Chlamydia Trachomatis In Patients Research Articles

Chlamydia trachomatis in patients who used oral contraceptives and had intermenstrual spotting : Krettek JE, Arkin SI, Pongsakdi C, et al Obstet Gynecol 81:728–731 May 1993

Chlamydia trachomatis in patients who used oral contraceptives and had intermenstrual spotting : Krettek JE, Arkin SI, Pongsakdi C, et al Obstet Gynecol 81:728–731 May 1993

Significance of positive cervical cultures for Chlamydia trachomatis in patients with preterm premature rupture of membranes.

We tested the hypothesis that in patients with preterm premature rupture of membranes the presence of Chlamydia trachomatis in the cervix shortens the latent period (time from rupture of membranes to delivery) and increases the incidence of chorioamnionitis and early endometritis. A total of 178 conservatively managed patients with PROM between 22 and 35 weeks' gestation had cervical cultures for chlamydia, group B Streptococcus (GBS) and Neisseria gonorrhoeae performed at the time of rupture. Patients with GBS and gonorrhea were treated at the time the culture results were available and excluded from analysis. The remaining patients were divided into group 1: 26 patients (14.6%) positive for only chlamydia (and not treated until discharge from the hospital); group 2: 120 patients (67.4%) negative for all three organisms. The two groups did not differ in cesarean rate, duration of conservative management, hospital stay, or birthweight. Furthermore, the rates of chorioamnionitis (30.8% group 1; 38.3% group 2) or early endometritis (11.5% group 1; 20.8% group 2) were similar. We conclude that in patients with preterm premature rupture of membranes, the presence of chlamydia in the cervix appears to neither decrease the latent period nor increase the incidence of chorioamnionitis and early endometritis.

Genital Infection with Chlamydia trachomatis in Patients with Chlamydial Conjunctivitis

It is generally believed that a chlamydial eye infection in adults is the result of autoinoculation of the eye by infected genital secretion. Genital samples of 60 microbiologically verified, adult, non-trachomatous chlamydial conjunctivitis cases were investigated. Only two of the 38 men and none of the 22 women tested had symptoms of genital infection when the sampling was made for establishing the diagnosis of chlamydial infection. Of the men, 23 (61%), 20 (53%), 19 (50%), and 20 (53%) were positive in urethral samples by culture, ELISA (Chlamydiazyme, Abbott, USA), and immunofluorescence tests (Chlamyset, Orion, Finland and MicroTrak, Syva, Finland), respectively. The corresponding figures for the female urethral samples were 12 (55%), 11 (50%), 9 (41%), and 12 (55%) and for the cervical samples 15 (68%), 15 (68%), 14 (64%), and 14 (64%), respectively. Thirty-nine mothers to neonates with chlamydial conjunctivitis were also studied. In 34 (87%) of the mothers, a genital chlamydial infection could be verified. It has been a general belief that the eye in chlamydial conjunctivitis in adults is generally infected by autoinoculation of infected genital secretion. Different means to explain the discrepancy between the results of the diagnostic tests for the eye and genital samples are considered.

Antigen specific serum antibody response to Chlamydia trachomatis in patients with acute pelvic inflammatory disease.

Sera from 35 patients with acute pelvic inflammatory disease (PID) with and without Chlamydia trachomatis confirmed by culture and sera from 19 control patients with neither evidence of pelvic infection nor C trachomatis infection were studied for the presence of serum IgG, IgA, and IgM antibodies to C trachomatis using enzyme immunoassay (EIA) and immunoblotting techniques. There was no correlation between the antibody concentrations in the EIA and the spread of chlamydial infection, as determined by cervical, endometrial, and laparoscopic sampling for chlamydia. The immunoblot analysis showed antibodies to the major outer membrane protein (MOMP) of C trachomatis elementary bodies in all patients who had had C trachomatis isolated. Reactivity was also frequently observed against the 68, 62, 60, 45, and 31 kilodalton antigens. About 20 antigenic polypeptides were identified. Differences in antibody prevalence to specific chlamydial antigens, however, were not related to the site of chlamydial isolation or serum antibody concentrations observed with the EIA. The results indicate that patients with PID with and without upper genital tract infection with C trachomatis cannot be differentiated by reactivity of sera to specific chlamydial polypeptide antigens. The determination of a specific serum IgA antibody response by EIA was the most effective single test to discriminate between patients with and without acute chlamydial infection.

Evaluation of Abbott Testpack® Chlamydia for Detection of Chlamydia trachomatis in Patients Attending Sexually Transmitted Diseases Clinics

This work compares a rapid solid-phase EIA (Abbott TestPack Chlamydia) to tissue culture and a direct fluorescent antibody test (Syva Microtrak) for detection of C. trachomatis in 436 patients attending two inner-city sexually transmitted diseases (STD) clinics. The prevalence of C. trachomatis by culture was 12% (5% in men, 15% in women). Overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TestPack compared to culture were 70%, 98%, 80%, and 96% respectively. In men, 12 specimens were positive by TestPack, while only eight specimens were positive by culture. Six TestPack-positive, culture-negative specimens were further evaluated by centrifugation of culture transport media and examination of the sediment for chlamydia elementary bodies (EBs) using fluorescent monoclonal antibodies to C. trachomatis. Using this procedure, five of six culture negative specimens contained EBs (revised sensitivity 85%, specificity 99%, PPV 92%, NPV 99%). In 285 women evaluable in culture and TestPack, 44 (15%) specimens were culture positive; TestPack was positive in 29 (sensitivity 66%) culture positive women. Of 241 culture negative patients, 238 had negative TestPack results (specificity 99%) and no EBs were detected in the culture-negative, TestPack-positive specimens. Twenty-three (8%) Microtrak specimens were unsatisfactory for testing; two of these were culture and TestPack positive. Therefore, of 263 specimens evaluable using Microtrak, 42 (16%) specimens were culture positive; Microtrak was positive in 32 (sensitivity 76%) culture-positive women. Abbott TestPack Chlamydia is a rapid (25 minute), visually read format requiring no specialized equipment for detection of chalmydia infections with a sensitivity comparable to that of Microtrak.

The role of chlamydial antibodies in an in vitro fertilization program

The reported incidence of antibodies to Chlamydia trachomatis in patients attending infertility clinics is at least 30%. It has been reported that chlamydial antibodies are associated with decreased pregnancy rates following in vitro fertilization (IVF). A study was performed to investigate the significance of chlamydial antibodies in an established IVF program. The results did not show a decreased pregnancy rate in the presence of chlamydial antibodies. Of the women achieving pregnancy, 41% were seropositive compared with 38% seropositivity in women who did not become pregnant. There was no apparent benefit of the use of prophylactic antibiotics. The results also suggested that past infection with C. trachomatis in men did not adversely affect semen analysis or fertilization.

Serologic evidence of prior chlamydial infection in patients with tubal ectopic pregnancy and contralateral tubal disease

Oviductal damage from infectious salpingitis is a principle cause of ectopic pregnancy. To examine the role of Chlamydia trachomatis in patients with ectopic pregnancy, 24 patients undergoing laparotomy for ectopic pregnancy were evaluated by assessment of chlamydial serology and chlamydial cultures of tubal biopsy specimens. The patients were divided into two groups based on the presence or absence of gross abnormalities in the fallopian tube contralateral to the ectopic gestation. Ten patients in group I showed gross evidence of chronic salpingitis in the contralateral tube; 14 patients in group II had normal-appearing contralateral tubes. Chlamydial cultures were negative in both groups. Chlamydial immunoglobulin M antibodies assayed by indirect microimmunofluorescence were negative in both groups (less than or equal to 1:32). Mean geometric immunoglobulin G titers for C. trachomatis were significantly higher in the patients with evidence of contralateral chronic salpingitis (78.9 versus 13.1). These findings suggest that C. trachomatis may be a major cause of oviductal damage, which predisposes to ectopic pregnancy.

Evidence of infection with Chlamydia trachomatis in patients with pelvic inflammatory disease: value of partner investigation

A retrospective analysis was made of the records of 71 women with clinically diagnosed PID presenting to the Department of Genito Urinary Medicine in Doncaster. Twenty-nine of the 71 women (40.8%) showed evidence of active chlamydial infection. Six women (8.5%) had infection with N. gonorrhoeae. Of the 45 male partners investigated, 16 (35.6%) had recoverable C. trachomatis in the anterior urethra. Only four (8.9%) had gonorrhea.

Studies on antibody to Chlamydia trachomatis in patients with internal diseases

Studies on antibody to Chlamydia trachomatis in patients with internal diseases