Longitudinal studies on chlamydial infections in the first year of life.

Abstract

We followed 60 infants born to mothers with cervical chlamydial infection and a group of control infants through 1 year of age. Thirty-three percent of infants born to positive mothers who received neonatal ocular prophylaxis with AgNO3 developed conjunctivitis as opposed to none of the infants who received topical erythromycin ointment. However, nasopharyngeal (NP) infection was not affected and the nasopharynx was the most frequent site of infection with 78% of infected infants having positive NP cultures. Only 4 of 12 (33%) infants with isolated NP infection subsequently developed pneumonia. The presence of Chlamydia trachomatis in the nasopharynx of those infants who did not develop pneumonia was not associated with any specific symptoms and cleared by 6 months of age without treatment. Preliminary results also suggested that treatment of chlamydial conjunctivitis with oral erythromycin was superior to topical sulfonamide drops. The results of the 1-year examination did not reveal any excess history of upper respiratory infection or otitis media in the infants with chlamydial infection as compared to controls. Micropannus was not detected at 1 year of age in any of the infants who had chlamydial infection. The predictive value of tear antibody for the diagnosis of chlamydial conjunctivitis was only 35%. However, the presence of either tear or NP antibody had a predictive value of 68% for chlamydial infection at some site. The presence of detectable serum antibody to C. trachomatis at 1 year of age was in all but two instances associated with known infection and disease.