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PubMed1980

Colonisation of pregnant and puerperal women and neonates with Chlamydia trachomatis.

Chlamydia trachomatis was cultured from cervical specimens of 14 (16.1%) of 231 women applying for legal abortion and from 23 (8.7%) of 273 puerperal women. The chlamydial isolation rate was related to the women's age. Of the pregnant and puerperal women under 20 years C trachomatis was isolated in 10% and 24% respectively; in those aged between 20 and 24 years the rates were 8.7% and 10.2% respectively whereas in those over 24 years the rates were 4.2% in both groups. Chlamydia were isolated more frequently from cervical specimens than from urethral specimens. However, if a cervical specimen alone had been examined the diagnosis would have been missed in three (17%) of 18 women. IgG antichlamydial antibodies (titre greater than or equal to 1/32) were detected by a micro-immunofluorescence test in samples of cord blood from 35 (25%) of 139 infants of the puerperal women. Of the 23 infants born to mothers harbouring chlamydia in the cervix C trachomatis was isolated from the conjuntival folds in five (22.5%). The chlamydial isolation rate from the eyes of the neonates was related to the time of sampling. None of the 108 infants examined between 6 and 7 days old was chlamydia-positive whereas chlamydia could be recovered from the conjunctival folds of four of them when re-examined from three to 23 days later.

Adult↗
PubMed1994

Factors affecting urine EIA sensitivity in the detection of Chlamydia trachomatis in men.

OBJECTIVE: This study examined the effects of four variables on the detection of Chlamydia trachomatis in urine from men by enzyme immunoassay (EIA). These variables were: symptoms and signs of urethritis, urine polymorphonuclear leucocytes (PMN), inclusion counts from urethral chlamydia cell cultures and the time between testing and last voiding. METHODS: Included were patients with and without symptoms and/or signs of urethritis attending the Edmonton Sexually Transmitted Disease Clinic. Men were asked to submit a 20 ml volume urine sample. Urethral swabs were collected for gram stain, chlamydia and gonorrhea culture. RESULTS: A total of 318 men were evaluated of whom 47 had chlamydia. Excluding six men who were coinfected with gonorrhoea, sensitivities and specificities of the Microtrak, Chlamydiazyme and IDEIA systems were 78.1% and 99.6%, 75.6% and 100%, and 80.5% and 97.8% respectively. Last void time did not affect the sensitivity. However, sensitivity was best when applied to men with severe evidence of urethritis. CONCLUSION: There is evidence that urine EIA could be used to detect chlamydia in men with acute urethritis but not in those without signs of urethritis.

Chlamydia Infections↗
PubMed1994

Expanded gold standard in the diagnosis of Chlamydia trachomatis in a low prevalence population: diagnostic efficacy of tissue culture, direct immunofluorescence, enzyme immunoassay, PCR and serology.

OBJECTIVE: To evaluate the diagnostic efficacy of chlamydia culture, direct immunofluorescence (DFA), direct enzyme immunoassay (EIA), polymerase chain reaction (PCR) and serology by defining positive culture or at least two positive non-culture tests as true positive. SETTING: Three gynaecological departments located in separate areas of Sweden. PATIENTS AND DESIGN: All pregnant women requesting abortion during a six month period were included. In cases with unconfirmed non-culture tests, reculture with multiple passage and PCR on the culture transport medium was performed for confirmation. Serum was analysed for chlamydial antibodies type IgG, IgM and IgA using microimmunofluorescence. RESULTS: 18 of 419 (4.3%) patients were positive for chlamydia according to the defined criteria. Twelve of 419 (2.9%) were positive in standard culture (primary inoculation). The sensitivity of standard culture, DFA, EIA and PCR were 66.7%, 77.8%, 64.7% and 71.4% respectively. The specificity 100% (by definition), 99.5%, 100%, 100% respectively. The positive predictive value 100% (by definition), 87.5%, 100%, 100% respectively. Negative predictive value 98.5%, 99.0%, 98.5%, 98.9% respectively. Serum IgG titre of > or = 64 and > or = 1024 gave positive predictive values of 10% and 21% respectively. CONCLUSIONS: When an expanded gold standard is used, the specificity and positive predictive value of the non-culture tests used are comparable with that of standard culture even in this low prevalence population. Standard culture underestimated the chlamydia prevalence by 33%. The prevalence found represents a decrease from 10 to 2.9% of culture verified chlamydia during four years in comparable populations. Chlamydial antibodies of certain immunological classes are not necessarily present in cases with chlamydia.

Adult↗
PubMed1988

Anti-chlamydial immunity in ewes conferred by vaccination with a combination of three live chlamydia, brucella and salmonella vaccines.

Live attenuated vaccines against Chlamydia psittaci var ovis, Brucella melitensis and Salmonella abortus ovis have previously been shown to be compatible in mice by subcutaneous administration. Immunity against challenge with virulent chlamydia was, however, slightly decreased in associations including the B melitensis Rev 1 vaccine. The chlamydia strain 1B vaccine was administered to four- to five-month-old female lambs, either alone or in combination with the B melitensis Rev1 and the S abortus ovis Rv6 vaccines. Clinical, serological and bacteriological observations demonstrated the compatibility of the three vaccines. Control, singly and triply vaccinated ewes were challenged with a virulent strain of chlamydia during their second pregnancy, 15 months after vaccination. Five of the 12 control ewes lambed normally and 10 of them were infected, as shown by the excretion of the challenge chlamydia in genital secretions. Sixteen of the 17 ewes in the triple vaccine group lambed normally and none was infected. All 12 in the single vaccine group lambed normally and three of the 12 were infected. In spite of this unusually poor protection by the single vaccine, antichlamydial immunity was clearly not decreased by the association with the two other vaccines.

Animals↗
PubMed1997

Chlamydiae in porcine abortion.

Formalin-fixed, paraffin-embedded fetal livers and lungs from 139 cases of swine abortion were investigated retrospectively for chlamydiae by means of immunohistochemistry. Using a genus-specific antibody, chlamydial antigen was found in eight livers obtained from five (3.6%) abortion cases from different herds. All lung sections were negative. Chlamydiae were also labeled in five of the eight positive livers using a monoclonal antibody against immunotype 1 of Chlamydia psittaci; the remaining three livers were negative. No reactivity was seen using an antibody specific for C. trachomatis. Chlamydiae should be considered a cause of abortion in sows in Switzerland. Porcine abortigenic strains identified in this study differed immunologically from intestinal strains (known to be mainly C. trachomatis) but shared similarities with abortigenic chlamydiae of ruminants.

Abortion, Septic↗
PubMed2002

Dynamic diversity of the tryptophan pathway in chlamydiae: reductive evolution and a novel operon for tryptophan recapture.

BACKGROUND: Complete genomic sequences of closely related organisms, such as the chlamydiae, afford the opportunity to assess significant strain differences against a background of many shared characteristics. The chlamydiae are ubiquitous intracellular parasites that are important pathogens of humans and other organisms. Tryptophan limitation caused by production of interferon-gamma by the host and subsequent induction of indoleamine dioxygenase is a key aspect of the host-parasite interaction. It appears that the chlamydiae have learned to recognize tryptophan depletion as a signal for developmental remodeling. The consequent non-cultivable state of persistence can be increasingly equated to chronic disease conditions. RESULTS: The genes encoding enzymes of tryptophan biosynthesis were the focal point of this study. Chlamydophila psittaci was found to possess a compact operon containing PRPP synthase, kynureninase, and genes encoding all but the first step of tryptophan biosynthesis. All but one of the genes exhibited translational coupling. Other chlamydiae (Chlamydia trachomatis, C. muridarum and Chlamydophila pneumoniae) lack genes encoding PRPP synthase, kynureninase, and either lack tryptophan-pathway genes altogether or exhibit various stages of reductive loss. The origin of the genes comprising the trp operon does not seem to have been from lateral gene transfer. CONCLUSIONS: The factors that accommodate the transition of different chlamydial species to the persistent (chronic) state of pathogenesis include marked differences in strategies deployed to obtain tryptophan from host resources. C. psittaci appears to have a novel mechanism for intercepting an early intermediate of tryptophan catabolism and recycling it back to tryptophan. In effect, a host-parasite metabolic mosaic has evolved for tryptophan recycling.

Bacterial Proteins↗
PubMed2003

Chlamydia trachomatis uses host cell dynein to traffic to the microtubule-organizing center in a p50 dynamitin-independent process.

Chlamydiae are pathogenic obligate intracellular bacteria with a biphasic developmental cycle that involves cell types adapted for extracellular survival (elementary bodies, EBs) and intracellular multiplication (reticulate bodies, RBs). The intracellular development of chlamydiae occurs entirely within a membrane-bound vacuole termed an inclusion. Within 2 hours after entry into host cells, Chlamydia trachomatis EBs are trafficked to the perinuclear region of the host cell and remain in close proximity to the Golgi apparatus, where they begin to fuse with a subset of host vesicles containing sphingomyelin. Here, we provide evidence that chlamydial migration from the cell periphery to the peri-Golgi region resembles host cell vesicular trafficking. Chlamydiae move towards the minus end of microtubules and aggregate at the microtubule-organizing center (MTOC). In mammalian cells the most important minus-end-directed microtubule motor is cytoplasmic dynein. Microinjection of antibodies to a subunit of cytoplasmic dynein inhibited movement of chlamydiae to the MTOC, whereas microinjection of antibodies to the plus-directed microtubule motor, kinesin, had no effect. Surprisingly, overexpression of the protein p50 dynamitin, a subunit of the dynactin complex that links vesicular cargo to the dynein motor in minus directed vesicle trafficking, did not abrogate chlamydial migration even though host vesicle transport was inhibited. Nascent chlamydial inclusions did, however, colocalize with the p150(Glued) dynactin subunit, which suggests that p150(Glued) may be required for dynein activation or processivity but that the cargo-binding activity of dynactin, supplied by p50 dynamitin subunits and possibly other subunits, is not. Because chlamydial transcription and translation were required for this intracellular trafficking, chlamydial proteins modifying the cytoplasmic face of the inclusion membrane are probable candidates for proteins fulfilling this function.

Animals↗
PubMed2004

Detection of mycobacteria and chlamydiae in granulomatous inflammation of reptiles: a retrospective study.

A retrospective study on reptile tissues presenting with granulomatous inflammation was performed to detect the possible presence of mycobacteria and chlamydiae in these lesions. Ninety cases including 48 snakes, 27 chelonians, and 15 lizards were selected. Mycobacteria were detected by Ziehl-Neelsen (ZN) staining and a broad-range polymerase chain reaction (PCR) followed by DNA sequencing. To detect chlamydiae, immunohistochemistry with monoclonal antibodies against chlamydial lipopolysaccharide (LPS) and a Chlamydiales order-specific PCR and sequencing were applied. Acid-fast bacilli were found in 14 cases (15.6%) by ZN staining and in 23 cases (25.6%) by PCR. Sequence analysis revealed the presence of Mycobacteria other than Mycobacterium tuberculosis complex (MOTT). Chlamydial LPS antigen was observed within granulomas from five samples (5.6%), whereas the PCR screen revealed 58 positive cases (64.4%). Of these, 9 cases (10%) showed 98-99% similarity to Chlamydophila (Cp.) pneumoniae and 49 cases (54.4%) displayed a high similarity (88-97%) to the newly described "Chlamydia-like" microorganisms Parachlamydia acanthamoebae and Simkania negevensis. Results from this study confirm, on the one hand, that MOTT are probably the most important infectious etiology for granulomatous inflammation in reptiles. On the other hand, they indicate that chlamydia infects reptiles and that Cp. pneumoniae should be considered an etiological agent of granulomatous lesions of reptiles. Because both MOTT and Cp. pneumoniae are human pathogens, the potential of zoonotic transmission from reptiles to humans has to be considered. In contrast, the significance of Chlamydia-like isolates remains completely open, and further studies are needed to evaluate their role.

Animals↗
PubMed2000

An interface of chlamydia testing by community family planning clinics and referral to hospital genitourinary medicine clinics.

OBJECTIVES: To assess compliance with the protocol for the management of women with Chlamydia trachomatis diagnosed in community family planning (FP) clinics; to assess the rate of attendance at genitourinary medicine (GUM) clinics by these women; to assess the rate of adequate treatment and to assess the level of communication between GUM clinics and FP clinics. METHOD: Retrospective review of FP clinic records and case notes to identify all women with positive or equivocal Chlamydia results during a 6 month period, and a retrospective review of records from five local GUM clinics. RESULTS: One hundred and twelve women were identified from FP clinic records with positive or equivocal Chlamydia results. Eighty-nine (79.5%) were referred to a GUM clinic. Twelve out of 14 women not referred had equivocal results. The median delay from the test being taken to the results being seen by a doctor was 9 days, and to the woman being referred was 10 days. Fifty-eight (51.7%, n = l12) women definitely attended a local GUM clinic. The FP clinics provided a letter of referral in 76 (85.4%, n = 89) women and the GUM clinics provided a letter of reply in 21 (48.8%, n = 43) women who attended with a referral letter. Three months after testing, only 54 (48.2%) of the 112 women with positive or equivocal Chlamydia tests were known by the referring FP clinic to have been treated. CONCLUSIONS: The majority of women with positive or equivocal Chlamydia results were referred to a GUM clinic according to the protocol. Attendance at GUM clinics was disappointing, as only 51.7% of the 112 women with positive or equivocal results had documented evidence of having attended. This raises the question not whether community clinics should be testing, but whether they should be initiating treatment and partner notification. Collaborative work between GUM clinics and community clinics around partner notification is needed, as well as funding for training and additional pharmacy costs. Further collaborative work between GUM and FP and reproductive healthcare (RHC) to evaluate the role of community clinics in the diagnosis and management of chlamydial infection and other sexually transmitted infections (STIs) is needed.

Adolescent↗
PubMed2001

Evaluation of near patient testing for Chlamydia trachomatis in a pregnancy termination service.

AIM: To identify and evaluate advantages and disadvantages of a near patient test (NPT) for Chlamydia trachomatis, using Clearview Chlamydia MF (Unipath Ltd) in a British Pregnancy Advisory Service (BPAS) clinic. METHOD: The improved Clearview Chlamydia MF test was used to test endocervical swabs from 400 women attending BPAS clinic for termination of pregnancy. The results were compared with Ligase Chain Reaction (LCR), using Polymerase Chain Reaction (PCR) as the arbiter. RESULTS: Twenty-seven women tested positive by Clearview Chlamydia MF (24 confirmed by LCR) and 32 by LCR. COMMENT: NPT has potential advantages in specific situations where a quick result is required for optimal management of those testing positive. However, the current technology available for detection of Chlamydial infection results in time constraints, which limited its benefits in this study, where there was a high throughput of clients. A significant number of cases were missed by Clearview Chlamydia MF, though the sensitivity found is within the ranges reported for various enzyme immunoassays (EIA) - currently the most commonly used testing method. The study confirmed the high positivity in those attending for termination, especially in under 25-year-olds.

Abortion Applicants↗
PubMed2003

An inclusion membrane protein from Chlamydia trachomatis enters the MHC class I pathway and stimulates a CD8+ T cell response.

During its developmental cycle, the intracellular bacterial pathogen Chlamydia trachomatis remains confined within a protective vacuole known as an inclusion. Nevertheless, CD8(+) T cells that recognize Chlamydia Ags in the context of MHC class I molecules are primed during infection. MHC class I-restricted presentation of these Ags suggests that these proteins or domains from them have access to the host cell cytoplasm. Chlamydia products with access to the host cell cytoplasm define a subset of molecules uniquely positioned to interface with the intracellular environment during the pathogen's developmental cycle. In addition to their use as candidate Ags for stimulating CD8(+) T cells, these proteins represent novel candidates for therapeutic intervention of infection. In this study, we use C. trachomatis-specific murine T cells and an expression-cloning strategy to show that CT442 from Chlamydia is targeted by CD8(+) T cells. CT442, also known as CrpA, is a 15-kDa protein of undefined function that has previously been shown to be associated with the Chlamydia inclusion membrane. We show that: 1) CD8(+) T cells specific for an H-2D(b)-restricted epitope from CrpA are elicited at a significant level (approximately 4% of splenic CD8(+) T cells) in mice in response to infection; 2) the response to this epitope correlates with clearance of the organism from infected mice; and 3) immunization with recombinant vaccinia virus expressing CrpA elicits partial protective immunity to subsequent i.v. challenge with C. trachomatis.

Amino Acid Sequence↗
PubMed2005

Up-regulation of the JAK/STAT1 signal pathway during Chlamydia trachomatis infection.

Chlamydia trachomatis infection is the most common cause of sexually transmitted disease, leading to female pelvic inflammatory disease and infertility. The disease process has been linked to cellular response to this bacterial pathogen. This obligate intracellular pathogen infects macrophages, fibroblast cells, and epithelial and endothelial cells. We show in this study that infection of cervical epithelial cells, the primary target of Chlamydia trachomatis, leads to up-regulation and activation of the JAK/STAT signal pathway. Specifically, Chlamydia trachomatis infection of HeLa 229 cells selectively induces STAT1, STAT2, and IFN-stimulated transcription factor 3gamma expression and promotes STAT1 activation. The up-regulation of STAT1 is dependent on bacterial replication, because treatment of infected cells with antibiotics prevents STAT1 up-regulation. By analysis of the gene transcriptional and cytokine expression profiles of host cells combined with the use of neutralizing Abs, we show that IFN-beta production is critical for STAT1 induction in epithelial cells. Finally, we demonstrate that the host up-regulates STAT1 to restrict bacterial infection, because Chlamydia propagates more efficiently in STAT1-null or STAT1 knockdown cells, whereas Chlamydia growth is inhibited in cells with up-regulated STAT1 expression. This study demonstrates that the infected cells up-regulate the host innate antimicrobial response to chlamydial infection. It also highlights the importance of cellular response by nonimmune cells in host clearance of chlamydial infection.

Cell Line, Tumor↗
PubMed1989

Chlamydia trachomatis infections--the Royal Women's Hospital experience.

During the 18-month period from December 1, 1985 to May 31, 1987 Chlamydia trachomatis was the most-common sexually-transmitted agent to be identified at the Royal Women's Hospital, Melbourne. It was isolated from 4% of all specimens for which such culture was requested and was found five-times more frequently than was Neisseria gonorrhoeae. A review of the clinical presentation and the management of the 100 public patient for this period whose cervical specimens were found to give positive results for the presence of chlamydiae revealed that 77% of the women were less than 25 years of age, 78% of the women were single and 65% of the women were nulliparous. Thirty-five women were asymptomatic carriers of chlamydiae. Of the remaining 65 patients with symptoms, 46% experienced pelvic pain, 39% experienced a vaginal discharge and 26% experienced irregular bleeding. The importance of abnormal bleeding is emphasized. In patients who presented for therapeutic abortions, morbidity occurred in 19% of those who were carriers of Chl. trachomatis; accordingly, screening for chlamydiae as routine is recommended in such patients. Furthermore, because of the risk of pelvic inflammatory disease and its consequences, it is important not only to treat female patients in whom chlamydiae have been isolated, but also to treat and to follow-up their sexual partners simultaneously.

Adolescent↗
PubMedDate not supplied

Chlamydia trachomatis infection among pregnant women: prevalence and prenatal importance.

BACKGROUND: Chlamydia trachomatis infection in pregnant women is suspected to result in low birth-weight and premature infants. We conducted studies to ascertain the prevalence of this infection among pregnant women in our setting and whether its presence is a risk factor for low birth-weight or prematurity. METHODS: In the first study, 94 pregnant women between 26 and 30 weeks of gestation were screened for infection with Chlamydia trachomatis. The second investigated a cohort of 172 pregnant women presenting in spontaneous labour. The infection status was related to perinatal outcome in terms of birth-weight and gestation. In both the studies, Chlamydia trachomatis infection was diagnosed using the Chlamydiazyme test performed on endocervical swabs. RESULTS: The prevalence of Chlamydia trachomatis infection in mid-pregnancy and at labour was 17% (16/94) and 18.6% (32/172), respectively. Women with infection were relatively older than those without it [mean (SD) age: 26.6 (4.5) years v. 24.8 (3.6) years, p = 0.01]. The mean (SD) birth-weight [2869 (611) g v. 2814 (496) g], gestation [38.5 (2.6) weeks v. 38.3 (2.0) weeks], and incidence of low birth-weight [18.7% v. 20.7%] as well as prematurity [9.4% v. 10.7%] were similar among neonates born to women with or without infection. Neonates born to infected mothers experienced purulent conjunctivitis more frequently than those born to non-infected mothers [12.5% v. 2.8%, p = 0.04]. CONCLUSION: Chlamydia trachomatis is a relatively common infection in pregnant women. However, it was not associated with either low birth-weight or prematurity.

Adult↗
PubMed1999

An open label comparative study of azithromycin and doxycycline in the treatment of non-gonococcal urethritis in males and Chlamydia trachomatis cervicitis in female sex workers in an STD clinic in Singapore.

AIM OF STUDY: The aim of this study was to compare the clinical and microbiological efficacy of a single 1 gram dose of azithromycin against 1 week of doxycycline at 100 mg twice a day in the treatment of: (1) uncomplicated non-gonococcal urethritis (NGU) in male patients, and (2) culture proven Chlamydia trachomatis cervicitis in female sex workers. METHOD: The subjects were 53 male patients who attended the clinic and were diagnosed to have non gonococcal urethritis based on clinical symptoms and a urethral smear, and 63 female sex workers, who had both a positive enzyme immunoassay (EIA) test and Chlamydia trachomatis cultures. Follow-up visits were made at one and two weeks post-treatment to assess efficacy, subsequent relapse and presence of side effects. The male patients were also assessed at four weeks post treatment to determine default and reinfection rates. RESULTS: Both azithromycin (clinical cure rates 62.5% at one week, 86.4% at two weeks in male patients; 96.6% at two weeks in female sex workers) and doxycycline (clinical cure rates 65.4% at one week, 90.9% at two weeks in male patients; 100% at two weeks in female sex workers) were effective in treating non-gonococcal urethritis and chlamydial cervicitis. Both drugs were very effective in eradicating proven Chlamydia trachomatis infections, with success in 100% of cases of Chlamydia trachomatis NGU in males, and 96.6% and 100% cure rates, for azithromycin and doxycycline respectively, in female sex workers with cervicitis. There were no statistically significant differences between the two drugs in terms of clinical efficacy, influence on default rates or subsequent risk of reinfection. CONCLUSIONS: We conclude that a single dose of azithromycin is as effective as a one week course of doxycycline in treating non-gonococcal urethritis in males and in the elimination of Chlamydia trachomatis in females with cervicitis, with the added advantage of a convenient single dose that can be supervised.

Adolescent↗
PubMed1998

PCR studies on the presence of Chlamydia trachomatis in the upper urinary tract of patients with obstructive pyelonephritis.

Chlamydia trachomatis infections are among the most common sexually transmitted diseases in the world and it is only logical to hypothesize that it alone or in association with mycoplasmas can participate in the initiation and persistence of upper urinary tract infections. Having in mind the inconclusive evidence regarding the role of C. trachomatis in upper urinary tract infections we decided to study the presence of C. trachomatis in the upper urinary tract of patients with obstructive pyelonephritis using the polymerase chain reaction. We studied 20 patients (12 female and 8 male, aged 20-60 years) with symptoms and signs of acute pyelonephritis in accordance with Kunin's criteria (1997). Samples were taken during surgery of the upper urinary tract by aspirating urine from the renal pelvis or the ureter above the level of the obstruction and analyzed for the presence of bacterial pathogens using routine microbiological techniques and employing the "AMPLICOR CT/NG" test (Roche Diagnostic Systems, Branchburg, NJ, USA) for the presence of C. trachomatis. Chlamydia trachomatis was found in the aspirated urine of 5 patients (25%). In 3 of the patients the microbiological tests of the aspirated urine did not establish any other microbial agent. In the other two Escherichia coli and Proteus mirabilis were cultured. The analysis of the clinical and laboratory findings in the patients with Chlamydia trachomatis infection alone and those with an associated bacterial pathogen failed to reach statistical significance. Following the operation all of the patients received treatment with Ofloxacin 200 mg bid for 7 days with a favorable clinical and laboratory outcome. In our opinion, the AMPLICOR CT/NG test is a sensitive and specific method for diagnosing low-number Chlamydia trachomatis infections of the upper urinary tract in patients with obstructive pyelonephritis. Chlamydia trachomatis should be considered as a possible etiologic agent in acute pyelonephritis and the therapeutic regimen in such patients should be targeted at its possible underlying presence.

Adult↗
PubMed1999

[Chlamydia trachomatis in men with impaired fertility].

OBJECTIVE: The objective of the prospective study was to assess whether there exists a relationship between the results of positive laboratory tests for the presence of Chlamydia infection (assessment of the presence of Chlamydia trachomatis in the ejaculate by the DNA amplification method, IgA and IgG antichlamydia antibodies in the ejaculate and serum), an abnormal spermiogram and total number of sexual partners in men from infertile couples examined at the Gynaecological and Obstetric Clinic of the First Medical Faculty, Charles University Prague. DESIGN: Prospective clinical study. SETTING: Department of Gynaec.-Obstet., the 1st Medical Faculty of the Charles University, Prague, Czech Republic--Institut of Clinical Biochemy, the 1st Medical Faculty of Charles University, Prague, Czech Republic. METHOD: 101 men were examined. In all the spermiogram was evaluated according to WHO criteria. Specific antichlamydial antibodies IgA and IgG is serum and the ejaculate were assessed by the ELISA method. Evidence of the DNA portion of Chlamydia trachomatis was provided by the MEIA method. Amplification of DNA by LCR was made on a Thermocycler. By means of an aimed questionnaire the number of all sexual partners was assessed. The men were divided into three groups with 1-5, 6-9 and with 10 or more partners. Patients where Chlamydia infection was detected were treated with Ig Azitromycin and their spermiogram was checked 6-8 weeks after treatment. The results of the examination were tested by the chi square test. RESULTS: An abnormal spermiogram was found in 44 (44%) of the examined subjects. With the increasing number of sexual partners the number of men with pathospermia increased. In none LCR for the presence of Chlamydia trachomatis was positive in the ejaculate. In 15 examined patients IgA antichlamydia antibodies were found in the ejaculate. At the same time in all an abnormal spermiogram was found and 11 (73%) of them had six or more sexual partners. After treatment in 8 (62%) of 13 (two did not attend the check-up) marked improvement of the spermiogram occurred. CONCLUSION: IgA antichlamydial antibodies in the ejaculate proved in 62% of the examined men with an abnormal spermiogram a useful indicator of infection in the genital tract. With the increasing number of sexual partners the number of pathospermias increased.

Adult↗
PubMed2002

[The infections by Chlamydia trachomatis and Neisseria gonorrhoeae].

Among sexually transmitted diseases, Chlamydia trachomatis and Neisseria gonorrhoeae infections are found most frequently. Recently, their incidence in youths has increased. The rate of infection by human immunodeficiency virus is increased in patients who have been infected by Chlamydia trachomatis. In view of this, early detection and treatment of Chlamydia trachomatis infection appear to be important. Asymptomatic infections by Chlamydia trachomatis and Neisseria gonorrhoeae are not rare among gynecological patients. However, in patients infected by both of these pathogens it is difficult to detect microbial antigens using specific antibodies. Therefore, patients suspected of infection by these pathogens should receive precise genetic testing for Chlamydia trachomatis and Neisseria gonorrhoeae, and the results of such tests should be evaluated carefully.

Chlamydia Infections↗