Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Chlamydia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources
PubMed1997

On the need to screen for Chlamydia and gonorrhea infections prior to colposcopy in adolescents.

PURPOSE: The purposes of this study were to explore the association of pelvic inflammatory disease (PID) with cervical biopsy and to examine whether screening for Chlamydia and gonorrhea infections within 2 weeks prior to colposcopy is a standard clinical practice among adolescents' care providers in the United States. METHODS: An anonymous questionnaire was distributed to U.S. physicians and nurses who are members of the Society for Adolescent Medicine, and/or the North American Society for Pediatric and Adolescent Gynecology. RESULTS: A total of 368, from all the states in America, responded. Only 5% of the respondents have encountered biopsy-associated PID owing to Chlamydia and/or gonorrhea. The incidence rate of biopsy-associated PID reported by the respondents to this survey was approximately 1:1000 colposcopic biopsies. Fifteen percent of the respondents screen their adolescent patients, and 23% favor screening for Chlamydia and gonorrhea infections within 2 weeks prior to colposcopy. Previous experience with colposcopy and previous encounters with biopsy-associated PID in adolescents did not significantly affect the practice or the opinion of the respondents. CONCLUSIONS: Screening for Chlamydia and gonorrhea infections within 2 weeks prior to colposcopy in adolescents is presently not a common clinical practice among U.S. adolescents' care providers. Because of the potential risk of biopsy-associated PID, it is advisable to minimize the interval between Chlamydia and gonorrhea screening and colposcopy in adolescents.

Adolescent↗
PubMed2004

The resurgence of Chlamydia trachomatis.

The objective of the review is to alert reproductive-care providers to the unexpected resurgence of Chlamydia infections and to new findings related to complications associated with Chlamydia infection. Data sources consisted of national and local guidelines and literature searches of MEDLINE with the heading Chlamydia infections 2002 and 2003. The complications of Chlamydia infections are considered to be longterm, and may include debilitating pain, infertility, tubal pregnancy, cancer, and HIV infection. Only a strong disease-management response from reproductive-care providers, using new diagnostic techniques and simpler treatment regimens, as well as a strong public health reaction, will be effective to limit the scourges of Chlamydia infection in the female population.

Canada↗
PubMed2003

Opportunistic screening for Chlamydia in general practice: the experience of health professionals.

Chlamydia trachomatis is the most common curable bacterial sexually transmitted infection in the UK. The infection is asymptomatic in up to 70% of women, and if untreated, can lead to pelvic inflammatory disease, ectopic pregnancy and infertility. Chlamydial infection can be diagnosed using urine testing and is easily treated with antibiotics. In 1999, the UK Department of Health funded a pilot opportunistic Chlamydia screening programme in two health authorities. All sexually active women between the ages of 16 and 24 years attending general practices and other healthcare settings, such as family planning clinics, antenatal clinics and genito-urinary medicine services, were offered the opportunity to be screened for Chlamydia, regardless of the purpose of their visit. This evaluation was funded to assess the feasibility and acceptability of opportunistic screening. The evaluation was conducted using both qualitative and quantitative methods. The present paper describes findings from the qualitative evaluation study arising from the health professionals' experience of opportunistic screening in general practice. Receptionists were central to the opportunistic screening model in general practice and it was this aspect of the model that raised most concerns. Whilst general practitioners reported that the involvement of receptionists saved them time, the receptionists themselves were sometimes drawn into discussions for which they felt ill equipped and unsuitably located. This research suggests that a call-recall national screening programme would provide a better model to undertake Chlamydia screening in general practice. The advantages of this model are threefold. First, each individual within the target age range can receive information about Chlamydia through the post. Secondly, the test and more detailed information can be managed by a practice nurse in a private and confidential setting. Thirdly, individuals are not repeatedly offered the test when visiting the surgery.

Adolescent↗
PubMed2002

Chlamydia trachomatis in older Los Angeles County residents, 1991-1998: implications and recommendations for the detection of sexually transmitted infections in older age groups.

OBJECTIVES: This study examined the incidence and implications of reported chlamydia cases in Los Angeles County residents aged 50 and older. DESIGN: Observational study of passive surveillance data submitted to the Los Angeles County Sexually Transmitted Disease Program. SETTINGS: Private and public health facilities in Los Angeles County. PARTICIPANTS: Los Angeles County residents aged 50 and older. MEASUREMENTS: Chlamydia cases were identified from the Los Angeles County Sexually Transmitted Disease Program passive surveillance system reports received from 1991 to 1998. RESULTS: Between 1991 and 1998, 1,421 cases of chlamydia were reported in persons aged 50 and older in Los Angeles County, accounting for 1% of total chlamydia cases. The average annual incidence rate for this period was 9.3 per 100,000, and appeared relatively stable. The mean age +/- standard deviation was 59.0 +/- 9.2 years, with a range of 50 to 96 years. Rates for older women were 1.1 to 3.0 times higher than in older men, similar to rate ratios for 20- to 35-year-olds. Rates among older African Americans appear to be substantially higher than any other older racial/ethnic group. CONCLUSIONS: Our data show that there are no age barriers for sexually transmitted infections. Although this population is highly unlikely to experience adverse reproductive outcomes, transmission to younger sex partners and contribution to the overall chlamydia epidemic are serious concerns. Surveillance and prevention strategies aimed at older persons will be needed as this population continues to grow.

Aged↗
PubMed2006

The cost effectiveness of screening for genital Chlamydia trachomatis infection in Australia.

BACKGROUND: In Australia, there is no published study on the cost effectiveness of screening for chlamydia. The aim of this study was to examine the cost effectiveness of a hypothetical screening programme for chlamydia based on annual opportunistic testing of all women 25 years of age or younger consulting a general practitioner, compared with no screening. METHODS: A decision-analytic modelling approach was used to determine the incremental cost effectiveness ratio (ICER) of screening compared with no screening over 25 years. The analysis measured Australian health-care costs and benefits were assessed in terms of quality-adjusted life years (QALYs). RESULTS: The analysis resulted in a cost per QALY of 2968 dollars for screening. One-way sensitivity analyses on all variables, and multi-way sensitivity analyses on some variables, showed a wide range for the cost effectiveness, from dominance (where screening is effective and saves money overall) to an ICER of 67,715 dollars per QALY. CONCLUSIONS: The results indicate that annual opportunistic screening for chlamydia in women under 25 is a potentially worthwhile undertaking. However, the analysis also highlights uncertainties around the natural history of chlamydia and the effectiveness of chlamydia screening. Given these uncertainties, the need for further primary data collection in these areas becomes apparent.

Adolescent↗
PubMed2006

Chlamydia in colposcopy clinics: to screen or not to screen?

The objective of the study was to assess the prevalence of Chlamydia trachomatis in our colposcopy clinic. A total of 337 consecutive patients newly referred to the colposcopy clinic between May and November 2003 were screened for chlamydia trachomatis. All our patients were referred by their GPs and none of the patients had had a recent chlamydia test performed. Four patients screened positive, overall giving a prevalence of 1.2% [95% CI 0.04-2.36%]. Three of those with positive results were in the 21 - 30 year age group (139 in the group, which equals 2.2% prevalence [95% CI 0 - 4.6%]). The fourth positive result was in the group over the age of 60. None of those screened in the other age groups was positive (< or =20, 31 - 40, 41 - 50, 51 - 60 years). Numbers screened in each of those groups were: 14, 115, 53 and 12, consecutively. Our study, though small in sample size, supports the view that the prevalence of chlamydia is not high in all colposcopy clinic attenders. Women younger than 30 years old are more likely to be infected than older women; hence opportunistic screening should target this age group. The prevalence rate may be low due to the enzyme linked immunosorbent assay giving a poor detection rate for chlamydia screening.

Adult↗
PubMed2003

Increasing diversity within Chlamydiae.

In recent years, 16S ribosomal DNA analyses has allowed the recognition of new chlamydia organisms, requiring the creation of new species, genera, and families within this unique, deep lineage of prokaryotes. The trachoma and psittaci groups chlamydiae are now recognized as separate genera, Chlamydia and Chlamydophila, respectively, and biovars of each group have been elevated to the species rank. Simkania and Parachlamydia have been associated with human respiratory infections, while Waddlia seems to be implicated in abortion in bovins. DNA amplification studies targeting the 16S rDNA have revealed a richer diversity within chlamydiae, identifying new lineages from both environmental and clinical samples. Further studies will be of interest to both examine the ecology and evaluate the clinical importance of these novel chlamydiae. Herein, we provide a summary of literature and our data about the novel chlamydial lineages.

Chlamydia↗
PubMed2000

Impact of switching laboratory tests on reported trends in Chlamydia trachomatis infections.

Improvements in the sensitivity and specificity of laboratory testing methods for Chlamydia trachomatis infections in recent years have created potential problems with interpreting data on chlamydia prevalence trends. A switch to a more sensitive test can result in an increase in chlamydia positivity even with no increase in the true disease prevalence. To examine the impact of switching laboratory testing methods on chlamydia positivity trends among women, the authors analyzed data from chlamydia screening programs in family planning clinics in two geographic areas of the United States. Data from 7,287 tests performed in Philadelphia, Pennsylvania, indicated a 46% increase in positivity (from 4.1% to 6.0%) when the clinics switched from a nucleic acid probe assay to a ligase chain reaction test. Data from 35,306 tests performed in Oregon and Washington State laboratories showed a 21% increase in positivity (from 3.3% to 4.0%) when clinics switched from a direct immunofluorescent antibody testing procedure to an enzyme immunoassay with negative gray zone confirmation. These increases were within ranges consistent with the variability of the testing methods and occurred primarily in asymptomatic women and in women over age 20 years. Any switch in laboratory testing methods must be considered when interpreting data on chlamydial infection trends.

Adult↗
PubMed1997

Ligase chain reaction in detection of Chlamydia DNA in synovial fluid cells.

Synovial fluid cells from 12 patients with reactive arthritis (ReA) triggered by Chlamydia trachomatis were studied for the presence of Chlamydia DNA using the ligase chain reaction (LCR) LCx (Abbott) and the polymerase chain reaction (PCR) Amplicor (Roche). In addition, peripheral blood leucocytes from 11 of these patients were analysed by LCR. As controls, seven patients with newly diagnosed rheumatoid arthritis (RA) were included. Chlamydia trachomatis DNA was detectable by LCR in samples of synovial fluid cells from 4/12 patients with C. trachomatis-triggered ReA, and in none by PCR. Chlamydia trachomatis DNA was not detectable in the synovial fluid cells of the seven RA patients by either method, neither was C. trachomatis DNA detectable in the peripheral blood leucocytes of the ReA patients (0/11) or controls (0/6) by LCR. The LCR technique may be useful in the demonstration of Chlamydia DNA in synovial fluid cells.

Adolescent↗
PubMed1993

Vaginal discharge as an indicator of gonorrhea and Chlamydia infection in girls under 12 years old.

Cultures for sexually transmitted diseases (STDs) are frequently obtained as part of an evaluation for alleged sexual abuse, but the prevalence of STDs in abused children is very low. Furthermore, STDs in children may not be identified if the clinician does not maintain a high index of suspicion in the symptomatic child. A retrospective review was done to study the symptoms and presenting complaints of girls under 12 with gonorrhea and chlamydia infections and to examine the prevalence of STDs in asymptomatic girls. The charts of 622 patients were reviewed. All patients were females under 12, Tanner I or II, who were initially seen for evaluation of sexual abuse or who were diagnosed with an STD. During the study period, 28 girls were found to have STDs. Twenty-two of these girls had vaginal gonorrhea; vaginal chlamydia was diagnosed in eight. Twenty-three of the 28 girls (82%) with an STD were initially seen and cultured for a chief complaint of vaginal discharge. Of the 581 patients who were cultured for evaluation of abuse, only five STDs were diagnosed (0.7%). All 22 girls with gonorrhea had a vaginal discharge on examination. Of the eight girls with chlamydia, two also had vaginal gonorrhea. Of the six who had chlamydia without gonorrhea, asymptomatic infection was common; four gave histories of discharge but only one had a discharge on examination. Our review indicates that girls under 12 who present for evaluation of vaginal discharge may have an STD and should be cultured for gonorrhea and chlamydia whether or not sexual abuse is suspected.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMedDate not supplied

Antibodies to Chlamydia trachomatis in cervicovaginal secretions: relation to serum antibodies and current chlamydial infection.

Concentrated cervicovaginal washings obtained from women attending a venereal disease clinic were tested for Chlamydia-specific immunoglobulins by means of a single-antigen, indirect immunofluorescence technique. Chlamydial antibodies (IgA and/or IgG) were present in washings from 22 (42%) of 52 patients tested. These Chlamydia-specific antibodies were significantly (P less than 0.001) associated with Chlamydia-specific antibodies in serum, which suggests that the former antibodies may have been derived from the serum rather than synthesized in the cervix. The association between chlamydial antibodies in cervicovaginal washings and isolation of Chlamydia from the cervix was much weaker. These results indicate that the diagnostic value of detection of Chlamydia-specific antibodies in sera and in cervical secretions is questionable.

Antibodies↗
PubMedDate not supplied

Risk factors for infection in women undergoing testing for Chlamydia trachomatis and Neisseria gonorrhoeae in Manitoba, Canada.

BACKGROUND AND OBJECTIVES: Despite sharing common modes of transmission, characteristics of individuals infected with Chlamydia trachomatis differ in several respects from those with Neisseria gonorrhoeae infection. Further characterization of women at high risk for chlamydial infection is needed to deliver appropriate and effective preventive, diagnostic, and therapeutic care to this population. GOAL OF THIS STUDY: The demographic and socioeconomic characteristics of women with laboratory confirmed chlamydia, gonorrhea, or coinfection were compared with those of control women who tested negative for both pathogens. STUDY DESIGN: A random sample of 400 women in Manitoba, Canada, who had undergone testing for sexually transmitted diseases at a public health laboratory in 1988 were studied. After linkage with medical insurance and census databases, logistic regression analysis was used to compare age, ethnicity, urban status, and mean income (using postal codes) of women with gonorrhea alone, chlamydia alone, and coinfection, with the same data for women who tested negative for both organisms. RESULTS: Young age, North American Indian status, urban residence, and low mean income according to postal code were significantly associated with gonococcal and chlamydial infection in the study population, compared with women who tested negative for both infections. Young age, Indian status, and urban residence also were associated with gonorrhea infection alone. Only young age and Indian status were associated with chlamydial infection. Mean incomes of women with chlamydial infection alone and control subjects were higher than those of women with gonorrhea and gonorrhea and chlamydia coinfection. CONCLUSIONS: Differences in the demographic and socioeconomic characteristics of women with gonorrhea, chlamydia, and coinfection suggest the existence of multiple reservoirs of infection due to these agents in the study population. The preventive, diagnostic, and therapeutic strategies of sexually transmitted disease control programs must be adapted to the individual needs of identified high-risk groups.

Adolescent↗
PubMed1998

Evaluation of the Gen-Probe PACE 2 assay for the detection of asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections in male arrestees.

BACKGROUND: The LET and Gen-Probe PACE 2 assay are used to screen male arrestees for evidence of infection with chlamydia and gonorrhea in the intake/booking area of the Jefferson Parish Correctional Center. GOAL OF THIS STUDY: To determine the accuracy of the Gen-Probe PACE 2 assay for the detection of asymptomatic infection with Chlamydia trachomatis and Neisseria gonorrhoeae infections in male arrestees. STUDY DESIGN: From December 1993 to March 1994, 196 arrestees younger than 22 years were screened with the Gen-Probe PACE 2 assay and McCoy shell vial culture for Chlamydia trachomatis. From April to October 1994, 444 arrestees of all ages were screened with the Gen-Probe PACE 2 assay and standard culture for Neisseria gonorrhoeae. The sensitivity, specificity, and predictive values of the Gen-Probe PACE 2 assay, compared with culture, were calculated with 95% confidence intervals. RESULTS: The Gen-Probe PACE 2 assay compared with culture had a sensitivity, specificity, and positive predictive value for Chlamydia trachomatis of 84%, 99%, and 93% and for Neisseria gonorrhoeae of 54%, 99.5%, and 78%. CONCLUSION: The Gen-Probe PACE 2 assay is useful for screening young males in this jail setting and is more accurate for detecting Chlamydia trachomatis compared with Neisseria gonorrhoeae.

Adolescent↗
PubMed2003

Demonstration of declining community prevalence of Chlamydia trachomatis infection using sentinel surveillance.

BACKGROUND: Chlamydia trachomatis infection rates in Alabama increased dramatically from 1996 to 1998, due in part to expanded screening. Detection of prevalent infection through increased testing could mask timely detection of the impact of screening programs on community prevalence. GOAL: The goal of the study was to evaluate the temporal trend in prevalence among women aged 15 to 34 years attending reproductive healthcare clinics in Birmingham, Alabama. STUDY DESIGN: Between 1995 and 1998, systematic screening of the first 60 women presenting each month to each of six participating clinics was performed with urine-based testing for chlamydia. RESULTS: In contrast to the 218% increase in chlamydia prevalence detected through passive surveillance, during the study period surveillance in sentinel sites revealed that first-visit chlamydia prevalence declined from 12.8% to 8.6%. CONCLUSIONS: Sentinel site surveillance served as a valuable adjunct to passive surveillance for determining the true trend of chlamydia prevalence during the hyperendemic phase of a local epidemic.

Adolescent↗
PubMed2005

Spontaneous resolution of asymptomatic Chlamydia trachomatis in pregnancy.

OBJECTIVE: We sought to estimate the rate of spontaneous resolution of asymptomatic Chlamydia trachomatis in pregnancy and to evaluate factors associated with its resolution. METHODS: A cohort of women enrolled in a large multicenter randomized bacterial vaginosis antibiotic trial (metronidazole versus placebo) that, when randomly allocated, had asymptomatic C trachomatis diagnosed by urine ligase chain reaction (from frozen archival specimens) between 16(0/7) and 23(6/7) weeks were included. The urine ligase chain reaction is a highly accurate predictor of genital tract chlamydial infection. A follow-up ligase chain reaction was performed between 24(0/7) and 29(6/7) weeks. RESULTS: A total of 1,953 women were enrolled in the original antibiotic trial; 1,547 (79%) had ligase chain reaction performed both at randomization and follow-up. Women receiving antibiotics effective against Chlamydia between randomization and follow-up or having symptomatic Chlamydia infection were excluded (26 women). Of the 140 women (9%) who were diagnosed as positive via the initial ligase chain reaction assay, 61 (44%) had spontaneous resolution of Chlamydia by the follow-up ligase chain reaction assay. Factors associated with spontaneous resolution included older age (P = .02), more than 5 weeks from randomization to follow-up (P = .02), and a greater number of lifetime sexual partners (P = .02). Using a logistic regression model, maternal age and a greater-than-5-week follow-up interval remained significant; for every 5-year increase in maternal age, the odds of a positive result on the ligase chain reaction test at follow-up decreased by 40% (odds ratio 0.6; 95% confidence interval 0.4-0.9). Race, substance abuse, parity, and treatment with metronidazole were not associated with spontaneous resolution. Gram stain score and vaginal pH at randomization and follow-up also were not associated. CONCLUSION: The prevalence of asymptomatic C trachomatis in pregnancy was 9%; infection resolved spontaneously in almost half of these women. The association of older age and increasing time interval to spontaneous resolution of Chlamydia is consistent with a host immune-response mechanism.

Adult↗
PubMed1988

Failure of Chlamydia trachomatis to pass transplacentally to fetuses of TO mice infected during pregnancy.

Mice (strain TO) were inoculated with a human strain of Chlamydia trachomatis (serovar E) either 14 days before the detection of a vaginal plug (day 1 of pregnancy), or from one to nine days thereafter. The organisms were given via the intraperitoneal route (ip) or intravenously with an additional intravaginal inoculum (iv + ivag). Mice were killed on day 18 of pregnancy and the contents of the uterus examined. Chlamydiae were isolated from at least one placental disk of about a quarter of the mice. Organisms given via the ip route established placental colonisation more effectively. Thus, placental colonisation was detected in five of 16 mice given chlamydiae by the ip route (in six of eight placentas in one mouse), whereas colonisation occurred in only a single placenta from one of nine mice infected via the iv + ivag routes. Chlamydiae were isolated from 13 (6.25%) of 208 placentas examined; the degree of colonisation was variable and the individual placentas were colonised independently. Chlamydiae were not recovered from fetal tissue, even when there was heavy placental colonisation. Nor were they isolated from maternal spleens, even though there was antibody to C. trachomatis in all maternal sera; the titres were in the range 4-2048, depending on the time of chlamydial challenge. These experiments show that C. trachomatis did not cross the placenta and that the pregnancy outcome in these mice was not affected.

Animals↗
PubMed1988

The relevance of Chlamydia trachomatis in acute epididymitis in young men.

Young men presenting to a General Surgical Unit with acute epididymitis underwent microbiological investigation, including culture for Chlamydia trachomatis. The results were compared with similar investigations in an asymptomatic control population and with patients presenting to the Department of Genito-urinary Medicine with urethral discharge. Chlamydia trachomatis was cultured from 15% of patients with acute epididymitis and a further 15% had serological evidence of exposure to Chlamydia. Nearly 50% of patients attending the Genito-urinary clinic grew Chlamydia from the urethra. The background prevalence of Chlamydia in the control population was low. It is necessary to identify the significant minority of young men with acute epididymitis associated with chlamydial infection, because of the risk of pelvic inflammation and infertility in their female partners. At present this can only be achieved by submitting all young men with acute epididymitis to full microbiological investigation.

Acute Disease↗
PubMedDate not supplied

Screening for Chlamydia trachomatis at a university health service.

Chlamydia trachomatis is the most common sexually transmitted infection in the United States. The aim of this study was to determine the prevalence of Chlamydia in college family planning patients and to identify diagnostic indicators associated with Chlamydia. A thorough history and physical examination was performed, including culture for gonorrhea, cancer (papanicolaou test), and Chlamydia trachomatis. Chlamydia occurred in 12.6% of 419 subjects. The lack of signs and symptoms and the possibility of inaccurate historical data limit the clinical predictability of chlamydial infections. Routine screening of college women is recommended.

Adolescent↗