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PubMedDate not supplied

Chlamydia trachomatis urethritis in university men: risk factors and rates.

This study reports the rates of Chlamydia trachomatis genital infection in two groups of university men. One hundred twenty-seven came to the student health center with genitourinary complaints, and 29 were identified as the sexual partners of women with chlamydia infections. Evidence of chlamydial infection was found in 29 (22.8 percent) of those presenting with complaints and in 6 (20.7 percent) who were contacts of chlamydia-infected women. Comparison of all symptomatic patients with sexually active controls without genitourinary complaints showed that the symptomatic patients had significantly more frequent exposures to different sexual partners and that they, or their partners, were more likely to have had a sexually transmitted disease. Chlamydial urethritis was significantly more frequent than "nonspecific" urethritis in symptomatic patients who claimed membership in a campus fraternity (P = 0.004). Complaints more likely to be noted with chlamydia included itching (P = 0.004), burning on urination (P = 0.0325), and purulent discharge (P = 0.036).

Adult↗
PubMedDate not supplied

[Chlamydia trachomatis in cytologically diagnosed cervical dysplasia].

Chlamydia trachomatis strains were isolated from the endocervix by the Mc Coy technique in 31 (13.4%) of 232 women aged 18 to 26 years. From 213 women with a negative Papanicolaou smear, chlamydia strains were isolated in 22 (10.9%), and they were isolated in 9 (47.4%) out of 19 women with a cytologic finding of cervical dysplasia. There is a statistically significant difference in the presence of chlamydia trachomatis among women with cervical dysplasia and women with a negative cytologic finding (p less than 0.001). There was no statistically significant difference in the presence of chlamydia trachomatis among women with colpitis (29/213) and in the group of women without colpitis (2/19) (p greater than 0.05).

Adolescent↗
PubMed1990

TestPack Chlamydia for chlamydial detection in physicians' offices.

Chlamydia trachomatis is widely recognized as the most prevalent sexually transmitted disease. It is often asymptomatic and can lead to serious sequelae, including infertility and ectopic pregnancy. For this reason, testing of patients at risk is a necessary health care measure. This study compared TestPack Chlamydia to Chlamydiazyme for the direct detection of chlamydial antigen in endocervical specimens. One thousand three hundred seventy-six patients seen in 47 private practice offices of obstetrician-gynecologists and family practitioners were screened. TestPack Chlamydia, a 25-minute enzyme immunoassay, had a specificity of 98.6% and sensitivity of 90% when compared with Chlamydiazyme, a four-hour laboratory test. The overall prevalence of chlamydial infection in this population was 3.6%. The prevalence among patients less than or equal to 24 years of age was 7.6% higher among subgroups with symptoms and other identified risk factors. The positive predictive value of TestPack Chlamydia (83.7%) makes it an accurate assay for testing women at risk for chlamydial infections.

Adolescent↗
PubMed1990

Detection of Chlamydia trachomatis in cervical smears from pregnant population.

Specimens were obtained for chlamydial cultures and for routine cytologic studies from 281 consecutive pregnant women who presented for their first prenatal visit. Forty patients (14%) had positive cultures for Chlamydia trachomatis. The cervical smears from all patients with positive cultures and from an equal number of age-matched patients with negative cultures were screened for cytologic features reported to be associated with Chlamydia infection. The following features were noted to be more common in the patients with positive cultures: squamous metaplasia, cytoplasmic vacuolation, nuclear abnormalities, human papillomavirus-associated changes, and a greater degree of inflammation. Cytoplasmic inclusions were present in only a single cell in each of 4 (10%) of the patients with positive cultures. None of the cytologic findings was considered to be specific enough to allow a diagnosis of Chlamydia infection. In our experience, the evaluation of cervical smears is of limited value in the detection of Chlamydia infection in pregnant women.

Chlamydia Infections↗
PubMed1990

[Frequency of Chlamydia trachomatis in women under 35 years of age consulting the general practitioner for gynecologic or obstetric reasons].

In a general practice, we examined 173 women under the age of 35 years who sought help for gynaecological or obstetric reasons, consecutively. 18% of all of the examinations for Chlamydia rendered positive results. Chlamydia infection was commonest in the younger age groups. The case histories and objective findings were unsuited for predicting which of the patients had Chlamydia infection. Routine examination for Chlamydia is recommended in women under 25 years in general practice.

Adult↗
PubMed1990

[The role of Chlamydia infection in the development of infectious inflammatory diseases in premature newborn infants].

It is highly probable that neonates may be infected with chlamydiae provided their mothers are chlamydia carriers, especially in disease exacerbation before delivery. Parallelism was noted between the intensity of antigen demonstration in the mother and the child. Infection with chlamydiae potentiates secondary infectious inflammatory diseases in premature neonates. However, diseases of chlamydia etiology developed only in 20.5% of children of all the infected and manifested themselves by pneumonias or total toxicosis without any localized focus of infection.

Adult↗
PubMed1990

Severity of salpingitis in mice after primary and repeated inoculation with a human strain of Chlamydia trachomatis.

Groups of inbred female mice of strains CBA or C3H were infected genitally with a pathogenic human strain of Chlamydia trachomatis (N.I.1, serovar F) known to produce salpingitis and infertility in mice. Mice were inoculated under the ovarian bursa or directly into the uterine cavity with chlamydiae (test groups) or with sucrose-phosphate transport medium (control groups) before being challenged with chlamydiae by the same route 12-17 weeks later. Twenty-five pairs of test and control animals were killed from 7 to 77 days after challenge and oviductal inflammatory changes, recovery of organisms, and antibody responses were compared in the two groups. Salpingitis in the mice infected previously (tests groups) was more severe than in the controls in 56% of comparisons, the same in 24% and less severe in 20%. However, despite the increase in the severity of disease, shedding of C. trachomatis from the lower genital tract was less prolonged after rechallenge or did not occur. Salpingitis occurred in spite of the almost certain presence of pre-existing serum antibody, and accelerated and accentuated antibody response in the rechallenged mice. Furthermore, the continued existence of high titres of antibody was not associated with less severe disease. Thus, the results reveal that previous exposure to chlamydiae does not prevent salpingitis and suggest that its severity is influenced by cell-mediated immune mechanisms.

Animals↗
PubMedDate not supplied

[Maternal-child transmission of Chlamydia trachomatis. A prospective inquiry in 168 pregnant women].

A prospective study was performed in 168 pregnant women in order to evaluate the frequency of perinatal transmission of Chlamydia trachomatis and to measure its effects on the child's health during his first 3 months of life. The micro-organism was detected by an immunoenzymatic method specific to Chlamydia antigens, and microimmunofluorescence was used for serological testing. Cervical smears taken at the end of pregnancy were positive in 3 women (1.7 per cent), while the sera of 37 women were positive for Chlamydia trachomatis. Altogether, 26.8 per cent of the women explored had had a contact with the micro-organism. Conjunctival smears taken from 1 month old infants were all negative, but 4 infants (out of 126) had positive nasal smears. The mothers of 2 of these had been exposed to the bacterium, but all 4 mothers had negative cervical smears. Antibody titres in 3-month old infants were 1.2 dilution on average below those found in the mothers. Women exposed to Chlamydia trachomatis are frequently unmarried; their pregnancies tend to shorter than normally, and their infants have more frequent episodes of rhinitis. These peculiarities are insufficiently pronounced to single out a population at risk that might benefit from detection of the bacterium.

Adolescent↗
PubMedDate not supplied

[Chlamydia trachomatis in smears of irradiated uterine cervix: cytologic and immunocytochemical aspects].

Some authors recently suggested the role of Chlamydia trachomatis as a potentiating agent of female genital tract neoplasias. Cervicovaginal smears of women with uterine carcinoma treated with radiotherapy are analyzed in the present work. A series of such smears showed morphological changes suggestive of Chlamydia infection with the Papanicolaou stain. Confirmation of the presence of such agent was done using an avidin-biotin-peroxidase technique. A higher prevalence of Chlamydia in the group of patients with carcinoma of the uterus treated with irradiation than in the population without ionizing treatment was verified. The presence of cells with radiotherapic changes infected by Chlamydia is a new finding in cytology.

Cervix Uteri↗
PubMed1989

Pathogenesis of acute arthritis due to viable Chlamydia trachomatis (mouse pneumonitis agent) in C57Bl/6 mice.

The purpose of this investigation was to determine the natural history and pathogenesis of the acute arthritis induced by inoculation of a viable Chlamydia trachomatis biovar (mouse pneumonitis agent or MoPn) in C57Bl/6 mice. Immunologically naive (previously unsensitized) mice as well as mice immunized against Chlamydia (MoPn) by vaginal infection were employed. Both intravenous and intraarticular inoculations were employed. No arthritis developed after intravenous injections of MoPn although statistically significant antibody titers and splenic enlargement ensued. Intra-articular inoculation into knee joints produced a definite arthritis of 7 to 10 days duration marked by granulocyte and mononuclear cell infiltration of the joint and vacuolated synovial macrophages that stained heavily for chlamydial antigen by immunoperoxidase technique. Statistically significant increases in articular acute and chronic inflammation (P less than 0.02 were observed in previously sensitized, but not unsensitized, female mice at 2 but not 7 days after intra-articular chlamydial challenge. Chlamydiae were isolated from injected joints up to day 5, but not at day 10, after challenge. Chlamydial antigen disappeared rapidly from knee joints between day 10 and 15 after challenge. Electron micrographs demonstrated vacuolated synovial cells of the macrophage type, many of which contained degenerating chlamydial elementary bodies. Reticulate and intermediate bodies also were seen but were far less frequent than degenerating elementary bodies. Unaltered elementary bodies were difficult to identify beyond day 2 after articular inoculation. Thus, it appears likely that intra-articular chlamydial survival is shorter than the duration of the arthropathy. This may have important implications in attempts to identify chlamydiae in human joints in Reiter's Disease.

Animals↗
PubMedDate not supplied

Evaluation of proposed cytomorphologic criteria for the diagnosis of Chlamydia trachomatis in Papanicolaou smears.

To evaluate the proposed cytomorphologic criteria for the cervical cytologic diagnosis of Chlamydia trachomatis infection, a study was made of 171 endocervical smears. All cytomorphologic elements that could be ascribed to Chlamydia trachomatis infection were correlated with the diagnostic confirmation of this microorganism by monoclonal antibody (MAb) staining. The presence of Chlamydia trachomatis was detected in 21 samples (12.28%) by MAb staining. Comparing the cytomorphologic results with the MAb results, the sensitivities and specificities of the Papanicolaou smear diagnoses were 19% and 86% using the cytologic criteria proposed by Gupta and coworkers, 38% and 87% using the criteria proposed by Kiviat and coworkers and 23% and 91% using the criteria proposed by Shiina. In view of (1) its low sensitivity, (2) the subjective elements and individual variations in the proposed cytologic criteria, (3) the similarity with Trichomonas vaginalis-produced exudates and (4) the implications of a misdiagnosis of a sexually transmitted disease, it is concluded that cervical cytology is not useful for ascertaining the presence of Chlamydia trachomatis.

Cervix Uteri↗
PubMed1989

[Chlamydia trachomatis and infertility in women].

Humoral IgG antibodies to Chlamydia trachomatis were determined in 131 infertile women, 102 with fallopian tube disorders and 29 with other infertility diagnosis and normal fallopian tubes. Chlamydia antibodies were identified significantly more often among women with abnormal fallopian tubes (89%) than among women with other infertility diagnosis (48%). Among Chlamydia antibody positive subjects the mean index was significantly higher among subjects with tubal disorders than among subjects with normal tubes (3,4 versus 2,2; p less than 0.01). This study indicates a close association between anti-bodies to Chlamydia trachomatis and tubal infertility.

Adult↗
PubMedDate not supplied

Prevalence of Chlamydia trachomatis and the genital mycoplasmas in a nonmetropolitan population.

Results of cultures from patients with nonspecific urethritis (NSU) during a 4-year period were retrospectively analyzed. NSU cultures included chlamydiae and mycoplasmas. Seventy-five of 2,408 cultures run by the Missoula Community Hospital microbiology laboratory were positive for chlamydiae (3%). Seventy-five of 1,944 mycoplasma cultures were positive for Mycoplasma hominis (4%), 532 of 1,944 for Ureaplasma urealyticum (27%), and 305 of 1,944, for both (15%), for a total of 46% culture positive for any genital mycoplasma. Results of a prospective study of 40 NSU patients' cultures were tabulated separately. From these 40 patients, no chlamydiae were isolated, but the cultures were 15% positive for M. hominis, 42% positive for U. urealyticum, and 10% positive for both. These studies suggest that the prevalence of chlamydiae may vary with patient population and geographic area. In our population, the mycoplasmas appear to be over 15 times as common (3% vs. 46%).

Chlamydia Infections↗
PubMedDate not supplied

[When in pregnancy should screening for Chlamydia be carried out?].

One goal of every prenatal care should be the diagnosis of a cervical infection with Chlamydia trachomatis and the prevention of its transmission to the neonate. Therefore, we studied the questions (1) at which gestational age a screening would be most meaningful and (2) whether the woman's medical history, a vaginal smear or cervical cerclage suggests any risk of infection. 11 of 121 pregnant women (9.1%) had a positive test for cervical infection with Chlamydia trachomatis at their booking visit. More than half of them had a spontaneous remission at the follow-up visit. Practically, all newborns to infected mothers (at follow-up visits) had a positive test as well. We did not find any relationship between the medical history, vaginal smear or cervical cerclage and the incidence of Chlamydia trachomatis infection. In conclusion, we propose a screening for Chlamydia trachomatis infection of all pregnant women between the 34th and 38th week of gestation and treatment of infected individuals with erythromycin (4 x 500 mg t.i.d.).

Bacteriological Techniques↗
PubMed1986

Evidence of Chlamydia trachomatis infection in gynaecological patients.

Direct microscopic examination of cervical smears taken from gynaecological patients and stained by Giemsa and Gimenez revealed the presence of chlamydial inclusions in 2 and elementary bodies in 6 out of 40 samples tested. Attempts of demonstration of chlamydiae from cervical smears of further patients in chick embryo yolk sacs and cycloheximide-treated McCoy cells using the centrifugation of infectious inocula succeeded in 4 and 9 cases of 71 patients examined, respectively. One isolated strain behaved as Chlamydia trachomatis based on its sensitivity to sulfadiazine, absence of killing the intraperitoneally inoculated mice, demonstration of its inclusions by iodine staining and by detection of its elementary bodies by immunofluorescence technique using mouse serum directed to C. trachomatis but not C. psittaci serotypes. At the same time, 11 of 68 patient sera tested by microimmunofluorescence test contained IgG antibodies to genitourinary serotypes of C. trachomatis, suggesting the previous contact of patients with sexually-transmitted chlamydiae. The results obtained indicate that chlamydiae may pose a public health problem in women of sexually active age also in Czechoslovakia.

Adult↗
PubMed1988

Nursing management of the patient with Chlamydia trachomatis infection.

Information on the recognition and management of clinical syndromes commonly caused by Chlamydia should be widely disseminated. Clinicians must be able to make risk assessments on their patients who may have asymptomatic disease. Because chlamydial infections are often undiagnosed, infected patients continue to spread the organisms to their sexual partners and to neonates. Sexual contacts of patients with Chlamydia or gonorrhea should receive treatment regimens effective against both organisms. Patients who are infected with gonorrhea should receive treatment regimens effective against both organisms. Chlamydia culture is the gold standard for detection of the organism. Antigen detection methods have been developed that offer a low-cost alternative to culture, but these tests are not ideal. Chlamydia tests are not a substitute for clinical experience and risk assessment by the nurse practitioner.

Anti-Bacterial Agents↗
PubMed1988

[Chlamydia trachomatis infection among sexual partners of the patients with non-gonococcal urethritis].

During the past 3 years, 30 sexual partners including 18 married couples and 12 extramarital sexual pairs whose male partners were diagnosed as having non-gonococcal urethritis were examined for Chlamydia trachomatis infection. Twenty-three of the 30 couples (76.7%) had identical results either positive or negative for Chlamydia trachomatis infection. All 3 male partners of the 3 pairs who had the non-identical results for Chlamydia trachomatis infection, male negative and female positive, had history of urethritis or prostatitis. Fourteen of the 17 female partners (82.4%) who were positive for Chlamydia trachomatis, had no subjective complaints. The above findings suggest the necessity of treating the female sexual partners of the non-gonococcal urethritis patients irrespective of their symptom.

Adult↗
PubMed1986

[Incidence of Chlamydia trachomatis infections in pregnant patients in Vienna].

Pregnant women were examined for chlamydia trachomatis-infection on a routine basis during a multicentric study in Vienna. Samples were taken from the cervix and fornix between the 30th and 34th week pregnancy. FTIC-conjugated monoclonal antibodies and immunofluorescence techniques were used to verify chlamydia trachomatis. Out of 1238 pregnant women, 101 (8.16%) were positive for chlamydia trachomatis. Since chlamydia infections can result in severe local or generalized complications and also spread to the newborn baby, screening investigations should be regularly performed during pregnancy and, if indicated, adequate treatment undertaken.

Austria↗