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Query: EC:2.7.10.2 (
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With recent advances in the development of detection methods, the number of
STD
(Sex transmitted disease) cases detected is greater than ever. Among many
STD
,
Chlamydia
trachomatis (= CT), a microbe that has been given a great deal of attention in the urologic field as a cause of nonspecific urethritis and has a characteristic life cycle, has been gradually proved to exist commonly and to become a cause of various obstetrical and gynecological diseases. However, as it is clinically still unknown which symptoms are actually influenced by CT, we studied infection with CT in 706 cases, consists of a group of patients with some symptoms and an asymptomatic group mainly consisting of pregnant women. As a result, the positive rate was found to be 12.3% (87 cases); 10.8% (21 out of 194) in asymptomatic pregnant women, 11.0% (13 out of 118) in patients with cervicitis, and 14.9% (30 out of 202) in patients with adnexitis including PID. As to age, the positive rate was highest, 23.1%, in patients under 20 years old. In fact, 1) CT positive pregnant women are not rare, and 2) CT was detected in high frequency in the young generation under 20 years old; and in these young women, the possibility of transmission of the disease to the infant in the birth canal should be considered in connection with future pregnancy and delivery. Tubal sterility may also result. We concluded that it was necessary to establish a satisfactory examination system.
...
PMID:[Chlamydia trachomatis infection in the female patients]. 337 74
From August of 1982 through February of 1983, the Sapporo Clinical Research Group for
STD
treated 131 cases of male gonorrheal urethritis at its affiliated clinical facilities in Sapporo City. The therapeutic efficacy of AT-2266 was investigated, together with an epidemiological study on the cases and bacteriological studies on the isolated strains of gonococcus. In addition, a few cases of female gonorrheal cervicitis were treated, and the therapeutic results for 3 of these cases evaluated. AT-2266 was administered at a daily dosage of 600 mg in one dose to 14 patients, 2 doses to 10 patients and 3 doses to 98 patients. At the end of 3 days of this therapy, the gonococci had been eliminated in all of the cases, but there was variation in the status of disappearance of the secretion. The "excellent" efficacy rates for these three regimens were thus 7.7%, 50% and 57%, respectively. These results showed that administration of the total dosage in two or more divided doses maintained higher minimum concentrations of the antibiotic in the blood and the urine, and were thus more clinically beneficial than when the dosage was given as one daily dose. Of the patients who were treated with 600 mg/day of AT-2266 in 3 divided doses, 93 were evaluated for the therapeutic efficacy. At the end of 3 days 57.0% were "excellent" cases, 39.8% were "good" cases and 3.2% were "fair" cases, and at the end of 7 days of therapy, 67 patients were 74.6% "excellent" cases, 23.9% were "good" cases and 1.5% were "fair" cases. The clinical efficacy rate was thus quite high. Those cases in which the secretion and leukocytes had not disappeared from the urine even at the end of the 7 days of therapy were probably cases of mixed infection involving
Chlamydia
, etc. Eight of the 77 gonococcal isolates (10.4%) were beta-lactamase producers. The MIC of AT-2266 hardly differed with the size of the bacterial inoculum. With an inoculum of 10(6)CFU/ml, the MIC distribution showed two peaks, i.e., at 0.05-0.2 micrograms/ml and 3.16-12.5 micrograms/ml. Only 11.7% of the strains were found to have high MICs. The distribution of these high MICs was found to be unrelated to the ability to produce beta-lactamase. Mild side effects of AT-2266 were seen in 2 out of 128 patients. (1.6%), an extremely low incidence.
...
PMID:[Epidemiologic and therapeutic studies on gonorrheal infections--use of AT-2266--Sapporo Clinical Research Group for STD]. 346 20
Urogenital swabs (571) were investigated with a solid-phase enzyme immunoassay for the detection of
Chlamydia
trachomatis antigen (Chlamydiazyme, Abbott). The results were compared with the conventional cell culture method (McCoy cell culture). Urogenital C. trachomatis infections were diagnosed with the cell culture in 14 of 122 male
STD
patients (12%), in 12 of 79 female
STD
patients (15%), in 23 of 89 prostitutes (26%), and in 3 of 115 asymptomatic males (3%). In comparison with cell culture, the sensitivity of Chlamydiazyme for urethral specimens from male
STD
patients was 86%. In female
STD
patients, for urethral specimens a sensitivity of 83% was found and for cervical specimens a sensitivity of 80%. The corresponding values for specimens from prostitutes were 60% and 100%, respectively. The specificity of Chlamydiazyme for urethral specimens of male
STD
patients reached 95%. With respect to urethral and cervical specimens of female
STD
patients, the specificity was 88% and 82%, respectively, and in prostitutes 92% each. The low specificity in female patients cannot be ascribed only to Chlamydiazyme since, after subcultivation and detection of inclusions by the use of fluorescein-labeled monoclonal antibodies, some of the false-positive Chlamydiazyme results turned out culture positive. This means that the specificity of Chlamydiazyme is actually higher. Because it can be performed rapidly and simply and reaches detection rates approaching those of the cell culture method, the enzyme immunoassay is an improvement in the diagnosis of C. trachomatis infections.
...
PMID:[Detection of Chlamydia trachomatis antigen with an enzyme immunoassay]. 351 82
An enzyme immunoassay (Chlamydiazyme) for detecting
Chlamydia
trachomatis was evaluated on genital specimens from 96 men and 272 women attending a clinic for sexually transmitted diseases (
STD
clinic). Compared with a direct immunofluorescence test for chlamydial elementary bodies, the enzyme immunoassay had a sensitivity of 58% on specimens from men, a specificity of 90%, a positive predictive value of 93%, and a negative predictive value of 88%; the assay had a sensitivity of 67% on specimens from women, a specificity of 89%, a positive predictive value of 63% and a negative predictive value of 90%. Immunofluorescence provided the most stringent test for the performance of the enzyme immunoassay as values were improved a little when a cell culture procedure was used for comparison. Further evidence for the lack of sensitivity was the detection of elementary bodies, sometimes in large numbers, in the enzyme immunoassay buffer of 13 of 19 specimens that had given a negative enzyme immunoassay result and the finding in comparative titrations of four laboratory strains that the enzyme immunoassay was at least 100-fold less able to detect chlamydiae than either immunofluorescence or the cell culture procedure. Lack of specificity may be associated with the finding that the enzyme immunoassay antibody reacted with strains of Acinetobacter calcoaceticus, Escherichia coli, Gardnerella vaginalis, Neisseria gonorrhoeae and group B streptococci. The enzyme immunoassay was not considered to be sufficiently sensitive, specific, or reproducible for routine use.
...
PMID:Evaluation of enzyme immunoassay (Chlamydiazyme) for detecting Chlamydia trachomatis in genital tract specimens. 354 97
Further studies are needed to define the clinicopathologic manifestations of CT infection. Many questions remain regarding the natural history and pathogenetic mechanisms of CT and its biologic and clinical interactions with other prevalent STDs. However, it is apparent that CT is a major cause of
STD
in the Western world and that its incidence and prevalence have increased to epidemic proportions in young, sexually active women and men. As with other STDs, epidemiologic control of CT infection is of paramount importance. The clinician and pathologist should develop a heightened awareness of the probability of
Chlamydia
infection in all patients at risk for
STD
, and in clinical settings, only a high index of suspicion will result in timely therapeutic intervention. Although more simplified and less expensive diagnostic procedures for CT are being investigated, presently, culture isolation is the best and most accurate diagnostic method for CT genital infection and its use should be popularized and made more easily available. Immunofluorescent staining using monoclonal and heterologous antibodies to extracellular CT elementary bodies in preselected smears appears promising as a diagnostic technique and requires further study. There is no apparent role for the use of routine cyto- and histologic microscopy in the diagnosis of CT infection and the practice of diagnosing presumed chlamydial vacuoles or inclusions from cervicovaginal Pap smears should be actively discouraged. Although CT cervicitis plays a dominant role in the pathogenesis and dissemination of CT infections, it should be remembered that multiple sites of genital involvement occur commonly with CT infection and this multifocality should be considered when CT cervical cultures are negative and in post-treatment follow-up. Cultures should be obtained from sites of suspected involvement and should include scrapings or biopsy sampling of the tissue surface to insure the presence of sufficient numbers of epithelial cells. Local secretions or exudate should not be considered adequate. In the female, sampling of the urethra, rectum, and endometrium may facilitate accurate diagnosis. Scraping or sampling of the tubal epithelium by biopsy may provide diagnostic material in acute salpingitis and PID and should be considered if laparoscopy or laparotomy are performed. Routine screening by culture for CT cervicitis has been suggested in high-risk clinical groups and in antepartum patients for prophylaxis of fetal and neonatal disease and requires serious consideration because of the high prevalence of CT infection.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Chlamydia trachomatis infection of the female genital tract. Pathogenetic and clinicopathologic correlations. 355 20
A seroepidemiological study was performed on HTLV-III, T. pallidum, C. trachomatis and Hepatitis B virus (HBV), in Butare, Rwanda, among 33 female prostitutes, 25 male customers of prostitutes, and 60 male and female controls. As compared with female controls the prostitutes had a higher prevalence of antibodies to HTLV-III (29/33 versus 4/33, p less than 0.001), T. pallidum (TPHA: 27/33 versus 6/33, p less than 0.001; RPR: 19/33 versus 2/33, p less than 0.001; FTA-Abs: 27/33 versus 5/33, p less than 0.001) and C. trachomatis (IgG IF: 31/33 versus 13/33, p less than 0.001). HBV serological markers were more often detected in the prostitutes than in the female controls (31/33 versus 18/33, p less than 0.001) although HBs antigen carriage rate was similar in both groups. As compared with male controls, the male customers of prostitutes had more frequently detectable antibodies to HTLV-III (7/25 versus 2/27, p = 0.05), and a positive RPR (10/25 versus 1/27, p less than 0.01). Among the 118 individuals studied, odds ratios and trend analysis disclosed a significant association between HTLV-III seropositivity and a positive TPHA, RPR, FTA-Abs,
Chlamydia
IgG IF test and serological markers to HBV. No association was found between HTLV-III seropositivity and HBs Ag carriage. This study suggests that HTLV-III has to be considered as an infectious agent transmitted among promiscuous Central African heterosexuals by sexual contact and/or parenteral contact with unsterile needles used for
STD
treatments.
...
PMID:Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection. 355 10
Urethral swabs from 322 men without urethritis, 73 of whom had venereal warts (condylomata acuminata, CA) and 249 who had none, were investigated between 1981 and 1984 by microscope and culture for the presence of Neisseria gonorrhoeae,
Chlamydia
trachomatis, Ureaplasma urealyticum, Mycoplasma species, Trichomonas vaginalis, Garderella vaginalis, B streptococci, aerobic pathogenic bacteria and Candida species. The isolation frequencies in patients with and without CA were as follows: N. gonorrhoea: with CA 0%, without 0.4%; C. trachomatis: with CA 6%, without 4.4%; U. urealyticum in high CFU: with CA 15%, without 17.7%; Mycoplasma spp. in high CFU: with CA 6%, without 4%; T. vaginalis: with CA 0%, without 0.4%; G. vaginalis: with CA 4%, without 5%; B streptococci: with CA 4%, without 6%; Candida spp. only in low CFU: with CA 3%, without 2.4%.--The results indicate that as far as the isolation frequencies of sexually transmittable pathogens in the urethra are concerned, there are no significant differences between patients with CA and asymptomatic patients presenting to an
STD
department. However, N. gonorrhoeae was significantly less frequently isolated and C. trachomatis and U. urealyticum significantly more frequently isolated in our patients than has been reported in previous studies.
...
PMID:[Condylomata acuminata-associated STD infections of the urethra of the male. A comparative epidemiologic study]. 355 79
The purpose of this study was to determine whether selected clinical features can distinguish salpingitis associated with endocervical Neisseria gonorrhoeae from that caused by
Chlamydia
trachomatis in black, inner-city adolescents. We reviewed retrospectively the charts of teenagers presenting to a university hospital outpatient department between January 1982 and January 1984 who were diagnosed as having salpingitis. We included all teenagers who presented with a history of low abdominal pain plus (1) either cervical motion tenderness (n = 15), adnexal tenderness (n = 13), or both (n = 57); and (2) either cervical cultures positive for N. gonorrhoeae and negative for C. trachomatis (n = 31) or cervical cultures negative for N. gonorrhoeae and positive for C. trachomatis (n = 54). Discriminant analysis indicated that the presence of breakthrough vaginal bleeding (standard regression coefficient [
SRC
] = 0.301; P = 0.023), current usage of oral contraception (
SRC
= 0.408; P = 0.009), and an elevated erythrocyte sedimentation rate (
SRC
= 0.522; P = 0.0002) were significantly more often related to the presence of endocervical C. trachomatis. However, we found no significant differences between the two groups for other variables that have been described as distinguishing features (i.e., duration of pain, fever, and leukocyte count).
...
PMID:Pelvic inflammatory disease associated with Neisseria gonorrhoeae and Chlamydia trachomatis: clinical correlates. 366 Jan 68
Methods for detecting microbial antigens in clinical specimens offer an alternative to culture in the diagnosis of some sexually transmitted diseases. Developers of the immunologic methods are faced with a number of problems in evaluating the new tests. Traditionally, these tests are compared to culture as the "gold standard." Unfortunately, culture for Neisseria gonorrhoeae or
Chlamydia
trachomatis--the two agents most commonly sought--is considerably less sensitive than 100 percent. Immunologic methods may appear to produce false positives when the paired specimens are actually false-negative cultures. Another source of discordant results is sampling variation. These considerations, however, will not account for all false-positive results. Even the best non-culture methods have a low rate of false-positive results. If a new test has a specificity of 97 percent, it, by definition, yields approximately 3 percent false-positive reactions. In low-prevalence settings this false-positive rate will create problems in interpreting the results. For example, in a population with 3 percent prevalence of infection, a positive result in a 97 percent specificity test could only have a predictive value of 50 percent. Most testing for
STD
agents is performed in low-prevalence settings. None of the currently available immunodiagnostic procedures has a performance profile that suggests it will be satisfactory for diagnostic use in the low-prevalence setting.
...
PMID:Immunodiagnosis of sexually transmitted disease. 391 5
Adenoviruses were isolated from the urethral swabs of 129 male patients in an
STD
clinic. After exclusion of patients with
Chlamydia
trachomatis or Neisseria gonorrhoea infections, 85 of the remaining 120 patients had urethritis, compared with 28 men with urethritis detected in a control group which was closely matched for age, sex, and date of specimen collection. This statistically significant difference suggests that genital adenovirus infection may be a cause of urethritis in some male patients.
...
PMID:Association of genital adenovirus infection with urethritis in men. 609 96
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