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PubMed1976

Isolation of Chlamydia trachomatis from women attending a clinic for sexually transmitted diseases.

Attempts were made to isolate Chlamydia trachomatis from the cervix of 300 women attending a clinic for sexually transmitted diseases in Leeds. The women were divided into four groups; (1) 130 were consorts of men suffering from non-specific urethritis; (2) 66 were suffering from gonorrhoea, or were consorts of men suffering from this disease; (3) 56 were suffering from other sexually transmitted diseases; (4) 48 had no evidence of STD. The overall isolation rate of Chlamydia trachomatis was 20%. Positive results were obtained in 30%. of Group 1, in 27-3%. of Group 2, in 3-6%. of Group 3, and in 2-1%. of Group 4. No pathogenic sign or symptom of Chlamydia trachomatis infection of the cervix was detected.

Adolescent↗
PubMed1981

Toxic effect of sampling swabs and transportation test tubes on the formation of intracytoplasmic inclusions of Chlamydia trachomatis in McCoy cell cultures.

The ability of Chlamydia trachomatis, immunotype E, to produce intracytoplasmic inclusions in cycloheximide-treated McCoy cells after being exposed to different types of sampling swabs in experimentally infected transport medium was studied. A larger number of inclusions was obtained with cotton-tipped aluminium and rayon-tipped plastic swabs than with calcium-alginate-tipped aluminium and cotton-tipped wooden swabs (P less than 0.0001). Transport medium stored in glass tubes caused a cytopathic effect when inoculated on to McCoy cell cultures; no such effect occurred with plastic tubes. When cotton-tipped aluminium instead of calcium-alginate-tipped aluminium swabs were used to collect 50 make urethral specimens significantly more were chlamydia-positive (P less than 0.025). This was also true when cotton-tipped aluminium swabs were used instead of alginate-tipped swabs in a study of 123 cervical specimens (P less than 0.01). When the calcium-alginate-tipped aluminium and cotton-tipped wooden swabs were shaken in the transport medium after sampling from the male urethra and the cervix, instead of being left in the medium during transport to the laboratory, more specimens were chlamydia-positive and a greater number of chlamydial inclusions were found per culture-positive sample; these results were, however, not statistically significant (P greater than 0.05).

Cell Line↗
PubMed1985

Pivampicillin in treating genital infection with Chlamydia trachomatis.

Pivampicillin was used to treat urogenital colonisation with Chlamydia trachomatis in 41 women and 24 men who yielded chlamydiae but not gonococci. They were treated for 10 days. All but one patient gave negative chlamydia cultures 10 days after the start of treatment, and all 65 patients gave negative results at the second examination seven days later. Ten days of treatment with pivampicillin seems to be the optimum to eradicate C trachomatis from the lower genital tract in man.

Ampicillin↗
PubMed2001

Incidence of recurrent diagnoses of Chlamydia trachomatis genital infections among male and female soldiers of the US Army.

BACKGROUND/OBJECTIVES: Few studies of Chlamydia trachomatis incidence, especially among men, and most studies of C. trachomatis in US military populations are cross sectional prevalence surveys. A population based retrospective cohort was used to determine risk factors for repeat diagnoses of genital C. trachomatis infections among male and female soldiers with previous C. trachomatis infections. METHODS: All active duty soldiers diagnosed with C. trachomatis genital infections between 1994 and 1998. Cohort members were passively followed until repeat diagnoses of C. trachomatis infection, termination of army service, or the end of the study. RESULTS: Among 11,771 soldiers with initial diagnoses of chlamydia, the crude rate of repeat diagnoses was 52.0 per 1000 person years. Women and men aged 20-24 were at greatest unadjusted risk of reinfection. After adjustment, women aged 20-24 and men aged 25-29 were at higher risk than their younger or older counterparts. CONCLUSIONS: Results of this study suggest that both male and female soldiers who are diagnosed with chlamydia infections have relatively high risks of reinfection through their 20s.

Adult↗
PubMed2002

Outreach health adviser in a community clinic screening programme improves management of genital chlamydia infection.

OBJECTIVE: To assess the effectiveness of an outreach health adviser on treatment, partner notification and outcome for clients diagnosed with genital chlamydia (CT) infection at a community young people's clinic. METHODS: From August 1999 to March 2000, a genitourinary medicine (GUM) based health adviser helped to develop testing and undertook outreach management of clients aged under 26 years diagnosed with CT infection. In addition to facilitating referral to GUM, she gave antibiotic treatment based on a GUM derived patient group direction to those not wishing to travel to the GUM clinic. She also advised them on contact tracing and the need for a compliance check (CC). RESULTS: Chlamydia positive tests with ligase chain reaction (LCR), on first void urine, were obtained for 62 (12.9%) of 481 female clients, one (5%) of 20 male clients, and nine (53%) of 17 male contacts of female positive cases. All 72 testing positive received their result and were treated. Two urine samples positive for CT showed positive LCR tests for gonorrhoea. Proportions of named contacts seen (67%) and reattendances for compliance checks (60%) were similar to those for women seen in GUM services. CONCLUSIONS: Health adviser input with the ability to treat can be effective in reducing the growth of identified but untreated genital chlamydia infection consequent upon community based screening. Such a strategy appears comparable with, and can add to, GUM based treatment of infection. It helps to address the need for alternative management strategies in the light of the national sexual health strategy.

Adolescent↗
PubMed1989

Variations in the virulence of strains of Chlamydia psittaci for pregnant ewes.

Invasive and non-invasive strains of Chlamydia psittaci isolated from faeces of clinically healthy ewes and from vaginal swabs of ewes which had aborted were injected intravenously or intradermally into pregnant ewes. The results were studied by recording the ewes' thermal and serological responses, lambing performance and the excretion of chlamydia from the vagina. The differences between the effects of different invasive strains were greater after intradermal inoculation than after intravenous inoculation. After intradermal inoculation non-invasive strains did not disturb pregnancy (11 of 13 ewes lambed normally) whereas invasive strains induced abortion in 23 of 25 ewes, 24 of which excreted chlamydia in vaginal secretions.

Abortion, Veterinary↗
PubMed1975

Electron microscopy of the in vivo internalization of virulent Chlamydia psittaci 6BC strain.

The internalization of virulent Chlamydia psittaci 6BC particles by wandering mononuclear phagocytes in the peritoneal cavity of intraperitoneally inoculated mice occurred asynchronously, i.e., fragile reticulate bodies (RB) appeared to be more readily phagocytized than the rigid elementary bodies (EB). Early damage of mononuclear phagocytes occurred after internalization of chlamydiae. This was followed by a decreased uptake of particles, and may explain the relatively long persistence (up to 6 h after inoculation) of free, extracellular, "swollen", and RB-like particles. Internalized particles within phagolysosomes showed varying degrees of disintegration. The subsequent influx of polymorphonuclear phagocytes and monocytes into the inflammed peritoneal cavity may explain the rapid disappearance of chlamydiae and their antigens from the peritoneal fluid. The alteration in ultrastructure of peritoneal cells and chlamydial parasites during the inflammatory process are discussed.

Animals↗
PubMed2001

Modulation of P2Z/P2X(7) receptor activity in macrophages infected with Chlamydia psittaci.

Given the role that extracellular ATP (ATP(o))-mediated apoptosis may play in inflammatory responses and in controlling mycobacterial growth in macrophages, we investigated whether ATP(o) has any effect on the viability of chlamydiae in macrophages and, conversely, whether the infection has any effect on susceptibility to ATP(o)-induced killing via P2Z/P2X(7) purinergic receptors. Apoptosis of J774 macrophages could be selectively triggered by ATP(o), because other purine/pyrimidine nucleotides were ineffective, and it was inhibited by oxidized ATP, which irreversibly inhibits P2Z/P2X(7) purinergic receptors. Incubation with ATP(o) but not other extracellular nucleotides inhibits the growth of intracellular chlamydiae, consistent with previous observations on ATP(o) effects on growth of intracellular mycobacteria. However, chlamydial infection for 1 day also inhibits ATP(o)-mediated apoptosis, which may be a mechanism to partially protect infected cells against the immune response. Infection by Chlamydia appears to protect cells by decreasing the ability of ATP(o) to permeabilize macrophages to small molecules and by abrogating a sustained Ca(2+) influx previously associated with ATP(o)-induced apoptosis.

Adenosine Triphosphate↗
PubMed2004

[Prognostic value of antibodies anti-Chlamydia pneumoniae in ischemic heart disease].

INTRODUCTION AND OBJECTIVES: Coronary artery disease has been related to infection by Chlamydia pneumoniae even only in a few studies the association between presence of antibodies to this microorganism and the prognosis of patients with ischemic heart disease has been assessed. The objective of our study was to assess the impact of positivity of anti-Chlamydia pneumoniae antibodies in the morbidity and mortality associated to ischemic heart disease. METHODS: 249 patients with ischemic cardiopathy were evaluated (97 with myocardial infarction, 83 with unstable angina and 69 with stable angina), recluted along 1 year and with 3-year follow-up. IgG anti-Chlamydia pneumoniae antibodies were measured with microimmunofluorescence. The cut off point considered for positive serology was set in 1/64. RESULTS: In the group of 97 patients with acute myocardial infarction, 43% showed positive titers of IgG antibody to C. pneumoniae. We observed a statistically significant association (p = 0.007) between positive serology and higher survival of acute myocardial infarction patients. A logistic regression was carried out with mortality, age, and serology as variables; age was the only variable that explained mortality (p = 0.0012), and the serology lost its statistical meaning. In the groups of 83 patients with unstable angina and of 69 patients with stable angina, 42% and 58%, respectively, showed positive serology for C. pneumoniae. We did not find a statistically significant association in both groups between positive serology to C. pneumoniae and the prognostic factors related to morbidity and mortality (rehospitalization and mortality). CONCLUSIONS: The presence of IgG antibodies to C. pneumoniae is not a marker of morbidity and mortality in our population of patients with ischemic heart disease.

Adult↗
PubMed1998

Cytokine responses in patients with pneumonia caused by Chlamydia or Mycoplasma.

The serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) were measured by enzyme immunoassays in 44 patients with Chlamydia (n = 13) or Mycoplasma (n = 14) pneumonia or influenza A infection (n = 17) and in 20 control subjects. The levels of IFN-gamma were raised in 29/44 patients. The concentrations of IL-6 were raised in 32/44 patients. Raised levels of TNF-alpha were seen in 26/44 but there was no significant difference between the levels of the different groups of patients. All three cytokines indicated clinical recovery when acute and convalescent samples from 10 patients with Chlamydia pneumonia were analyzed. IFN-gamma, IL6 and TNF-alpha are present in the circulation in the majority of patients with Chlamydia and Mycoplasma pneumonia and in influenza A infection. We suggest that repeated measurement of cytokines, such as IL-6, IFN-gamma and TNF-alpha, may be useful in the management of lower respiratory tract infections but further studies are needed to define the value of cytokine measurements in acute pneumonia.

Adolescent↗
PubMed1999

No association of Chlamydia with abortion.

Case reports and serological work have raised the possibility that chlamydias can infect the placenta and thus harm the fetus. We investigated the involvement of Chlamydia in a series of 195 unselected cases of spontaneous abortion or miscarriage. Formalin-fixed placental tissues from all cases were examined immunohistochemically, for the presence of chlamydial lipopolysaccharide, as well as histopathologically. A serum sample was collected from 187 of the patients for detection of anti-chlamydial antibodies by microimmunofluorescence. All placental sections were negative for chlamydial antigen. Serological findings indicated that 8 patients had been in contact with C. trachomatis, 15 patients with C. pneumoniae, and none with C. psittaci. A few cases of perivillitis or intervillitis were detected, but none exhibited the intracytoplasmic inclusions typical of C. psittaci. Although these results are negative a search for Chlamydia in abortion materials should be encouraged.

Abortion, Spontaneous↗
PubMed2001

Host immune response to Chlamydia pneumoniae heat shock protein 60 is associated with asthma.

Chlamydia pneumoniae infection has been associated with asthma. It has also been suggested that heat shock protein 60 (Hsp60) belonging to a class of highly conserved proteins may play a role in the pathogenesis of chlamydial infections. The purpose was to study whether the host immune response to C. pneumoniae Hsp60 is associated with asthma and decreased pulmonary function. An enzyme immunoassay was used to measure immunoglobulin-(Ig)A and IgG antibodies against recombinant C. pneumoniae Hsp60 and human Hsp60 in a study group consisting of 24 cases of recently symptomatic asthma and 62 nonasthmatic controls. A strong (r=0.50) and significant (p<0.001) correlation was observed between C. pneumoniae and human Hsp60 IgA antibodies, but only C. pneumoniae Hsp60 IgA antibodies were significantly associated with asthma (p = 0.02). Pulmonary function, as measured by forced expiratory volume in one second, also inversely correlated (r = -0.23, p = 0.04) with the quantity of C. pneumoniae Hsp60 IgA antibodies, suggesting an association with the severity of pulmonary obstruction. By showing an association of Chlamydia pneumoniae heat shock protein 60 immunoglobulin A antibodies with asthma, the results support the hypothesis of an association between Chlamydia pneumoniae infection and asthma and support the need for further investigations on the role of heat shock protein 60 in the pathogenesis of asthma.

Acute Disease↗
PubMed2002

Chlamydia pneumoniae infection associated with enhanced MRI spinal lesions in multiple sclerosis.

Cerebrospinal fluid (CSF) from 66 patients with multiple sclerosis (MS) and 25 patients with other neurological diseases (OND) were examined for the infection of Chlamydia pneumoniae by culture, polymerase chain reaction (PCR) assay, and determination of antibodies to C. pneumoniae. PCR was positive not only in 9 of 28 (32%) patients with MS but also in 2 patents with inflammatory disorders in 15 (13%) OND controls (p = 0.18). Viable C. pneumoniae was isolated from one patient with MS and one with paraneoplastic encephalomyelitis. C. pneumoniae could be detected only in cell-containing CSF. In MS, enhanced spinal magnetic resonance imaging (MRI) lesions were detected in all of four PCR-positive patents but none of five PCR-negative patients, and the difference was significant (p = 0.0079). However, no correlation was found between enhanced brain MRI lesions and CSF C. pneumoniae DNA. Elevated titers of anti-C. pneumoniae IgG were detected in CSF in 13 of 66 (20%) patients with MS and 1 of 25 (4%) OND controls (p = 0.064). CNS C. pneumoniae infection is not uncommon in MS as well as in other inflammatory disorders of the nervous system. The association of active spinal lesions with Chlamydia in CSF collected by lumber puncture suggests the detection of a recent infection. On the other hand, the lack of association of active MS brain lesions with CSF Chlamydia and the presence of PCR-positive patents who are clinically stable and have no enhancing MRI lesions imply the existence of a chronic infectious process.

Adult↗
PubMed2006

Trafficking from CD63-positive late endocytic multivesicular bodies is essential for intracellular development of Chlamydia trachomatis.

Chlamydiae are obligate intracellular bacterial pathogens that replicate solely within the confines of a membrane-bound vacuole termed an inclusion. Within this protected organelle, chlamydiae acquire host-cell-derived biosynthetic precursors necessary for intracellular subsistence, yet the mechanisms and pathways responsible for this acquisition remain elusive. The present study identifies an interaction between the chlamydial inclusion and multivesicular bodies, complex organelles pivotal in protein and lipid transport that are positioned along the endosome-lysosome pathway, and intersect the exocytic pathway in various cell types. Resident protein and lipid constituents of multivesicular bodies colocalized with intracellular chlamydiae, with direct delivery of the resident protein CD63 to the chlamydial inclusion. Interruption of trafficking from multivesicular bodies by pharmacological inhibitors and exogenous antibodies subsequently disrupted sphingolipid delivery to the maturing chlamydial inclusion and intracellular bacterial growth. This study identifies a trafficking pathway from CD63-positive multivesicular bodies to the bacterial inclusion, a novel interaction that provides essential lipids necessary for maintenance of a productive intracellular infection.

Animals↗
PubMed2004

Completeness and timeliness of treatment for chlamydia within a sexual health service.

Prompt treatment of genital Chlamydia trachomatis infection will reduce the duration of infectiousness and further transmission of infection. In 2002, an audit was conducted to assess the completeness and timeliness of treatment for uncomplicated chlamydial infection at the Sydney Sexual Health Centre, Australia. Over a nine-month period, chlamydia was diagnosed in 250 patients, 97% of whom received appropriate treatment. The median duration between initial attendance and treatment was two days. Prompt delivery of treatment was facilitated by: initial treatment of patients likely to be chlamydia-infected; rapid availability of test results; urgent communication of positive test results; and effective procedures for recalling untreated patients.

Adult↗
PubMed1997

Application of 'Clearview Chlamydia' for the rapid detection of cervical chlamydial antigen.

In a study to evaluate the Clearview chlamydia test in a genitourinary medicine clinic, the sensitivity and specificity were 76.4% and 99.4% respectively when compared with the DAKO IDEIA chlamydia test processed in a department of medical microbiology. The time taken to perform and read the Clearview chlamydia test 'on site' did not interfere with the normal routine functioning of the clinic and the nurses who performed it as part of their routine duties found it simple and easy to use.

Chlamydia Infections↗
PubMed1986

Infertility in mice infected genitally with a human strain of Chlamydia trachomatis.

Progesterone-treated C3H and TO mice were inoculated genitally with a human C. trachomatis strain, serovar E, designated N.I. 1 or with 2SP control medium. Of the C3H mice serving as controls 93% had litters by the end of a 6-month period compared to 31% of mice infected with chlamydiae. This infertility could not be explained by tubal occlusion, since the oviducts appeared normal at autopsy. Some of the mice were induced to superovulate. Eggs were never recovered from the oviducts on the inoculated sides of infertile mice although they were sometimes found in the lumen of the uninoculated oviducts. In contrast, eggs were recovered routinely from both oviducts of control mice. In addition, eggs and/or their accompanying cumulus cells could be seen in the periovarial space of mice inoculated with chlamydiae, indicating a failure of the transportation of eggs to the oviduct. This could explain the high incidence of ectopic pregnancies in women after chlamydial infection. No adverse effect on fertility was seen in TO mice inoculated genitally with strain N.I.1. Of the mice given 2SP medium, 73% had litters, but 87% of the mice inoculated with chlamydiae were also fertile. There was, however, a significantly greater variation in the birth weights of mice born to infected TO mothers than those born to control mice. This difference in the susceptibility of mouse strains suggests that a genetic predisposition should also be considered for man.

Animals↗
PubMed2003

Field-delivered therapy increases treatment for chlamydia and gonorrhea.

In 1998, treatment completion was low among chlamydia and gonorrhea cases reported to the San Francisco Department of Public Health and assigned for treatment follow-up. To improve treatment completion among growing numbers of chlamydia and gonorrhea cases, the department implemented field-delivered therapy (FDT), a single-dose, directly observed therapy protocol for uncomplicated chlamydial and gonococcal infections. After the protocol was implemented in March 1999, the proportion of cases completing treatment increased significantly, from 61.8% in 1998 to 81.0% in 2000. The greatest increases in treatment completion were observed for females and individuals younger than 20 years old. FDT is an effective, feasible, and convenient way to reach and treat individuals who are unlikely to return for chlamydia and gonorrhea treatment.

Adolescent↗