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PubMed1993

Isolation of Chlamydia spp. from ostriches (Struthio camelus) (short report).

Post mortem examination of ostrich chicks (Struthio camelus) originating from a flock with a high mortality rate is described. The main pathological lesions found, indicated colibacillosis which was further corroborated by the isolation of pure culture E. coli. Furthermore Chlamydia spp. was isolated for the first time from ostriches. A detailed isolation procedure is presented. The association of colibacillosis with Chlamydia and the latency of Chlamydia is discussed.

Animals↗
PubMed1993

[A child with Chlamydia trachomatis pneumonia].

A six week old boy is presented with a Chlamydia trachomatis pneumonia. This pneumonia is seldom diagnosed because of the mild clinical symptoms and the good prognosis, even without therapy. Diagnosing the Chlamydia trachomatis infection of the neonate is of importance for the mother and the child. Chlamydia trachomatis infections in neonates are an underestimated problem.

Chlamydia Infections↗
PubMedDate not supplied

[Profile of Chlamydia test utilization by the physicians of Laval].

Before recommending systematic screening for Chlamydia trachomatis in young sexually-active women in its population, the Laval Community Health Department set out to document current practices in chlamydia testing. The objective of the study was to determine for whom these tests were prescribed, by whom and why. Data were obtained from a representative sample of 413 medical records. The greatest proportion of tests were prescribed for young women between the ages of 15-24 years. More than 85% of the tests were ordered by general practitioners, most of whom practiced in both hospital setting and private clinics. More than half of the tests were administered to obtain a diagnosis; approximately 42% were done for screening purposes. The study revealed a failure to document the sexual history of patients. It was estimated that between 30 and 40% of Chlamydia tests were not justified in being prescribed (according to the recommendations in the literature). It is possible that the criteria in the medical literature are too complex for use in everyday practice. The authors recommend the creation of specific tools adapted to physicians' needs, and the development of a screening program based on a systematic, step-by-step approach to determine whether or not a test is warranted.

Adolescent↗
PubMed1993

Long-term eradication of Chlamydia trachomatis genital infection after antimicrobial therapy. Evidence against persistent infection.

OBJECTIVE: To determine whether Chlamydia trachomatis urogenital infections persist or relapse after antimicrobial therapy by serial measurement of chlamydial-specific DNA using the polymerase chain reaction (PCR), cell cultures, and serological studies. DESIGN: Prospective evaluation of an inception cohort. SETTING: University student health clinic. PARTICIPANTS: Twenty women with culture-proven and PCR-proven C trachomatis urogenital infections. MEASUREMENTS: Incidence of persistent infection as determined by PCR, culture, and serial measurement of local and systemic antibody to C trachomatis for 5 months after doxycycline therapy. RESULTS: Prior to therapy, C trachomatis was isolated in cell culture from the cervix in 19 of 20 women, from the urethra in 13 women, and from the rectum in 13 women. All culture-positive specimens were also PCR-positive. Immediately after completion of antimicrobial therapy, all women had negative cell cultures for chlamydia. Ten of 20 culture-negative cervical specimens and two culture-negative urethral specimens had chlamydial DNA present immediately after treatment. In addition, three women had detectable DNA from cervical specimens 1 week after treatment. The presence of cervicitis (P = .01), high inclusion counts (P = .004), and serological evidence of recent infection (P = .0004) were each significantly associated with PCR positivity after treatment. All 384 subsequent cervical, rectal, and urethral specimens collected over 5 months were negative by both PCR and culture with the exception of one woman who was reinfected. Serum immunoglobulin M (IgM) titers, geometric mean serum immunoglobulin G (IgG) titers, and prevalence of local antibody to chlamydia progressively declined after treatment. CONCLUSIONS: Standard antimicrobial therapy is effective in the long-term microbiologic eradication of uncomplicated C trachomatis urogenital infections. The presence of chlamydial DNA after antimicrobial therapy is of short duration and reflects excretion of nonviable organisms rather than persistent infection.

Adult↗
PubMed1993

Pregnancy outcome in serologically indicated active Chlamydia trachomatis infection.

A serological test for chlamydial infection was administered to 281 Jerusalem women in order to determine the rate and influence of Chlamydia on pregnancy outcome. Serological indication of active infection was present in 7.8% of the tested women, while 15.3% were shown to be positive for Chlamydia. Among the ultraorthodox subpopulation of Mea Shearim, serological indication of active infection was present among 5.9% of the women, and 12.3% of this population tested positive. In comparison, women from the secular subpopulation had 12.7% serological indication of active infection and 22.95% tested positive (P < 0.01). There were no statistically significant differences between pregnancy duration, birthweight, incidence of premature uterine contractions, premature rupture of membranes, and postpartum febrile morbidity in the infected and noninfected groups. Women with a previous history of induced abortions showed a significantly higher evidence of past Chlamydia infection (9.3%) when compared with the women who did not have an infection (1.4%) (P < 0.006). Among the ultraorthodox women with positive or active infection, 41% had suffered at least one spontaneous abortion, as compared with 25% of the religious women who had no serological evidence of infection.

Abortion, Induced↗
PubMedDate not supplied

[Chlamydia trachomatis and Reiter's syndrome].

Results of the study of incidence of chlamydia trachomatis infection in patients with Reiters syndrome are presented. Chlamydia trachomatic was isolated from the uretral smear in 12 (34.28%) of 35 patients with Reiter's syndrome. In the group of patients with other rheumatologic diseases Chlamydia trachomatis was isolated in 2 (5.13%) of 39 patients. In all patients with negative isolation, infection was confirmed serologically also and in some patients with negative isolation it was also proved.

Antibodies, Bacterial↗
PubMedDate not supplied

The prevalence of Chlamydia trachomatis infection among gynaecological patients.

The prevalence of chlamydia trachomatis infection in the population screened, at All Saints Hospital in Chatham between 1988 and 1990, was 6.3%. The main risk factors for cervical chlamydia infections in gynaecological patients were found to be an age less than 25, low socioeconomic status, and exposure to other sexually transmitted diseases. More research is needed to elucidate the factors that contribute to the differences in sociodemographic characteristics of this disease. Meanwhile it is clear that public health intervention is crucial to its control. The disease is frequently asymptomatic and occurs often in a population that is not seen routinely in standard STD outreach efforts. Furthermore, the chlamydia prone population is only moderately successful at referring sexual partners.

Adult↗
PubMed1993

Chlamydia trachomatis in patients who used oral contraceptives and had intermenstrual spotting.

OBJECTIVE: To identify the incidence of positive assays for direct antigen detection of Chlamydia trachomatis in oral contraceptive (OC) users with and without intermenstrual spotting and in women seeking contraception. METHODS: We studied 65 women who had used OCs for more than 3 months and who presented with intermenstrual spotting for which no readily demonstrable cause could be identified. They were compared with 65 matched controls who were taking OCs without intermenstrual spotting and who had chlamydia testing because of one or more risk factors, and 65 matched controls seeking contraception. The incidence of positive tests for each group was compared by chi 2 test for independence using the Yates formula. The strength of the relationship was analyzed by determining the Craemer phi coefficient. RESULTS: Nineteen of the 65 women (29.2%) taking OCs for more than 3 months and experiencing bleeding had positive tests, in contrast to seven of 65 matched controls (10.7%) who were also on OCs and who had had chlamydia testing because of vaginitis or new or multiple sexual consorts, and four of 65 women (6.1%) who were screened for C trachomatis before initiation of contraception. The significance level for the chi 2 statistic was P < .01. CONCLUSION: Intermenstrual bleeding in women previously well regulated on OCs appears to be an added marker for chlamydial infection.

Adult↗
PubMed1993

Double-blind randomized study comparing amoxicillin and erythromycin for the treatment of Chlamydia trachomatis in pregnancy.

OBJECTIVE: To compare the efficacy and patient tolerance of amoxicillin to that of erythromycin in the treatment of lower genital tract chlamydia infections during pregnancy. METHODS: A double-blind, randomized study was conducted comparing oral amoxicillin 500 mg three times daily versus oral erythromycin 500 mg four times daily for 7 days. One hundred forty-three women with positive cervical cultures for chlamydia at less than 36 weeks' gestation were enrolled. A test-of-cure culture was obtained 4 weeks after entry into the study and side effects were assessed. Success of the regimen was defined as completing the course of medication and having a negative test-of-cure culture. RESULTS: Thirty of the 65 women in the erythromycin group (46.1%) developed symptoms while taking the medication and 15 of them were unable to continue treatment (23.1%). In contrast, five of the 65 women (7.7%) in the amoxicillin group became symptomatic, with only one of these patients intolerant of the side effects (1.5%) (P < .001). Of the 50 patients in the erythromycin group who were able to complete their course of medication, only three had a positive test of cure (6.0%). In comparison, nine of the 64 patients (14.1%) taking amoxicillin who completed their course had positive cultures at test of cure. This difference was not statistically significant (P = .14). Forty-seven of the 65 patients (72.3%) in the erythromycin group successfully completed their regimen, compared to 55 of the 65 women (84.6%) in the amoxicillin group. This difference was not statistically significant. CONCLUSIONS: These findings suggest that amoxicillin is a reasonable alternative for the treatment of chlamydia in pregnant patients intolerant to erythromycin. The incidence of side effects and intolerance to therapy for amoxicillin are less than those for erythromycin.

Adult↗
PubMed1993

[Contact tracing of genital Chlamydia infection].

The present study evaluates two strategies for partner notification among young women with genital Chlamydia trachomatis infection. The study included 443 women, aged 14-21 years, who visited one of 20 youth clinics during a two months period in 1991. The youth clinics were randomized to use patient referral or provider referral. In the latter group, 11 of 14 women with genital Chlamydia infection revealed their sexual partners. Only five of 24 sexual partners were notified by a letter, and six of 24 partners turned up for examination. In the patient referral group, 16 of 34 women asked to notify their partner, and ten of 31 partners were examined. Partner notification in young women with genital Chlamydia infection seems to be difficult.

Adolescent↗
PubMed1993

[Chlamydia trachomatis conjunctivitis in adults. Study of diagnostic techniques].

The place of Chlamydia trachomatis in acute or chronic conjunctivitis is certainly underestimated due to the difficulties involved in the diagnosis. Three diagnostic techniques for Chlamydia trachomatis conjunctivitis were compared: conjunctival sac swab for ELISA technique, scraping of the tarsal conjunctiva for direct immunofluorescence and for culture. Two groups of patients were studied: 73 patients with acute or chronic conjunctivitis and 44 asymptomatic patients. 19.2% of the patients in the first group had a positive result with the two techniques and 6.8% of the patients in the second group also had positive results with the same criteria. Our results show that indirect immunofluorescence is the technique most frequently positive, followed by ELISA, while culture remains the most specific but the least sensitive technique. The existence of healthy carriers Chlamydia trachomatis is demonstrated.

Adolescent↗
PubMed1993

[Urine samples for screening of asymptomatic Chlamydia trachomatis infection in young male recruits].

A prevalence rate of asymptomatic Chlamydia trachomatis infection among young Danish male military conscripts of 7.8% in 1989 and of 10.8% in 1992 is presented. A urine sample seems to be as valid a specimen type as a conventional urethral swab for demonstrating presence of Chlamydia trachomatis antigen by either ELISA (Enzyme-linked immunosorbent assay) or DFM (Direct Fluorescent Microscopy). The method is noninvasive and very suitable for screening young men in order to control urogenital Chlamydia trachomatis infection.

Adult↗
PubMed1995

DNA amplification assays: a new standard for diagnosis of Chlamydia trachomatis infections.

Infections caused by Chlamydia trachomatis are among the most common bacterial sexually transmitted infections in the world with an estimated 50 million new cases occurring each year. Since the prevalence of chlamydial infections range from 3%-5% among asymptomatic men and women to 20%-25% among adolescents attending sexually transmitted disease (STD) clinics, widespread screening for this infection has been recommended. With the advent of DNA amplification technology, several assays have become commercially available which have high sensitivity and specificity, and can utilise convenient, non-invasive specimens such as urine. Using the endogenous plasmid of C trachomatis as target DNA, polymerase chain reaction (PCR) and ligase chain reaction (LCR) have demonstrated sensitivities of 90% to 96%, with specificities of 98% to 100%. In contrast, culture, the previous gold standard for C trachomatis detection, had sensitivities of 50% to 70% for male urethral specimens and 60% to 80% for female endocervical specimens when compared to confirmed PCR and LCR. DNA sequencing and restriction fragment length polymorphisms (RFLP) of amplified target DNA from the major outer membrane protein gene (OMPI) of C trachomatis has been performed to verify specificity and to study the molecular epidemiology of C trachomatis. Nucleic acid amplification assays have proven to be effective in the detection of chlamydia in other clinical specimens including ocular specimens from patients with trachoma, epididymitis, salpingitis, and reactive arthritis. Urine-based screening of both men and women by LCR or PCR provides a unique sensitive method for widespread population-based screening for C trachomatis, a necessary tenet of chlamydia control programmes.

Chlamydia Infections↗
PubMed1996

[Detection of Chlamydia in inflammation of the cervix and uterus in cows].

Clinical findings in cows of seven farms with a frequent occurrence of birth canal inflammations were matched against results of serological and direct immunofluorescence tests for Chlamydia sp. infection. Normal clinical picture, weak to moderate and serious inflammations were found in 16.1%, 46.7% and 37.2% of the 205 examined cows, respectively. The results of micro CFT were negative in 32.7% and titres 1:5, 1:10, 1:20, and 1: > or = 40 were found in 8.7%, 38.0%, 12.3%, and 8.3%, respectively. Direct immunofluorescence test of cervical swabs, using the Progen Biotechnic GmbH set, was negative in 29.1% and clearly positive in 34.7% of the tested cows. The rest was animals in which sporadic elementary bodies were seen. The significance of the findings is discussed and the necessity to test Chlamydia infections in herds affected by frequent and/or chronic inflammations of genital organs is stressed. Evidence of the transmission of Chlamydia infection by contaminated semen is presented.

Animals↗
PubMedDate not supplied

[Chlamydia trachomatis in family planning. Is screening necessary?].

The authors used cellular cultures obtained from endocervix samples in order to determine the predominant factors of infection caused by Chlamydia trachomatis in a population of 391 women who attended a family planning consultation. The authors studied the relation between the infection and the following variables: age, geographical origin, social class, marital status, history of sexually transmitted diseases (STD), risk behaviours, contraceptive methods and attitudes towards both the disease and therapy. Chlamydia trachomatis was isolated in 7 women (1,8%). The highest infection rates were found in the following categories: women between the ages of 35-40 (4,9%), women who resort to hormonal contraception (3,4%), women between the ages of 20-25 (3,2%) and single women and/or women who do not have a regular partner (2,6%). No statistically relevant relation between the above variables and the infection was found, although a relatively high risk was revealed for women who resort to hormonal contraception (O.R = 7,4). The authors have concluded the following: 1. There is no need to proceed with the systematic universal screening of infection caused by Chlamydia trachomatis in the yearly family planning consultations for the low risk STD populations; 2. Hormonal contraception is a factor to be considered when selecting the women to be screened; 3. The yearly gynaecological supervision of women who attend family planning consultations is an important factor in checking the disease; 4. Information on the couple's attitude towards the disease and therapy is essential in the prevention of relapses.

Adult↗
PubMed1997

Chlamydia trachomatis genital infections--United States, 1995.

Genital tract infections with Chlamydia trachomatis are a major cause of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility among women, and perinatal transmission of C. trachomatis to infants can cause neonatal conjunctivitis and pneumonia. In 1994, the estimated cost of untreated chlamydial infections and their complications was $2 billion in the United States. To determine the number of reported cases of infection and to assess the impact of screening and treatment programs on chlamydial infection in 1995, CDC analyzed notifiable disease surveillance data on chlamydia and data on chlamydia test positivity among women screened in family-planning clinics funded through CDC and the Office of Population Affairs as a result of the Preventive Health Amendments of 1992. This report summarizes the findings of the analysis, which indicate that, although the number of reported cases of chlamydial infection among women continued to increase concomitantly with the expansion of screening programs and improved reporting, the prevalence of chlamydial infections declined among women attending Title X family-planning clinics in areas that implemented screening and treatment programs.

Adolescent↗
PubMed1997

[Use of an experimental Chlamydia trachomatis salpingitis model for evaluating the effectiveness of antibiotics and anti-inflammatory agents on fertility].

OBJECTIVES: An experimental model of Chlamydia trachomatis salpingitis was developed in mice to study the effect of combination antibiotic and antiinflammatory therapy on restoring fertility after tubal infection. METHODS: The mice were infected by injection via the ovarian bursa with a suspension containing a human strain of Chlamydia trachomatis sevar F. After treatment with antibiotics alone or in combination with antiinflammatory agents, fertility was studied at 4 months. RESULTS: With doxycycline and ofloxacine, there was not a significant difference in fertility between animals treated with antibiotics alone and those treated with antibiotics and antiinflammatory agents. However, a piroxicam and azythromycin combination improved fertility with a longer delay than with azythromycin alone. The most important factor appeared to be the antibiotic treatment. CONCLUSION: Associating an antiinflammatory agent was not shown to have a beneficial effect in reducing infertility after Chlamydia trachomatis salpingitis.

Animals↗
PubMed1997

Chlamydia trachomatis genital infection.

OBJECTIVE: To determine family physicians' approaches to detecting, managing, and preventing genital Chlamydia trachomatis infection and their perceptions of barriers to prevention. To determine whether sex of physician is associated with differences in clinical approach to chlamydia, with levels of effort aimed at its prevention, and with perceived barriers to preventive efforts. DESIGN: Questionnaires were sent to a random sample of family physicians. SETTING: All health regions in Nova Scotia. PARTICIPANTS: Two hundred fifty-seven Nova Scotia family physicians. MAIN OUTCOME MEASURES: Responses to survey questions analyzed for association of practice behaviours with sex of physician. RESULTS: Response rate was 60%. Most physicians performed diagnostic tests for chlamydia on all patients. Responses indicated that 17% would test for C trachomatis during an annual Papanicolaou test in a low-risk 30-year-old, 61% would test a high-risk 21-year-old man, and 89% would test a pregnant 17-year-old. Therapies physicians might use were judged appropriate in 96% of responses. Only 51% indicated they would ever discuss false-positive test results with patients. Men physicians were less likely than women to ask 75% or more of their adolescent patients about sexual activity or to educate them about prevention of sexually transmitted diseases. Women physicians saw time and the fee schedule as less serious barriers to prevention than men did. CONCLUSIONS: Some physicians are not managing C trachomatis well. We should explore situations where gaps in performance are associated with sex of physician.

Adolescent↗