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PubMed1998

[Chlamydia pneumoniae in patients with acquired pneumonia in the Santiago of Chile community].

BACKGROUND: The prevalence of Chlamydia pneumoniae infection varies according to the population and geographic area studied. AIM: To evaluate the incidence of Chlamydia pneumoniae infection in Chilean subjects with community acquired pneumonia. PATIENTS AND METHODS: Between 1995 and 1997, patients with community acquired pneumonia attending two emergency rooms in Santiago, were studied. The diagnosis of Chlamydia pneumoniae infection was based on the detection of Chlamydia pneumoniae specific IgG antibody in samples from both the acute and convalescent phase, using an indirect microimmunofluorescent technique. Evidence of present infection was defined as seroconversion, a significant increase in the titer of the second sample and an initial titer equal or greater than 1/512. RESULTS: During the study period, 160 patients consulted and seven (six male), aged 54 +/- 27 years old, complied with the diagnostic criteria of present Chlamydia pneumoniae infection. These patients had no special clinical or radiological features. Five of seven patients improved without any specific treatment. CONCLUSIONS: Eight percent of this sample of patients with community acquired pneumonia had Chlamydia pneumoniae infection. This agent should be included in the design of empiric treatment schemes, although our results cast doubt on the pathogenic role of Chlamydia pneumoniae in pneumonia.

Chile↗
PubMed2000

[Chronic Chlamydia pneumonia infection in patients with chronic obstructive pulmonary disease].

The aim of our study was to evaluate the frequency of Chlamydia pneumoniae infection (especially chronic infection) in COPD patients. Microimmunofluorescence method has been applied Chlamydia pneumoniae Micro-IF test (Labsystems) has been used. The levels of specific IgG, IgA and IgM have been estimated in patients' serum. According to serologic criteria, 64.1% of COPD patients and 20.5% of healthy controls appeared to be chronically infected with Chlamydia pneumoniae (p < 0.001). Taking in account COPD severity, persistent Chlamydia pneumoniae infection has been present in 68.2%, 57.1%, and 50% of patients with severe, moderate and mild COPD, respectively. Our study has revealed that chronic Chlamydia pneumoniae infection occurs more frequently in COPD patients than in healthy controls and in patients with severe COPD than in ones with mild and moderate disease. It is possible that persistent Chlamydia pneumoniae infection can initiate or amplify inflammatory reactions in the respiratory tract. The results suggest a need to diagnose chronic Chlamydia pneumoniae infection in COPD patients and, if confirmed, to take an attempt of antimicrobial therapy.

Case-Control Studies↗
PubMed2001

[Prevalence of Chlamydia among young men. A screening among men liable for military service and coming before the military board].

INTRODUCTION: Chlamydia is the most common sexually transmitted bacterial infection in Denmark. Each year 13-14,000 cases are diagnosed; of these about 3000 occur in men. In order to describe the prevalence of chlamydia among young men, screening for chlamydia was conducted in those liable for military service and coming before the medical board. MATERIALS AND METHODS: Of 2500 men coming before the medical boards in North Jutland State County, Arhus State County, and Copenhagen County during the winter of 1996-97, 1345 men aged 17-32 (median 18 years) were entered in the study. The participants sent a urine sample and a filled-in questionnaire to Statens Serum Institut. The urine samples were analysed by an in-house PCR and the test results were sent to the participant; if permission had been granted, the positive test results were further sent to the general practitioner, along with a second questionnaire. RESULTS: Chlamydia was found in 4.8% (65/1345) of all participants and in 6.9% of those sexually active. In North Jutland State County 7.1 and 9.8%, respectively, had chlamydia, whereas the corresponding figures for Arhus State County and Copenhagen County were about 4% and 6%. Two-thirds of the patients had no symptoms of urethritis. DISCUSSION: The results of this study indicate that a considerable reservoir of unrecognised chlamydia must exist in young men. The prevalence of chlamydia was higher in North Jutland State County than in the other two districts. One explanation could be that there is more focus on sexually transmitted infections and contact tracing in the largest cities than in the rest of the country.

Adolescent↗
PubMed2001

[Chlamydia pneumoniae infection in patients with chronic obstructive pulmonary disease].

OBJECTIVE: To investigate the association of chlamydia pneumoniae infection with chronic obstructive pulmonary disease (COPD). METHODS: 61 patients with acute exacerbations of COPD, 35 patients with stable COPD and 26 healthy subjects were selected. Chlamydia pneumoniae-specific serum IgG, IgA, IgM antibodies were measured by microimmunofluorescence method. Chlamydia pneumoniae DNA in sputum were detected by nested polymerase chain reaction. RESULTS: The prevalence of acute chlamydia pneumoniae infection in COPD patients with acute exacerbation was significantly higher (31.1%) than that in patients with stable COPD (P < 0.05) and in healthy subjects (P < 0.01). The prevalences of chronic chlamydia pneumoniae infection in COPD patients with acute exacerbations (21.3%) and stable COPD patients (31.4%) were higher than that in healthy subjects (P < 0.05) The level of geometric mean titer of the serum IgA antibodies was the highest in COPD patients with acute exacerbations (20.5), intermediately elevated in stable COPD patients (10.8) and lowest in healthy subjects (3.6). CONCLUSION: Acute chlamydia pneumoniae infection is a rather frequent event in acute exacerbation of COPD, and chronic chlamydia pneumoniae infection may be involved in pathogenesis of COPD.

Acute Disease↗
PubMed2002

[Increasing number of Chlamydia infections--how can we reverse this trend?].

The incidence of chlamydia in Göteborg, the second largest city in Sweden, increased by 81 percent between 1995 and 2001. The majority (82%) of men and women diagnosed with chlamydia were aged 15-29 years. The incidence of chlamydia was higher among teenagers from areas of lower socio-economic index during the first years of the study but after 1995 there was no difference between low and high socio-economic groups. Chlamydia tests were taken three times more often in women than men. Analysis of original data from the Swedish survey of sexual behaviour 1996 demonstrated a strong correlation between the number of sexual partners and STD. Strategies for preventing the spread of chlamydia should be to a greater extent directed towards men and include better accessibility for men to STD clinics as well as a general improvement in contact tracing. The general public should be informed about the fact that chlamydia infections do not always give symptoms and may lead to infertility. Campaigns about condom use in order to avoid chlamydia, HIV-infection and other STD are needed.

Adolescent↗
PubMed2003

[Chlamydia-like and coronavirus-like agents found in dead cases of atypical pneumonia by electron microscopy].

OBJECTIVE: To explore the causative agents of the atypical pneumonia (also SARS) occurred recently in some regions of our country. METHOD: Organ samples of 7 dead cases of SARS were collected from Guangdong, Shanxi, Sichuan Provinces and Beijing for electron microscopic examination. 293 cell line was inoculated with the materials derived from the lungs to isolate causative agent(s). The agents in the organs and cell cultures were revealed by immunoassay. RESULTS: Both Chlamydia-like and coronavirus-like particles were found in EM. Inclusion bodies containing elementary bodies, reticulate antibodies and intermediate bodies of Chlamydia-like agent were visualized in multiple organs from the 7 dead cases, including lungs (7 cases), spleens (2 cases), livers (2 cases), kidneys (3 cases) and lymph nodes (1 cases), by ultrathin section electron microscopy (EM). In some few sections, coronavirus-like particles were concurrently seen. A coronavirus RNA- polymerase segment (440 bp) was amplified from the lung tissues of two cases of the SARS. After inoculated with materials from the lung samples, the similar Chlamydia-like particles were also found in the inoculated 293 cells. Since the Chlamydia-like agents visualized in both organs and cell cultures could not react with the genus specific antibodies against Chlamydia and monoclonal antibodies against C. pneumoniae and C. psittaci, the results might well be suggestive of a novel Chlamydia-like agent. CONCLUSION: Since the novel Chlamydia-like agent was found co-existing with a coronavirus-like agent in the dead cases of SARS, it looks most likely that both the agents play some roles in the disease. At the present time, however, one can hardly determining how did these agents interact each other synergetically, or one follows another, need further study.

Chlamydia↗
PubMed1989

Asymptomatic Chlamydia infection in pregnant women.

Chlamydia trachomatis infection is currently among the most prevalent sexually transmitted diseases in the United States. A review of three textbooks of obstetrics reveals that none of them recommend routine chlamydia screening in prenatal patients, although two recommend routine screening for gonorrhea. A study was done at the Barberton Citizens Hospital Family Practice Residency Program to determine the incidence of asymptomatic chlamydia infection in pregnant women and to compare this to the incidence of asymptomatic Neisseria gonorrhoeae infection in the same population. A total of 69 patients were screened for Neisseria gonorrhoeae and Chlamydia trachomatis as part of their routine prenatal evaluations at the first prenatal visit and the visit of 36 weeks gestation. Neisseria gonorrhoeae was detected by growth on standard Martin-Lewis culture plates. Chlamydia trachomatis was detected by positive immunofluorescence using a standardized specimen kit (Syva Company, Palo Alto, California). The data were collected over a 12-month period from July of 1987 through July of 1988. There were no positive cultures for Neisseria gonorrhoeae (0%) in this group of patients. On the other hand, five patients tested positive for Chlamydia trachomatis (7.2%). The results of this study indicate that routine screening for Chlamydia trachomatis should be considered as part of the routine prenatal care. A larger, multi-centered study could be done in the future to confirm these results, as well as to determine if any regional differences exist.

Chlamydia Infections↗
PubMed1980

[Morphogenesis of Chlamydia].

A morphological investigation was carried out on more than 12 chlamydia strains of avian and mammalian origin, multiplied in chick embryos. A number of investigations were carried out under an electronic microscope, including 674 samples of concentrated and purified chlamydia as well as yolk sacs in ultrathin sections and in negatively contrasted preparations. In the cytoplasm of the cells we proved the presence of a chlamydial matrix, an autonomous synthesis of chlamydial bodies, the morphology and polymorphism of the chlamydiae, as well as the degenerative changes in the endodermal and endothelial cells in the yolk sacs of the chick embryos. Conclusions were drawn out that in the development of chlamydia in the chick embryos no intertransformation of chlamydial bodies and no binary divisions are observed, i.e. there are no proofs of the so-called cycle of development. The development of chlamydia in chick embryos takes place in the form of specific chlamydia morphogenesis which is characterized by an autonomous synthesis and morphogenesis of chlamydia bodies on the basis of a multivacuolated matrix.

Animals↗
PubMed1995

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↗
PubMed1998

Chlamydia trachomatis: an underestimated cause for rhinitis in neonates.

The incidence of Chlamydia trachomatis genital tract infection among randomly selected attendants of the ante-natal clinic of the Suez Canal University Hospital, Ismailia, Egypt, during 1996 was detected. It was found to be 9% by examining endocervical swabs using the direct immunofluorescent test and 13% after serological detection by the indirect immunofluorescent test. The incidence of neonatal Chlamydia infection in the same population assessed by nasal and conjunctival swabs tested for Chlamydia using the direct immunofluorescent test was found to be 9%. In spite of the low incidence of neonatal Chlamydia infection detected in this study, neonates 'at risk' i.e. born to infected mothers, showed a high rate of Chlamydia transmission (57%) with 21.4% of the infected neonates presenting with this specific rhinitis. This study documents Chlamydia trachomatis as an underestimated cause of rhinitis in neonates characterized by being resistant to empirical remedies.

Chlamydia Infections↗
PubMed1992

Chlamydia trachomatis infection in women: a need for universal screening in high prevalence populations?

Chlamydia trachomatis is the most prevalent sexually transmitted bacterial pathogen. Nevertheless, selective, rather than universal, screening for chlamydia has been recommended, largely because testing is expensive and requires considerable technical expertise. A total of 1,348 women in four family planning clinics in San Francisco, California, were screened from March 1987 to January 1988 to identify criteria for selective screening. Of these, 9.2% had a positive chlamydia test using direct fluorescence. Logistic regression analysis identified five factors associated with infection: age less than 25 years, cervical friability, single marital status, a new sexual partner within the past 3 months, and lack of barrier contraceptive use. No single risk factor or combination of risk factors had both a high sensitivity and a high positive predictive value for infection. While screening all women who were unmarried would detect 93% of those with chlamydia, the positive predictive value of 10.7% was not much higher than the overall prevalence. Conversely, screening all women with cervical friability, which had a positive predictive value of 23.2%, would only detect 11% of those with chlamydia. On the basis of the authors' findings, selective screening should not be used in high prevalence populations in which all women are at risk and should be screened for chlamydia.

Adolescent↗
PubMed1976

Chlamydiae as agents of sexually transmitted diseases.

Chlamydiae are being increasingly recognized as an important cause of human disease. The known geographical distribution of lymphogranuloma venereum and the role of chlamydiae as agents of sexually transmitted diseases are reviewed. The presence of chlamydiae in the urethra and the cervix, and their etiological relationship to genital infections, first recognized in connexion with ocular infections, have been proved in a number of studies in selected populations in a few countries. Chlamydiae appear to be the most important agent of nongonococcal urethritis, which in some cases appears now to be more frequent than gonococcal urethritis. In addition to their association with cervicitis, chlamydiae appear also to be fairly frequent in the cervix of apparently normal, asymptomatic, and sexually active women. The role of chlamydiae as agents of other human diseases still requires to be clarified. The organisms have been found in association with pelvic inflammatory disease, neonatal pneumonia, pharyngitis, and otitis. There is need for additional studies in view of the fact that effective chemotherapy is available. An outline is given of laboratory methods that may be useful for the diagnosis of chlamydial infections.

Arthritis, Reactive↗
PubMed1985

Chlamydia trachomatis infection at a family planning clinic.

Endocervical samples were taken for the detection of Chlamydia trachomatis from 500 consecutive patients attending a family planning clinic. The Microtrak direct specimen immunofluorescence test was used. Swabs from 79 patients (15.8%) were positive for chlamydia. Seventy-one (95%) of these patients were symptom free, and 39.8% were under 20 years old. Twenty-one patients were pregnant, seven (33%) had chlamydia. Those positive for chlamydia had twice the frequency of abnormal smears and other sexually transmitted infections as those who were negative. Contraceptive use was similar except that intrauterine devices were used less frequently by patients with chlamydia infection. This report indicates the frequent occurrence of Chlamydia trachomatis infection in New Zealand and that newly developed methods of diagnosis enable us to identify and treat those with this infection. Characteristically these patients are under 20, have multiple partners and a high incidence of abnormal smears and other sexually transmitted infections.

Adolescent↗
PubMed2001

Chlamydia pneumoniae infection in acute exacerbations of chronic obstructive pulmonary disease: analysis of 250 hospitalizations.

Two hundred fifty hospitalizations were included in a serologically based prospective study to assess the role of Chlamydia pneumoniae in episodes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the percentage of COPD patients chronically infected with this pathogen. Chlamydia pneumoniae-specific IgG, IgA and IgM antibody titers were determined using a commercial kit with the microimmunofluorescence method. A significantly higher geometric mean titer in the COPD patients compared to the control group was found for IgG (P<0.00001) and IgA (P<0.000001). The serological criterion for chronic Chlamydia pneumoniae infection (IgG > or = 28 concomitant with IgA > or = 64) was positive in 73 (33.3%) COPD patients compared with 7 (7%) controls (P=0.000001). No difference was found in any serological parameter when the study population was divided by severity of COPD. When the serological profiles were compared between the first and second of 31 pairs of hospitalizations, 7 of the 62 (11.3%) hospitalizations showed evidence of acute infection with Chlamydia pneumoniae around one of the episodes of AECOPD. It is concluded that compared with the control group, the COPD patients had a significantly higher prevalence of chronic Chlamydia pneumoniae infection. In the COPD group, there was no correlation between the severity of the disease and the rate of chronic Chlamydia pneumoniae infection. In a substantial percentage of AECOPD cases, there is serological evidence of acute Chlamydia pneumoniae infection around the time of the exacerbation. The clinical and pathophysiologic implications of these findings should be clarified by further studies.

Adult↗
PubMed2006

[Erythema multiforme majus and Chlamydia pneumoniae infection].

BACKGROUND: Erythema multiforme majus of infectious origin is an acute eruptive syndrome seen more commonly in young subjects and characterised by an appearance of round target lesions. In most cases, it is associated with infection involving Herpes simplex virus or Mycoplasma pneumoniae. We report an original case of erythema multiforme majus subsequent to infection with Chlamydia pneumoniae. CASE REPORT: An 18 year-old man was hospitalised for management of generalised skin rash comprising lesions in rings, associated with bullous and post-bullous lesions, chiefly in the oral (preventing eating) and genital areas in a setting of febrile cough. Various bacterial agents (Mycoplasma pneumoniae, Chlamydia pneumoniae) and viral agents were suspected, but serological testing for Chlamydia pneumoniae alone was positive with IgM of 128 IU and IgG of 64 IU. The outcome was favourable within several days following administration of symptomatic treatment (rehydration, mouthwashes, etc.) and aetiological treatment (acyclovir: 30 mg/kg/d, ofloxacine: 400 mg/d). At D15, serologic tests for Mycoplasma pneumoniae continued to be negative. Anti-Chlamydia pneumoniae IgM and IgG were 256 IU. At D30, IgM was 128 IU while IgG remained at 256 IU. DISCUSSION: The existence of a systematic skin rash comprising typical target lesions and mucosal lesions in the oral and genital areas suggested to us a diagnosis of erythema multiforme majus. Screening for the agents generally responsible was negative and drug-induced rash was ruled out. Serological tests for Chlamydia pneumoniae were positive at various times, resulting in diagnosis of erythema multiforme majus secondary to infection with Chlamydia pneumoniae. Following demonstration of the presence of Chlamydia pneumoniae using reliable methods and the elimination of other causes of erythema multiforme majus, dermatologists should opt for this aetiology in order to optimise treatment.

Acyclovir↗
PubMed1998

Does Chlamydia pneumoniae cause coronary heart disease?

Evidence continues to accumulate to support a role for Chlamydia pneumoniae in the pathogenesis of atherosclerosis, and in particular, coronary heart disease. In an analysis of 18 seroepidemiological studies, individuals with high-titer antibodies to Chlamydia pneumoniae have at least a twofold or larger odds ratio for coronary heart disease compared with seronegative individuals. In addition, viable Chlamydia pneumoniae has been cultured directly from atherosclerotic tissue, and has been demonstrated by polymerase chain reaction, immunocytochemistry, and electron microscopy in nearly 50% of atheromatous lesions, but in only 5% of control samples. Chlamydia pneumoniae has been shown to infect and reproduce in vitro in human smooth muscle cells, coronary artery endothelial cells, and macrophages, and has been shown to induce procoagulant activity and platelet adhesion factors known to contribute to the pathogenesis of atherosclerosis. Furthermore, Chlamydia pneumoniae has been identified in atherosclerotic tissue in two experimental animal models. Finally, two pilot antibiotic trials of post-myocardial infarction patients receiving antibiotics effective against Chlamydia pneumoniae have demonstrated a fivefold reduction in cardiovascular events compared with those patients receiving placebo. Although a causal effect has not been proved, the relationship between Chlamydia pneumoniae and atherosclerosis continues to grow and to stimulate more definitive studies.

Journal Article↗
PubMed2005

Recovery of an environmental Chlamydia strain from activated sludge by co-cultivation with Acanthamoeba sp.

Chlamydiae are a unique group of obligate intracellular bacteria comprising important pathogens of vertebrates as well as symbionts of free-living amoebae. Although there is ample molecular evidence for a huge diversity and wide distribution of chlamydiae in nature, environmental chlamydiae are currently represented by only few isolates. This paper reports the recovery of a novel environmental chlamydia strain from activated sludge by co-cultivation with Acanthamoeba sp. The recovered environmental chlamydia strain UV-7 showed the characteristic morphology of chlamydial developmental stages as revealed by electron microscopy and was identified as a new member of the family Parachlamydiaceae (98.7 % 16S rRNA sequence similarity to Parachlamydia acanthamoebae). Infection studies suggested that Parachlamydia sp. UV-7 is not confined to amoeba hosts but is also able to invade mammalian cells. These findings outline a new straightforward approach to retrieving environmental chlamydiae from nature without prior, tedious isolation and cultivation of their natural host cells, and lend further support to suggested implications of environmental chlamydiae for public health.

Acanthamoeba↗
PubMed1971

Effect of Interferon and Interferon Inducers on Infections with a Nonviral Intracellular Microorganism, Chlamydia trachomatis.

The effect of mouse interferon (IF) on the multiplication of Chlamydia trachomatis (strain MRC-1/G) in homologous (L-929) cell cultures and the effect of the IF inducers Newcastle disease virus (NDV) and polyriboinosinic acid-polyribocytidylic acid complex (poly I:C) on the experimental infection of mice with aerosolized C. trachomatis (strain MoPn) were investigated. Treatment of infected cell cultures with IF reduced the number of cells containing chlamydial inclusions and depressed the yield of chlamydiae as determined by titrations for infectivity. Growth of chlamydiae was reduced when cultures were exposed to IF 6 or 18 hr before infection, and slight reduction of the yield was also detectable in cell cultures treated with IF at early intervals (0 or 4 hr) after chlamydial infection. No effect of IF on penetration of chlamydiae into mouse cells was observed, whether phagocytic cells from peritoneal washings or L-929 cells were used, indicating that the inhibitory effect of IF occurs after chlamydiae enter the host cell. Additional evidence was obtained that a significant effect of IF occurs at an early stage in maturation of the intracellular chlamydiae. In mice exposed repeatedly to NDV aerosols and challenged with aerosolized MoPn 8 hr after the first exposure to NDV, mortality was delayed by 2 to 3 days and lung consolidation was slightly reduced at 3 days after infection. Yields of chlamydiae from lung pools of NDV-treated mice, taken at 3, 6, and 9 days after challenge, were not significantly different from those of controls. Similar results were obtained when mice were challenged with MoPn 8 hr after intranasal injection with 100 mug of poly I:C or 24 hr after intravenous injection with 200 mug of poly I:C. In contrast, administration of 0.2 ml of NDV (10(8.3) plaque-forming units) intravenously 10 hr before or 24 hr after challenge with MoPn accelerated mortality of mice by 2 to 3 days. In all experiments, detectable levels of IF in sera or 20% lung suspensions were found only up to 48 to 72 hr after exposure of mice to IF inducers.

Journal Article↗