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PubMed2000

Risk behaviors and the prevalence of Chlamydia in a juvenile detention facility.

The prevalence of Chlamydia trachomatis, a sexually transmitted disease, and the association of selected behavioral risk factors were assessed in a population of adolescents in two juvenile detention facilities. Urine was collected for Chlamydia testing and a brief interview conducted for risk and demographic information. Almost all of the 200 participants were sexually active, many before the age of 13 years. The prevalence of Chlamydia infection was 22.2% among female and 8.7% among male participants. Injection drug use was the only statistically significant variable associated with infection. Education and community services are necessary to break the cycle of infection for this high-risk population.

Adolescent↗
PubMed1990

Incidence of Chlamydia antibody in patient groups, as measured by the ELISA technique.

An ELISA technique has been used to study the incidence of antibody against Chlamydiae: the results obtained with a panel of control sera were compared with those for the complement fixation (CF) and whole inclusion immunofluorescence (WIF) tests. The results indicate that the ELISA results correlate well with the WIF test but poorly with the CF test; and the correlation allows ELISA results to be directly related to WIF antibody titres. Using the ELISA test, the incidence of antibody to Chlamydiae by age was determined in sera collected in Great Britain and Iraq; and in sera collections made at three periods during the last 30 years in Great Britain: the results indicate the higher incidence of antibody in this country compared to Iraq, but do not suggest an increased incidence of antibody in Great Britain during the last 30 years. Studies on sera collected from patients with non-gonococcal urethritis and pelvic inflammatory disease indicate significantly higher titres and incidence of antibody compared to controls, which suggest a contiguous spread of infection for the primary genital lesion to involve more distant tissues and organs. A higher incidence of antibody was also seen in patients with cervical intraepithelial neoplasia (CIN) which may be interpreted as either indicating a causal relationship between Chlamydiae and CIN or indicating the importance of a venereal infection in this condition.

Adolescent↗
PubMed1990

Comparison of Pharmacia Chlamydia EIA, IDEIA and cell culture in the detection of urogenital chlamydial infection.

Two commercial test kits, Pharmacia Chlamydia EIA (PhEIA) and IDEIA Chlamydia Test, for the identification of Chlamydia trachomasis and McCoy cell culture were compared in urogenital specimens. The sediments of the transportation buffers of specimens with discordant results were investigated for elementary bodies (EB) with fluorescein-labelled antichlamydial antibodies. The prevalence of chlamydial infection among the men was 16% (48 of 293), 47 culture positive and one EB positive, and among the women 10% (10 of 97), 10 culture positive. In men, the sensitivity of PhEIA, IDEIA and culture was 71%, 40% and 98%, respectively. In women, irrespective of site, corresponding figures were 100%, 80% and 100%. The specificity and positive predictive values were 100% for both enzyme immunoassays in men and women. The low sensitivity of IDEIA could not be explained by the degree of infection as measured by the number of inclusion bodies in cell culture, the presence of antigen as measured by the number of EBs or the sampling order.

Adult↗
PubMedDate not supplied

Prevalence of urogenital Chlamydia trachomatis infection in El Salvador. I. Infection during pregnancy and perinatal transmission.

One-hundred and twenty-nine pregnant women in labour (age range 15-46 years; median age 23) and 42 infants born to chlamydia-positive mothers (age range 5-15 days; median age 10) were investigated to estimate the prevalence and incidence, respectively, of Chlamydia trachomatis infection in San Salvador, El Salvador. Urethral and cervical samples were obtained from all women and conjunctival specimens were taken from both eyes of each child. The chlamydial antigen was detected with the commercial Pharmacia Chlamydia EIA kit. Direct immunofluorescence (DFA) (Syva MicroTrak) was used for confirmation. In the newborns both EIA and DFA tests on direct preparations from ocular smears were performed on all the samples. The prevalence of chlamydial infection in pregnant women was 44% (57/129). The incidence of chlamydial infection in neonates was 64% (27/42), and the majority of the infected children (56%) had conjunctivitis. Referring to individuals rather than specimens the sensitivity of EIA tests on conjunctival samples from the infants was low (37%) as compared with 91% on urethral and cervical specimens from the pregnant women.

Adolescent↗
PubMed2002

Chlamydia--inside out.

The aim was to inform other health care professionals within the field of sexual health about the expanding role of the health adviser in genitourinary medicine. It also highlights the complementary role of a community health adviser that may develop if the chlamydia pilot study became a national screening programme. An audit of time management and workload created by partner notification for the positive patients generated by the chlamydia pilot was undertaken. This was done prospectively over a two-month period and the data were collected by the health advisers in the genitourinary medicine department. The results showed that 164 people generated by the pilot study were treated for chlamydia (80 cases and 84 partners): 25 letters and 8 phone calls were required to achieve this. The national sexual health strategy now addresses the issue of integration of sexual health services. It may be suggested that the role of the health adviser could be fundamental to this strategy and development of a community health adviser may then evolve.

Adolescent↗
PubMed2003

Does bacterial vaginosis alter the sensitivity of screening tests for Chlamydia trachomatis? An analysis of patient characteristics.

The aim of this study was to assess if patient characteristics could influence the sensitivity of enzyme immunoassay (EIA) testing used for chlamydia screening. Our cohort consisted of 56 patients who were known polymerase chain reaction-positive for chlamydia, but with variable EIA results. Characteristics analysed included those already known to influence the EIA (menstruation, pregnancy, difficult examination) and those suspected from clinical observation (including presence of symptoms or signs, coexistent gonorrhoea, duration from last sexual exposure). An unexpected finding was that significantly more cases of bacterial vaginosis were found in those chlamydia EIA-negative compared to those with positive results. We postulate that an enzyme produced in bacterial vaginosis, proline aminopeptidase, may cause destruction of the chlamydial cell wall, therefore affecting the EIA adversely. Further research is needed to explore this hypothesis.

Chlamydia Infections↗
PubMed2005

Are women with chlamydia infection who self-refer to genitourinary medicine clinics different?

The objective of this study was to explore whether patients with Chlamydia trachomatis infection who self-refer to genitourinary medicine clinics have different demographic characteristics to those who initially attend other agencies. This study took place in three genitourinary medicine clinics from Birmingham, Nottingham and Sheffield. Demographic and post-code data were collected from female patients diagnosed with genital chlamydia infection in 2000. Townsend scores, as an index of socioeconomic status, were derived from post-codes from a subset of the cohort (from Birmingham). Comparison was made between those who were diagnosed by genitourinary medicine clinics and those diagnosed in the community and referred to genitourinary medicine clinics for further management. Data were collected from 1047 genitourinary medicine and 816 non-genitourinary medicine women, of whom 686 (84.1%) attended genitourinary medicine clinics following referral. After excluding those with incomplete data, 1614 (987 genitourinary medicine and 627 non-genitourinary medicine) patients were included in the study. Using logistic regression analysis, we were unable to demonstrate any significant differences in age or Townsend scores between genitourinary medicine and non-genitourinary medicine patients. However, significantly more Black Caribbean (odds ratio [OR] = 2.72, 95% confidence interval [CI]: 2.22, 3.20) and single women (OR = 1.97, 95% CI: 1.64, 2.29) self-referred to genitourinary medicine clinics compared with other health-care settings. This trend was consistent between Birmingham and Nottingham. In Sheffield, there was no difference in marital status. Ethnicity was not a factor as there were no Black Caribbean patients in the Sheffield cohort. Women who were diagnosed with genital chlamydia infection in genitourinary medicine clinics have some different demographic characteristics to those who were diagnosed in the community.

Adolescent↗
PubMed1998

Detection of male genital infection with Chlamydia trachomatis and Neisseria gonorrhoeae using an automated multiplex PCR system (Cobas Amplicor).

We evaluated Cobas Amplicor, a highly automated polymerase chain reaction (PCR) system, to test first-void urine (FVU) and urethral swab specimens for Chlamydia trachomatis and Neisseria gonorrhoeae in men attending a sexually transmitted infection (STI) clinic. Results were compared against an in-house radioimmune dot blot (DB) test for C. trachomatis and selective culture for N. gonorrhoeae. Three hundred and ninety sets of specimens were obtained from 378 consecutive new and returned-new patients. Gonorrhoea prevalence was 9.49%, with no significant difference in sensitivity or specificity between culture and PCR. Chlamydia prevalence was 15.4%, with sensitivities of: DB 55%, PCR of FVU 86.7%, urethral swab PCR 90%. The specificity of PCR on FVU and urethral swabs was 100%. We have shown that Cobas Amplicor PCR is highly sensitive and specific in the diagnosis of chlamydia and gonorrhoea in men attending an STI clinic. Further economic and scientific studies are needed to determine the cost-effectiveness of this technique for screening in primary care settings.

Automation↗
PubMed1998

Quantification of Chlamydia trachomatis in cervical and urine specimens from women attending a genitourinary medicine clinic: implications for screening strategies.

Population screening and intervention programmes can reduce the prevalence and incidence of infection with Chlamydia trachomatis, especially if sensitive molecular diagnostic tests are used. However, diagnostic tests that perform well on genitourinary medicine (GUM) clinic populations may be less useful for screening, particularly if the majority of infected subjects are asymptomatic and their samples contain fewer organisms. We have compared the extent of low organism load in cervical and urine samples from symptomatic and asymptomatic chlamydia-positive women, by using a direct fluorescent antibody staining method and counting the chlamydial elementary bodies (EBs). We have investigated the ability of an enzyme immunoassay (EIA; MicroTrak) and a DNA amplification (ligase chain reaction; LCR) assay to detect low numbers of organisms in cervical samples and the ability of the LCR assay to detect low numbers of organisms in urine. A low organism load (< 10 EBs) was seen by direct fluorescent antibody (DFA) staining in about 30% of cervical samples and in about 75% of urines from chlamydia-positive women; the proportions in symptomatic women were not significantly different from those in asymptomatic women. The EIA identified only 16% of cervical samples that contained < 10 EBs by DFA staining; the LCR identified 100% of cervical samples and 93% of urine samples that contained < 10 EBs by DFA staining. The findings suggest that the ability of chlamydial diagnostic tests to identify positive women should be similar among patients attending a GUM clinic and those taking part in a population screening programme, and that sensitive molecular assays such as the LCR should identify subjects with a low organism load in both groups.

Chlamydia Infections↗
PubMed2025

Genome-wide identification of modulators of Chlamydia trachomatis parasitophorous vacuole stability highlights an important role for sphingolipid supply.

A mechanistic understanding of how intracellular pathogens evade the intrinsic defenses of their host cells could open up intriguing therapeutic opportunities. Here, we applied a genome-wide genetic screening approach to investigate the nature of the defensive host cell death response suppressed by the membrane trafficking modulator CpoS, an effector protein secreted by the obligate intracellular bacterial pathogen Chlamydia trachomatis. Initially, this work revealed a CpoS-deficient mutant to exhibit a markedly increased dependence on host cellular synthesis of ceramides, the precursors of complex sphingolipids. Using novel microscopic reporters, we then established CpoS' role in defense evasion to occur by preserving the integrity of Chlamydia's parasitophorous vacuole (the inclusion) via ensuring an adequate sphingolipid supply. More specifically, we observed CpoS deficiency to destabilize inclusions, initially characterized by a release of individual bacteria into the host cell cytosol, then followed by inclusion rupture concomitant with host cell death. Exogenous addition of sphingosine stabilized CpoS-deficient inclusions, whereas disruption of host cellular ceramide synthesis destabilized wild-type inclusions. In combination, CpoS deficiency and impaired ceramide synthesis - presumably disrupting both Chlamydia's vesicular and non-vesicular sphingolipid supply routes - destabilized inclusions even earlier, resulting in infection clearance and host cell survival rather than host cell death. Overall, this study highlights how the vacuolar pathogen C. trachomatis maintains vacuole integrity by ensuring a steady sphingolipid supply, potentially offering inspiration and directions for future therapeutic strategies targeting parasitophorous vacuoles.

Chlamydia trachomatis↗
PubMed2001

Chlamydia trachomatis infection and the risk of perinatal mortality in Hungary.

INTRODUCTION: Chlamydial infections of the genital tract are thought to often lead to preterm birth, which is the most important perinatal problem in Hungary. AIM OF STUDY: A multicenter study was carried out to determine the prevalence of Chlamydia trachomatis infection, risk factors for the infection and to relate the infection to perinatal mortality, accounting for potential confounding effects. METHODS: The nucleic acid hybridization method (PACE2 Gen-Probe) was applied for the examination of Chlamydia trachomatis. Logistic regression analysis was used to assess risk. RESULTS: A total of 6156 pregnancy women were examined for the occurrence of Chlamydia trachomatis. The observed overall rate of chlamydial infection was 5.9%. Young age (less than 24 years old) (OR and 95% CI: 1.6 (1.3-2.0)), unmarried status (1.5 (1.2-1.9)) and the high unemployment rate (2.1 (1.6-2.7)) were statistically significant predictors of the infection. In logistic regression analysis, chlamydial infection (1.9 (1.1-3.3)), high unemployment rate (1.5 (1.2-2.2)) and low birth weight (1.7 (1.1-2.7) were significant predictors of perinatal mortality. CONCLUSIONS: Testing pregnant women for diseases that can be transmitted perinatally is an important part of obstetric care. Screening for C. trachomatis of unmarried women under 24 years of age is suggested and need increased observation during labor.

Adult↗
PubMed2001

Management of Chlamydia trachomatis in a women's hospital: a review of current practice.

OBJECTIVE: To establish a measure of testing for Chlamydia trachomatis within the Liverpool Women's Hospital with a view to optimising both testing and management of infection. DESIGN: Prospective observational study to review the outcome of Chlamydia testing and subsequent management of patients between September 1997 - September 1998. RESULTS: It was observed that opportunities for detecting infection were missed and testing was undertaken predominantly for diagnostic purposes. RECOMMENDATION: Consideration be given to a centralised system for overview of positive results linking with audit/education to reduce sequelae of Chlamydia within gynaecology.

Adult↗
PubMed2002

Screening for genital Chlamydia trachomatis in teenagers attending a family planning youth clinic: a prevalence study using a strand displacement assay on urine samples.

BACKGROUND: Chlamydia trachomatis is the most common bacterial sexually transmitted infection. Rates are highest in the 16-24-year-old age group. Untreated it can be a significant cause of morbidity. At least 50% of men and 70% of women with C. trachomatis are asymptomatic. STUDY AIMS: The aims of the study were: To determine the prevalence of C. trachomatis. To determine the success of our referral policy to genitourinary medicine (GU clinic). To determine the characteristics of the population with C. trachomatis. To estimate the level of recognition of 'chlamydia' as a concept. PARTICIPANTS: Attendees at our youth clinic between October 2001 and March 2002. METHODS: Ethical approval was obtained for this ongoing study. All attendees who were sexually active were asked to participate. An information leaflet was provided. Those who agreed to participate answered a questionnaire, which included a number of lifestyle questions, and provided a urine sample for C. trachomatis testing using a strand displacement assay. Positive results were forwarded to the GU clinic, which provided antibiotic therapy, contact tracing and follow-up. RESULT: The ongoing study has yielded 616 results with 73 positive (11.9%). To date 66 individuals (90%) have attended the GU clinic and 41 (50%) of the possible 82 partners have responded to contact tracing. CONCLUSION: Initial results show a high prevalence of C. trachomatis. There is a low condom usage despite a reasonable level of awareness of 'chlamydia'. Contact tracing has not been as successful as anticipated. When the study is complete, various service provision questions will need to be answered, such as the ability to treat the disease in a dedicated youth clinic, making urine testing for C. trachomatis by strand displacement assay (SDA) more widespread, the problem of follow-up, screening for associated sexually transmitted infections (STIs) and contact tracing in a relatively less mobile and less empowered population.

Adolescent↗
PubMed1981

Chlamydia pneumonia in infants: radiography in 125 cases.

Chlamydia trachomatis was recently discovered to be the causative organism in a distinctive afebrile pneumonia occurring in infants under 6 months of age. Experience with the first 125 cases seen at this hospital during a 3 1/2 year period is reported. Chest radiographs were reviewed of 2,273 infants in this age group with signs of lower respiratory tract infection. The first group comprised 148 patients admitted to the hospital. Chlamydia pneumonia was diagnosed in 41 cases. The second group of 2,125 infants was first seen in the outpatient department where 84 additional cases were detected. From this experience it was concluded that, although there are no radiographic findings specific for Chlamydia pneumonia, a combination of the clinical and radiographic findings strongly suggests the diagnosis before cultures and serum antibody titers are available. Important clinical features include age of onset at 2-14 weeks of age, cough, lack of fever, and elevated serum immunoglobulins. Most chest films show bilateral hyperexpansion and diffuse infiltrates with a variety of radiographic patterns including interstitial, reticular nodular, atelectasis, coalescence, and bronchopneumonia. Pleural effusion and lobar consolidation are not seen. The radiographic changes often suggest a more serious illness than that observed clinically. Radiographic features are described in detail.

Chlamydia Infections↗
PubMed1991

Survival of chlamydiae in human semen prepared for artificial insemination by donor.

Semen specimens from 21 men with urethral infection with Chlamydia trachomatis were tested for the presence of the organism before and after cryopreservation for 3 weeks of storage at -196 degrees C. Five specimens were chlamydia-positive before preservation and four of them were still positive after storage when examined by enzyme immunoassay (Chlamydiazyme). When examined by cell culture, four proved chlamydia- positive before storage and two afterwards. The results indicate that testing for C. trachomatis has to be performed from the urethra of all donors of semen used for artificial insemination before the inoculation takes place.

Chlamydia Infections↗
PubMed1988

Chlamydia trachomatis: a currently recognized pathogen of tonsillitis.

The authors investigated whether or not Chlamydia trachomatis could be isolated from tonsillar crypts in order to establish directly the relationship of the organism to the tonsillar infection. In 17 of 65 (26.2%) cases with tonsillitis, C. trachomatis was recovered from tonsillar crypts. Ten of the 17 Chlamydia-positive patients were attended for recurrent sore throat and 5 for lingering tonsillitis. Thirteen of the 17 cases had serum antibody to C. trachomatis. We also isolated this microorganism from one of 18 persons complaining of a lumpy throat. Eleven of the 18 Chlamydia-positive patients had pertinent histories of oro-genital sexual activity, and pharyngeal infection apparently resulted from direct inoculation. The available data suggest that tonsillitis, the most common problem in otorhinolaryngology, may be caused by C. trachomatis more often than has been suspected.

Antibodies, Bacterial↗
PubMed1985

Detection of Chlamydia trachomatis with fluorescent monoclonal antibody.

Commercial kits of fluorescein-labelled monoclonal antibody against Chlamydia trachomatis have been evaluated (1) as an alternative to Giemsa staining for detection of chlamydia inclusions in cell culture and (2) for direct detection of chlamydia in conjunctival, urethral and cervical smears. The inclusion-detection kit (Micro Trak Culture Confirmation Test) was tested on 270 cultures and was found to be highly sensitive, detecting all 16 Giemsa-positive specimens plus an additional 3 that were negative by Giemsa. It was also superior to Giemsa-staining in terms of simplicity of use, ease of detection, and readability with toxic specimens. The direct detection kit (Micro Trak Direct Specimen Test) gave results which agreed with the culture result for all 33 genital tract specimens and for 32 of 34 conjunctival specimens tested in parallel. The kit is considered to be a valuable test for diagnosis of chlamydial infection by laboratories lacking adequate tissue-culture facilities.

Antibodies, Monoclonal↗
PubMedDate not supplied

Chlamydiae as pathogens: new species and new issues.

The recognition of genital chlamydial infection as an important public health problem was made first by the recognition of its role in acute clinical syndromes, as well as in serious reproductive and ocular complications, and secondly by our awareness of its prevalence when diagnostic tests became widely accessible. The recent availability of effective single dose oral antimicrobial therapy and sensitive molecular amplification tests that allow the use of noninvasive specimens for diagnosis and screening is expected to have a major impact in reducing the prevalence of disease in the next decade. Clinical manifestations associated with Chlamydia pneumoniae infection continue to emerge beyond respiratory illness. In particular, its association with atherosclerosis deserves further investigation. Chlamydia pecorum, a pathogen of ruminants, was recently recognized as a new species. The continued application of molecular techniques will likely elucidate an expanding role for chlamydiae in human and animal diseases, delineate the phylogenetic relationships among chlamydial species and within the eubacteria domain, and provide tools for detection and control of chlamydial infections.

Anti-Bacterial Agents↗