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PubMed2005

[Chlamydia infections in urogenital tract--application of direct immunofluorescence in the diagnostics of Chlamydia trachomatis in the East Bohemian Region of Czech Republic during 1997-2003].

OBJECTIVE: The aim of the study was an evaluation of results of Chlamydia trachomatis antigen detection by means of direct immunofluorescence in samples from patients suspected from this infection. DESIGN: Retrospective study. SETTING: Institute of clinical microbiology, University Hospital and Medical Faculty of Charles University, Hradec Králové. METHODS: Samples from females were swabs from uterine cervix, vagina and urethra, from male urethral swabs; moreover conjunctival swabs, bronchoalveolar irrigation, lower respiratory tract aspirates and sputum. Samples were fixed and "dyed" with monoclonal specific antibody labeled by fluorescent dye in the lab with a commercial diagnostic kit and they were evaluated microscopically after adding a drop of glycerol and covering with a top slide. RESULTS: Within a group of 6126 samples from patients suspected from Chlamydia infection we have found positivity in 14.4%. Of this subgroup 14.1% in samples from genitourinary tract of females and 15.2% in males, 14.1% from conjunctival swabs and 3.7% from lower respiratory tract. According to an age differentiation, positive samples in individual life-decades from genitourinary tract were 0-13-14.4-13.9-13.9 and in females over 60 13.9%. In males the corresponding walues were 0-21.4-15.1-16-13.4 and those over 60 years 16%. So, the highest positivity in our region has been detected in samples from young men aged 20-30, where it is nearly two-fold higher comparison to age-matched females. CONCLUSION: Direct detection of Chlamydia trachomatis antigen with immunofluorescence method still remains a reliable diagnostic tool. But for a control or confirmation of disputable results it is inconditionally necessary to have at least one more method available, e.g. PCR.

Adolescent↗
PubMed1989

[Chlamydia infections in dermatology].

The serovares D-K of Chlamydia trachomatis (CT) are associated with inclusion conjunctivits, non-gonoccoccal urethritis (NGU), post-gonoccoccal urethritis (PGU), epididymitis, and ensuing male infertility. CT can be isolated from testicular tissue, in sexually acquired reactive arthritis (SARA) and in proctitis. Female partner infection primarily involves the cervix with ascending infection and ensuing infertility. Asymptomatic CT infection of the urogenital tract does not only present epidemiological problems, but also calls for smear examination in the asympotomatic partner. Double infection with CT and Neisseria gonorrhoeae is not necessarily followed by PGU. Incomplete detection of CT must be taken into account especially after application of penicillin and in the isolation procedures from sperm. The serovares L1-L3 are the infectious agents in venereal lymphogranuloma. Tetracyclines and erythromycin are usually recommended as the therapy of choice in CT infection. Sulfonamides should be applied with caution, since resistent CT isolates have been made known. There is still further clinical study required regarding the efficacy of quinolines in urogenital infections with chlamydiae.

Chlamydia Infections↗
PubMed2003

[Effect of chronic Chlamydia infection with non-specific inflammation on cardiovascular complications in acute myocardial infarct].

It is known that local and systemic inflammatory processes play an important role in the genesis and development of atheroclerotic lesions and in the pathophysiology of acute coronary syndromes. This hypothesis is supported by findings of elevated parameters of the "inflammatory" reaction in the affected blood vessels but also in the blood of atherosclerotic patients. Known risk factors do not explain quite satisfactorily epidemiological cardiovascular phenomena and different manifestations of coronary heart disease. It is very probable that also Chlamydia pneumoniae is a risk factor. This assumption is based on evaluation of seroepidemiological data, examination of atherosclerotic plaques not only in humans but also in animal models with chlamydial infection. Based on retrospective and prospective evaluation of case-records the authors analyzed the incidence of cardiovascular complications in 83 patients with acute myocardial infarction (AIM), incl. 51 patients (31 men and 20 women, mean age 64.4 +/- 3.4 years who had a non-specific inflammation and chlamydial infection, and 32 patients (24 men and 8 women, mean age 64.7 +/- 3.6 years) who had chlamydial infections but no non-specific inflammation (in the blood). These patients were selected from all patients hospitalized during 1998-2001. When diagnosing acute myocardial infarction we applied WHO criteria, and the presence of at least two of three criteria was necessary: a history of prolonged (more than 20 min). stenocardia, electrocardiographic changes typical for ischaemia and/or necrosis and elevation of myocardial enzymes in serum, Non-specific inflammatory activity was present in patients (i.e. positive) if the following laboratory parameters were recorded: C-reactive protein > 5 mg/l assessed by the radial immunodiffusion method; fibrinogen > 4 mg/l assessed by the coagulation method according to Claus; leukocytes > 9.6 x 10(3)/microliter, leukocytes were counted automatically in a Coulter chamber; lymphocytes > 3.4 x 10(3)/microliter. Red cell sedimentation rate > 20 mm/hour. The activity was evaluated as positive when all parameters were elevated. The presence of chronic infection with Chlamydia pneumoniae was assessed qualitatively by antibody positivity (IgG) in serum using the microimmunoflurescent method (using a set from Labsystems Co.). The incidence of associated risk factors (obesity, smoking, diabetes, hyperlipidaemia and hypertension) is higher in the sub-group of patients with Chlamydia infections without inflammation, however, the difference is not statistically significant. The incidence of cardiovascular attacks was higher in the sub-group of patients with chlamydial infection and concurrent inflammation as compared with the sub-group of patients with chlamydial infection without inflammation. In case of re-infarction of the myocardium, a sudden cerebrovascular attack, death and arrhythmia the difference was statistically significant, while in case of cardiac failure and cardiogenic shock the difference was not significant. Patients with acute myocardial infarction with chlamydial infection and a concurrent non-specific inflammation had to be treated more often by combined (i.e. more intense) treatment, thrombolytic treatment, PTCA and surgery (bypass) of the coronary vessels as compared with patients with Chlamydia infections but without inflammation. The authors assume therefore that not only different risk factors but also the effect of non-specific inflammation and Chlamydia infection contribute towards the increased number of cardiovascular postinfarction complications. Therefore a therapeutic approach involving eradication of infection and suppression of the inflammatory reaction should be considered.

Arteriosclerosis↗
PubMed1991

Evidence of Chlamydia infection in a Belfast antenatal population.

Chlamydia trachomatis is an important cause of postpartum endometritis and neonatal conjunctivitis. However, the prevalence of chlamydial genital infection varies considerably from one population group to another. A study was thus conducted to determine the incidence of C trachomatis infection of the cervix in an unselected group of women attending a Belfast antenatal clinic. One hundred and six patients were screened for evidence of current cervical infection with C trachomatis or serological evidence of past infection. C trachomatis was identified in 2.9%, and there was evidence of past infection in 18.9%. No significant risk factors were identified from gynaecological, contraceptive or sexual histories. C trachomatis infection was treated with erythromycin and there were no perinatal complications ascribed to chlamydia.

Adult↗
PubMed2004

Cell death, BAX activation, and HMGB1 release during infection with Chlamydia.

Infection by a number of Chlamydia species leads to resistance of the host cell to apoptosis, followed by induction of host-cell death. In a population of infected cells that displays protection against staurosporine-induced apoptosis among the adherent cells, we find that cells that had been recovered from the supernatant share characteristics of both apoptosis and necrosis, as assayed by the propidium iodide (PI)-annexin V double-labeling technique. Cell death was observed in both an epithelial cell line and primary fibroblasts, although the primary cells had a higher propensity to die through apoptosis than the immortalized cell line. Staurosporine-mediated activation of the pro-apoptotic BCL-2 family member, BAX, was inhibited in the epithelial cell line infected for 32 h with the lymphogranuloma venereum (LGV/L2) but not the murine pneumonitis (MoPn) strain of C. trachomatis, but inhibition of staurosporine-mediated BAX activation disappeared after 48 h of infection with the LGV/L2 strain. Conversely, infection with MoPn (C. muridarum) but not LGV/L2 led to BAX activation after 72 h, as previously reported for shorter (48 h) infection with the guinea pig inclusion conjunctivitis (GPIC) serovar of C. psittaci (C. caviae). These results suggest that the ability to inhibit staurosporine-mediated BAX activation or to activate BAX due to the infection itself may vary as a function of the chlamydial strain. Interestingly, both the epithelial cells and the fibroblasts also released high mobility group box 1 protein (HMGB1) during infection, although much less HMGB1 was released from fibroblasts, consistent with the higher level of apoptosis observed in the primary cells. HMGB1 is released preferentially by necrotic or permeabilized viable cells, but not apoptotic cells. In the extracellular space, HMGB1 promotes inflammation through interaction with specific cell-surface receptors. Higher levels of HMGB1 were also measured in the genital-tract secretions of mice infected vaginally with C. trachomatis, compared to uninfected controls. These results suggest that cells infected with Chlamydia release intracellular factors that may contribute to the inflammatory response observed in vivo.

Animals↗
PubMed1986

[Sterility and Chlamydia infection. Risk factors].

The authors distributed a questionnaire to 89 patients who consulted them for sterility for reply by themselves. The blame for chlamydia trachomatis infection as a cause of sterility was worked out as a level of IgG above 1/8. The risk factors for being infected with chlamydia trachomatis is above all the number of sexual partners; the odds ratio of 2,68 being significant for those who had more than one partner. The age of marriage and the age at first intercourse do not count. The prevention of the consequences of infection depends on education about the risks and screening for infection when the partner is changed.

Age Factors↗
PubMed1991

[Chlamydia infection. A common, usually mild, infection with often severe consequences].

Today, chlamydiae are among the most frequently sexually transmitted organisms. At least 5 to 10% of young, sexually active adults, will have a florid chlamydial infection. On account of its chronic nature, the paucity of symptoms, and the difficulty in diagnosing it, this infection is still underdiagnosed. The spectrum of the manifested pathologies range from genital to abdominal lesions, to conjunctivitis, pneumonia and arthritis. On account of the specific intracellular reproduction cycle, antibiotic therapy is not always able to completely clear up the infection. Today, chlamydial infection is the most common cause of infection-related sterility. During parturition, the neonate is often infected, with subsequent chronicity and sequelae.

Chlamydia Infections↗
PubMed1992

[Endometrial Chlamydia infection in women with habitual abortion].

Endometrial, endocervical, and urethral specimens were obtained from 16 nonpregnant women with a history of habitual abortions. Chlamydia were isolated from the endometria of 4 women, but only in one case chlamydial intracytoplasmic incorporations in endometrial cells were detectable by the Romanovsky Giemza staining. Endometrial Chlamydia infection was diagnosed in 5 of the 16 patients. No Chlamydia were isolated from the cervix uteri or urethra of 2 patients with endometrial involvement. The study has demonstrated that eradication of intrauterine chlamydial infection before pregnancy improves the efficacy of treatment of habitual abortions. It is possible that asymptomatic chlamydial endometrial infection is injurious for the placenta.

Abortion, Habitual↗
PubMed1989

[Reactive arthritis following Chlamydia infection].

The authors report on the clinical observation of 23 patients (5 women, 18 men) who suffered from seronegative spondylarthritis following chlamydia infection diagnosed clinically and serologically. Nine patients (2 women, 7 men) carried HLA B27 histocompatibility antigen. Sacroileitis confirmed by radiology was found in 16 cases. Genicular synovitis was the most frequent peripheral articular syndrome as well as Achilles tendinitis, "sausage-like" swelling of the finger and toes were observed and the ankle-, wrist-, elbow- and in a few cases the sternoclavicular and temporomandibular joint showed also involvement. Urological inflammation occurred in 9 cases, ophthalmological inflammation in 3 cases and pleuritis, pericarditis was observed in 1 patient. During the observation period 15 patients recovered upon Doxycyclin (Chinoin), Eryc (Biogal) non-steroid and occasional steroid therapy given 3 weeks long.

Adult↗
PubMed1989

[Cervical Chlamydia infections among pregnant women in a rural district. A screening study].

In a rural district, 241 pregnant women were screened for cervical Chlamydia infection. Eleven positive cases were found (4.6%). The infection was observed most frequently among nulliparous women and the diagnosis could not be established clinically. Following treatment, all of the cases became negative. Out of the same population, 162 women were re-examined after delivery. Three were found to be positive (1.9%) which is not any significant reduction in the prevalence. It is concluded that the infection is frequent among pregnant women also outside city environments and that screening at routine control in the second trimester is not effective as the only effort to eliminate C. trachomatis from the pregnant population.

Adult↗
PubMed1984

Epidemiology and therapy of Chlamydia trachomatis infections.

Chlamydia trachomatis infections are exceedingly prevalent, and can be associated with significant sequelae. The major infections are urethritis, cervicitis, salpingitis, and ocular infection. Chlamydial genital infections present as syndromes, where C. trachomatis is one of the causes of the syndrome. Because specific laboratory diagnosis of a chlamydial infection is often not available, and even if available does not exclude the concurrent presence of other pathogens, therapy should usually be directed at all the major causes of the syndrome. Thus, although C. trachomatis is readily eradicated by tetracyclines, macrolides, sulphonamides, and rifampicin, for most situations tetracyclines are the drugs of choice. Penicillins have some activity when used in multiple-dose therapy, but are not reliable for eradication of chlamydiae. Aminoglycosides, nitroimidazoles, and the newer cephalosporins have minimal or no useful activity. Seven days of tetracycline hydrochloride 500mg 4 times daily or doxycycline 100mg twice daily are the optimum regimens for uncomplicated urethritis, cervicitis (except in pregnancy), and gonorrhoea. These regimens should be extended to 10 days for epididymitis and salpingitis. Additional antimicrobials should be added to the salpingitis regimen. For chlamydial infection during pregnancy, erythromycin 500mg 4 times daily for 1 week or 250mg 4 times daily for 2 weeks should be utilised. Neonatal infection requires 2 to 3 weeks of systemic treatment with erythromycin. Inclusion conjunctivitis responds well to antimicrobials, but improved sanitation has a greater effect than antimicrobial therapy in the management of trachoma.

Adult↗
PubMed2002

[Increasing incidence of Chlamydia infections in Sweden. Shortcomings in primary health care management].

The incidence of Chlamydia trachomatis infections in Sweden is increasing. The primary health care encounters many of the patients with C trachomatis infections. The aim of this study was firstly to examine if the primary health care met the requirements of the Swedish STD legislation and secondly to find out why the testing was done. A total of 44 case-books of patients tested positive for C trachomatis in Orebro county were studied. Contact tracing was ignored in a fourth of the patients identified as contacts. In four cases partners received treatment without testing. Not even half of the patients were examined after treatment as required. Symptoms were the most common reason for testing. Dysuria was the predominant symptom. Almost half of all the cases in women but none in men were diagnosed by screening or voluntary testing in asymptomatic patients. In to many cases the primary health care did not meet the requirements of the STD Act. This must improve. Generous testing of asymptomatic women is supported by this study. Chlamydia trachomatis infection should be considered in patients with cystitis. Voluntary testing in men should be encouraged.

Chlamydia Infections↗