Ocular and genital infections with chlamydia.
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Chlamydia Infections↗
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Pneumonia associated with Chlamydia trachomatis infection in an infant.
Chlamydia trachomatis was isolated from the epipharynx of a 10-week-old baby girl taken ill with pneumonia but without signs of conjunctivitis. The infant developed specific antibodies to the organism. The course of the pneumonia was protracted, with cough and tachypnea. The baby, who was afebrile, improved on antibiotic therapy but pulmonary infiltrates persisted for several months. To our knowledge, this is the first case of pneumonia in an infant associated with C. trachomatis infection reported elsewhere than North America.
Chlamydia Infections↗
Chlamydia trachomatis infection and veneral disease.
Chlamydia trachomatis was isolated by the irradiated McCoy cell technique from 44 out of 103 men with non-gonorrhoeic urethritis and from 11 out of 15 patients with post-gonococcal urethritis. In women attending the venereal diseases clinics, chlamydial infection was observed in 49 out of 130 patients (38%), an infection incidence of the same order of magnitude as the one noted for gonococcal infection (40%). In 19% both infections occurred simultaneously. Treatment with tetracycline eliminated symptoms and chlamydial infection in almost all cases. The significance of the findings is discussed.
Anti-Bacterial Agents↗
Division of single host cells after infection with chlamydiae.
Mouse fibroblasts (L cells) were infected in suspension with Chlamydia psittaci (6BC) and then plated out on a solid substrate at a density of 80 cells per cm2 so that the effect of chlamydial infection on the division of single host cells and their progeny could be determined. Uninfected L cells multiplied with a mean generation time of 15 h. The generation time of single L cells infected with 1.5 50% infectious units (ID50) of C. psittaci was over twice as long. Half of the infected L cells had divided once by day 4 after infection, and the rest had divided more than once. Division of infected cells frequently produced one infected and one uninfected daughter. About half of the L cells infected with 15 ID50 of C. psittaci divided at least once before most of them detached from their substrate before observation on day 3. Less than 10% of the L cells infected with 75 ID50 of C. psittaci divided before they were lost from their substrate by day 2. Comparable results were obtained with single L cells infected with a lymphogranuloma venereum (440L) strain of C. trachomatis and with single HeLa 229 cells infected with C. psittaci. It was concluded that high multiplicities of infection of host cells with chlamydiae quickly bring cell division to a halt, whereas lower multiplicities slow but do not immediately stop the division of host cells. However, indefinitely multiplying clones of chlamydia-infected host cells were not observed. The method used here should be applicable to other studies on the division of cells in culture.
Cell Division↗
Treatment of Chlamydia trachomatis infections.
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Anti-Bacterial Agents↗
Spectinomycin hydrochloride in the treatment of gonorrhoea: Its effect on associated Chlamydia trachomatis infections.
Sixty-three heterosexual men were successfully treated with a single injection of spectinomycin hydrochloride 2 g for urethral infections with Neisseria gonorrhoeae. Chlamydia trachomatis was recovered from the urethra of 11 of these men both before and after treatment. In six men, the organism was isolated after but not before treatment. No isolates were obtained from the remaining men either before or after treatment. All 17 of the men who yielded C. trachomatis developed post-gonococcal urethritis. Eight of 46 men from whom no isolate was obtained in their cultures developed post-gonococcal urethritis. Seventeen of 50 women successfully treated with spectinomycin for cervical infections with N. gonorrhoeae yielded isolates of C. trachomatis both before and after treatment. The organism was isolated from five women before but not after treatment, and from four women after but not before treatment. In 24 women culture for C. trachomatis was negative both before and after treatment. Spectinomycin hydrochloride in the dosage used rarely eliminated C. trachomatis from the genital tract of either men or women; in this respect it resembled two other drugs commonly used for the treatment of gonorrhoea-pencillin and ampicillin.
Chlamydia Infections↗
Endocarditis as a manifestation of Chlamydia B infection (psittacosis).
A case of Chlamydia B (psittacosis) endocarditis is described in a patient with no known previous valve disease. After mitral valve replacement a fall in Chlamydia B antibody titre occurred. At repeat mitral valve replacement five months later for a paravalve leak no evidence of continuing endocarditis was present. Direct confirmation of infection in the patient's apparently healthy budgerigar was obtained. Aspects of the pathogenesis, diagnosis, and treatment are discussed.
Adult↗
Loss of inorganic ions from host cells infected with Chlamydia psittaci.
Mouse fibroblasts (L cells) infected with the 6BC strain of Chlamydia psittaci released potassium ion (K(+)) into the extracellular milieu in a way that depended on size of inoculum and time after infection. When the multiplicity of infection was 500 to 1,000 50% infectious units (ID(50)) per L cell, loss of intracellular K(+) was first apparent 4 to 10 h after infection and was nearly complete at 6 to 20 h. Magnesium ion and inorganic phosphate (P(i)) were also released. Similar multiplicities of ultraviolet-inactivated C. psittaci also caused release of K(+). Leakage of inorganic ions probably resulted from immediate damage to the host-cell plasma membrane during ingestion of large numbers of chlamydiae. With multiplicities of 1 to 50 ID(50) per L cell, ingestion of C. psittaci was not by itself enough to cause release of K(+) and P(i) from infected L cells. There was a delay of 36 to 72 h between infection and massive leakage of intracellular ions during which time the chlamydiae multiplied extensively. Fifty ID(50) of ultraviolet-inactivated C. psittaci per L cell did not bring about significant leakage of K(+), even after 72 h. The mechanism whereby these multiplicities of infection destroy the ability of host cells to retain intracellular molecules is not known. HeLa 229 cells also released K(+) and P(i) after infection, but these losses occurred more slowly than in comparably infected L cells, possibly because C. psittaci did not multiply as extensively in HeLa cells as it did in L cells. The significance of the inability of chlamydiae-infected cells to regulate the flow of molecules through their plasma membranes is discussed.
Cell Membrane Permeability↗
Prospective study of chlamydial infection in neonates.
Chlamydia trachomatis was recovered from the cervices of 4% (36/900) of pregnant women tested. 20 infants born through chlamydia-infected cervices were followed up for a year, as were 18 infants born to chlamydia-negative mothers. A statistically significant excess of conjunctivitis and pneumonia was found in infants exposed to chlamydia. The attack-rate for inclusion conjunctivitis was 35% (7/20) and for chlamydial pneumonia it was 20% (4/20). Chlamydiae were recovered from 10 of the 20 (50%) exposed infants, and seroconversion was demonstrated in 14 (70%). None of the 18 unexposed infants showed evidence of chlamydial infection. Thus in our clinic 2.8% of all newborns acquired chlamydial infection, with incidence-rates of 14 cases of conjunctivitis and 8 cases of pneumonia per 1000 live births. Neonatal chlamydial infection is thus a major public-health problem warranting a preventive programme based on the fuller provision of diagnostic services and the treatment of infected pregnant women.
Cervix Uteri↗
Genital Chlamydia trachomatis infections in patients with cervical atypia.
Of 177 gynecologic outpatients with cervical dysplasia studied, 29 (16%) were found to excrete Chlamydia trachomatis from their urogenital tract. Sera collected from 93 of these patients were significantly more often positive for and showed higher levels of antichlamydial micro-complement fixation (CF) and immunofluorescence (IF) antibodies than sera obtained from the controls. However, when the sera were tested for anti-herpesvirus type II (HSV-II) and cytomegalovirus (CMV) antibodies, no difference between the cases and the controls were encountered.
Adolescent↗
Infection with Chlamydia trachomatis: involvement of multiple anatomic sites in neonates.
In a study of infection due to Chlamydia trachomatis in infants, chlamydiae were recovered not only from the conjunctiva and respiratory tract but also from the vagina and rectum. The timing of recovery suggested that the vagina and conjunctivae are exposed to chlamydiae at birth and that pneumonia and gastrointestinal infection occur later. Sampling of the rectum may be a useful procedure for the diagnosis of chlamydial disease in infants.
Chlamydia Infections↗
Isolation of Chlamydia from patients with urethritis.
From October 1973 through August 1974, 335 genitourinary tract specimens from patients with urethritis were inoculated into McCoy's cell cultures for the diagnosis of Chlamydia infections. Of the 45 Chlamydia isolates, 42 were recovered when glass vials rather than plastic microtiter plates were used as cell culture vessels. Herpes simplex virus was isolated 15 times. Bacterial overgrowth occurred 42 times; however, in 20 specimens the contamination was not apparent until after the first subculture. This is the first report of the frequency of Chlamydia infections in patients with urethritis in the Midwest and indicates that these organisms have a significant etiologic role in nongonococcal urethritis in this community.
Bacteriological Techniques↗
Prospective study of maternal and infantile infection with Chlamydia trachomatis.
We examined the prevalence of chlamydial infection in a population of pregnant women and observed their infants to determine the risk of development of ocular or respiratory infection. We examined endocervical and serum specimens from 322 pregnant women for Chlamydia trachomatis and chlamydial antibody. The cultures were obtained at the first prenatal visit. Six (2%) of the women were infected with C trachomatis. Chlamydial antibody was present in the genital secretions of 47% and 73% of the serum samples. The six infants born to infected women, 61 infants born to women who were culture-negative, but local antibody-positive, and 28 control infants born to culture-negative, antibody-negative women were followed for up to six months. Four of six infants born to infected women developed chlamydial infection: two developed culture-positive conjunctivitis, one had asymptomatic nasopharyngeal infection, and one infant developed pneumonitis. Three of 61 infants born to mothers who were culture-negative and local antibody-positive developed conjunctivitis due to C trachomatis. None of the 28 control infants developed chlamydial infection. Most (79%) of the infants had chamydial antibody in their serum at 2 to 4 weeks of age. The correlation between maternal and infant serum antibody titer was r=0.71 suggesting that antibody was placentally transferred.
Adolescent↗
Activity of oral amoxicillin, ampicillin, and oxytetracycline against infection with chlamydia trachomatis in mice.
The effects in mice of oral treatment with amoxicillin, ampicillin, and oxytetracycline against an otherwise lethal intranasal infection with Chlamydia trachomatis (mouse pneumonitis) were studied. When treatment was started 30 min after infection and continued once daily thereafter for a total of seven treatments, the mean protective doses of amoxicillin, ampicillin, and oxytetracycline were 9.5, greater than 50, and 31.3 mg/kg, respectively. If 14 oral treatments were given, these values were 1.6 mg/kg for amoxicillin, 12.7 mg/kg for ampicillin, and 12.3 mg/kg for oxytetracycline.
Administration, Oral↗
Infertility and cervical Chlamydia trachomatis infections.
Of the 51 women examined for infertility, 19.6 per cent were found Chl. trachomatis culture-positive. This differs, although not significantly, from the 9 per cent isolation rate among our general gynecological outpatients. The results suggest that Chl. trachomatis should be considered in women with unexplained infertility.
Adult↗
Chlamydia trachomatis infection in patients with acute salpingitis.
We examined the prevalence of Chlamydia trachomatis in the cervix and the fallopian tubes of patients with acute salpingitis. Cycloheximide-treated McCoy cells were used as the growth medium. For purposes of comparison, women with infections confined to the lower genital tract and women without signs of genital infections were also studied. C. trachomatis was isolated from the cervix in 19 of 53 patients with acute salpingitis, in one of 18 lower-genital-tract infections and in none of 12 without signs of genital infection. C. trachomatis was recovered from six of the 20 valid specimens from the fallopian tubes of the patients with acute salpingitis. Our results indicate that chlamydia is a common etiologic agent in acute salpingitis.
Acute Disease↗
Chlamydia trachomatis infection of the Fallopian tubes. Histological findings in two patients.
In two patients with acute salpingitis, C. trachomatis was isolated from the cervix. In one of the patients, the organism was also recovered from the Fallopian tubes, and in the other, chlamydial inclusions were found in Giemsa-stained tubal epithelial cells. A significant change in micro-immunofluorescence antibodies to C. trachomatis occurred in both patients during the course of the disease. The Fallopian tubes of both patients were removed and studied by conventional histological techniques and, in the case of one of them, by transmission electron microscopy.
Adult↗
Single-dose minocycline in the treatment of gonococcal urethritis. Clinical efficacy in relation to bacterial resistance and its effects on associated Chlamydia trachomatis infections.
Seventy-two men with gonococcal urethritis were given a single 300-mg dose of minocycline. The failure rate was 13% and the trial was terminated at an early stage. Failure was correlated with increased resistance of Neisseria gonorrhoeae to minocycline. The activity of penicillin, spectinomycin, erythromycin, tetracycline, sulphamethoxazole, cefuroxime, cefotaxime, rosamicin, thiamphenicol, and piperacillin against N. gonorrhoeae were examined in vitro. With the exception of spectinomycin, parallel patterns of resistance to the other antibiotics and minocycline were found. Resistance to spectinomycin was not found, confirming the usefulness of this antibiotic in the treatment of gonorrhoea. The incidence of PGU was significantly lower after a single dose of minocycline than in previous studies.
Anti-Bacterial Agents↗