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PubMedDate not supplied

Evaluation of field follow-up in a sexually transmitted disease clinic for patients at risk for infection with Neisseria gonorrhoeae and Chlamydia trachomatis.

Field follow-up to locate and treat partners of patients with syphilis and gonorrhea is standard procedure in the United States. The present study utilized 12,732 heterosexual index patients with gonococcal infection, chlamydial infection, and related syndromes to evaluate the effectiveness of field follow-up over a 6-year period. Field follow-up located 82% of the 13,845 partners identified by the index patients. Of those partners who were located, 36% had a documented infection with either chlamydia or gonorrhea. An average of only 1.09 partners per index patient was named, however, indicating that all partners may not have been reported. The largest number of infected partners was located for all index patients with gonorrhea and for men with chlamydia. Contact tracing was also effective for women with chlamydia, although less so. Field follow-up, as conducted in this study, is effective in locating the partners who are reported by the index patients.

Adolescent↗
PubMedDate not supplied

Chlamydia trachomatis infection in pregnant women hospitalised in the Institute of Mother and Child in Warsaw, Poland.

UNLABELLED: Chlamydia trachomatis infection is the most common sexually transmitted disease. It concerns both epidemiologists and clinicians as it is often asymptomatic and can cause permanent sequelae. Chlamydia trachomatis infection in women causes nongonococcal cervicitis, endometritis, urethritis, inflammation of the Bartholin's gland, acute and chronic pelvic inflammatory disease, Fitz-Hugh-Curtis syndrome and can lead to Fallopian tube obstruction, infertility and ectopic pregnancy. During pregnancy it can cause chorioamnionitis, premature rupture of membranes, premature delivery, intrauterine growth restriction, low birth weight. post partum endometritis and also infection in the newborn. AIM: To assess the prevalence and to describe risk factors (behavioural and clinical) of genital infection caused by Chlamydia trachomatis in the population of pregnant women attending the Obstetrics Clinic at the Institute of Mother and Child and to study the impact of this infections of pregnancy outcome. METHODS: We have tested 80 pregnant women attending the clinic of obstetrics and gynaecology of the Mother and Child Institute in Warsaw: The presence of C. trachomatis in cervical swabs was assessed using the Polymerase Chain reaction (PCR). RESULTS: We found two cases of C. trachomatis infection, which represents 2.5% of the tested population. CONCLUSIONS: controversial data on the prevalence of C. trachomatis in pregnant women and its influence on pregnancy duration justify further investigations despite the observed law prevalence in this study. This will allow to determine the role and usefulness of routine screening for C. trachomatis in pregnant women in Poland.

Chlamydia Infections↗
PubMed2005

[Experience with the PCR method in chlamydia detection.].

PURPOSE OF THE STUDY: The study was intended to summarize and evaluate the results in patients with a suspected infection by the genus Chlamydia, investigated with an in-house method of nested PCR (polymerase chain reaction). The study worked with data from patients living in eastern Bohemia, who were examined in the years 2001-2003 at the Dept. of Molecular Biology, a research laboratory shared by the Institute of Clinical Microbiology and the Institute of Clinical Biochemistry and Diagnostics. MATERIAL AND METHODS: 291 explorations were done in 2001, in 2002 already 562 and in 2003 their figure reached 760. The total number of samples received for investigation during that period was 1 613. 1 587 were actually investigated, 26 were unsuitable and could not be used. More than 70 % of all investigations were done with three types of material: urine (41.8 % of all the investigated samples), BAL (15.3 % of all the investigated samples) and whole blood (14.9 % of all the investigated samples). The investigations were carried out with the in-house nested PCR method, which uses primers from the MOMP(ompA) area of the genus Chlamydia spp. RESULTS: Total positivity was 5.67 %, in 1.26 % of the samples the resulted was considered uncertain and 93.07 % of the investigated samples were negative. In men PCR positivity was 6.11 %, in women 5.35 %. The major proportion of positive samples was from the age groups 70-79 years (11.67 %), 10-19 years (6.51 %) and 40-49 years (6.45 %). Overall positivity in smears from the urogenital system was 6.48 %, from urine 3.92 %, from BAL 10.70 % and from whole blood 5.51 %. KEYWORDS: nested PCR, Chlamydia spp., detection.

Chlamydia Infections↗
PubMed1975

Isolation of Chlamydia from patients with urethritis.

From October 1973 through August 1974, 335 genitourinary tract specimens from patients with urethritis were inoculated into McCoy's cell cultures for the diagnosis of Chlamydia infections. Of the 45 Chlamydia isolates, 42 were recovered when glass vials rather than plastic microtiter plates were used as cell culture vessels. Herpes simplex virus was isolated 15 times. Bacterial overgrowth occurred 42 times; however, in 20 specimens the contamination was not apparent until after the first subculture. This is the first report of the frequency of Chlamydia infections in patients with urethritis in the Midwest and indicates that these organisms have a significant etiologic role in nongonococcal urethritis in this community.

Bacteriological Techniques↗
PubMed2005

Prevalence and risk factors for Chlamydia trachomatis infection in pregnant women.

The aim of this study was to determine the prevalence and risk factors for Chlamydia trachomatis infection in pregnant women. A total of 351 asymptomatic pregnant women (first to second trimesters; age range: 15-30 years) were examined. The background data related to social and marital status, age, anamnestic data were also recorded. Serum samples were tested for IgM antibodies specific to Chlamydia trachomatis by an enzyme-linked immunosorbent assay (ELISA). In the present study the overall rate of C trachomatis infections in pregnant women was 33% including 41 women (38.7%) under 20 years, 39 women (36.8%) in age of 21-25, and 26 women (24.5%) in age of 25-30. The age group under 20 years exhibited higher risk of infection. There was a significant correlation between the Chlamydia trachomatis infection rate and clinical risk factors such as rare visits to the gynecologist, pelvic inflammatory disease, premature delivery, spontaneous abortions, ectopic pregnancies, C. trachomatis-positivity, chlamydial cervicitis in anamnesis. The prevalence of asymptomatic C. trachomatis infection in pregnant women is 72.6%, therefore, we suggest the screening for chlamydial infection of all pregnant women at least once during their pregnancy.

Adolescent↗
PubMed2006

Pap testing and direct immunofluorescence for Chlamydia trachomatis infection in pregnant women.

The aim of the study was to determine the potential for both Pap testing and direct immunofluorescence assay for detection of chlamydia trachomatis infection in pregnant women. A total of 351 pregnant women (first to second trimesters; age range: 15-30 years) were recruited. The background data relating to social and marital status, age, anamnestic data were recorded. Serum samples were tested for IgM antibodies specific to Chlamydia trachomatis by ELISA. Cervical Pap smears were stained by Papanicolaou and direct immunofluorescence. In the present study the overall rate of C. trachomatis infections in pregnant women was 33%. Pap testing suggested a diagnosis of chlamydia trachomatis infection in 8.5% of cases only, direct fluorescence showed positivity in all patients. The highest incidence of unmarried status was recorded in the patients with mixed chlamydial infection and trichomoniasis, also with chlamydial monoinfection, rare visits to the gynecologists were common in patients with mixed chlamydial infection and trichomoniasis, mixed chlamydial and HPV infections, also with chlamydial monoinfection, multiple lifetime sex partners were reported by the patients with combined chlamydial infection and trichomoniasis, also with chlamydial monoinfection. The prevalence of asymptomatic C. trachomatis infection was lower in women with mixed non-viral infections. The incidence of pelvic inflammatory disease was higher in the patients with mixed chlamydial infection and trichomoniasis, mixed chlamydial and HPV infections, and chlamydial monoinfection, incidence of spontaneous abortions was higher in the patients with mixed chlamydial and HSV infections, also with chlamydial monoinfection, incidence of ectopic pregnancy was higher in the patients with mixed chlamydial infection and trichomoniasis, also with mixed chlamydial and HPV infections. Chlamydial infection including cervicitis was frequently diagnosed in women with mixed chlamydial and HSV infections, also with chlamydial monoinfection.

Adolescent↗
PubMed2006

Chlamydia trachomatis infection & female infertility.

BACKGROUND & OBJECTIVES: Chlamydia trachomatis is a well recognized sexually transmitted pathogen. Besides its potential to produce genital tract infection, C. trachomatis is increasingly being associated with long-term complications like infertility. The present study was undertaken to assess the role of C. trachomatis in female infertility as such data are lacking. METHODS: Women of primary and secondary infertility (n=110) and 30 healthy term pregnant women as control group were enrolled in the study. Detailed clinical history of each patient was recorded. Hysterosalpingography was performed in all patients. Endocervical swabs were collected for culture on cycloheximide treated McCoy cell line and for antigen detection by ELISA. RESULTS: C. trachomatis was detected in 31 (28.1%) of the 110 infertile women while one (3.3%) in control group was positive for C. trachomatis (P<0.01). Cell culture alone identified 25 (22.72%) patients suffering from chlamydial infection while C. trachomatis antigen was detected by ELISA in 18 (16.37%) patients. The one control case was positive for Chlamydia antigen by ELISA and not by cell culture. Chlamydial positivity was seen in 20 of the 74 (27%) women with primary infertility and in 11 of the 36 (30.6%) with secondary infertility. Of the 58 asymptomatic women, 21(36.2%) had chlamydia infection while among the 52 symptomatic cases 10 (19.2%) were infected; 38 per cent women with chlamydial infection also had tubal occlusion. INTERPRETATION & CONCLUSION: A significantly high rate of C. trachomatis infection was found in infertile women and more so in asymptomatic females and in secondary infertility cases. Lack of symptoms make clinical diagnosis of chlamydial infection difficult. Screening of infertile women for C. trachomatis is therefore recommended so far early therapeutic interventions.

Antigens, Bacterial↗
PubMedDate not supplied

Prevalence of Chlamydia trachomatis infection in pregnant patients.

Chlamydia is a sexually transmitted disease of epidemic proportions, infecting an estimated 4 million people a year. It results not only in infertility and ectopic pregnancy but also in infant morbidity and mortality. Ectopic pregnancy is responsible for 11 percent of maternal deaths. About 60 percent of infected women can transmit the bacteria at birth to their infants. Early detection and treatment of chlamydia in both men and women, especially prenatal women, is critical. Chlamydia trachomatis infection of the cervix was found in 8.1 percent of a group of 1,004 pregnant women at a hospital prenatal clinic by means of a direct fluorescent antibody test. The prevalence of C. trachomatis was only 0.7 percent in 277 pregnant women receiving prenatal care from private practitioners. All patients between 27 and 30 weeks gestation who tested positive were treated with oral erythromycin. Their partners were treated with tetracycline. The outcome of pregnancy in patients treated for chlamydial infection was compared with a control group of noninfected mothers from the same population. The frequency of premature rupture of the membranes, prematurity, and low Apgar scores among the treated women were not significantly different from those in the control group. There was a significant difference, however, between the two groups in the incidence of low mean birth weight infants and the presence of meconium. Children can acquire a chlamydial infection at birth from contact with infected cervico-vaginal secretions. If not detected and treated, these infected infants may develop conjunctivitis, bronchiolitis, and pneumonia. It is suggested, therefore, that all patients at prenatal clinics be screened for chlamydial cervicitis. Those testing positive and their partners should be treated.

Adult↗
PubMed1991

Diagnosis of chlamydial infection in pregnant women using the Testpack Chlamydia diagnostic kit.

We compared the performance of Testpack Chlamydia to tissue culture isolation for detection of endocervical chlamydia in an obstetric clinic population at high risk for infection. Among 227 evaluable patients, 30 tissue culture-confirmed chlamydial infections were found (13.2%). The sensitivity, specificity, and positive and negative predictive values of Testpack compared with tissue culture isolation were 66.7, 95.4, 69.0, and 94.9%, respectively. This test can be performed on a desktop within 30 minutes by staff with limited laboratory experience and no special equipment. Based upon our preliminary experience, we believe that Testpack Chlamydia offers promise as a screening device for the detection of endocervical chlamydial infections in high-risk obstetric populations.

Chlamydia Infections↗
PubMed1991

[Chlamydia as the cause of abortions in horses].

Between 1982 and 1989 59 equine fetuses were investigated for chlamydiae using animal experiments and embryonated eggs. Chlamydiae were isolated from 16 fetuses (27.1%) originating from 8 studs. The macroscopical lesions of the fetal organs were characterized by extensive haemorrhages. The histological picture shows severe lesions of the blood vessels of different organs. In 6 studs in which chlamydiae had been isolated, blood sera of clinically healthy and pregnant mares were investigated for antibodies during 1989 and 1990. Antibody titres between 1:10++ and 1:40 were detected by using complement fixation test in sera of mares of 4 studs.

Abortion, Veterinary↗
PubMedDate not supplied

Enoxacin in the treatment of Chlamydia trachomatis genitourinary infection.

Twenty women with Chlamydia trachomatis genitourinary infection were treated with oral enoxacin 800 mg/day in two divided doses for 12 days starting on day 1 of the menstrual cycle. A physical examination was performed before the start and 28-30 days after the end of the treatment. At the final examination cultures of urethral and endocervical swabs and endometrial samples were negative in all cases, demonstrating that Chlamydia trachomatis infection had been eradicated. No significant results were obtained at serologic evaluation with the indirect immunofluorescence method to show specific IgM, IgG and IgA antibodies. In the four women with subjective symptomatology this was improved by the treatment with enoxacin. Only two patients presented mild side effects (headache, tachycardia, nausea). Enoxacin seems therefore a very effective and well tolerated drug in the treatment of Chlamydia trachomatis genitourinary infection.

Adult↗
PubMed1990

[Our experience with the treatment of Chlamydia trachomatis in acute and chronic inflammatory diseases of the female genitalia].

The effect of antibiotic treatment was studied on 41 women with inflammatory gynecological diseases at the acute and chronic stages as the patients were examined for presence of Chlamydia trachomatis in the endocervix. The high frequency of isolated Chlamydia trachomatis in these women (44.1%) with predominance at the age of 21-25 years show the important role of Chlamydia trachomatis in the etiology of the inflammatory process. Possibilities for therapeutic effect by using various antibiotic combinations are discussed.

Acute Disease↗
PubMed1990

[Male genito-urinary tract infection caused by Chlamydia trachomatis and seminal characteristics: use of minocycline].

The authors evaluated the activity of Minocycline in 30 male patients with urinary tract infection caused by Chlamydia trachomatis (Ct) and alterations of the seminal parameters using three different dosage schedules (100 mg/day for 10 days, 200 mg/day for 10 days and 200 mg/day for 20 days). At baseline, at the end of therapy and one month after clinical and bacteriological parameters and seminal characteristics, including some sperm function tests (acridine orange test to study chromatin heterogeneity; triple staining technique, to study acrosome; swim-up technique, to study the sperm kinetics) were verified. The seminal characteristics were checked again three and six months after the end of the therapy. All the results show that Minocycline is an excellent drug for the treatment of urinary tract infection caused by Chlamydia trachomatis both for its therapeutic efficacy and for the absence of side effects. Although 10 days cycles using 1 cap/day are sufficient to eliminate inflammation and infection, in order to obtain more valid results it is preferable to use the following dosage schedule: 200 mg/day of antibiotic (100 mg twice daily) for 10 days. The results of our trial show that in cases of Chlamydia trachomatis infection associated with dispermia (reduced nemaspermic concentration, hypomotility, teratozoospermia, increased number of leucocytes), if the parameters of sperm function are within normal limits, the resolution of the infection is usually followed by a recovery of normozoospermia. Follow-up performed 3 and 6 months after the end of treatment showed an increase in the number of spermatozoa, a percentage increase in their motility, mostly in the progressive motility, and a reduction of the atypical forms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Chlamydia-induced arthritis: diagnosis--follow-up--therapy].

Chlamydia-induced arthritis (CIA) is an inflammatory reactive arthritis caused by extraarticular infection with Chlamydia trachomatis. CIA presents as peripheral arthritis or spondylarthropathy. Extraarticular manifestations are present in most but not all cases, Reiter's syndrome occurs only in a minority of patients. Detection of Chlamydia trachomatis in genitourinary smears and demonstration of serum-antibodies against chlamydial antigens lead to diagnosis. Analysis of synovial fluid reveals nonpurulent inflammatory synovitis and, in some cases, chlamydial antigen has been demonstrated in synovial specimens. The therapy of CIA combines physical medicine, NSAID and shortterm antibiotic treatment of the genitourinary infection. Whether longterm antibiotic therapy or-in chronic cases--DMARDs are successful, needs further investigation.

Arthritis, Infectious↗
PubMed1990

A comparison of rapid enzyme immunoassay tests for the detection of Chlamydia trachomatis cervical infections.

Two rapid enzyme immunoassay test kits were compared with culture for the detection of Chlamydia trachomatis endocervical infections. Endocervical samples for C trachomatis culture and the two enzyme immunoassay tests were evaluated from 502 county health department and Planned Parenthood patients. The prevalence of infection in this population was 12%. Sensitivity and specificity of the Abbott TestPack Chlamydia were 51.7% and 99.5%, respectively, and of the Kodak Surecell Chlamydia were 76.7% and 98.6%, respectively. The positive and negative predictive values for TestPack were 93.9% and 93.8%, and for Surecell were 88.5% and 96.9%, respectively. Additionally, an in vitro investigation was used to evaluate whether typical office staff (physicians, nurses, medical technicians, receptionists, and radiology technicians) were able to perform competently the tests in each kit. Office personnel tested 12 dilutions of a C trachomatis stock sample or negative control sample as unknowns for each kit in the in vitro investigation. There were no differences among office staff in performance when compared for each test kit. Selective use of these enzyme immunoassay tests for high-risk patients in a family practice population that has a high prevalence of patients with C trachomatis infection may be helpful when rapid test results are required and cultures are not feasible. After appropriate training, most physician office personnel were equally able to perform the enzyme immunoassay tests evaluated.

Adult↗
PubMed1990

Isolation of Chlamydia trachomatis from amniotic fluid.

A 26-year-old white woman had premature rupture of membranes at 35 weeks' gestation. Cervical specimens initially demonstrated group B streptococci and Chlamydia trachomatis. Amniocentesis was performed and the amniotic fluid was positive for chlamydia by direct fluorescent antibody stain. The Gram stain was negative. The patient had an elevated white blood cell count. Labor was induced because of suspected chorioamnionitis. A 2120-g female infant was delivered with an Apgar score of 9 at 1 and 5 minutes. The infant's eye and nasopharyngeal specimens were positive for chlamydia by direct fluorescent antibody stain. After delivery, both Ureaplasma urealyticum and C trachomatis were isolated from the amniotic fluid and fetal membranes. This is the first reported case of chlamydial isolation in amniotic fluid.

Adult↗
PubMedDate not supplied

[Correlation of detection of Chlamydia infection of the urethra sperm].

In the group of 150 men with urological diseases simultaneous examinations of urethra swabs and sperm specimens were done. By culture method on McCoy cells Chlamydia trachomatis was found more frequently in semen (46.7%) than in urethra (35.3%); in 103 patients with urethritis the results were 43.6% and 33.0% respectively. Consistently positive results were obtained in 33 (26.0%) and consistently negative ones in 66 (44.05) of all examined men. In 31 (20.7%) patients, 22 with urethritis including Chlamydia trachomatis was cultured from semen alone and in 14 (9.3%) from urethra alone. The above findings suggest that human semen constitutes a valuable diagnostic material in cases suspected of infection due to Chlamydia trachomatis.

Adolescent↗
PubMed1986

Immunocytochemical detection of Chlamydia trachomatis on cytological specimens.

Chlamydia trachomatis can cause many kinds of diseases in humans, both men and women. Its diagnosis depends on the observation of intracytoplasmic inclusion bodies on smears. To observe intracytoplasmic inclusion bodies we applied the Papanicolaou and immunocytochemical techniques. Elementary and reticulate bodies were seen more easily using the immunocytochemical technique in 3 hours on gynecological and urethral specimens. The immunocytochemical technique is rapid, accurate and specific with unstained gynecological and urethral specimens as well as destained Papanicolaou smears. It appears that fixation is the most important factor in immunocytochemical observations of Chlamydia. Absolute methanol or ethanol was the fixation agent of choice based on our experience. After proper fixation, the immunocytochemical technique can be applied for routine examinations to detect Chlamydia trachomatis.

Chlamydia Infections↗