[Urinary tract infections. Chlamydia].
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Chlamydia Infections↗
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Inhibition of apoptosis in chlamydia-infected cells: blockade of mitochondrial cytochrome c release and caspase activation.
We report that chlamydiae, which are obligate intracellular bacterial pathogens, possess a novel antiapoptotic mechanism. Chlamydia-infected host cells are profoundly resistant to apoptosis induced by a wide spectrum of proapoptotic stimuli including the kinase inhibitor staurosporine, the DNA-damaging agent etoposide, and several immunological apoptosis-inducing molecules such as tumor necrosis factor-alpha, Fas antibody, and granzyme B/perforin. The antiapoptotic activity was dependent on chlamydial but not host protein synthesis. These observations suggest that chlamydia may encode factors that interrupt many different host cell apoptotic pathways. We found that activation of the downstream caspase 3 and cleavage of poly (ADP-ribose) polymerase were inhibited in chlamydia-infected cells. Mitochondrial cytochrome c release into the cytosol induced by proapoptotic factors was also prevented by chlamydial infection. These observations suggest that chlamydial proteins may interrupt diverse apoptotic pathways by blocking mitochondrial cytochrome c release, a central step proposed to convert the upstream private pathways into an effector apoptotic pathway for amplification of downstream caspases. Thus, we have identified a chlamydial antiapoptosis mechanism(s) that will help define chlamydial pathogenesis and may also provide information about the central mechanisms regulating host cell apoptosis.
Animals↗
[The effect of tetracycline therapy on the laboratory indices of chlamydia infection in Reiter's disease (preliminary report)].
The authors studied the effect of tetracycline therapy (short and long courses) on the indices of chlamydia infection (antigens and antibodies) in Reiter's urogenous disease. The concentration of tetracycline in the blood serum and synovial fluid when administered in a daily dose of 2.0 g (single dose 0.5 g) was determined. It has been established that tetracycline exerts an inhibitory effect on the chlamydia infection not in all the patients suffering from Reiter's disease despite sufficient concentration of the antibiotic in biological fluids (blood serum, synovial fluid). Prolonged courses of tetracycline therapy proved most effective.
Adolescent↗
[Is there a correlation between tubal occlusions in chronic salpingitis and urogenital chlamydia infections?].
A prospective study was performed to analyse the relationship between urogenital infections caused by Chlamydia trachomatis and occlusions of the fallopian tubes with histologically confirmed chronic salpingitis and salpingitis isthmica nodosa. 110 infertile patients were tested for C. trachomatis infection. 23 patients with tubal occlusions and histologically confirmed chronic salpingitis (group 1) and eight patients with salpingitis isthmica nodosa (group 2) were compared to 13 patients with tubal occlusions after tuboligation (group 3), and to 66 patients with patent fallopian tubes as demonstrated by laparoscopy or hysterosalpingography (group 4). The prevalence of infections of the endocervix or urethra and the presence of Chlamydia in urine was low in all four groups. However, in groups 1 and 2, the median Chlamydia IgG and IgA serum antibody titres were significantly higher (p < or = 0.0002) than in groups 3 and 4. This result illustrates the association between urogenital infections with Chlamydia and tubal occlusions with histologically documented chronic salpingitis and salpingitis isthmica nodosa.
Adult↗
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↗
Blocking antibody assay for confirmation of urogenital Chlamydia infection.
We evaluated the Syva MicroTrak Chlamydia Blocking Antibody Assay as a confirmatory assay for the detection of Chlamydia trachomatis in urogenital specimens. During a 5-month period, 109 positives were obtained (4.9%) by the MicroTrak II Enzyme Immunoassay as implemented with the Syva XL automated enzyme immunoassay instrument. Of 98 evaluable samples, 92 (93.9%) were confirmed as positive by the blocking assay, and 3 blocking-negative samples had organisms detected by direct fluorescent-antibody analysis (blocking sensitivity, 96.8%). We found that direct fluorescent-antibody analysis of samples with a specimen-to-cutoff absorbance ratio of < or = 2.0 was a reasonable confirmation alternative and was more cost-effective than the blocking assay.
Adult↗
[Testing pattern and prevalence of Chlamydia infections among men].
BACKGROUND: The knowledge of testing patterns and prevalence of chlamydia among Norwegian men is sparse. MATERIALS AND METHODS: Data on chlamydia tests for men were selected from the database at the only laboratory in a Norwegian county carrying out chlamydia tests. 12,633 men aged 15-59 at first test and resident in the county were included in the study. RESULTS: Age-specific rates for first test for young men increased throughout the study period. By the age of 25, one in five men had been tested for chlamydia at least once. One in six of first tests was positive. Chlamydia prevalence at first test was highest among men 20-24 years old (21% in 2003). Men who initially had a positive test more often had a repeated test than men who initially had a negative test. Furthermore, 12-month incidence of chlamydia infection subsequent to the first test was higher among men who initially tested positive (12%) than among men who initially tested negative (7%). INTERPRETATION: Even though testing rates increased throughout the study period, the proportion of men who had been tested for chlamydia at the age of 25 was low. The prevalence at first test was high throughout the study period. Increased availability of urine-based testing will probably lead to more chlamydia testing among men.
Adolescent↗
[Studies on infectivity and microbiological incubation time of Chlamydia infection in men with urethritis and in their sexual partners. II. Significance of the microbiological incubation time for the correct determination of the risk of infection].
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Chlamydia trachomatis↗
Prevalence and correlates of Chlamydia infection in Canadian street youth.
PURPOSE: To determine the prevalence and correlates of Chlamydia trachomatis in Canadian street youth. METHODS: A cross-sectional study of street youth between the ages of 15-24 years was conducted over a 9-month period in seven large urban centers across Canada. Youth were recruited through "drop-in" centers, outreach work, and mobile vans in each city. Information was collected through a nurse-administered questionnaire. Youth were asked to provide urine to test for chlamydia trachomatis by polymerase chain reaction. Separate logistic regression models were run for males and females controlling for age. RESULTS: The prevalence rate of chlamydia was 8.6% in 1355 youth (95% CI = (7.1%, 10.1%)). Higher prevalence rates were found in females than in males (10.9% vs. 7.3%, respectively) and in Aboriginal youth than in non-Aboriginal youth (13.7% vs. 6.6%, respectively). Four variables were associated with increased risk of chlamydia infection in females: Aboriginal status; self-perceived risk; having no permanent home; and having been in foster care. One predictor of chlamydia for males was having had a social worker. CONCLUSIONS: A high prevalence of chlamydia was found in this vulnerable population in comparison to other Canadian youth. Having been in foster care and having had a social worker were found to have a strong association with chlamydia.
Adolescent↗
[Epidemiology of Chlamydia infections].
Cultural and serological tests for Chlamydia trachomatis infection were performed in 213 patients at Düsseldorf University Gynecological Clinic Düsseldorf. 16 of these patients were tissue culture positive. Titers of antibodies greater than 1:100 were found in 37 patients with the ELISA. In tumorpatients the incidence of acute infection is not different from others, however antibodies were found in 35% of all tumorsera tested.
Adult↗
Risk profile for Chlamydia infection in women from public health clinics in New York State.
The prevalence of chlamydial infection and associated risk factors were studied in 1531 women from ten clinics in New York State excluding New York City. Overall Chlamydia infection rates were 13.6%; 17.6% in eight high risk family planning and STD clinics, and 5.7% in two low risk college and private clinics. Risk factors for Chlamydia infection included: age < 20 years (odds ratio 1.6), use of oral contraceptives (odds ratio 2.0), a history of having more than one sexual partner (odds ratio 1.7) and, in one clinic where data was available, inflammation on Papanicolaou smears (odds ratio 2.1). These data helped secure funding for Chlamydia preventive services and permitted development of a risk profile (score card) of Chlamydia for each age group. Use of such a score card can be most helpful in assigning which patients could benefit most from Chlamydia cultures, especially in those areas where testing is unavailable or too costly to screen all patients.
Adolescent↗
Are adolescent girls with Chlamydia infection notifying their partners?
OBJECTIVES: (1) To determine the proportion of inner-city adolescent girls diagnosed with chlamydial cervicitis who notify their sex partners; (2) to examine girls' attitudes and perceptions about partner notification and treatment; and (3) to assess whether or not girls knew if their partners were treated for chlamydia infection. DESIGN/METHODS: Adolescent girls who had a positive DNA hybridization test for chlamydial cervicitis from March 2000 to May 2002 completed a 37-item self-administered survey assessing sexual behavior and partner notification, as well as the Rosenberg self esteem scale. Subjects completed the survey 1-3 months after the diagnosis of chlamydia infection. RESULTS: Fifty-five adolescent girls (46% Hispanic, 36% African American) aged 13-21 years (mean 18.3 years) completed the survey. The median age at first intercourse was 14 (SD = 1.6); median number of lifetime sex partners was 4. Forty-one subjects (75%) notified their sex partners. The most common reasons for partner notification were"I did not want my sex partner to give the infection back to me"and"I wanted to let my sex partner know that he/she had given me the infection". There was a trend toward increased notification if the girls were 18 years of age or older (P = 0.07) or had only one lifetime sex partner (P = 0.08). Of the 41 subjects who notified their partners, 22 (54%) reported that the partners were treated; 16 did not know, and three knew that partners were not treated. CONCLUSIONS: The majority of inner-city girls in this study notified their partners about chlamydia infection. Self-protection from re-infection was an important reason given for notification and suggests that girls in committed ongoing relationships might be more likely to notify partners.
Adolescent↗
[Increasing number of Chlamydia infections--how can we reverse this trend?].
The incidence of chlamydia in Göteborg, the second largest city in Sweden, increased by 81 percent between 1995 and 2001. The majority (82%) of men and women diagnosed with chlamydia were aged 15-29 years. The incidence of chlamydia was higher among teenagers from areas of lower socio-economic index during the first years of the study but after 1995 there was no difference between low and high socio-economic groups. Chlamydia tests were taken three times more often in women than men. Analysis of original data from the Swedish survey of sexual behaviour 1996 demonstrated a strong correlation between the number of sexual partners and STD. Strategies for preventing the spread of chlamydia should be to a greater extent directed towards men and include better accessibility for men to STD clinics as well as a general improvement in contact tracing. The general public should be informed about the fact that chlamydia infections do not always give symptoms and may lead to infertility. Campaigns about condom use in order to avoid chlamydia, HIV-infection and other STD are needed.
Adolescent↗
Role of Nramp1 deletion in Chlamydia infection in mice.
Elicited macrophages from 129sv mice with a functional deletion of the natural-resistance-associated macrophage protein 1 gene (Nramp1) were shown to be as susceptible as wild-type mice to infection with the Chlamydia trachomatis mouse pneumonitis and L3 serovars and to Chlamydia pneumoniae. Furthermore, the two groups of mice were shown to be similarly susceptible to an intranasal infection with these microorganisms. In conclusion, the Nramp1 gene does not appear to play a major role in the regulation of the susceptibility of mice to a chlamydial infection.
Animals↗
[Genital chlamydia infections--clinical aspects, diagnosis and therapy].
Non-gonococcal urethritis and its counterpart in women have become the most frequent genital infection worldwide. As Chlamydia trachomatis is the major causative agent interest has focused on this bacterium. While genital chlamydial infection in men often is manifest the opposite holds true for women. Major complications such as pelvic inflammatory disease can nevertheless turn up. Therefore efficient diagnostic tools are badly needed. If tissue culture procedures are not available direct specimen tests can be performed using fluorescence labelled monoclonal antibodies. For therapy tetracyclines and erythromycin are still the drugs of choice although the cure rates are not totally acceptable. Therefore evaluation of the new quinolones deserves interest.
Anti-Bacterial Agents↗
Clinical aspects of diagnosis of gonorrhea and Chlamydia infection in an acute care setting.
We found a 10.4% prevalence of unrecognized genital gonorrhea and Chlamydia infection among young adults of an urban emergency department. Intensified detection and treatment policies are needed to prevent continued transmission and complications of sexually transmitted infections.
Adolescent↗
Genital chlamydia infection.
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Chlamydia Infections↗
[Follow-up after treatment of genital chlamydia infection].
We surveyed routine practice among a random sample of 302 Norwegian general practitioners. 49% perform a test of cure in all the patients whom they treat for genital infection caused by Chlamydia trachomatis. 22% of the practitioners test "most" patients, 19% test "some" patients while 10% of the general practitioners test none of the patients after treatment for genital chlamydial infection. Female practitioners perform more tests of cure than male practitioners do. Most tests are performed 1-4 weeks after completion of treatment. Although test of cure has been a controversial topic, we believe it to be a useful measure against the epidemic of genital chlamydial infections. The purposes of the test are to establish whether or not the treatment has been effective and ensure that the patient has not been reinfected by a partner who did not receive treatment. The test of cure must be performed later than two weeks after completion of treatment, in order to avoid false positive tests as a result of residual chlamydial antigen in the genitalia.
Bacteriological Techniques↗