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PubMed2004

Phagocytes transmit Chlamydia pneumoniae from the lungs to the vasculature.

Chlamydia pneumoniae, a major cause of community-acquired pneumonia, primarily infects the respiratory tract. Chronic infection of nonrespiratory sites, such as the vascular wall, the brain or blood monocytes, requires evasion from the lungs and spreading via the bloodstream. The cell types involved in dissemination are insufficiently characterised. In this study, New Zealand White rabbits were infected intratracheally with C. pneumoniae, and lung manifestation and systemic dissemination were monitored by polymerase chain reaction and immunohistochemistry. Infection of the lungs was characterised by an early phase dominated by granulocytes and a late phase dominated by alveolar macrophages (AM). Granulocytes, AM and alveolar epithelial cells acted as host cells for chlamydiae, which remained detectable for up to 8 weeks. AM transported the pathogen to the peribronchiolar lymphatic tissue, and subsequently C. pneumoniae entered the spleen and the aorta via dissemination by peripheral blood monocytes. In conclusion, Chlamydia pneumoniae-infected alveolar macrophages transmigrate through the mucosal barrier, and give the pathogen access to the lymphatic system and the systemic circulation. Infected peripheral blood monocytes are the vector system within the bloodstream and transmit the infection to the vascular wall. This is the first description of granulocytes acting as a reservoir for Chlamydia pneumoniae early in infection.

Animals↗

PubMedDate not supplied

Coinfection with chlamydia and gonorrhoea among pregnant women and bacterial vaginosis.

The role of sexual transmission of microorganisms in bacterial vaginosis (BV) is controversial. If sexual intercourse were a risk factor for BV, then we would expect that women with BV would also be coinfected with other sexually transmitted diseases (STD). We investigated the prevalence of STD among pregnant women a low socio-economic status with bacterial vaginosis in Indonesia. Among these women, 23.3% had at least one STD (chlamydia, gonorrhoea, syphilis or trichomoniasis). Chlamydial infection was the most prevalent (19.5%), followed by trichomoniasis (3.8%), gonorrhoea (3.2%) and syphilis (0.4%). Compared to the rates of STD observed in a previous study of all pregnant women (with or without BV) in Indonesia, pregnant women with BV have more than a 2-fold increase in chlamydia (19.5% vs 8.2%) and a 6-fold increase in gonorrhoea (3.2% vs 0.5%). Because detection of BV by Gram stain is easy to perform and economical, detection of BV has potential as a prescreening marker for chlamydia and gonorrhoea among asymptomatic pregnant women of low socio-economic status in Indonesia. Further work is needed to evaluate the usefulness of BV as a prescreening marker for chlamydia and gonorrhoea.

Adult↗

PubMed1999

[Chlamydia abortion in sheep: possibilities for serological diagnosis using a competitive ELISA and insight into the epidemiologic situation in Switzerland].

466 sheep sera out of 19 flocks in Switzerland were examined by a competitive enzyme linked immunosorbent assay (cELISA) for antibodies against Chlamydia psittaci "serotype 1" ("ovine enzootic abortion"). Since numerous positive reactors were found in flocks without abortion history, 30 fecal samples out of two of these flocks were examined by PCR for evidence of chlamydial DNA. One of these samples turned out to contain DNA of Chlamydia psittaci "serotype 1". These results suggest, that in Switzerland "serotype 1" of Chlamydia psittaci is widespread not only as cause of chlamydial abortion but also as latent intestinal infection in sheep. The resulting difficulties for serological diagnosis of chlamydial abortion and possible solutions based on the cELISA are discussed. The complement fixation test (CFT), still considered as standard method for serological examination for Chlamydiae, has additionally been applied.

Abortion, Veterinary↗

PubMed2001

[Evaluation of an atypical clinical presentation for pneumonia caused by Mycoplasma pneumoniae and Chlamydia sp in children].

Mycoplasma pneumoniae and Chlamydia sp. frequently cause atypical pneumonia in children. The study aim was the analysis of clinical picture of pneumonia caused by Mycoplasma pneumoniae and Chlamydia sp. in 278 children treated in the period of 1985-1998 in the IInd Clinic of Pediatrics and Gastroenterology, Medical Academy of Wrocław. The influence of etiological factor and age of children for the clinical picture of the disease was estimated. The most characteristic clinical symptom of the atypical pneumonia in children was "staccato" cough observed in 89.9% of children. More severe course of the mycoplasmal pneumonia in comparison with that of Chlamydia origin was demonstrated. The most severe course of pneumonia was observed in infants. The afebrile course of the disease was observed in the group of Chlamydia pneumonia (in 26.3% of infants, 40% of children aged 1-6 years and 54.8% of children aged 7-15 years). None of children with mycoplasmal pneumonia had an afebrile course of the disease. The most characteristic radiological picture in children with atypical pneumonia were diffused, symmetrical interstitial inflammatory changes of the lungs. In the group of children with mycoplasmal pneumonia in over 50% of cases the enlargement of lymph nodes of the lungs hili were observed.

Adolescent↗

PubMed2001

[Chlamydia pneumoniae: an cause of reactive arthritis?].

Chlamydia pneumoniae is a common cause of acute infections within the upper respiratory tract. It is less well known that chlamydia pneumoniae, just like chlamydia trachomatis, may also trigger reactive arthritis. We describe three patients with arthritis possibly triggered by chlamydia pneumoniae. The patients showed the typical symptoms of reactive arthritis like asymmetric oligo- or polyarthritis, dactylitis, enthesiopathies and tendovaginitis. The course of the disease was quite different. The first patient developed persistent polyarthritis which required longterm treatment with a rheumatic disease modifying drug; the second patient improved after several weeks and the third patient experienced a full remission within a few days.

Acute Disease↗

PubMed2002

[Submitral annular aneurysm, postpartum cardiomyopathy, and anti-Chlamydia pneumoniae antibodies in Niamey (Niger)].

Idiopathic annular submitral left ventricular aneurysm has been described mainly in young Africans living in tropical countries. Association with peripartum cardiomyopathy has been previously pointed out. The purpose of this report is to describe 3 patients with idiopathic annular submitral left ventricular aneurysm identified in a series 50 patients with peripartum cardiomyopathy in Niamey, Republic of Niger. Anti-Chlamydia pneumoniae antibody status was determined in all 50 patients using the micro-immunofluorescence technique that differentiates IgG, IgA and IgM antibodies. Findings showed that all 3 patients with annular submitral left ventricular aneurysm had significantly elevated plasma IgG and IgA anti-Chlamydia pneumoniae antibody levels at the time of diagnosis. In one patient analysis of 2 samples collected 3 months apart indicated chronic elevation with exceptionally high IgG antibody levels (1/2048e). These previously unreported data suggest a possible link between Chlamydia pneumoniae and development of peripartum cardiomyopathy and annular submitral left ventricular aneurysm. This possibility is supported by recent evidence that specific IgA anti-Chlamydia pneumoniae antibodies may be predictive of aortic abdominal aneurysms.

Adolescent↗

PubMed2004

[The relationship between Chlamydia pneumoniae infection and primary biliary cirrhosis].

OBJECTIVE: The aim of this study was to evaluate the association between Chlamydia pneumoniae (CP) infection and primary biliary cirrhosis (PBC). METHODS: Chlamydia pneumoniae IgG and IgM were determined by enzyme-linked immunosorbent assay (ELISA) in 41 well-established PBC patients and two race-matched control groups, PHC, n = 70; healthy controls, HC, n =57). RESULTS: The mean levels and seroprevalence of CP IgG in PBC group and PHC group were significantly higher than in the HC [(46.8 +/- 43.4) RU/ml, (49.5 +/- 45.2) RU/ml vs (28.3 +/- 32.7) RU/ml, P = 0.042 and P < 0.001 respectively; 68.3%, 71.4% vs 42.1%, chi2 values were 5.389 and 11.110 respectively]. There was a markedly elevated seroprevalence of CP IgM in patients with PBC (22.0%) compared with the PHC and HC groups. The odds ratios (ORs) for the presence of CP IgG and IgM for the PBC patients versus the HC were 2.7 (95% CI 0.9 to 6.1) and 5.1 (95% CI 1.4 to 18.5). Though there was no correlation in the level of CP IgG with total IgG in sera of patients with PBC (r=-0.857, p=0.344), CP IgM was related with the abnormally high concentrations of total IgM in the PBC group. CONCLUSIONS: The results of this study do not support the hypothesis that infection with Chlamydia pneumoniae may be a triggering agent for PBC, but suggest that Chlamydia pneumoniae infection probably contributes to the high level of IgM presented in most of the patients with PBC

Adult↗

PubMed2005

[Respiratory infection caused by Chlamydia pneumoniae].

INTRODUCTION: Chlamydia pneumoniae is a pathogen usually associated with respiratory pathology. It has been estimated that this agent causes 5 to 15% of all pneumonias but its incidence among hospitalised children with respiratory infections is unknown. OBJECTIVE: Characterization of the Chlamydia pneumoniae respiratory infections in hospitalised children. PATIENTS AND METHODS: Retrospective longitudinal study of the Chlamydia pneumoniae respiratory infections in children admitted between January 1999 and June 2001 in the Department of Pediatrics in the Fernando Fonseca Hospital-Portugal. Sex, age, race, socio-economic status, number of scholar siblings, frequency of nursery/school, parents smoking habits, familiar atopy, personal history, clinical presentation, diagnosis, treatment and follow-up were analysed for each child. RESULTS: 55 cases were documented, 60% males and 73% whites. The age on admission varied between 17 days and 14 years-old, with a higher incidence below 5 years-old (60%). Twenty-three (42%) of the children were in nursery or in school and 12 (44%) had siblings at school-ages. Parent smoking habits were documented in 21 (38%) and familiar atopy in 21 (38%) children. Respiratory atopy (6 children), gastroesophageal reflux (3), cerebral palsy (1), cleft palate (1) and prematurity (1). Pneumonia was the most frequent clinical presentation (63%), followed by bronchiolitis (20%). The clinical presentation was not specific, with cough (84%), respiratory distress (65%) and fever (58%) being the most frequent signs. The most prevalent radiological pattern was the interstitial (42%). Coinfection by other agents occurred in five cases: S. pneumoniae (2), H. influenzae tipo b (1), P. aeruginosa (1) and tuberculosis (1). Complications were documented in 32 (58%) children: hypoxemia (20), pleural effusion (8), atelectasis (2) e atelectasis and hypoxemia (2). Macrolides were prescribed in 44% cases. DISCUSSION: This study calls the attention to the fact that Chlamydia pneumoniae infection is an etiology to be considered in children with respiratory infection and hospitalisation criteria. This infection can occur in all ages. Because the clinical presentation is not specific and complications can occur, a high level of suspicion is necessary for its diagnosis.

Adolescent↗

PubMed1990

[Chlamydia isolation from a large aviary for birds of prey].

Antigen against Chlamydia psittaci was detected in 31% to 41% of healthy birds of prey (Accipitriformes, Falconiformes, and Strigiformes) by examination of cloacal swabs and faeces out of 119 birds with antigen-ELISA and cell culture. Chlamydia psittaci-antibodies could be demonstrated in 34% of birds by CF, in 74% by BELISA, and in 71% by Chlamydia-Antibody-ELISA (Chlamydia-AK-EIA). Changes of governmental regulations are discussed.

Animals↗

PubMed1990

Efficacy of a vaccine to prevent Chlamydia- or Campylobacter-induced abortions in ewes.

In a sheep flock, Chlamydia psittaci, Campylobacter fetus, Ca jejuni, and Salmonella dublin caused abortions. A vaccine that contained C psittaci type I from 2 sources: a cow with pneumonia and an aborted ovine fetus, Ca fetus, Ca jejuni, and 4 strains of K99 Escherichia coli was given to 240 ewes before they were bred. All fetuses, placentas, and lambs, that died within 36 hours of birth were examined for infectious agents. Of 55 abortions, 30 (55%) were caused by Chlamydia or Campylobacter spp; 25 of the 30 (83%) abortions took place in the nonvaccinated group (n = 240). Forty-five more lambs survived in the vaccinated group than in the nonvaccinated group. Abortion rates for Chlamydia and Campylobacter spp (2.1 vs 10.4% in vaccinated and nonvaccinated groups, respectively) were significantly different (P = 0.003). Abortion rates for S dublin were not significantly different between groups. The Salmonella epizootic was controlled quickly by sanitation and treatment procedures. The vaccine was at least 80% efficacious against Chlamydia and Campylobacter spp and appeared to be protective.

Abortion, Veterinary↗

PubMed1987

[The cat as a possible infection source for Chlamydia psittaci keratoconjunctivitis in humans].

Acute follicular keratoconjunctivitis in a 25-year-old female patient was diagnosed as an infection with Chlamydia psittaci supposedly originating from a household cat with similar symptoms. The diagnosis was based on clinical symptoms, the appearance of Chlamydia-psittaci-specific IgM in the patient and the cat, and excluded other pathogenic agents. Chlamydiae organisms could not be isolated, probably due to prior antibiotic treatment. Two weeks of continuous treatment led to complete recovery of the patient and the cat. Other zoonotic infections of conjunctivitis in cats and keratoconjunctivitis in man caused by Chlamydia psittaci are mentioned.

Adult↗

PubMed1985

In vitro expression of factor-mediated cytotoxic activity generated during the immune response to Chlamydia in the mouse.

Supernatant fluid (SF) prepared by mitogen incubation of spleen cells from A/J mice previously immunized against lethal challenge by the 6BC strain of Chlamydia psittaci was cytotoxic for mouse fibroblasts (L cells) infected with 6BC, as detected by the [3H]thymidine release assay and the trypan blue exclusion test. In contrast, SF prepared from spleen cells taken from unimmunized animals (controls) was not cytotoxic when added to infected L cells. No cytotoxicity was observed when SF was added to uninfected L cells. Maximal levels of cytotoxicity were observed only from cells infected with 6BC for at least 26 hr and exposed to SF for greater than 20 hr. Furthermore, the degree of cytotoxicity was dependent on both the dose of Chlamydia administered and the concentration of SF in the medium. We conclude that the capacity to secrete a spleen cell cytotoxic factor is an aspect of the immune response against the obligate intracellular prokaryotic pathogen Chlamydia. Our results indicate that SF-mediated cytotoxicity is induced subsequent to immunization with Chlamydia, and is significantly more pronounced against infected as opposed to uninfected L cells.

Animals↗

PubMed1993

[Intestinal Chlamydia psittaci infection of cattle: frequency and technical aspects of the cultural detection of the agent].

With the purpose to evaluate the prevalence of latent chlamydial infections in cattle, 190 animals were examined for fecal shedding of chlamydiae. From the feces of 42 animals (22.1%) Chlamydia (C.) psittaci was grown either in the yolk sac of chicken embryos and/or in coverslip cultures of BGM-cells. The cell culture proved to be of lower susceptibility to chlamydial infections. In comparison with the chicken egg technique a sixfold quantity of chlamydial particles was required to initiate detectable intracellular growth. With the chicken embryo technique as a standard cell culture with a sensitivity range of 31.6% was not satisfactory for isolating chlamydiae from bovine feces. Attempts to recover chlamydiae from feces of two experimentally infected heifers in embryonated chicken eggs provided evidence that at least four randomly subsequent isolation trials are required to detect asymptomatic chlamydial infections of the bovine gut with a 95% confident level. Based on this fact, the positivity rate of 22.1% obtained by single fecal specimen examination indicates a wide spread occurrence of chlamydial infections in cattle.

Animals↗

PubMedDate not supplied

Mucosal and systemic humoral immune response of turkeys after infection and reinfection with a Chlamydia psittaci serovar D strain.

The purpose of this study was to examine the effects of Chlamydia-specific antibodies in tears and tracheal washings (IgA and IgG) and sera (IgG) on chlamydial excretion during the course of an experimental infection and reinfection of turkeys with Chlamydia psittaci. Two groups of turkeys were experimentally infected with a serovar D strain of Chlamydia psittaci, either at the age of 7 days or at the age of 35 days. A third group was infected at the age of 7 days and reinfected with the same strain at 35 days of age. A control group consisted of sham infected turkeys. All turkeys were observed daily for clinical symptoms. At the age of 49 days, the turkeys were euthanized and examined for macroscopic lesions. Following primary infection and reinfection, turkeys were equally depressed and dyspneic. Necropsy findings revealed no significant differences in the lesions of the birds which received both the prime and challenge infection and the birds, which received only a single infection. Anti-chlamydial antibodies in sera, tears, and tracheal washings were determined by IgA and IgG immunoblot assays. A clear local and systemic antibody response towards a broad range of chlamydial antigens was already seen 10 to 14 days following the experimental infections at both 7 and 35 days of age. In spite of the presence of Chlamydia-specific antibodies in tears, tracheal washings, and sera, chlamydial excretion was observed in all infected and reinfected turkeys throughout the experiment. In most turkeys, this chlamydial excretion was detected in three or four tissues sampled at set times, i.e., the conjunctiva, nostrils, trachea, and cloaca.

Aging↗

PubMedDate not supplied

A decision analysis to guide antibiotic selection for Chlamydia infection during pregnancy.

OBJECTIVE: To analyze the cost and effectiveness of different antibiotic combinations for the treatment of infection with Chlamydia trachomatis in pregnant women. METHODS: Using availability treatment effectiveness rates from the literature, a decision analysis model was constructed to determine the effectiveness and cost of therapy with 4 antibiotics shown to be useful for Chlamydia infection during pregnancy. Women who were still infected after initial therapy were then treated with a second antibiotic. Outcomes included the total cost of the treatment (including pretreatment and posttreatment cultures and antibiotic cost) and treatment failure rates. RESULTS: The lowest failure rates could be achieved with the use of amoxicillin followed by azithromycin for treatment failures or azithromycin followed by clindamycin hydrochloride. When costs were compared, a strategy starting with amoxicillin followed by azithromycin for nonresponders was favored, with costs approximately 15% lower than starting with azithromycin followed by amoxicillin. Strategies using clindamycin were significantly more expensive. The drug combination recommended by the Centers for Disease Control and Prevention (erythromycin followed by amoxicillin in nonresponders) was more expensive than amoxicillin-azithromycin and had one of the highest failure rates. Variation in the cost of the medications and in the effectiveness of the antibiotics under consideration did not significantly alter the findings. CONCLUSIONS: For pregnant women infected with Chlamydia, initiating treatment with amoxicillin, 500 mg 3 times a day for 7 days, followed by a single 1-g dose of azithromycin for nonresponders is the most cost-effective strategy for treatment.

Adult↗

PubMed1992

Recurrent tonsillitis. The role of Chlamydia and Mycoplasma.

The core tissue microflora of 40 patients who underwent tonsillectomies were examined with cultures, DNA probe tests, enzyme immunoassays, and direct immunofluorescence antibody tests for Chlamydia and Mycoplasma. We believe this is the largest and most accurate prospective study that has examined the role of Chlamydia and Mycoplasma in the core tonsil tissue of patients with recurrent or chronic tonsillitis. The data strongly indicate that, unlike acute tonsillopharyngitis, Chlamydia and Mycoplasma are not involved in recurrent or chronic tonsillitis.

Adolescent↗

PubMed1989

Chlamydia and the adolescent girl. The enzyme immunoassay as a screening tool.

To evaluate the enzyme immunoassay for Chlamydia detection in a population of sexually active urban adolescent girls, 100 endocervical screens using both immunoassay and tissue cell culture were performed. Prevalence of Chlamydia trachomatis was 35%, with more than two thirds of infected adolescents being asymptomatic. When compared with cell culture, the immunoassay was determined to have a sensitivity of 74%, a specificity of 98%, and positive and negative predictive values of 96% and 88%, respectively. Adolescents with false-negative immunoassay test results were more likely to lack evidence of cervical inflammation on examination and have lower-titer infections than their peers with positive results. When the immunoassay was matched against culture for test of cure after therapy, a 10% false-positive rate was found. We conclude that the immunoassay is a useful screening technique for detection of Chlamydia in high-risk adolescent populations; however, its limitations with respect to decreased sensitivity in asymptomatic girls and poor positive predictive value in the context of tests of cure must be appreciated.

Adolescent↗

PubMed2000

Interventions for treating genital chlamydia trachomatis infection in pregnancy.

BACKGROUND: Chlamydia trachomatis is a sexually transmitted infection. Mother-to-child transmission can occur at the time of birth and may result in ophthalmia neonatorum or pneumonitis in the newborn. OBJECTIVES: The objective of this review was to assess the effects of antibiotics in the treatment of genital infection with Chlamydia trachomatis during pregnancy with respect to neonatal and maternal morbidity. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register (Cochrane Library issue 1, 1999). SELECTION CRITERIA: Randomised trials of any antibiotic regimen compared with placebo or no treatment or alternative antibiotic regimens in pregnant women with genital Chlamydia trachomatis infection. DATA COLLECTION AND ANALYSIS: Trial quality assessments and data extraction were done independently by two reviewers. Study authors were contacted for additional information. MAIN RESULTS: Eleven trials were included. Trial quality was generally good. Amoxycillin appeared to be as effective as erythromycin in achieving microbiological cure (odds ratio 0.54, 95% confidence interval 0.28 to 1.02). Amoxycillin was better tolerated than erythromycin (odds ratio 0.16, 95% confidence interval 0.09 to 0.30). Clindamycin and azithromycin also appear to be effective, although the numbers of women included in trials are small. REVIEWER'S CONCLUSIONS: Amoxycillin appears to be an acceptable alternative therapy for the treatment of genital chlamydial infections in pregnancy when compared with erythromycin. Clindamycin and azithromycin may be considered if erythromycin and amoxycillin are contra-indicated or not tolerated.

Anti-Bacterial Agents↗