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PubMedDate not supplied

Factors associated with the geographic variation of reported Chlamydia infection in Minnesota.

BACKGROUND AND OBJECTIVES: In Minnesota, physicians have been required to report cases of Chlamydia trachomatis infection since 1985. The distribution of reported cases suggests that there is substantial geographic variation in the rate of chlamydia infection. GOAL OF THIS STUDY: We conducted chlamydia screening at selected sites and a survey of primary care physicians in counties with high and low rates of reported chlamydia infection. We hypothesized that chlamydia infections are uniformly distributed in nonmetropolitan areas, and the geographic differences in reported cases can be attributed to variable testing and reporting practices by physicians. STUDY DESIGN: The number of reported female chlamydia cases per 1,000 women was calculated for each rural Minnesota county in 1990. Fourteen counties with high and low rates of reporting were selected for further investigation. From September to December 1991, universal chlamydia screening was carried out at 11 clinics serving patients in these counties. A questionnaire was mailed to all primary care physicians in these counties. RESULTS: In 1990, the rate of reported chlamydia cases was 4.7/100,000 and 0.1/100,000 for women living in the high-reporting and low-reporting counties, respectively. Chlamydia infection was present in 5.5% and 9.7% of women screened at selected clinics in high- and low-reporting counties, respectively. Physicians in high- and low-reporting counties did not differ significantly in terms of age, gender, number of pelvic exams, or frequency of chlamydia testing. However, physicians in high-reporting counties were significantly more likely to test for chlamydia when evaluating mucopurulent cervicitis or salpingitis, and they were more likely to test a woman whose sex partner had urethritis. Physicians in high-reporting counties were also more likely to have reported a case of chlamydia.

Adolescent↗

PubMedDate not supplied

Chlamydial serology among patients with tubal factor infertility and ectopic pregnancy in Alexandria, Egypt.

BACKGROUND AND OBJECTIVES: Little is known about the role of Chlamydia trachomatis in the etiology of tubal factor infertility and ectopic pregnancy in Egypt. GOAL OF THIS STUDY: To assess the association between past chlamydial infection, tubal factor infertility, and ectopic pregnancy in an Egyptian population. STUDY DESIGN: This report consists of two concurrent case-control studies. First, 51 patients with tubal factor infertility were compared with 48 healthy subjects who did not have tubal factor infertility and 53 pregnant subject subjects. Second, 66 patients with ectopic pregnancy were compared with 51 pregnant control subjects. RESULTS: Geometric mean titers for Chlamydia trachomatis were higher among patients with tubal factor infertility and ectopic pregnancy, and they were more likely to have high antichlamydial titers (> or = 1:128 immunoglobulin G). Serum titer was significantly correlated with histologic evidence of salpingitis among the patients with an ectopic pregnancy. CONCLUSION: Our findings, similar to those from Western societies, suggest that among Egyptian women, prior chlamydial infection is associated with an increased risk of tubal factor infertility and possibly ectopic pregnancy.

Adult↗

PubMed1981

Chlamydial genital infections: manifestations and management.

Infection with Chlamydia trachomatis is an important cause of nongonococcal urethritis and cervicitis, and may be the most common sexually transmitted disease in the United States. Associated complications include epididymitis, proctitis, salpingitis, bartholinitis, arthritis, perihepatitis, and endocarditis. Perinatal transmission of infection may result in neonatal inclusion conjunctivitis and/or pneumonia of infancy. Chlamydial genital infection should be suspected in a patient (male or female) who presents with a gonorrhea-like syndrome but whose laboratory studies fail to demonstrate Neisseria gonorrhoeae. Such patients, together with their sex partners, should receive antichlamydial therapy; the uncomplicated genital infections respond well to oral treatment with tetracycline, erythromycin, and sulfonamide. The most important cause of treatment failure in nongonococcal urethritis is lack of simultaneous treatment of both patient and partner.

Erythromycin↗

PubMed2004

Ultrasound of pelvic inflammatory disease.

Pelvic sonography is commonly performed in patients with a clinical diagnosis of pelvic inflammatory disease. Though the study may be normal or sometimes non-specific, there are a variety of findings that are characteristic of this process. Understanding of the sonographic features of pelvic inflammation, salpingitis, pyosalpinx, tubo-ovarian complex and tubo-ovarian abscess will allow the interpreter to make more specific, clinically useful diagnoses. Sonography can also help to distinguish acute from chronic abnormalities in the fallopian tubes. Correlation of sonography with pelvic CT is important as CT is ordered with increasing frequency in patients with unexplained lower abdominal pain.

Diagnosis, Differential↗

PubMed2003

Extrauterine lesions of intermediate trophoblast.

Lesions of intermediate trophoblast arising in the uterus include exaggerated placental site, placental site nodule, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor. Only 12 examples of extrauterine lesions of intermediate trophoblast (ELIT) have been previously reported; 7 new cases are described herein. Six lesions were located in the fallopian tube or paratubal region and one in the ovary. The patients were 25 to 47 (average 36) years of age. The lesions ranged from 0.6 to 4 cm in diameter; four were cystic. The four placental site nodules (three tubal, one paratubal) were composed of small, sharply circumscribed nodules of intermediate trophoblast with no mitotic activity. The three PSTTs (two tubal, one ovarian) exhibited irregular stromal infiltration by intermediate trophoblast, mitotic activity, and necrosis. Chronic salpingitis was seen in the six tubal/paratubal cases, and endometriosis was seen in four cases. Immunoreactivity for human placental lactogen, human chorionic gonadotropin, and cytokeratin in two cases was consistent with an origin from intermediate trophoblast. ELITs presumably arise from previous ectopic pregnancies, a history of which was present in two of these patients. Follow-up, available on two of the three patients with PSTT, was uneventful at 6 and 12 years, but study of additional cases is necessary to reliably determine the behavior of extrauterine PSTTs.

Adult↗

PubMed1994

Epidemiology of urogenital infections caused by Chlamydia trachomatis and outline of characteristic features of patients at risk.

A study of Chlamydia trachomatis infection was conducted in two stages on 15,656 subjects at urogenital clinics of the Faculty of Medicine and Surgery at La Sapienza University in Rome, the S. Anna Hospital in Turin, and the Niguarda Hospital in Milan. The overall incidence of the disease was 6.4% in patients examined throughout the whole study period. The rate of positive cases was 5.8% for the 5270 patients examined up to 1990, and 6.7% for the 10,386 patients examined from 1990 to 1992, showing an increasing trend. There was a much higher positivity rate in men (9.8%) than in women (6.0%); the difference was statistically significant. Of all patients, 60%, were asymptomatic. In symptomatic patients, C. trachomatis was present in 18.5% of cases of non-gonococcal urethritis and in 12.8% of cases of salpingitis. The highest incidence of C. trachomatis infection was in women who had begun sexual activity at an early age, (under 25 years in age), had several sexual partners and used intra-uterine contraceptive devices or spermicides or both.

Adult↗

PubMed2003

Genetic relationships among avian isolates classified as Pasteurella haemolytica, 'Actinobacillus salpingitidis' or Pasteurella anatis with proposal of Gallibacterium anatis gen. nov., comb. nov. and description of additional genomospecies within Gallibacterium gen. nov.

Bacteria of the avian [Pasteurella haemolytica]-'Actinobacillus salpingitidis' complex have been associated with different pathological conditions in birds, among which salpingitis and peritonitis in chickens of layer type seem to dominate. The aim of this study was to classify these bacteria by comparison of 37 strains tentatively classified as biovars of the avian [P. haemolytica]-'A. salpingitidis' complex or as Pasteurella anatis. PFGE, AFLP and plasmid profiling showed that strains representing different biovars were genotypically different. Phylogenetic analysis of 22 strains characterized by 16S rRNA gene sequence comparison showed that strains classified as biovars 5, 8 and 9 were closely related to the suggested type strain of 'A. salpingitidis' (98.4-99.9% similarity), whereas the remaining strains classified in 12 biovars or as P. anatis were closely related to the type strain of P. anatis (98.1-100% similarity). The two groups were related at 95.7-97.1% similarity. The closest similarity outside this group was 94.6%, between biovar 15 and Bisgaard taxon 3. DNA-DNA hybridization was performed with 34 strains and showed binding above 85% for strains of biovars 5 and 8, including the suggested type strain of 'A. salpingitidis'. Two strains of P. anatis (F 149T and F 279) were closely related at 79% DNA binding to 27 strains of biovars 1,3, 4, 11, 12, 17-20, 22 and 24. A new genus, Gallibacterium gen. nov., is proposed to include the avian [P. haemolytica]-'A. salpingitidis'-P. anatis complex, since these taxa form a monophyletic unit with similarities above 95% on the basis of 16S rRNA sequence comparison and they are unrelated to other genera of the family Pasteurellaceae Pohl 1981. The new genus consists of Gram-negative, non-motile, rod-shaped or pleomorphic bacteria. The bacteria are catalase-, oxidase- and phosphatase-positive. Nitrate is reduced and acid is produced without gas formation from glycerol, (-)D-ribose, (+)D-xylose, (-)D-mannitol, (-)D-fructose, (+)D-galactose, (+)D-glucose, (+)D-mannose, sucrose and raffinose. The genus Gallibacterium can be separated from other genera of Pasteurellaceae by differences in catalass, symbiotic growth, haemolysis, urease, indole, acid production from (+)D-xylose, (-)D-mannitol, (-)D-sorbitol, (+)D-mannose, maltose, raffinose and dextrin and ONPG and PNPG tests. Pasteurella anatis Mutters et al. 1985 is transferred to the new genus as Gallibacterium anatis gen. nov., comb. nov. Genomospecies 1 of Gallibacterium is proposed to include the former biovars 5 and 8 of the avian [P. haemolytica]-'A. salpingitidis' complex. The type strain of Gallibacterium anatis is F 149T (=ATCC 43329T = NCTC 11413T) and the reference strain of Gallibacterium genomospecies 1 is CCM 5974.

Actinobacillus↗

PubMed1988

Bacteriological contamination during laparoscopy with dye injection.

Peritoneal contamination with bacteria during the laparoscopy and dye procedure was studied in 38 subfertile women by culturing samples of peritoneal fluid, aspirated before, and after, injection of dye solution. Bacteria were carried with the dye into a previously sterile peritoneal cavity in 34 women (90%). These vaginal organisms were present in low concentrations, not exceeding 10(5) organisms/ml. These findings explain the low incidence of acute salpingitis after tubal patency tests, but the selective use of antibiotic prophylaxis is recommended.

Coloring Agents↗

PubMed1993

Black-pigmented gram-negative anaerobes in genito-urinary tract and pelvic infections.

Black-pigmented Gram-negative anaerobes are part of the normal vaginal flora and contribute to a range of superficial and deep genital infections. Prevotella melaninogenica is found in moderate numbers (10(4-6) cfu/g) in healthy women; the numbers and detection rates increase in anaerobic vaginosis (where it may be a significant contributor to changed microbial metabolic activity that gives the signs and symptoms of this condition) and in other vaginal infective conditions. Pr. melaninogenica is also part of the mixed flora in deep pelvic infections: endometritis, post-partum and post-abortal uterine infections; salpingitis and tubo-ovarian abscesses; PID and pelvic abscesses. Porphyromonas asaccharolytica is probably not a vaginal commensal, but may be isolated from patients with vaginal or pelvic disease. It is more specifically associated with superficial abscesses (e.g. Bartholin's abscess) and ulcers of the genitalia and perineum. P. asaccharolytica was the commonest species isolated from men with genital ulcers of various primary causes and ranging in severity from superficial balanitis/balanoposthitis to synergic gangrene.

Abscess↗

PubMed1998

Leukemia inhibitory factor in human reproduction.

PROBLEM: Leukemia inhibitory factor (LIF) is a pleiotropic cytokine of the interleukin-6 family and has different biological actions in various tissue systems. Although named for its ability to inhibit proliferation of a myeloid leukemic cell line by inducing differentiation, it also regulates the growth and differentiation of embryonic stem cells, primordial germ cells, peripheral neurons, osteoblasts, adipocytes, and endothelial cells. LIF is crucial for successful implantation of the embryo in mice. Currently, there is an accumulation of data about the role of LIF in human reproduction. METHOD OF STUDY: This review of the literature and of our studies focuses on the expression, regulation, and effects of LIF in the human endometrium, fallopian tube, and ovarian follicle. RESULTS: Human endometrium expresses LIF in a menstrual cycle-dependent manner. Maximal expression is observed between days 19 and 25 of the menstrual cycle, coinciding with the time of implantation. Various cytokines and growth factors induce endometrial LIF expression in vitro. LIF receptor is expressed in endometrial tissue throughout the menstrual cycle and on human blastocysts in a stage-dependent manner. Affecting the trophoblast differentiation pathway toward the adhesive phenotype, LIF plays a role in implantation. LIF is also expressed and secreted by the epithelial cells of the fallopian tube. Its increased expression in the tubal stromal cell cultures by the inflammatory cytokines suggests a link between salpingitis and ectopic implantation in the tube. The rising follicular fluid LIF level around the time of ovulation indicates that LIF may play a role in ovulatory events, early embryonic development, and implantation. CONCLUSIONS: There is growing evidence that LIF may be one of the entities that plays a role in human reproduction.

Animals↗

PubMed1995

The immunobiology and immunopathology of chlamydial infections.

Chlamydiae are obligate intracellular bacterial pathogens of eukaryotic cells responsible for a wide variety of important human and animal infections. In humans, chlamydial infections are generally localised to superficial epithelial or mucosal surfaces, are frequently asymptomatic and may persist for long periods of time if untreated, inducing little protective immunity. Nevertheless, neutralising antibodies of limited efficacy are produced against the main chlamydial outer envelope protein, while gamma interferon (IFN gamma) is chlamydiastatic and paradoxically may play a role both in chlamydial persistence and in protective immunity. Delayed hypersensitivity responses to chlamydiae caused by repeated or persistent infection are thought to be important in the development of the severe scarring sequelae characteristic of cicatricial trachoma and of chronic salpingitis. Chlamydial heat shock proteins bearing close homology with their human equivalents may be major targets for immunopathological responses and their expression is upregulated in IFN gamma induced persistent infection. C. pneumoniae, a common cause of acute respiratory infection in humans, may persist in coronary arteries and is strongly implicated as a risk factor in atherosclerosis and in acute myocardial infarction. This paper reviews the immunology and immunopathology of chlamydial infections in the context of the unique biology of this fascinating but challenging group of organisms.

Animals↗

PubMed2000

Update on Chlamydia trachomatis.

Chlamydia trachomatis is one the most important sexually transmitted diseases; it can cause serious sequelae despite the absence of symptoms in some people. It's estimated that about 25% of women who have acute salpingitis become infertile, and chlamydial infection is the commonest cause. The introduction of screening programs for its detection are still a topic of discussion. The literature shows that the total cost of examination and treatment of complications known to be associated with genital chlamydial infection (PID, chronic pelvic pain, tubal factor infertility) is generally higher than the total cost of a large-scale Chlamydia screening program. The selection of a diagnostic test for detection of chlamydial genital infection depends on availability, local expertise, and prevalence of Chlamydia trachomatis in the test population. Cell culture is too expensive in nonendemic regions, so the use of non-culture techniques is very attractive. PCR (polymerase chain reaction) and LCR (ligase chain reaction) are actually the two most commonly used alternatives to conventional methods for detecting STD agents. In fact, PCR and LCR have proved useful for detection of Chlamydia trachomatis in cervical and urethral samples both in symptomatic and asymptomatic women. Recently, testing of first-void urine (FVU) specimens with these techniques has shown that the amplification tests are as sensitive as tests with endocervical swab cultures.

Animals↗

PubMed1975

The effect of natural and artificial breeding using bulls infected with, or semen contaminated with, infectious bovine rhinotracheitis virus.

Ten cows and heifers (Group B) were inoculated into the uterus at oestrus with semen followed by IBR virus for the first insemination and semen alone if a second insemination was necessary. All animals developed infectious pustular vulvo-vaginitis (IPV), and 2 cows conceived to the first and 2 to the second insemination (pregnancy rate of 40 percent requiring 4.5 services per conception). This group was compared with 10 control animals (Group A) which were treated similarly but received tissue culture fluid instead of virus at the first insemination. Group A had a pregnancy rate of 90 percent requiring 1.7 services per conception. Natural mating of 4 bulls with preputial infections due to infectious bovine rhinotracheitis (IBR) virus with 9 susceptible cows and heifers (group D), resulted in the production of lesions of IPV. The IPV infection did not affect their fertility (pregnancy rate of 89 percent requiring 1.4 services per conception) when it was compared to a similar group of females (group C) mated to the same bulls prior to infection with IBR virus (pregnancy rate of 100 percent requiring 1.2 services per conception). The 6 animals in Group B that were not pregnant and returned to oestrus 3 times were found on slaughter to have endometritis, salpingitis and vaginitis. A high incidence, 5 out of 18 (28 percent), of shortened oestrous cycles (less than 18 days) was a feature of the breeding pattern of this group. The undesirable consequences of distributing semen contaminated with IBR virus from artificial insemination centres are apparent.

Animals↗

PubMed1990

Rearing performance of farmed fallow deer (Dama dama).

The ability of fallow does to rear fawns to weaning age was examined in a group of 243 adult does of known age (Group 1) and 509 adult does of unknown age (Group 2). All does had between 1 and 8 opportunities to rear fawns. There was an increasing proportion of does that failed to rear a fawn to weaning age as the number of rearing opportunities increased, although most does (93.6%) only failed on one occasion. A small percentage of does in groups 1 and 2 failed repeatedly to rear fawns to weaning. At slaughter, the presumed causes of failure in chronic non-breeders included pyometron, cystic ovaries, cervical cysts, a vulval neoplasm and salpingitis. The overall rearing success of both groups of deer was 82.4% and there was no consistent pattern of rearing failure relating to parity or previous rearing history.

Animals↗

PubMed1989

Laboratory diagnosis of human chlamydial infections.

Chlamydia trachomatis is a human pathogen that causes ocular disease (trachoma and inclusion conjunctivitis), genital disease (cervicitis, urethritis, salpingitis, and lymphogranuloma venereum), and respiratory disease (infant pneumonitis). Respiratory chlamydioses also occur with infection by avian strains of C. psittaci or infection by the newly described TWAR agent. Diagnosis of most acute C. trachomatis infections relies on detection of the infecting agent by cell culture, fluorescent antibody, immunoassay, cytopathologic, or nucleic acid hybridization methods. Individual non-culture tests for C. trachomatis are less sensitive and specific than the best chlamydial cell culture system but offer the advantages of reduced technology and simple transport of clinical specimens. Currently available nonculture tests for C. trachomatis perform adequately as screening tests in populations in which the prevalence of infection is greater than 10%. A negative culture or nonculture test for C. trachomatis does not, however, exclude infection. The predictive value of a positive nonculture test may be unsatisfactory when populations of low infection prevalence are tested. Tests that detect antibody responses to chlamydial infection have limited utility in diagnosis of acute chlamydial infection because of the high prevalence of persistent antibody in healthy adults and the cross-reactivity due to infection by the highly prevalent C. trachomatis and TWAR agents. Assays for changes in antibody titer to the chlamydial genus antigen are used for the diagnosis of respiratory chlamydioses. A single serum sample that is negative for chlamydial antibody excludes the diagnosis of lymphogranuloma venereum.

Chlamydia Infections↗

PubMed1981

Antigen-specific serotyping of Neisseria gonorrhoeae: characterization based upon principal outer membrane protein.

Principal outer membrane protein (protein I) of Neisseria gonorrhoeae was prepared nearly free of lipopolysaccharide (LPS) and substantially purified from other membrane proteins by chromatography of partially purified gonococcal outer membranes over Sepharose 6B in the presence of deoxycholate at pH 9.0. This protein I of nine separate antigenic types was coated to polystyrene tubes and used in the enzyme-linked immunosorbent assay (ELISA) to measure antibody to protein I or in inhibition tests to quantitate protein I antigen. No significant inhibition of the ELISA test was produced by purified LPS from the strain used to prepare each of the protein I types or by whole gonococci bearing the same LPS but different protein I antigens as the strain used to produce a given protein I antigen. Of 125 strains of gonococci used as whole organisms to inhibit the protein I ELISA, 124 (99%) typed with one or more of the nine protein I types, and 35% of these typed with a single protein I serotype. Sixty-one of 65 (94%) strains from Seattle and Atlanta patients with disseminated gonococcal infection contained protein I serotype 1, and 16 of 24 (64%) strains from Seattle patients with salpingitis bore one or both of protein I serotypes 1 and 2.

Antigens, Bacterial↗

PubMed1994

Intravaginal inoculation of mice with the Chlamydia trachomatis mouse pneumonitis biovar results in infertility.

In an attempt to establish a model of chlamydial ascending salpingitis and infertility, three inbred strains of mice, C3H/HeN (H-2k), C57BL/6N (H-2b), and BALB/cAnN (H-2d), were inoculated intravaginally with 3 x 10(7) inclusion-forming units of the Chlamydia trachomatis mouse pneumonitis biovar. Mice mated 6 weeks following inoculation were found to have a significant decrease in fertility rate compared with the control groups, as shown by a reduction in the number of pregnant mice and a decrease in the number of embryos.

Animals↗

PubMed1984

Clinical evaluation of precipitin tests for genital actinomycosis.

A precipitin test system for antibodies against Actinomyces israelii, comprising a combination of counterimmunoelectrophoretic and crossed immunoelectrophoretic gel techniques, was evaluated for its clinical usefulness in diagnosing genital actinomycosis. A total of 263 serum samples from healthy women and women with proven actinomycosis, A. israelii-associated salpingitis, other gynecological infections, or miscellaneous gynecological diseases were analyzed. Six different precipitins could be detected. Five precipitins were defined as specific for actinomycosis, whereas one was found to occur nonspecifically in women with gynecological infections. The specificity of the test system for the detection of cases of genital actinomycosis was 98%, and the sensitivity was 83%. The accuracy was 100% for negative prediction and 45% for positive prediction. Thus, the test was shown to be valuable for a noninvasive diagnosis of genital actinomycosis.

Actinomyces↗