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PubMed2002

[Chlamydia trachomatis and Neisseria gonorrhoeae infections in sexually abused children in Jutland].

INTRODUCTION: At the Department of Forensic Medicine, University of Aarhus, Denmark, examinations are performed of children who are suspected of having been sexually abused. The medical forensic investigation aims at documenting sexual abuse if there are any physical findings. The presence of certain sexually transmitted diseases, which cannot be explained otherwise, may be such documentation. This article focuses on Chlamydia trachomatis and Neisseria gonorrhoeae, and the risk for the sexually abused child to contract these diseases. MATERIAL AND METHODS: Retrospectively, we went through the Institute's files from 1996 to 2000 concerning child abuse. Information about age, sex, cultures for Chlamydia trachomatis and for Neisseria gonorrhoeae, and the results of these cultures was registered. If the child had been cultured, the suspected perpetrator's age and gender were registered as well. The children were all between 0 and 15 years of age, and in all cases the suspicion of sexual abuse had led to reporting to the police. RESULTS: 295 girls and 41 boys were examined in the period from 1996 to 2000. A total of 100 cultures for Chlamydia trachomatis and 105 cultures for Neisseria gonorrhoeae were performed. Among the 111 children who were examined for Chlamydia trachomatis and/or Neisseria gonorrhoeae there were no positive results. In 102 cases the suspected perpetrator was known to be one or more men, and only in one case it was a women. The mean age of the suspected perpetrators was 35.4 years. DISCUSSION: The prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis should reflect the prevalence in the group of perpetrators. Neisseria gonorrhoeae is uncommon outside Copenhagen, the capital of Denmark, whereas Chlamydia trachomatis is quite common. On this background, we had expected some of the children to be infected with Chlamydia trachomatis. Therefore, the risk for sexually abused children to be infected with Chlamydia trachomatis or Neisseria gonorrhoeae is very low, depending on the kind of abuse and the perpetrator's possible risk behaviour, age, and gender. As a conclusion, only children with a clear indication should be tested for these sexually transmitted diseases.

Adolescent↗
PubMed1977

Isolation of Chlamydia trachomatis from the male urethra.

Chlamydia trachomatis was isolated from 26% of urethral swabs taken from 509 men with urethritis. The highest yield of 68% was obtained from a selected group of men with nonspecific urethritis (NSU) who had a frank urethral discharge. This is a higher than in previous reports, and is significantly higher than the isolation of C. trachomatis from men with less severe urethritis. The higher yield was similar to C. trachomatis isolation rates reported among patients with severe trachoma in hyperendemic areas. Men with a previous history of NSU had low isolation rates. Overall, 30% of 385 men with NSU had positive chlamydial culture results, 7% of 59 men with gonococcal urethritis alone were Chlamydia-positive, 15% of 59 men with gonorrhoea followed by NSU (post-gonococcal urethritis) were Chlamydia-positive, and only 3% of 61 men without urethritis harboured Chlamydia. Swabs taken from the cervical os of 28 of 108 female contacts of men with NSU had a positive result for C. trachomatis. Significantly more pairs of sexual partners had the same chlamydial culture result than had different results. The chlamydial isolation rate was higher among men admitting a casual sexual contact than in men claiming only regular partnerships. The findings provide further evidence for the sexual transmission of C. trachomatis and for its aetiological role in NSU.

Chlamydia Infections↗
PubMed2003

[Pseudoneoplastic form of Chlamydia trachomatis epididymo-orchitis: a case report].

Pseudoneoplastic Chlamydia trachomatis epididymo-orchitis is a rare clinical entity. The differential diagnosis with malignant tumour of the testis remains difficult and surgical exploration with orchidectomy is often difficult to avoid. Urgent testing for Chlamydia trachomatis by PCR in urine, semen and a urethral swab confirms the diagnosis and allows introduction of antibiotic therapy rather than surgical exploration.

Adult↗
PubMed1997

[Chlamydia trachomatis infection in asymptomatic Chilean men and with urethritis. Usefulness of first catch urine samples].

BACKGROUND: Chlamydia trachomatis is responsible for 30 to 50% of genital tract infections and is present, without symptoms, in 20% of men and 60% of women. We have little information in Chile about the prevalence of this infection. AIM: To assess the prevalence of Chlamydia trachomatis in men, using first catch urine samples. SUBJECTS AND METHODS: Three hundred and fifty one first catch urine samples of asymptomatic men and 50 samples coming from men with a primary urethritis, were analyzed. Urethral discharge samples from the latter were simultaneously studied. Analysis was performed using an enzyme immuno analysis (MicroTrak Chlamydia EIA, Syva Co.) and a nested polymerase chain reaction towards the gene that codifies MOMP (PCR/OMP). RESULTS: Among asymptomatic men, two of 154 teenagers aged 18 to 19 years old (1.3%), 10 of 100 university students (10%) and eight of 97 adults over 30 years old (8.2%), were infected. The global prevalence of infection in these men was 5.7%. The prevalence of infection in men with urethritis was 12%. Urine EIA had a higher detection frequency than PCR/OMP, but according to another PCR assay, these results were false positives. EIA in first catch urine, had a sensitivity, specificity, positive and negative predictive value of 83.3, 75, 31.3 and 97% respectively, for the detection of Chlamydia trachomatis. The figures for PCR/OMP were 100% for all these parameters. CONCLUSIONS: The prevalence of Chlamydia trachomatis infection in Chilean men is similar to that reported in developed countries. Enzyme immuno assay in first catch urine had a good diagnostic accuracy and could be used in epidemiological studies in asymptomatic men.

Adolescent↗
PubMed1988

[Minimum inhibitory concentration and minimum bactericidal concentration of tetracycline and erythromycin in 35 recent Munich isolates of Chlamydia trachomatis].

Thirty-five recent clinical isolates of Chlamydia trachomatis were subcultured and subjected to antimicrobial susceptibility testing with tetracycline and erythromycin. Detection of typical chlamydial inclusion bodies and elementary bodies was based on the use of fluorescence-labelled monoclonal antibodies. Minimum inhibitory concentration being defined as the lowest concentration suppressing all inclusion body formation and minimum bactericidal concentration as the lowest concentration preventing all detectable chlamydial growth, both these parameters were studied. With tetracycline the minimum inhibitory concentrations ranged from 0.03 to 0.08 microgram/ml, with erythromycin from 0.04 to 0.2 microgram/ml. The corresponding data for the minimum bactericidal concentrations were less than 0.2 to 1.0 and 0.2 to 2.0 respectively. Thus, at present, there still seems to be no major resistance problem with genital Chlamydia trachomatis isolates in the Federal Republic of Germany.

Chlamydia trachomatis↗
PubMed1996

[Prevalence of Chlamydia trachomatis among men consulting in urology. Comparative study between cell culture and sperm PCR].

OBJECTIVE: Genital Chlamydia trachomatis infection can be difficult to diagnose, depending on the precise site of infection. Given the lack of major clinical signs and symptoms in many cases and the risk of male and female infertility. Chlamydia trachomatis is a public health problem. It can be difficult to detect this pathogen in sperm by means of cell culture, because of seminal fluid toxicity for cell lines. New techniques such as the polymerase chain reaction (PCR) can be used to detect genomic DNA. STUDY DESIGN: We studies 81 patients by applying the Amplicor CT PCR test to sperm, in comparison with cell culture on sperm and urethral samples. RESULTS: The prevalence of Chlamydia trachomatis infection was not significantly different (3.7% vs 5%) in the urethral cell culture and PCR methods, respectively (p > 0.05). In contrast, PCR was significantly more sensitive than sperm cell culture (5% vs 1.2%; p < 0.03). Moreover, we have not detected of genital chlamydiose among the infertile men. CONCLUSION: These findings suggest that PCR detection of Chlamydia trachomatis can dispense with the need for urethral sampling and cell culture in selected male patients.

Adult↗
PubMed1980

[A microbiological study of swabs taken laparoscopically in cases of salpingitis and tubal sterility. Research for Chlamydia trachomatis and for mycoplasmas (author's transl)].

Research was made for chlamydia trachomatis and ureaplasma urealyticum in the peritoneum and the tubes of 99 women divided into 4 groups: 17 of them were being investigated because of acute salpingitis (Group A), 17 were being investigated for tubal sterility with chronic inflammation diagnosed laparoscopically (Group B), 29 were being investigated for tubal sterility without any laparoscopic evidence of inflammation (Group C) and 36 women had absolutely normal pelves and were being investigated for sterility. These were the control group (D). Swabs were also taken from the lower genital tracts as well as serological tests for chlamydia trachomatis and cytological samplings of the fluid from the Pouch of Douglas and the histology of the tubes. In the 17 women who had acute salpingitis the swabs 4 cases of C.T. and 4 of U.U. In the 46 women who had tubal sterility the laparoscopic swabs showed cases of C.T. and 7 of U.U. The swabs were most often positive in Group B. This group is characterised by a special appearence of the inflammation, with fluid present and viscous adhesions as well as peritoneal inflammatory cysts. These altogether help to make a presumptive diagnosis of C.T. infection on laparoscopy. In the control group of 36 cases there was no sign of C.T. in any case, although 2 swabs from the peritoneum showed U.U. So there is a statistically significant difference between the groups that were suspicious and the control group whether the results were obtained by cultures or by serological diagnosis. On the other hand there is no definitive difference as far as U.U. is concerned. These observations, which are similar to those published by other authors, lead us to think that micro-organisms and especially chlamydia trachomatis could be the bacteriological agent responsible for chronic inflammatory states found so frequently in women with tubal sterility.

Chlamydia trachomatis↗
PubMed1993

[Neonatal conjunctivitis caused by Chlamydia trachomatis].

32 newborns with neonatal Chlamydia trachomatis conjunctivitis were reported. Diagnosis was carried out through immunofluorescent monoclonal antibody of conjunctiva scraping staining; 37 conjunctiva samples were taken from same number of newborn patients not responds to topical antibiotic treatment. The sample came out from two different third level institutions with maternal facilities and attending more than five thousand deliveries per year each one of them. Were studied incidence and clinical picture from neonatal C. trachomatis conjunctivitis. Positive immunofluorescent and conjunctive culture of secretion to C. trachomatis in the sample were 86 per cent (32 out of 37). 19 of the newborns acquired Staphylococcus associated to C. trachomatis (59%): nine with S. aureus in six Staphylococcus negative coagulase was isolated and four with the latest two. Out of 32 patients who demonstrated positive cultures to C. trachomatis (86%), 22(69%) were males and ten (31%) were females. Significant proportion of newborns were identified as small for gestational age. 18 of them were born by natural way and 14 by cesarean section. In 16/32 (50%) had interstitial pneumonia by Chlamydia. The main clinical findings were stated as: conjunctiva exudate in different stages including purulent secretion and oedema or inflammation of the ophthalmic conjunctiva. Those newborns where topical therapy did not irradiate the organism and demonstrated clinical picture persistence or relapse and diagnosis of C. trachomatis infection, systemic treatment with erythromycin and topic tetracycline were installed, disappearing all symptoms. Maternal history related to neonatal disease were mainly: endocervical infection, miscarriages and or preterm delivery.

Chlamydia Infections↗
PubMed1993

Characterization of a neutralizing monoclonal antibody directed at variable domain I of the major outer membrane protein of Chlamydia trachomatis C-complex serovars.

A monoclonal antibody (MAb), C10, that neutralized in vitro the infectivity of serovars C, I, J, and L3 (members of the C and C-related complexes) of Chlamydia trachomatis was identified. Of the 15 major serovars and the mouse pneumonitis strain of C. trachomatis, Chlamydia psittaci, and Chlamydia pneumoniae, which were used as nontreated and heat-treated (56 degrees C, 30 min) antigens in a dot blot assay, only serovars C, I, J, and L3 were recognized with both the native and treated antigens. Western blot (immunoblot) results showed that MAb C10 recognized the major outer membrane protein of these four serovars. Overlapping hexameric peptides corresponding to variable domains (VDs) I, II, III, and IV of the major outer membrane protein of C. trachomatis serovar C were synthesized, and peptide screening showed that MAb C10 mapped to the VD I amino acid sequence VAGLQNDPT. Results of an in vitro neutralization assay correlated with those of the indirect immunofluorescence assay, Western blot, and dot blot assay in that only serovars C, I, J, and L3 were neutralized by MAb C10. In vitro competitive neutralization experiments, using a peptide representing VD I of serovar C to compete with C. trachomatis serovar C for MAb C10 binding, revealed that both serological and neutralizing activities of MAb C10 were inhibited by the VD I peptide. In an in vivo toxicity/infectivity assay using serovar L3 pretreated with MAb C10, there was 100% survival of mice infected with a lethal dose at 48 h. In contrast, the control group, consisting of mice injected with the same dose of L3 pretreated with a MAb that does not recognize L3, had no survivors during a 48-h observation period. In summary, since the surface-exposed contiguous epitope recognized by MAb C10 binds neutralizing antibodies that are subspecies specific for the C and C-related complexes, it should be considered for inclusion in the development of a chlamydial vaccine.

Amino Acid Sequence↗
PubMed2001

HLA-B27 expression does not modulate intracellular Chlamydia trachomatis infection of cell lines.

Chlamydia trachomatis is an obligate intracellular pathogen. Infection of susceptible individuals with this bacterium can trigger the development of reactive arthritis, an acute inflammation that is associated with the expression of the class I major histocompatibility antigen, HLA-B27. Other facultative intracellular pathogens, such as Yersinia and Salmonella spp., are also known triggers of reactive arthritis. Previous studies report conflicting results concerning whether the presence of HLA-B27 modulates the infection of cells with these enteric pathogens. In the present study, we have examined whether the expression of HLA-B27 can influence the infection of cell lines with C. trachomatis and also whether the replication of these bacteria is altered in HLA-B27-expressing cell lines. To do this, we have used a sensitive flow cytometric approach. We fixed and permeabilized cells and used fluorescein isothiocyanate-conjugated monoclonal antibody specific for chlamydia lipopolysaccharide to detect intracellular bacteria. The staining pattern obtained closely resembled the intracellular life cycle of chlamydia, with the appearance of brightly staining cells correlating to the microscopic detection of mature inclusion bodies. Moreover, since the percentage of cells that stained with the antibody was proportional to the infectious inoculum used, we were able to use the technique to quantitate the number of infectious organisms recoverable from infected cell lines. An important component of our study was the use of heparin to prevent reinfection of cells and thus enable the infection to be followed from a discrete time point. Our results suggest that HLA-B27 influences neither the infection nor replication of C. trachomatis serovar L2 within cell lines. Consequently, the role of HLA-B27 in the pathogenesis of reactive arthritis may lie downstream of the invasion and replication stages of the triggering pathogenic infection.

Cell Line↗
PubMed1986

Comparison of two enzyme immunoassays and an immunofluorescence test for detection of Chlamydia trachomatis.

Three rapid methods for the detection of Chlamydia trachomatis were compared: one immunofluorescence test and two enzyme immunoassays. Cervical and urethral specimens were obtained from 75 women in an outpatient clinic for therapeutic abortions and from 50 women in a sexually transmitted disease clinic. Urethral specimens were also obtained from 154 men in the same clinic. One hundred and nineteen cervical and 272 urethral specimens of a total 391 specimens were tested by the three methods. The direct immunofluorescence test detected Chlamydia trachomatis in 8% and the two enzyme immunoassays in 10% and 12% of the patients. The sensitivity of the immunofluorescence test was 76% compared to 91% and 80% for the two enzyme immunoassay tests. All three tests had a specificity of 99%. Dilution experiments confirmed that one immunoassay test, Chlamydiazyme, detected most of the positive specimens. The rapid and easily automated enzyme immunoassays are a valuable complement to the culture technique.

Cervix Uteri↗
PubMed1993

Routine testing for Chlamydia trachomatis on Curaçao, Netherlands Antilles.

OBJECTIVE: Although genital Chlamydia trachomatis infection is most often asymptomatic, early treatment may prevent serious complications. For screening or routine testing to be cost effective, the prevalence of the infection must not be too low. STUDY DESIGN: On Curaçao, Netherlands Antilles, the prevalence of chlamydial infection in 205 asymptomatic women of reproductive age, who were seen by a general practitioner or gynecologist for a gynecologic examination was measured. RESULTS: The overall prevalence was found to be 5.4% (95% confidence interval 2.7% to 9.4%) with the enzyme-linked immunosorbent assay method. Of all possible predictors of a chlamydial infection, only young age (< 25 years, prevalence 10.3%) seemed to be indicative of such an infection. CONCLUSION: Routine testing for Chlamydia trachomatis in sexually active women on Curaçao and on other Caribbean islands is indicated for women < 25 years old.

Adolescent↗
PubMed1990

Is serology of any use when searching for correlations between Chlamydia trachomatis infection and male infertility?

Evidence on Chlamydia trachomatis causing male infertility is conflicting. We therefore collected data on epidemiological and clinical correlates of chlamydial infection and male fertility in 184 males visiting our Fertility Unit. Antibodies against Chlamydia trachomatis in serum and semen were also determined. Significant correlations were demonstrated between current chlamydial urethral infection and semen immunoglobulin (Ig) A, serum IgA and serum IgG. These parameters, however, were neither related to a history of sexually transmitted disease nor to lifetime number of sexual partners. Why, in the male, serology does not correlate with chlamydial infection in a more remote past is explained. Our data support, on epidemiological as well as serological grounds, the conclusion that chlamydial infection probably does not contribute significantly to male infertility.

Chlamydia Infections↗
PubMed1996

[Isolation of Chlamydia trachomatis in trachomatous Moroccan patients].

PURPOSE: Isolation of Chlamydia trachomatis from ocular specimens of subjects living in trachomatous area in south Morocco. METHODS: One hundred and twenty ocular specimen of 60 subjects living in two provinces of a trachoma-endemic area (Errachidia and Ouarzazate) were tested by cells culture. The age range was 2 months to 85 years and the sex ratio was 1.06. RESULTS: The prevalence of positive cases was about 25% with a female predominance of 34% versus 16% for males. In our sample, 70% showed an active clinical trachoma. The most affected age ranges were children between 0 and 10 years old, with a very high frequency of isolation in children younger than 5 years. The intense inflammatory stage alone or associated with follicular stage was the most adequate for isolating Chlamydia trachomatis. CONCLUSION: Reducing or even eradicating trachoma can be realised only through a continuous treatment strategy associated with a sanitary education aiming at the development of hygienic conditions especially among children living in trachomatous communities.

Adolescent↗
PubMedDate not supplied

[Chlamydia trachomatis and acute pelvic inflammatory disease].

The incidence of Chlamydia trachomatis infection in women with acute pelvic inflammatory disease has been studied. Chlamydia trachomatis was isolated in 20 (35.71%) of 56 examined women. In all women with positive isolation, the infection was also confirmed serologically.

Acute Disease↗
PubMed1986

Relationship between Chlamydia trachomatis infection and elevated serum immunoglobulin M levels in premature infants.

Serum immunoglobulin M (IgM) antibodies to Chlamydia trachomatis and to human cytomegalovirus (CMV) were detected by enzyme-linked fluorescence assay and enzyme-linked immunosorbent assay, respectively in 19 premature infants with chronic lung diseases, in 43 extremely low birth weight premature infants and in 123 neonates with elevated serum IgM levels. Ten of the 19 premature infants with chronic lung diseases had elevated serum IgM levels, and five had IgM antibodies to Chlamydia trachomatis. Three of the 43 extremely low birth weight premature infants had elevated serum IgM levels, and two had IgM antibodies to Chlamydia trachomatis. Three of the 123 neonates with elevated serum IgM levels (excluding those with chronic lung diseases and extremely low birth weight) had IgM antibodies to CMV. These results suggest that chronic lung diseases in low birth weight infants might be caused by intrauterine Chlamydia trachomatis infection.

Antibodies, Bacterial↗
PubMed2005

A prediction rule for selective screening of Chlamydia trachomatis infection.

BACKGROUND: Screening for Chlamydia trachomatis infections is aimed at the reduction of these infections and subsequent complications. Selective screening may increase the cost effectiveness of a screening programme. Few population based systematic screening programmes have been carried out and attempts to validate selective screening criteria have shown poor performance. This study describes the development of a prediction rule for estimating the risk of chlamydial infection as a basis for selective screening. METHODS: A population based chlamydia screening study was performed in the Netherlands by inviting 21,000 15-29 year old women and men in urban and rural areas for home based urine testing. Multivariable logistic regression was used to identify risk factors for chlamydial infection among 6303 sexually active participants, and the discriminative ability was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with bootstrap resampling techniques. RESULTS: The prevalence of C trachomatis (CT) infection was 2.6% (95% CI 2.2 to 3.2) in women and 2.0% (95% CI 1.4 to 2.7) in men. Chlamydial infection was associated with high level of urbanisation, young age, Surinam/Antillian ethnicity, low/intermediate education, multiple lifetime partners, a new contact in the previous two months, no condom use at last sexual contact, and complaints of (post)coital bleeding in women and frequent urination in men. A prediction model with these risk factors showed adequate discriminative ability at internal validation (AUC 0.78). CONCLUSION: The prediction rule has the potential to guide individuals in their choice of participation when offered chlamydia screening and is a promising tool for selective CT screening at population level.

Adolescent↗
PubMed1983

Cervical cytology and Chlamydia trachomatis infection.

We found, as have others, a strong correlation between indirect immunofluorescence techniques and cell culture for the diagnosis of Chlamydia trachomatis infection in material obtained from the cervix. Five epithelial cell types indicative of Chlamydia trachomatis infection (indicator cells) were found in smears in patients with positive immunofluorescence. An attempt to diagnose Chlamydia trachomatis infection in 50 routine smears based on the presence of these indicator cells showed false positives and false negatives so that the diagnosis of Chlamydia trachomatis still requires confirmation by immunofluorescence or culture techniques. The indicator cells frequently had the same morphometric features as cells seen with cervical intraepithelial neoplasia, which may explain why some smears revert to normal after patients are given antibiotics.

Chlamydia Infections↗