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[Identification of Chlamydia trachomatis in cell culture (author's transl)].

The method for the identification of Chlamydia trachomatis in tissue culture described by Hobson was slightly modified and tested as to its usefullness for routine-diagnostic. Cervical swabs of 74 prostitutes and 100 unselected gynecological outpatients were examined for Chlamydia trachomatis. The isolation of Chlamydia was carried out by McCoy cell culture; the inclusions were identified by Giemsa and Lugol's train procedure. The isolation rate of Chlamydia trachomatis was 17% in the group of the prostitutes, whereas in the group of unselected women no Chlamydia were detected. The correspondence of our findings with previous results indicates the applicability of the method used.

Animals↗

Antigenic specificity and morphologic characteristics of Chlamydia trachomatis, strain SFPD, isolated from hamsters with proliferative ileitis.

Profound diarrhea associated with proliferating intestinal cells containing intraepithelial campylobacter-like organisms (ICLO) occurs in a variety of mammalian hosts, particularly swine and hamsters. Recently, intracellular bacteria were isolated from proliferative intestinal tissue of hamsters and propagated in intestine cell line 407. Oral inoculation of hamsters with cell culture lysates containing these organisms reproduced the disease in susceptible hamsters. In the present study, an intracellular bacterium from the INT 407 cell line was shown by a variety of techniques to be a member of the genus Chlamydia and has been designated Chlamydia sp. strain SFPD. McCoy cells infected with Chlamydia sp. strain SFPD demonstrated bright fluorescent-stained intracytoplasmic inclusions when examined with fluorescein-labeled species-specific C. trachomatis monoclonal antibodies. The organism also reacted to fluorescein-labeled polyclonal but not monoclonal ICLO "omega" antisera. Ultrastructural examination of the Chlamydia sp. strain SFPD from McCoy cells revealed electrondense elementary bodies and a less electron-dense reticulate-like body that was circular; both features are consistent in morphology to developmental forms of Chlamydia and do not conform to ICLO morphology. Molecular studies, 16S ribosomal sequence analysis, and sequencing of the outer membrane protein confirmed that the isolate is a C. trachomatis closely related to the mouse pneumonitis strain of C. trachomatis.

Animals↗

Two cases of lower respiratory tract infection due to Chlamydia pneumonia in Singapore.

Chlamydia pneumoniae, previously known as Chlamydia psittaci strain TWAR, causes both upper and lower respiratory tract infection. We report the first two cases of culture-positive Chlamydia pneumoniae lower respiratory infection in Singapore. Both patients had underlying fibrosing alveolitis and presented with a history of prolonged productive cough and fever. Chlamydia pneumoniae was isolated from the bronchoalveolar lavage fluid in the absence of other pathogens. The patients responded clinically to three weeks of oral doxycycline therapy. Infection due to Chlamydia pneumoniae should be considered when a patient with community-acquired pneumonia fails to respond to the usual standard antimicrobial therapy.

Anti-Bacterial Agents↗

[Chlamydia urethritis in nephrologic practice].

Chlamydia trachomatis is an ubiquitous bacterium, strictly intracellular organism. The D-K serovars urethritis, cervicitis, endometritis, salpingitis, periappendicitis and perihepatitis, in women, urethritis, prostatitis, epididymitis and Reiter's syndrome in 1-2% of cases in men. Sterility is the most serious complication in both sexes. Chlamydial infections are sexually transmitted diseases, often asymptomatic, prone to recurrences. Cure occurs only when both sexual partners are treated simultaneously. We treated 40 patients, 24 women and 16 men, from 1991-1994, who presented in nephrologic offices with symptoms of chlamydial urethritis. Detection of Chlamydia trachomatis was performed by direct fluorescent antibody stain. All patients had positive urethral swab, six women had chlamydial cervicitis too, one man had Reiter's syndrome, one man orchiepididymitis, and five men prostatitis. Optimal therapy for Chlamydia trachomatis infections consists of a 10-14 day regimen of quinolone, of tetracycline, and macrolides. We used sulfonamide rarely. Because of very serious sequelae of initial infection with Chlamydia trachomatis, every patient with urethritis should be examined by urethral swab for Chlamydia testing. Both partners should be examined and treated simultaneously.

Adult↗

Reinfection with Chlamydia pneumoniae may induce isolated and systemic vasculitis in small and large vessels.

It is a common clinical experience that the onset of the so called non infectious vasculitides is often preceded by upper respiratory tract symptoms. A specific agent is only occasionally recovered. We report five cases in Sweden with manifestations of vasculitis from different organs. In three of the five patients the onset was preceded by upper respiratory tract symptoms. All patients had serologic findings indicating Chlamydia pneumoniae infection and all required corticosteroid treatment for symptomatic recovery. One was diagnosed as an aseptic meningitis. Another was diagnosed as a cerebral arteritis, probably a variant of a giant cell arteritis. A third patient had symptoms similar to a polymyalgia rheumatica engaging the thighs. Two patients had an acute myocardial infarction. One of them had Cogan's syndrome. The other also had pulmonary and hepatic engagement and an elevated level of anti basement membrane IgM antibodies, though not to the Goodpasture antigen. He had no renal involvement. The diagnosis of Chlamydia pneumoniae infection was based on the detection of species-specific IgA, IgG and IgM antibodies to Chlamydia pneumoniae using microimmunofluorescence technique, MIF. Four of the 5 cases exhibited a fourfold increase in antibody titers, and the fifth case was found to have high levels of IgG and IgA antibodies, suggesting recent infection. Investigations for other infectious agents were negative in all patients. The serologic findings in those patients are consistent with a pattern of reinfection with Chlamydia pneumoniae. We therefore suggest that reinfection with Chlamydia pneumoniae may induce isolated and systemic vasculitis in virtually any organ of the body.

Adult↗

Cytologic investigations in Chlamydia infection.

Chlamydia is an extremely common genital infection. It can cause serious disseminated disease and can infect the neonate and the sexual partner. Morphologically, Chlamydia infection was identified in routine Fast smears obtained from 160 women. Chlamydia infection manifests as intracytoplasmic coccoid and inclusion bodies in the metaplastic cells. Infected cells also reveal cytomegaly and multinucleation. Immunofluorescence studies, electron microscopy, tissue studies, histochemical techniques and tissue cultures were undertaken to establish the diagnosis of Chlamydia infection as observed in Papanicolaou-stained material. Detailed cytomorphology of Chlamydia infection is described. Clinical implications of such a diagnosis are discussed.

Chlamydia Infections↗

[Frequency of human papillomavirus-herpes simplex-cytomegalovirus and Chlamydia trachomatis infection in genital tracts of sexual partners].

OBJECTIVES: Much attention is given nowadays to the role of Human Papillomavirus, Herpes simplex virus, Cytomegalovirus, and Chlamydia trachomatis--infections in cervical carcinogenesis. Cytomegalovirus, Herpes simplex and Chlamydia trachomatis are now thought to be teratogenic to humans. DESIGN: We investigated the prevalence of HPV, HSV, CMV and Chlamydia trachomatis in genital tracts of sexual partners. MATERIALS AND METHODS: 90 sexual partners were qualified for the research. Examination smears were taken with the dacron swab from the vaginal part of the uterine cervix, cervical canal, the lower vagina from women and from fossa navicularis penis in men. In the group of 67 men we have investigated semen as well. HPV, HSV, CMV and Chlamydia trachomatis were identified using PCR (Polymerse Chain Reaction)--method. RESULTS AND CONCLUSIONS: In 48% of investigated sexual partners we proved the presence of Human Papillomavirus, in 2.2% of women and 2.9% of men--Cytomegalovirus and in 11.1% of women and 14.9% of men--Chlamydia trachomatis. In the investigated biological material we did not find any HSV infection.

Chlamydia Infections↗

There is more to a test than technology-evaluation of testing for chlamydia infection in a charitable sector termination service.

In order to develop a possible strategy for chlamydia testing throughout the British Pregnancy Advisory Service (BPAS), it was decided to first find the prevalence of the infection in women attending and to examine the practicalities involved in offering tests and dealing with positive results. Urine samples at initial consultation were tested by a method based on the Ligase Chain Reaction (LCR). Five hundred and eighty seven women were tested with an overall chlamydia positivity of 8.1 per cent, but of 12.4 per cent (25/202) in women up to and including 20 years of age. Tests in women over 25 years showed a positivity of only 0.7 per cent (1/147). Urine testing proved to be a convenient, non-intrusive means of chlamydia detection with the potential to lead to prompt management of positive cases. However, in comparison with EIA testing of endocervical swabs, detection of chlamydia in the population studied was not enhanced and some limitations were demonstrated, imposed by requirements for controlled temperature for transport and storage of specimens. Alternative approaches to testing and management was discussed. The time and commitment required to offer this service effectively were observed to be important factors when staff and client were focused on the direct issues relating to the current pregnancy. Modified request forms enabled uniform data to be collated in the laboratory and compared with that from other services currently studied. Ongoing monitoring of chlamydia positivity in this nationwide termination service could provide useful sentinel data about the infection.

Abortion Applicants↗

Postabortal infectious morbidity after antibiotic treatment of chlamydia-positive patients.

The postabortal infection rate in chlamydia-positive women after antibiotic treatment (doxycycline or erythromycin) was compared with infectious morbidity among untreated culture-positive women in a comparable previous study. Of 69 chlamydia-positive patients, 5 (7.2%) developed endometritis and one (1.4%) salpingitis during the first postoperative month. The corresponding figures during the previous regimen were 16 (23.2%) and 10 (14.5%), respectively, i.e. a highly significant decrease (P less than 0.001). The infection rate among the chlamydia-negative women was unchanged. It is suggested that preoperative screening for C. trachomatis should precede legal abortion. Initiation of treatment of culture-positive cases before or at least in conjunction with the abortion seems to reduce the risk of infectious complications to the same level as in chlamydia-negative women.

Abortion, Induced↗

Chlamydia positivity versus prevalence. What's the difference?

BACKGROUND: Data on chlamydia screening collected as part of Regional Infertility Prevention Projects often do not include personal identifiers, therefore repeat tests for patients during a year cannot be identified. Consequently, positivity is calculated and used to monitor chlamydia prevalence. GOALS: To assess how well positivity can estimate prevalence in family planning and sexually transmitted disease (STD) clinic settings. STUDY DESIGN: Analyzed data from chlamydia screening programs in three geographic areas of the United States that used unique patient identifiers. RESULTS: The relationship between positivity and prevalence is related to both the percentage of tests that are repeat tests and the percentage of repeat tests that are positive. On average, the percentage of positive repeat tests was the same as or higher than prevalence in family planning clinics; thus, positivity was the same as or higher than prevalence. In STD clinics, the percentage of positive repeat tests was consistently lower than prevalence; thus, positivity underestimated prevalence. However, the absolute difference between positivity and prevalence was less than 0.5% in family planning and STD clinics. CONCLUSIONS: Positivity can be used to monitor chlamydia prevalence in women screened in family planning and STD clinic settings.

Chlamydia Infections↗

In vitro and in vivo activities of AM-1155, a new fluoroquinolone, against Chlamydia spp.

The in vitro and in vivo activities of AM-1155, a new quinolone, against Chlamydia spp. were investigated. The MIC of AM-1155 for 10 standard strains of different Chlamydia spp. and 25 wild-type strains of Chlamydia pneumoniae isolated in Japan, which were morphologically different from clinical isolates from the United States, ranged from 0.063 to 0.125 microg/ml. Its activity was almost the same as those of sparfloxacin and tosufloxacin and was 4 and 16 times superior to those of levofloxacin and ciprofloxacin, respectively, but lower than those of clarithromycin and minocycline (range for each, 0.016 to 0.031 microg/ml). The minimal chlamydiacidal concentration of AM-1155 ranged from 0.063 to 0.125 microg/ml, while those of clarithromycin and minocycline ranged from 0.016 to 0.031 microg/ml and 0.016 to 0.063 microg/ml, respectively. The therapeutic effect of a 7-day course of AM-1155 at doses of 5 and 10 mg/kg of body weight administered orally twice daily to mice with experimental Chlamydia psittaci pneumonia was excellent, with a 100% survival rate at 21 days after infection. The efficacy was equal to those of clarithromycin and minocycline and higher than those of ciprofloxacin and ofloxacin.

Animals↗

Molecular Characterization of the ClpC AAA+ ATPase in the Biology of Chlamydia trachomatis.

Bacterial AAA+ unfoldases are crucial for bacterial physiology by recognizing specific substrates and, typically, unfolding them for degradation by a proteolytic component. The caseinolytic protease (Clp) system is one example where a hexameric unfoldase (e.g., ClpC) interacts with the tetradecameric proteolytic core ClpP. Unfoldases can have both ClpP-dependent and ClpP-independent roles in protein homeostasis, development, virulence, and cell differentiation. ClpC is an unfoldase predominantly found in Gram-positive bacteria and mycobacteria. Intriguingly, the obligate intracellular Gram-negative pathogen Chlamydia, an organism with a highly reduced genome, also encodes a ClpC ortholog, implying an important function for ClpC in chlamydial physiology. Here, we used a combination of in vitro and cell culture approaches to gain insight into the function of chlamydial ClpC. ClpC exhibits intrinsic ATPase and chaperone activities, with a primary role for the Walker B motif in the first nucleotide binding domain (NBD1). Furthermore, ClpC binds ClpP1P2 complexes via ClpP2 to form the functional protease ClpCP2P1 in vitro, which degraded arginine-phosphorylated β-casein. Cell culture experiments confirmed that higher order complexes of ClpC are present in chlamydial cells. Importantly, these data further revealed severe negative effects of both overexpression and depletion of ClpC in Chlamydia as revealed by a significant reduction in chlamydial growth. Here, again, NBD1 was critical for ClpC function. Hence, we provide the first mechanistic insight into the molecular and cellular function of chlamydial ClpC, which supports its essentiality in Chlamydia. ClpC is, therefore, a potential novel target for the development of antichlamydial agents. IMPORTANCE Chlamydia trachomatis is an obligate intracellular pathogen and the world's leading cause of preventable infectious blindness and bacterial sexually transmitted infections. Due to the high prevalence of chlamydial infections along with negative effects of current broad-spectrum treatment strategies, new antichlamydial agents with novel targets are desperately needed. In this context, bacterial Clp proteases have emerged as promising new antibiotic targets, since they often play central roles in bacterial physiology and, for some bacterial species, are even essential for survival. Here, we report on the chlamydial AAA+ unfoldase ClpC, its functional reconstitution and characterization, individually and as part of the ClpCP2P1 protease, and establish an essential role for ClpC in chlamydial growth and intracellular development, thereby identifying ClpC as a potential target for antichlamydial compounds.

Humans↗

Analysis of caprine IgG1 and IgG2 subclass responses to Chlamydia psittaci infection and vaccination.

Enzyme-linked immunosorbent assays (ELISAs) specific for caprine IgG(H+L), IgG1 and IgG2 were developed and evaluated for serodiagnosis of Chlamydia psittaci infections in a Tunisian goat flock with currently occurring chlamydial abortions and a clinically inapparent goat flock of an animal research facility. Additionally, ELISAs were applied to record the IgG1 and IgG2 dynamics of four goats vaccinated with inactivated Chlamydia psittaci and Coxiella burnetii. For screening purposes, the IgG(H+L) ELISA proved to be superior to the complement fixation test because it detected a larger number of chlamydial abortions and was easier to perform and to interpret. Analysis of Chlamydia psittaci-specific IgG1 and IgG2 responses to naturally occurring infections by ELISA revealed high IgG1 levels associated with IgG2 in goats with current abortions, whereas clinically inapparent, but seropositive goats were characterized by significantly lower IgG1 levels only (P less than 0.001). Similarly, the four vaccinated goats responded initially with Chlamydia psittaci-specific IgG1, whereas second and third vaccinations induced (as in goats with chlamydial abortions) predominantly IgG1, but also IgG2. The results indicated that clinically inapparent chlamydial infection may be distinguished from overt disease by analysing specific IgG1 and IgG2 responses. Applying Coxiella burnetii- specific ELISAs on field samples, IgG1 alone could be detected in eight, IgG2 alone in one and IgG1 combined with IgG2 in nine goats. The coxiella-specific antibody response of the four vaccinated goats was--in contrast to the chlamydia-specific response--characterized by IgG2 dominance.

Abortion, Veterinary↗

Chlamydia psittaci in turkeys: pathogenesis of infections in avian serovars A, B and D.

At 7 days of age, 4 groups, each of twenty specific pathogen free turkeys kept in isolation units were inoculated by aerosol with the Texas Turkey strain (avian Chlamydia psittaci serovar D), strain 92/1293 (avian Chlamydia psittaci serovar D), strain 84/55 (avian Chlamydia psittaci serovar A) or strain 89/1326 (avian Chlamydia psittaci serovar B). A fifth group of 4 specific pathogen free turkeys were sham inoculated controls. At daily intervals for 10 days and then twice weekly up to 34 days post infection, one bird in each group was killed and the target tissues and cells for replication and the sequence of events of serovar A, B and D infections was examined. In these turkeys, the primary site of replication was the respiratory tract. Chlamydial replication could be detected in the respiratory tract on day 1 post inoculation (p.i.) for group A, on day 3 p.i. for group B and on day 1 to 2 p.i. for groups D1 and D2. Subsequently, there was chlamydaemia and localisation in the digestive tract, in one or more parenchymatous organs, in the pericardium and in the conjunctivae. Specific immunoperoxidase staining revealed chamydiae in these organs in epithelial cells and in monomorphonuclear cells in all infected groups. The monomorphonuclear cells were identified as macrophages by double immunofluorescence staining. Chlamydiae were present in the same tissues for serovars A and D, but could not be demonstrated in proventriculus, duodenum, pancreas, ovaries and testes for serovar B. Furthermore, the intensity of replication was similar for all serovars. However, for serovar B in comparison with the other serovars, the bacteria appeared in most tissues 1 to 6 days later and the maximal replication in these tissues occurred 3 to 4 days later.

Aerosols↗

Effects of glucocorticoids on the respiratory burst of Chlamydia-primed THP-1 cells.

We previously observed that the respiratory burst of human monocytes (THP-1 cell line) triggered by phorbol myristate acetate was strongly enhanced by a priming of the cells by Chlamydia pneumoniae [Biochem. Biophys. Res. Commun. 287 (2001) 781]. We describe here the modifications of the responses of Chlamydia-primed THP-1 cells to hydrocortisone (HCT) and methylprednisolone (MPL). HCT and MPL inhibited the production of the cytokines TNFalpha and IL-8. But HCT, which inhibited the respiratory burst in LPS-primed monocytes, paradoxically stimulated the phenomenon in Chlamydia-primed cells; MPL exerted no significant effect. Both glucocorticoids did not significantly modify the triggering effect of Chlamydia on NF-kappaB binding activity. On the expression of p22(phox), a protein subunit of the NADPH oxidase, HCT had an increasing and MPL a decreasing effect. Glucocorticoids thus had unexpected effects on the inflammatory response of Chlamydia-primed monocytes.

Anti-Inflammatory Agents↗

Protection of ewes vaccinated with A22 strain Chlamydia psittaci (ovis) against challenge in pregnancy with homologous and heterologous strains of the organism.

Fifty ewes were randomly divided into four groups. Groups A and B were vaccinated with an experimental vaccine derived from the A22 isolate of Chlamydia psittaci (ovis), an isolate known to cause ovine enzootic abortion (OEA). Groups C and D were unvaccinated controls. In mid-pregnancy, animals in group A and C were challenged with live A22 C. psittaci (ovis) and those in B and D were challenged with a field isolate of the organism (BS) against which the commercially available A22 vaccine appeared to offer poor protection. In group A, three animals showed clinical signs of OEA and six excreted chlamydiae. In group B, five ewes showed clinical signs of OEA and excreted chlamydiae. In group C, three ewes had clinical signs of OEA but seven excreted chlamydiae. In group D, all 11 ewes showed clinical signs of OEA and excreted chlamydiae in the products of parturition. This group produced only four live lambs with an average weight of viable lamb per ewe of 1.4 kg, whereas the other groups each produced 12 or 13 lambs with an average weight of viable lamb per ewe of more than 4 kg. The BS isolate was much more virulent than the A22 isolate for unvaccinated, pregnant ewes. However, the A22 vaccine offered significant protection against the heterologous BS isolate although on this occasion it did not appear to alter the course of disease produced by the less pathogenic A22 isolate.

Abortion, Veterinary↗

Field evaluation of a new commercially available ELISA based on a recombinant antigen for diagnosing Chlamydophila abortus (Chlamydia psittaci serotype 1) infection.

A new commercially available ELISA (ELISAr-Chlamydia) for detecting antibodies against Chlamydophila abortus has been evaluated using sheep field serum samples. The ELISA is based on a recombinant antigen which expresses part of a protein from the 80-90kDa family that is specific to C. abortus. Sera (105) from six flocks with confirmed ovine chlamydial abortion (OEA) outbreaks were used in this study, as well as sera (258) from 18 flocks which had suffered no OEA in the last lambing. The ELISAr-Chlamydia was compared with the complement fixation test (CFT) and with an ELISA using purified C. abortus elementary bodies (ELISA-EB), employing as reference technique a comparative microimmunofluorescence test that differentiates C. abortus infection from Chlamydophila pecorum infection. The results showed that the sensitivity of ELISAr-Chlamydia was 90.9% with a specificity of 85.9%, the sensitivity of CFT was 71.0% with a specificity of 83.6%, while the sensitivity of ELISA-EB was 95.2% and the specificity was 54.2%. Furthermore, ELISAr-Chlamydia was the test with fewer false positives resulting from positive reactivity to C. pecorum, although 15% of the sera positive for C. pecorum but negative for C. abortus antibodies reacted positively. This study demonstrated with field material that ELISAr-Chlamydia provides the most balanced results between sensitivity and specificity, especially in flocks with no clinical OEA but reactivity to C. abortus.

Abortion, Veterinary↗

The prevalence of Chlamydia psittaci infections in Belgian commercial turkey poults.

The prevalence of Chlamydia psittaci infections in Belgian commercial turkey poults was examined and a follow-up study of one Belgian turkey flock was performed. Sera were examined for the presence of anti-chlamydia antibodies by immunoblotting. Cloacal and conjunctival swab smears and lung impression smears were examined for the presence of chlamydial antigen using the IMAGEN Chlamydia immunofluorescence test. Anti-chlamydia antibodies were found in 90 of 100 sera collected at slaughter from turkeys raised during the summer of 1992. The following winter, 73 of 100 sera reacted positively. On all twenty farms examined during 1992, turkeys were positive for anti-chlamydial antibodies. During 1993, chlamydial antigen was detected in swabs from 20 of 40 slaughterhouse turkeys tested. Antigen was found more often in the cloaca than in the conjunctiva. Chlamydial antigen was detected in samples from each of the 4 farms examined. The follow-up study on a turkey farm, sampling the birds at weekly intervals from one week old until 12 weeks of age, revealed that chlamydial antigen and anti-chlamydial antibodies were present during the whole period. During 1994, chlamydial antigen was detected in 45 of 60 lungs from slaughterhouse turkeys from all of 6 farms. During 1995, chlamydial antigen was detected in 41 of 54 lungs of 6 week old commercial turkey poults. The results of the present study indicate that Chlamydia psittaci infections are highly prevalent amongst Belgian commercial turkey poults with apparently little seasonal or year-to-year variation and that turkeys can contract the infection at an early age.

Animals↗