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PubMed1995

Prevalence of transformation zone Chlamydia trachomatis DNA and serum antibodies in Tanzanian gynaecological in-patients.

Chlamydia trachomatis DNA was detected in cervical transformation zone swabs of gynaecological in-patients from Tanzania by two different polymerase chain reactions (PCR), one targetting the endogenous Chlamydia trachomatis plasmid (pCTT1) and the other a chlamydia genus specific rRNA gene. In only 7/131 (5.3%) cervical samples specific amplification products were obtained, in 6 cases with both PCRs, and in one with the plasmid-PCR alone. A 255 nt sequence was determined from the two plasmid-PCR fragments and revealed only one mismatch against the prototype sequence. Antibodies against genus specific chlamydia antigens were detectable by indirect immunofluorescence with titres > or = 1:256 in 29.0% (38/131) of all patients and in 50.0% (11/22) of patients with pelvic inflammatory disease (P = 0.17). No statistically significant association of either chlamydia antibodies or chlamydial DNA with any clinical condition was observable.

Adolescent↗
PubMed1993

[Chlamydia trachomatis as a cause of infection in women].

A sample of 596 women was examined by the direct immunofluorescent test (DIF) for the detection of chlamydia brachomatis antigens in the endocervical smear (with monoclonal antibodies), ELISA test for the detection of IgG antibodies against the group chlamydia-antigen. The chlamydia trachomatis infection was found in 30.20% of the cases, with a high positive rate in all age groups. These infections were more frequently found in women in whom sterility had been diagnosed, compared to other examined women. In relation to other inflammatory processes the significantly highest rate was found in women with changes in the cervix (endocervicitis and arythroplakia). A high rate of chlamydia positive (42.44%) was detected in women who had had pathological pregnancies and deliveries. Humoral immune response to the presence of chlamydia trachomatis infection was proved in 79.44% of the cases. We showed and analyzed diagnostic possibilities of the used diagnostic tests where a combination of the DIF test and ELISA was found the best. For a successful diagnosis two methods have been recommended: a direct one-for the detection of the cause (DIF test, isolation in the cell culture McCoy or Hela 229) and an indirect one for the detection of specific antibodies in the serum.

Adult↗
PubMed1994

[Chlamydia trachomatis infections of the cervix and postoperative course].

In the paper authors consider the problem if Chlamydia trachomatis infection of urogenital tract exerts an influence on postoperative course in women who were operated in the gynaecology department. 186 women have been examined in this study. Using the criteria for selective screening for Chlamydia trachomatis infection proposed by Handsfield, 29 women with higher risk for chlamydial infection were seperated. The personal details have been obtained by standardized questionnaire. Using the immunoenzymatic test "Chlamydiazyme" the incidence of Chlamydia trachomatis infection of the cervical canal was studied in 29 women from groups of higher risk for this infection. No Chlamydia trachomatis antigens were found in this group. These results don't answer the question if Chlamydia trachomatis infection of urogenital tract exerts an influence on postoperative course in women who were operated in gynaecology department, because it is to small trial.

Chlamydia Infections↗
PubMed1993

Conjunctivitis and keratoconjunctivitis associated with chlamydiae in swine.

Two swine herds housed in confinement had high prevalences of conjunctivitis and keratoconjunctivitis. Necropsies were performed on 7 pigs (2 to 8 weeks old) with mucopurulent conjunctivitis from one farm and on 1 sow with keratoconjunctivitis from another farm. Histologically, the small pigs had lymphoplasmacytic conjunctivitis with mild lymphofollicular hyperplasia. The sow had marked conjunctival lymphofollicular hyperplasia and ulcerative keratitis with neovascularization. Ultrastructural examination of conjunctival specimens from the pigs and sow revealed chlamydiae, often associated with glycogen within intracytoplasmic vacuoles in conjunctival cells. The identity of the chlamydiae isolated from 2 necropsied pigs as well as from conjunctival swab specimens from other pigs on the same farm was unknown. It is possible that the chlamydiae seen ultrastructurally within intracytoplasmic vacuoles containing glycogen in conjunctival cells were Chlamydia trachomatis. Results of this investigation suggested an etiologic role, at least in part, for chlamydiae in the disease process of these swine. On the basis of ultrastructural findings, mycoplasmal coinfection could not be ruled out. Several pigs also had cytomegalic inclusion virus rhinitis.

Animals↗
PubMed1993

Chlamydia trachomatis screening in a family planning clinic.

OBJECTIVE: The purpose of this study was to determine the prevalence of chlamydia in women attending a family planning clinic and to explore the feasibility of making chlamydia screening part of the routine procedure for all women. This study also investigated clinical and demographic parameters that may be associated with chlamydial infections. METHODS: Subjects were 239 female patients who attended the Planned Parenthood Clinic in Wichita, Kansas, during July 1990. Subjects included all patients receiving pelvic examinations regardless of indication. Each subject was screened for C. trachomatis using Testpack Chlamydia (Abbott Labs). RESULTS: Of the 239 women screened, 11 (4.6%) had positive Testpack Chlamydia tests. Young age (< 24 years), self-reported bleeding, and inflammation found on Papanicolaou exams were positively associated with chlamydial infection. CONCLUSION: These parameters provide additional information for the clinician deciding who should be screened for chlamydia infections.

Adult↗
PubMed1994

[In situ hybridization of cells infected by Chlamydia trachomatis].

Hybridization in situ of chlamydia trachomatis allows identification of the bacteria. Moreover exact chlamydia trachomatis localization at tissue level can be demonstrated. It seems to us very important to know for instance in conjunctiva were chlamydia trachomatis are located. We used DNA DIGOXIGENIN labelled plasmidic probe of 503 b.p. Detection of chlamydia trachomatis on paraffin embedded cells becomes possible. Specificity is 100% as plasmidic sequence is not found in other bacteria. Sensitivity seems to be good quality on experimental model. At present time, it is under clinical evaluation. This method could complete PCR for chlamydia detection in case of controversial diagnosis.

Chlamydia Infections↗
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↗
PubMed1999

Lack of association between prior infection with Chlamydia pneumoniae and acute or chronic coronary artery disease.

BACKGROUND: Higher than normal serologic titers and the detection of bacteria within atheroma have suggested an association between Chlamydia pneumoniae (C. pneumoniae) infection and coronary heart disease (CHD), but the relationship has not been well established. HYPOTHESIS: The study was designed to establish a lack of relationship between chronic C. pneumoniae infection and CHD. METHODS: Chlamydia-specific IgG-antibody was assayed using an indirect immunofluorescence test in the serum of 159 patients with severe arterial disease and 203 patients with a heart valve prostheses and no demonstrable CHD. Fatal and nonfatal vascular events and systemic thromboembolism were recorded over a 2-year period. RESULTS: In the arterial group 107 patients (67.3%) and in the valvular group 120/203 (59.1%) were positive for C. pneumoniae antibody. The number of patients with fatal or nonfatal vascular events (double end point) in the arterial and valvular groups was 23 and 2, respectively (p < .0001). Triple end points (fatal plus nonfatal vascular events plus thromboembolism) were also more frequent in the arterial group (p < 0.002). The prevalence of chlamydia antibody positivity was the same in the arterial and valvular groups, and the occurrence of clinical events was also the same for chlamydia-positive (227 patients) as for chlamydia-negative (135 patients). After adjustment for confounding variables, only arterial disease was a predictive factor for double (OR 17.0; 95% CI 3.94-73.3) or triple (OR 3.12; 95% CI 1.56-6.25) end points. CONCLUSION: We find C. pneumoniae chronic infection not to be an independent risk factor for acute or chronic arterial disease.

Acute Disease↗
PubMed1997

Chlamydia pneumoniae respiratory infections among patients infected with the human immunodeficiency virus.

Thirteen cases of Chlamydia pneumoniae infection in patients seropositive for the human immunodeficiency virus (HIV) are described. The occurrence, the clinical spectrum, and the significance of the infection during HIV disease are compared with data reported in the literature. Chlamydia pneumoniae infection was established by a serologic micro-immunofluorescence test using standard diagnostic criteria. In four cases the results of serological tests were confirmed by direct immunofluorescence on respiratory specimens. Five patients developed focal pneumonia but recovered completely after specific antibiotic treatment. Three patients developed severe and diffuse interstitial pulmonary involvement, two of whom died of acute respiratory failure. Five patients developed upper respiratory tract infection. Using 39 pair-matched HIV-seropositive subjects as controls, the cases of infection were found to be significantly associated with a previously diagnosed pulmonary disease. Upon retrospective analysis of 319 consecutive cases of pneumonia among HIV-infected patients, Chlamydia pneumoniae was the sole agent detected in eight (2.5%) cases, and Chlamydia pneumoniae together with other infectious agents was detected in seven (2.2%) cases. Chlamydia pneumoniae is a possible cause of severe respiratory infection in Italian HIV-infected immunocompromised patients, and its presence must be suspected when patients do not respond to therapy with beta-lactam agents or to anti-Pneumocystis carinii treatment.

AIDS-Related Opportunistic Infections↗
PubMed1993

Incidence of community-acquired pneumonia caused by Chlamydia pneumoniae in Italian patients.

The incidence of Chlamydia pneumoniae as a cause of community-acquired pneumonia was evaluated in a one-year prospective study in 108 patients with community-acquired pneumonia. The bacteriological diagnosis was based on culture of sputum or bronchial aspirate and examination of acute and convalescent phase sera for Mycoplasma pneumoniae, Legionella pneumophila and Chlamydia pneumoniae. A definitive microbiological diagnosis was obtained in 58 (54%) patients. Chlamydia pneumoniae was the causative agent in 14 patients (13%) on the basis of positive serological tests; in 10 of the 14 patients Chlamydia pneumoniae was also detected by means of an indirect immunofluorescence test using pharyngeal swab specimens. In conclusion, Chlamydia pneumoniae seems to be a common etiological agent of community-acquired pneumonia, as increasingly reported in the last six to seven years.

Adolescent↗
PubMed1986

In vitro activity of the two new 4-quinolones A56619 and A56620 against Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum and Gardnerella vaginalis.

The in vitro activity of tetracycline, ciprofloxacin and two recently developed 1-aryl-fluoroquinolones, A56610 and A56620, was tested against 65 beta-lactamase-negative and 35 beta-lactamase-positive Neisseria gonorrhoeae strains, 12 Chlamydia trachomatis, 50 Mycoplasma hominis, 28 Ureaplasma urealyticum and 50 Gardnerella vaginalis strains. In the case of Chlamydia trachomatis and Mycoplasma hominis both the MIC and the MBC were determined. The MIC90 of ciprofloxacin for Neisseria gonorrhoeae was 0.008 microgram/ml and of A56619 and A56620 less than or equal to 0.03 microgram/ml. No difference was observed between the activity against beta-lactamase-negative and beta-lactamase-positive strains. The MIC90 values of of ciprofloxacin and A56620 for Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum were identical, the values being 2 micrograms/ml, 1 micrograms/ml and 4 micrograms/ml respectively. The MIC90 of A56619 for Chlamydia trachomatis and Ureaplasma urealyticum was 0.5 micrograms/ml and 1 microgram/ml respectively. The MBC90 values of the three quinolones for Chlamydia trachomatis and Mycoplasma hominis were less than or equal to 2 micrograms/ml. The activity of the quinolones against Gardnerella vaginalis was rather low, the MIC90 being greater than or equal to 4 micrograms/ml. It is concluded that A56619 and A56620 might be useful for single-dose therapy of gonococcal infections.

Anti-Bacterial Agents↗
PubMed1998

[Persistence of Chlamydia pneumoniae in human arteriosclerotic plaque substance. Evidence and consequences].

The obligate intracellular bacterium Chlamydia pneumoniae has recently been implicated in the pathogenesis of atherosclerosis. Serological response to Chlamydia pneumoniae statistically indicates an increased risk of coronary artery disease and myocardial infarction. This surprising relation is corroborated by the presence of chlamydial structures and even viable Chlamydia pneumoniae in atherosclerotic plaques. These findings have already resulted in initial studies on the potential benefit of antimicrobial therapy in coronary heart disease. However, experimental proof of an etiological role of Chlamydia pneumoniae in arteriosclerosis has not yet been accomplished since a well established animal model and a system of genetic recombination are not yet available. In addition, clinical evaluation of patients is complicated by the lack of a useful parameter to indicate the risk of endovascular infection. Whether chlamydiae initiate atherosclerotic injury. facilitate progression of existing plaques, or merely colonize the lesions is therefore not known. Chlamydial contribution to the development of atherosclerosis is a fascinating hypothesis that may initiate a radical change of clinical practice for one of the leading causes of death. At the current state of scientific knowledge, however, an experimental antichlamydial treatment in coronary heart disease may only be justified in well controlled clinical trials.

Arteriosclerosis↗
PubMed2002

Chlamydia pneumoniae in atherosclerotic lesions of patients undergoing vascular surgery.

The pathophysiological implications of Chlamydia pneumoniae in atherosclerotic lesions and its contribution to atherosclerotic complications remain unclear. Therefore, the purpose of the present study was to evaluate whether or not there is an association between the presence of Chlamydia pneumoniae in atherosclerotic lesions and the clinical manifestations as well as risk factors of atherosclerotic disease in patients undergoing vascular surgery. Specimens from atherosclerotic arteries were collected during endarterectomy of the carotid artery (n = 15), endarterectomy of the femoral artery (n = 19), or repair of an abdominal aortic aneurysm (n = 28). Detection of Chlamydia pneumoniae was performed by using immunohistochemical staining (IHC) with specific antibodies. Clinical manifestations of atherosclerotic disease were defined by the presence of cardiovascular risk factors, coronary heart disease, and previous vascular surgery. Inflammatory serum markers were determined in all patients prior to surgery. The specimens of all 62 patients revealed severe atherosclerosis in histological examination and a positive IHC was observed in 41 samples (66%). There were no differences regarding cardiovascular risk factors, coronary heart disease, events of previous vascular surgery, or inflammatory serum markers when comparing patients with positive and negative IHC. In conclusion, our findings showed no correlation between clinical or laboratory parameters of atherosclerosis and the presence of Chlamydia pneumoniae in atherosclerotic lesions. Therefore, Chlamydia pneumoniae appears to be a concomitant phenomenon rather than a causative principle in atherosclerosis.

Adult↗
PubMed1998

Incidence of Chlamydia pneumoniae infection in vertically HIV-1 infected children.

The rate of seroconversion for antibody to Chlamydia pneumoniae was analysed in blood samples of 26 vertically HIV-1 infected children and 14 seroreverter children (HIV-negative children born to HIV-positive mothers) during a 3-year study period. Seroconversion for Chlamydia pneumoniae was found in 13 of 26 HIV-1 infected children and in 1 of 14 in the seroreverter group (P=0.013). A lower mean CD4+ cell count and p24 antigen positivity at enrolment were significantly associated with seroconversion for Chlamydia pneumoniae. Signs and symptoms of acute respiratory infection were recorded in the 30 to 40 days preceding collection of the blood samples showing seroconversion for Chlamydia pneumoniae in 8 of 13 HIV-1 infected children and in the single seroreverter. This study confirms the potential role of Chlamydia pneumoniae in the pathogenesis of respiratory tract infections in HIV-1 infected subjects.

Child, Preschool↗
PubMed2005

High rate of seropositivity of Chlamydia pneumoniae IgA in male patients with nonalcoholic steatohepatitis.

The aim of this study was to investigate if there was any relationship between nonalcoholic steatohepatitis and the rate of Chlamydia pneumoniae seropositivity in a male population. Fifteen men with nonalcoholic steatohepatitis and 20 healthy men were enrolled in the study. The seropositivity rate of Chlamydia pneumoniae immunoglobulin A in the nonalcoholic steatohepatitis and control groups was 53.3 and 5%, respectively. The rate of Chlamydia pneumoniae immunoglobulin A positivity was significantly higher in the nonalcoholic steatohepatitis group than the controls (P = 0.002), while such a difference did not occur for Chlamydia pneumoniae immunoglobulin G positivity (P > 0.05). There is an association between nonalcoholic steatohepatitis and persistent Chlamydia pneumoniae infection as a probable causative or triggering agent. These findings suggest that further studies are necessary to clarify this association.

Adult↗
PubMed2006

A comparison of the population diagnosed with chlamydia in primary care with that diagnosed in sexual health clinics: implications for a national screening programme.

OBJECTIVES: To compare demographic, behavioural and HIV testing characteristics of individuals diagnosed with chlamydia infection in primary care with those in genitourinary medicine clinics, in the absence of a screening programme. The aim was to explore the current and potential contribution of primary care to the control of chlamydia. STUDY DESIGN AND METHODS: We analysed data on individuals who reported one or more chlamydia diagnoses in the past 5 years in a large probability sample survey of the resident, UK general population aged 16-44 years. Estimates were weighted and odds ratios calculated. RESULTS: Women diagnosed in primary care reported fewer sexual partners, and were less likely to have had an HIV test in the past 5 years than their counterparts diagnosed in genitourinary medicine clinics. Age, ethnicity, social class, educational attainment and urbanization of area of residence did not differ between the two groups. Too few men were diagnosed in primary care to allow for such a comparison. CONCLUSIONS: Primary care already diagnoses a large number of women with chlamydia infection, who may perceive themselves as low risk through age or sexual behaviour, yet are likely to comprise a substantial proportion of all infections. Few men are diagnosed in primary care. These groups need to be strategically targeted in the context of a future chlamydia screening programme, which will focus on the screening of younger women at high risk, and in which the role of primary care is still in development.

Adolescent↗
PubMed2006

Chlamydiae-specific proteins and indels: novel tools for studies.

Chlamydiae species are important human and animal pathogens. Their obligate intracellular mode of replication has precluded the use of genetic and molecular biological approaches for understanding their biology. Comparative genomics have identified many rare genetic changes consisting of whole proteins and conserved indels (i.e. inserts or deletions) in widely distributed proteins that are distinctive characteristics of either all, or various subgroups within, chlamydiae. Additionally, several interesting cases of the lateral transfer of genes from free-living bacteria to a common ancestor of chlamydiae, and from chlamydiae to Trypanosoma/Leishmania, have been identified. These novel signatures have possible applications for advancing our understanding of the chlamydiae.

Bacterial Proteins↗
PubMed2005

Is provider continuity associated with chlamydia screening for adolescent and young adult women?

BACKGROUND: Longitudinal patient-provider relationships are a cornerstone of primary care. For many prevention services, better continuity of provider has been associated with better adherence to recommended practice. Our objective was to examine the relationship between continuity of care and chlamydia screening in adolescent and young women, a preventive service where large performance gaps exist. METHODS: The study population included 4117 sexually active women aged 14-25 years continuously enrolled at a large U.S. HMO. Administrative data from 2000 to 2002 were used to document chlamydia testing, provider continuity, and selected covariates. We used logistic regression to examine the relationship between provider continuity and chlamydia testing after controlling for potential confounders. RESULTS: 57.2% of eligible young women received a chlamydia test over the 2-year period. After controlling for utilization and other confounders, we found women in the lowest continuity of care quartile had 41% greater odds of being tested than those in the highest quartile (OR 1.41, 95% CI 1.14-1.76). CONCLUSIONS: For adolescents and young women, the likelihood of testing for chlamydia was reduced when care was concentrated with a usual provider. Potential implications for health service delivery are discussed.

Adolescent↗