contrasting method. A characteristic was made of Chlamydia infections in sheep, goats, cows, wild murine rodents, and birds. It was found that the morphologic and morphogenetic aspects of Chlamydia reproduction in diseased animals were the same as those described previously in the yolk sacs of chick embryos. The morphology of Chlamydia organisms in the viscera of animals with Chlamydia infections, and particularly in placentae of sheep that miscarried was characterized by the accumulation of elementary and initial bodies--condense, reticular, and intermediary. It was concluded that the morphogenesis of Chlamydia in animals with infections caused by Chlamydia represented a many sided morphologic process characterized by the following more important aspects: chlamydial matrix, initial chlamydial vacuoles, autonomic synthesis of chlamydial bodies in the initial vacuoles and the chlamydial matrix, high production of Chlamydia membranes, and accumulation of polymorphous Chlamydia bodies. Essential in the reproduction of Chlamydia was their massing into and around the capillaries.
Abortion, Veterinary↗
[Current problems in the clinical course, diagnosis and treatment of Chlamydia infection in newborns].
A comprehensive study of the course of the early neonatal period in 120 newborns infected with Chlamydia, analysis of somatic and obstetrical and gynecological anamnesis and the course of gestation, labor, and postpartum period in their mothers, and prospective clinical and microbiological examinations of these infants up to the age of 1 year revealed that the fetus is infected not only during delivery, but antenatally as well. The disease runs an extremely grave course in the neonates, often with generalization of the process. Chlamydial infection in the early neonatal period depends on the time and massiveness of infection of a child, the degree of morphofunctional maturity of the baby and presence of concomitant diseases related to unfavorable conditions of intrauterine development; it may take the following clinical forms: intrauterine sepsis, meningoencephalitis, intrauterine pneumonia, respiratory distress syndrome, gastroenteropathy, conjunctivitis. Problems in the diagnosis and treatment of the disease are discussed.
Case-Control Studies↗
Clonal isolation of chlamydia-infected cells using flow cytometry.
This manuscript describes a new technique for the microbiological cloning of chlamydia-infected cells using a fluorescence activated cell sorter (FACS). The approach exploits chlamydial acquisition of the fluorescent, Golgi-specific, stain 6-((N-7-(-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)-hexanoyl)sphingosine (C6-NBD-cer). This fluorescent lipid is delivered from the Golgi apparatus to the chlamydial inclusion membrane and then to the developmental forms within the inclusion in living, infected cells. Labeling with C6-NBD-cer results in easily identifiable chlamydial inclusions that can then be analyzed and sorted by FACS. This technique was used successfully to sort individual chlamydia-infected cells into individual wells of a culture dish and, in this experimental system, resulted in the isolation of cloned chlamydial isolates. FACS-based sorting was used to isolate clonal populations of prototype strains from Chlamydia trachomatis, C. caviae and C. suis. Recent clinical isolates were also successfully cloned using FACS. The procedure is simple and rapid, with single cloning cycles being completed 24 h post-culture of a sample. It is anticipated that FACS-based sorting of live chlamydia-infected cells will be a significant technical tool for the isolation of clonal populations of any chlamydial strain.
4-Chloro-7-nitrobenzofurazan↗
General practice update: chlamydia infection in women.
The prevalence of cervical Chlamydia trachomatis infection in general practice populations ranges between 2% and 12%. Untreated infection can cause pelvic inflammatory disease, tubal infertility and ectopic pregnancy. These risks are increased by cervical invasive procedures, especially termination of pregnancy. However, most women with chlamydia infection have no symptoms. General practitioners and practice nurses carrying out pelvic examinations should have facilities for taking endocervical specimens for chlamydia. Routine chlamydia screening, should be considered if the local prevalence of infection is over 6%. Otherwise chlamydia testing should be offered to women requesting termination of pregnancy and to those who have risk factors: aged less than 25 years, absence of barrier contraception, recent change of sexual partner, vaginal discharge, friable cervix or sterile pyuria. Women found to have chlamydia infection need appropriate antibiotics, advice about contact tracing and referral to a genitourinary medicine clinic. Good communication between general practitioners and genitourinary physicians is essential. Both general practitioners and practice nurses have an important role to play in reducing the prevalence of cervical chlamydia infection and its potentially devastating consequences.
Bacteriological Techniques↗
[Genital Chlamydia infections in female patients at risk of having sexually transmitted diseases].
Investigations for Chlamydia infections of the genital tract were performed in 270 Viennese registered, as well as in 51 non-registered prostitutes. The results were compared with findings obtained in 56 female patients attending an out-patient STD clinic and 48 pregnant women seeking antenatal care in a department of obstetrics. Diagnosis of Chlamydia infection was the organisms on cultured McCoy cells after treatment with cycloheximide. The highest infection rate (31%) was found in non-licensed prostitutes. In registered prostitutes, 20.4% of the cervical smears proved to be positive for Chlamydia. The control groups showed lower infection rates of 9% and 4%, respectively. These results indicate that women who frequently change their sexual partners are considerably more at risk of contracting Chlamydia infections. Hence, this group of persons should be more regularly investigated and--if necessary--given appropriate treatment in order to prevent further spread of the disease.
Austria↗
[Diagnostic methods of Chlamydia infections].
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Chlamydia Infections↗
[Chlamydia trachomatis infections].
Chlamydia trachomatis is the most common bacterial cause of sexually transmitted disease in the developed countries. The most important implications of genital chlamydia infections involve the reproductive health sequalae of upper genital tract infections in women: pelvic inflammatory disease, ectopic pregnancy, and infertility, infection by this organism is insidious, symptoms are absent or minor among most infected women and many man. This large group of asymptomatic and infectious persons sustains transmission within a community. This review discusses the epidemiology, of sexually transmitted chlamydial infections, the spectrum of clinical manifestations and their sequelae, the laboratory diagnosis of genital chlamydiasis, antibiotic treatment and prevention.
Anti-Bacterial Agents↗