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The most frequently seen type of infectious ophthalmia neonatorum, inclusion conjunctivitis, is caused by the organism Chlamydia trachomatis. This agent is known to be transmitted sexually. Until recently, the infections produced by C trachomatis were though to be relatively benign. Recent evidence, however, suggests that the organism may produce urethritis and epididymitis in the male; cervicitis, cervical erosions, salpingitis, and puerperal infections in the female; and prematurity and pneumonitis in the infant. An infant who develops ophthalmia neonatorum should be thoroughly evaluated for the presence of a chlamydial infection. In many instances the first evidence of chlamydial infection within the parents will be the development of inclusion conjunctivitis in their newborn infant. Family members of infants with inclusion conjunctivitis who manifest any evidence of clinical disease should be evaluated and treated with appropriate antibiotics.
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PMID:Ophthalmia neonatorum due to Chlamydia trachomatis: a family problem? 75 48

Sheep erythrocytes were coated with antigens of a strain of Chlamydia trachomatis serotype D. Chlamydial antibodies in sera from patients with salpingitis or pneumonia were demonstrated by passive hemolysis in agarose gel.
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PMID:Hemolysis-in-gel test for demonstration of Chlamydia antibodies. 79 67

The chlamydiae are a genetically diverse group of bacteria with a unique intracellular development cycle. The spectrum of clinical manifestations of Chlamydia trachomatis infections in the female includes cervicitis, acute urethral syndrome, pelvic inflammatory disease, salpingitis and the risk of exposure of infants born through an infected birth canal who may develop inclusion conjunctivitis and/or pneumonia. In order to determine the prevalence of cervicovaginal infections caused by C. trachomatis in female population in Cuernavaca, Morelos, we studied 2,407 sexually active women from a suburban area. Genital specimens were collected from each woman and cultured in McCoy cell monolayers. Detection of the bacteria was done by staining with fluorescein-conjugated monoclonal antibodies (Syva Microtrak, Palo Alto CA). 97 of them were culture-positive for C. trachomatis, with and overall prevalence of 4.02 per cent. The most important clinical symptom observed in 47 of the infected patients was an increased or altered vaginal discharge.
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PMID:[Prevalence of cervicovaginal infections caused by Chlamydia trachomatis among female population of the city of Cuernavaca, Morelos]. 161 48

A role for both the cellular and humoral components of the immune response has been established for chlamydial infection. The significance of helper (L3T4) T cells was evaluated by using a Chlamydia trachomatis murine salpingitis model for upper genital tract chlamydial infection. Mouse oviducts were inoculated with C. trachomatis by using the mouse pneumonitis agent (MoPn) or control medium. Mice depleted of L3T4-bearing lymphocytes had significantly higher (P less than 0.05) numbers of organisms recovered at day 7 postinoculation. The rate of hydrosalpinx formation was significantly higher in the mice depleted of L3T4-bearing lymphocytes (27 of 31 [87%] ) than in the infected undepleted group (8 of 16 [50%] ) (P less than 0.01). The geometric mean antichlamydial immunoglobulin G titers at day 54 postinoculation were significantly higher in the L3T4-depleted mice (mean titer, 2,030) than in the undepleted group (mean titer, 776; P less than 0.05). The rate of fertility was lower in the L3T4-depleted group (2 of 31 [6%]) than in the infected, undepleted mice (2 of 16 [13%]), but this difference did not reach statistical significance. In conclusion, the greater persistence of organisms in the oviduct and higher rates of hydrosalpinx formation in mice depleted of L3T4-bearing cells suggests that these cells play a role in the clearing of organisms following infection and thus in reducing the degree of oviduct obstruction and damage.
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PMID:Role of L3T4-bearing T-cell populations in experimental murine chlamydial salpingitis. 183 63

Chlamydiae are Gram-negative bacteria with obligate intracellular reproduction and disability to synthesize high-energy compounds such as ATP. Their cycle of development is unique among the prokaryotes: the host cells, mainly epithelial cells, are infected by so-called elementary bodies (EB) which undergo reorganization to form metabolically active reticulate bodies (RB). These RB multiply by binary fission, and after transition into infectious EB they are released within 48-72 hours. Chlamydiae cause prolonged subclinical infections of the conjunctiva, lung, cervix, and urethra. Complications in newborns are inclusion conjunctivitis, nasopharyngitis and pneumonia; in females, salpingitis, infertility, and perihepatitis; in male patients, epididymitis and prostatitis; and in both sexes, Chlamydiae-induced arthritis. Identification of the pathogenic agent confirms clinical diagnosis; tissue culture identification remains the diagnostic method of choice. Therapeutical drugs are tetracycline, erythromycin, josamycin, and in certain cases quinolone derivatives.
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PMID:Chlamydiae as pathogens--an overview of diagnostic techniques, clinical features, and therapy of human infections. 192 Dec 29

Chlamydia trachomatis is a human pathogen that causes ocular disease (trachoma and inclusion conjunctivitis), genital disease (cervicitis, urethritis, salpingitis, and lymphogranuloma venereum), and respiratory disease (infant pneumonitis). Respiratory chlamydioses also occur with infection by avian strains of C. psittaci or infection by the newly described TWAR agent. Diagnosis of most acute C. trachomatis infections relies on detection of the infecting agent by cell culture, fluorescent antibody, immunoassay, cytopathologic, or nucleic acid hybridization methods. Individual non-culture tests for C. trachomatis are less sensitive and specific than the best chlamydial cell culture system but offer the advantages of reduced technology and simple transport of clinical specimens. Currently available nonculture tests for C. trachomatis perform adequately as screening tests in populations in which the prevalence of infection is greater than 10%. A negative culture or nonculture test for C. trachomatis does not, however, exclude infection. The predictive value of a positive nonculture test may be unsatisfactory when populations of low infection prevalence are tested. Tests that detect antibody responses to chlamydial infection have limited utility in diagnosis of acute chlamydial infection because of the high prevalence of persistent antibody in healthy adults and the cross-reactivity due to infection by the highly prevalent C. trachomatis and TWAR agents. Assays for changes in antibody titer to the chlamydial genus antigen are used for the diagnosis of respiratory chlamydioses. A single serum sample that is negative for chlamydial antibody excludes the diagnosis of lymphogranuloma venereum.
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PMID:Laboratory diagnosis of human chlamydial infections. 265 Aug 58

The 1985 Communicable Disease Surveillance Center figures for sexually transmitted diseases document over 14,000 confirmed cases of genital chlamydial infection in women. Yet, this figure seriously underestimates the size of the problem as many chlamydial infections are silent. The mainstay of diagnosis until recently has been isolation of C. trachomatis in cell culture, which is time consuming, technically demanding, expensive, and available in only a few centers. A firm diagnosis of chlamydial infection cannot be based on serology alone. Antibodies can be detected in 78-100% of womn with C. trachomatis in the cervix, but in those who are culture negative 31-87% also will have antibodies. More support is given to the diagnosis by demonstration of a rising titre of IgG antibody or by detection of IgM, but because of the late presentation of most women with chlamydia this is seldom possible. Newer tests include direct immunofluorescence statining of genital secretions which is rapid and simple. Results of this method compare favorably with those of cell culture, but screening large numbers of smears is expensive and tedious. Enzyme-linked immunosorbent assays also give good results. C trachomatis is a well known cause of cervicitis and salpingitis and is consequently a major factor in infertility. The frequency of chlamydial infection is influenced by sexual activity and promiscuity, but the effect of contraceptive choice is more difficult to determine. An IUD can provide a nidus for many infections, but the role of oral contraceptives (OCs) is more controversial. Instrumentation of the endocervical canal provides a route for introduction of infection, which is therefore a frequent and important complication of induced abortion. Westergaard et al. in a study of women having 1st trimester abortions found that 10% had symptomless cervical chlamydia; postabortal pelvic inflammatory disease developed in 28% of these patients by comparison with 10% in culture-negative women. Other workers have found similar results. The role of chlamydia as a cause of morbidity in pregnancy is unclear. Complications for the newborn are better established. It has been estimated that between 2-37% of mothers will have a chlamydia infection in pregancy. If 33-50% of newborns at risk get conjunctivitis, and 10-20% get pneumonitis, this gives some indication of the extent of the problem. Several studies have suggested an association between cervical chlamydial infection, anti-chlamydial antibodies, and cervical dysplasia. Emphasis on early diagnosis and treatment is of paramount importance to reduce the prevalence of chlamydial infection and its complications; without this rates of ectopic pregnancy and infertility are bound to increase.
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PMID:Chlamydia in women: a case for more action? 287 Mar 60

Chlamydia trachomatis is a sexually transmitted intracellularly growing rod, causing cervicitis, endometritis, salpingitis and urethritis. Inclusion conjunctivitis and pneumonia are the sequelae of maternal cervicitis in newborns. In treatment tetracyclines and erythromycin are the drugs of choice.
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PMID:Chlamydial infections in gynaecology and obstetrics. 348 65

Chlamydia trachomatis serotype D-K is one of the most important pathogens of communicable diseases. 3 to 5 million new infections are observed annually in the USA. 10% to 30% of young sexually active persons in the age group 15 to 20 years are affected. The organism was isolated from 20% to 30% of patients attending dispensaries for sexually transmitted diseases, 5% to 10% of gynaecological outpatients, 1% to 8% of pregnant women and 0% to 5% of asymptomatic control persons. In men, C. trachomatis was found in 30% to 70% of patients with urethritis (15% to 25% simultaneously with gonorrhoea), in 30% to 60% of persons suffering from nongonoccocal urethritis and in 65% to 70% with postgonoccocal urethritis. 20% of newborns from mothers with positive cultures develop pneumonia and 37% conjunctivitis. Complications such as endometritis, salpingitis, periappendicitis, perihepatitis, ectopic pregnancy, premature birth, proctitis, cystitis, deferenitis, epididymitis, reactive arthritis, morbus Reiter, conjunctivitis, pneumonia (in infants and adults) may cause long lasting disease and may leave behind irreversible sequelae. Treatment with tetracyclines or erythromycin is always effective.
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PMID:[Epidemiology, clinical aspects and therapy of infections with Chlamydia trachomatis serotype D-K]. 349 42

Chlamydia trachomatis is an organism commonly transmitted through sexual intercourse. In women it is associated with cervicitis, salpingitis, perihepatitis and infertility. Neonates born to infected women may have inclusion conjunctivitis and pneumonia due to this organism. Screening in obstetrics and in gynecology clinics is not usually performed routinely because of the cost and time involved in culturing the organism. A rapid enzyme immunoassay (EIA) kit (Chlamydiazyme, Abbott Laboratories) that can detect C. trachomatis was developed recently. Women belonging to two different cohorts were studied to determine whether multiple endocervical samples increased the likelihood of a positive result from this EIA kit. One cohort consisted of 70 asymptomatic, sexually active female adolescents from a local family planning clinic. The second cohort included 80 women who were seen at a sexually transmitted disease (STD) clinic. Both groups were assayed for Chlamydia infections using the rapid EIA kit. Positive test results were found in 7 of the 70 asymptomatic teenagers (10%) and 12 of the 80 women from the STD clinic (15%). No significant differences were noted in the order of the positive swabs in either group, although more of the earlier swabs tended to be positive.
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PMID:Detection of Chlamydia trachomatis using consecutive endocervical swabs. Prevalence in asymptomatic female adolescents and women attending a sexually transmitted disease clinic. 352 34


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