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PubMedDate not supplied

[The role of Chlamydia trachomatis in the etiology of conjunctivitis].

PURPOSE: To turn attention to the etiological importance of chlamydia in chronic conjunctivitis. METHODS: From December 1993 to November 1994 the authors examined 95 patients with chronic conjunctivitis for the presence of Chlamydia trachomatis antigens in conjunctival epithelial cells using direct immunofluorescent antibody tests. RESULTS: The test was positive in 23 patients and most of them responded positively to general tetracycline treatment combined with locally used Sulfacetamide or Floxal. CONCLUSION: Chlamydia trachomatis are common causes of conjunctivitis in adults.

Administration, Topical↗
PubMed1994

[Validity of the Gram and Lendrum stains in conjunctival smears for the identification of Chlamydia trachomatis].

With the objective of finding reliable, valid, and economic diagnostic tests to identify Chlamydia trachomatis in conjunctival smears, the sensitivity, specificity, and positive and negative predictive values of Lendrum and Giemsa stains were evaluated using direct immunofluorescence as the gold standard. In addition, inter- and intraobserver reproducibility were estimated through the use of two independent observers, who were blinded to the results during their readings. The prevalence of ocular chlamydiosis in the study area was around 50%. In all, 103 persons (206 eyes) were studied. Three smears from each eye were taken for each subject. The kappa statistic was used to estimate the reproducibility of the stains. Interobserver reproducibility was null, and intraobserver reproducibility ranged between 0.35 and 0.79. The sensitivity of the Giemsa stain was a bit higher than that of the Lendrum stain (28% and 22%, respectively), and the specificity was similar (82% and 85%, respectively). Based on these results, the ability of both stains to detect positive cases was judged to be low, as was their reliability. The Lendrum and Giemsa stains are not adequate tests for the diagnosis of ocular chlamydiosis. For this purpose the use of direct immunofluorescence is recommended.

Adolescent↗
PubMedDate not supplied

[Use of siflox (ciprofloxacin) in paratrachoma and assessment of its effectiveness by immunoenzyme analysis].

The possibility of using an antibiotic ciprofloxacin quinolone (siflox) in combined therapy of paratrachoma was investigated. Fifty patients with acute and subacute paratrachoma were included in the study. The drug efficacy was assessed by clinical results and laboratory findings: by the time course of the levels of Chlamydia trachomatis antigen in smears from the conjunctiva, measured by enzyme immunoassay (EIA) using the Abbott kit. The results indicated a high efficacy of siflox in combination with local application of tetracycline ointment; such treatment helped shorten the treatment period. EIA proved to be not only a highly sensitive and effective method for the diagnosis of chlamydial infection of the eyes, but permitted assessment of changes in the levels of the antigen over the course of treatment and, hence, helped assess the treatment efficacy.

Adult↗
PubMed1995

Chlamydia trachomatis conjunctivitis. Prevalence and association with genital tract infection.

OBJECTIVES: To determine the prevalence of Chlamydia trachomatis in acute conjunctivitis (non-trachoma) in Australia and to examine the source of transmission. DESIGN: A prospective survey of 400 consecutive patients presenting with acute conjunctivitis to the Royal Victorian Eye and Ear Hospital Emergency Department, Melbourne, from May to November 1991. Patients identified with chlamydial conjunctivitis during the survey period and in the following two months were assessed for concomitant genital infection. RESULTS: Chlamydia was the causative organism in 2% of patients with acute conjunctivitis. Of 15 patients with chlamydial conjunctivitis, 11 presented with disease in one eye only, and the same number had had symptoms for longer than two weeks. Many had been seen previously by experienced ophthalmologists, yet there were long delays in making a definitive diagnosis. Ten of the 12 adult patients who were assessed had signs of concomitant genital tract infection, although none had past or current genital tract symptoms. Serotyping of chlamydial isolates from the genital tract and eye showed concordance in individual patients. CONCLUSION: Most cases of ocular chlamydia infection have a genital source. Therefore, it is essential that all patients with chlamydial conjunctivitis and their sexual partners are examined and treated for concomitant genital infection.

Acute Disease↗
PubMed1994

[A prospective study of maternal-infant transmission of Chlamydia trachomatis].

Direct immunofluorescent monoclonal antibody test was used for the examination of Chlamydia trachomatis at the cervices of 130 pregnant women and women after deliveries for 2-6 months with extragenital condyloma acuminatum and at the palpebral conjunctivae of their 102 newborns and infants. The results show that the rate of cervical infection in pregnant women is 4.92% and the rate of palpebral infection in the newborns 8.57%. After postnatal 2-6 months, the rates were markedly decreased both in the mothers and their infants, being 1.45% and 0%, respectively. Chlamydia trachomatis infection is a new topic in modern perinatal medicine. In the report, the prevention of maternal-infant transmission problem was discussed.

Adult↗
PubMed1994

[Ocular chlamydia infections in Munsterland. A clinical study of 409 patients].

We evaluated demographic data, McCoy cell cultures from conjunctival smears and chlamydia-specific IgG and IgA serum antibody titers in 409 patients (194 men and 212 women) suffering from (kerato)conjunctivitis of presumed bacterial etiology in 1988-1992. Overall, 105 patients were positive in culture and/or serology tests (78 in McCoy cell cultures, 45 in serology tests). In 33 patients (31%) corneal involvement was epithelial (5), subepithelial (13), phlyctenular (7) and/or took the form of pannus vasculosus (12). The incidence and severity of corneal signs correlated with the duration of the (kerato)conjunctivitis. Nasolacrimal duct complications were documented in 16 patients with a duration of illness exceeding 6 months. Some 33% of cases were recorded in May and June, a further 26% from November to January. The age groups primarily affected were: females 20-30 years (25%), males 30-40 years (25%). The highest number of new cases was registered in 1990.

Adolescent↗
PubMed1993

[Recurrent canaliculitis and dacryocystitis as a sequela of persistent infection with Chlamydia trachomatis].

We report on 4 patients aged 39-62 years with follicular conjunctivitis, canaliculitis, canalicular obstruction, dacryocystitis and nasolacrimal duct obstruction caused by chronic oculogenital infection with Chlamydia trachomatis. Microbiological diagnosis was accomplished by means of the McCoy cell culture technique as a highly specific tool for detection of the chlamydial infection. In addition, serological tests (IgA-IPA and IgG-IPA techniques) were performed. Bacteriological examination of conjunctival smears showed coinfection in 3 patients (Proteus mirabilis in 1, Staphylococcus aureus coagulase-positive in 3). Despite successful operation techniques, the obstructive inflammation caused by oculogenital chlamydial infection could only be cured by systemic treatment with specific antibiotics, such as doxycycline or erythromycin. All cases of chronic follicular conjunctivitis with lacrimal inflammation that are resistant to topical antibiotics should suggest the possibility of infection with Chlamydia trachomatis.

Adult↗
PubMed1993

[Chlamydia trachomatis in conjunctival specimens].

One hundred two patients with signs and symptoms of conjunctivitis and 45 asymptomatic subjects were screened for Chlamydia trachomatis using a direct fluorescent antibody test. 26.5% of the symptomatic and 6.6% of the asymptomatic patients were positive for C.trachomatis. The follicular response rate was significantly higher (p < 0.05) in the symptomatic group than in the asymptomatic population (48.1% and 29.3% respectively). This finding correlated well with chlamydial conjunctivitis.

Chlamydia trachomatis↗
PubMed1995

Chlamydia trachomatis can be transmitted by a nonporous plastic surface in vitro.

Chlamydial conjunctivitis is a disease associated with venereal transmission through direct sexual contact or autoinoculation with genital secretions. Appropriate therapy for patients and their sexual partners involves important questions regarding the source of infection and mode of transmission. This study explored the potential role of a fomite, i.e., an environmental surface, as a possible vector of transmission. We determined the in vitro recovery of Chlamydia trachomatis from a nonporous plastic surface under ambient and humid conditions using the standard shell vial technique and confirmation by direct monoclonal immunofluorescence. Under ambient conditions, the TP50 (time at which 50% of samples were positive for Chlamydia) was 5 min, with complete desiccation occurring at 45 min. Under humid conditions, the TP50 was 52.5 min and complete desiccation did not occur up to 3 h. Beyond 45 min, a significantly greater number of positive chlamydial samples were collected under humid conditions (11 of 30) than under ambient conditions (0 of 30) (p = 0.00016). We conclude that a fomite, such as a nonporous plastic surface, may serve as a potential vector for the transmission of chlamydial infection to the eye, especially under humid conditions. This new information may prove useful in counseling patients and their sexual partners.

Chlamydia trachomatis↗
PubMed1987

Oral immunization against chlamydial eye infection.

The effects of enteric administration of different preparations of Chlamydia trachomatis prior to ocular challenge with live chlamydia were compared to the immunity that develops after recovery from ocular infection. Oral immunization with either live homologous serovar B or with formalin-killed heterologus serovar L2 did not influence the response to subsequent ocular challenge. Although oral immunization with live serovar led to protection against heterologous ocular challenge with serovar B, oral immunization with noninfectious UV-irradiated serovar L2 led to more severe and prolonged disease. An immunizing regimen designed for maximal mucosal and systemic immunity also resulted in protection against homologous ocular challenge. Although protection was correlated with the presence of serum IgA antibodies, no clear mechanism for the protective ocular immunity to chlamydial infection has emerged. These studies show that it is possible to stimulate mucosal immunity to induce protection against subsequent ocular challenge with C. trachomatis that is equal to that which follows prior ocular infection.

Acute Disease↗
PubMed1996

[Chlamydia trachomatis in pregnant women in the county of Vestsjaelland. Prevalence, prevention of perinatal transmission and cost-effectiveness of screening].

The prevalence of genital Chlamydia trachomatis (CT) in pregnant women and the perinatal transmission after treatment was investigated. An analysis of the cost-effectiveness of introducing a screening program among women at risk of having CT was made. Out of 339 pregnant women 2.9% had cervical CT. CT-positive women were treated with erythromycin. CT-positive women were significantly younger than CT-negative women and the odds ratio (OR) of having CT if nulliparous was 3.35. The CT-prevalence was 6.6% among women younger than 25 years and 1.6% among women 25 years or older (p = 0.0163). OR of having CT if younger than 25 years was 4.3. The young women were significantly younger at sexual début. None of the children of women treated for CT during pregnancy developed neonatal CT-conjunctivitis. The screening of women younger than 25 years was considered to be cost-effective. It is concluded that women younger than 25 years are at risk of having CT. Treatment of CT-positive women with erythromycin during pregnancy seems to be effective in eradicating this microorganism and thus preventing perinatal transmission and neonatal CT-conjunctivitis. It therefore seems rational to screen all pregnant women under the age of 25 years for cervical CT, especially in high risk areas.

Adult↗
PubMedDate not supplied

Ophthalmia neonatorum associated with maternal chlamydial infections.

An unselected sample of 142 pregnant women had a single cervical culture for C trachomatis at 36 to 40 weeks' gestation. Of these women, 18 (12.7%) had positive cultures, and their infants were followed in postoperative fashion. Of these 18 infants, eight (44%) developed ophthalmia neonatorum. A combination of cultures and conjunctival smears for Giemsa staining and fluorescent-antibody examination for infected cells confirmed the diagnosis in 70% of the infants with conjunctivitis. However, 12 of 18 infants has serum antibodies against genital strain chlamydial antigens at 1 year of age, indicating that a majority of the infants were infected. Four of the infants had superior micropannus at 1 year of age; however, none of the infants had active conjunctivitis nor corneal or conjunctival scars.

Antibodies↗