Chlamydia Trachomatis Infection In Patients Research Articles

Trigger impact of Chlamydia trachomatis on various types of seronegative spondyloarthritis

Introduction. To date, clinical manifestations, laboratory changes and the results of instrumental examinations of the joints and spine in axial seronegative spondyloarthritis (aSpA) caused by Chlamydia trachomatis have not been fully elucidated. Purpose of the study: evaluation of clinical manifestations features, diagnosis, and evolution of seronegative spondyloarthritis associated with Chlamydia trachomatis infection. Objectives of the study: To compare clinical manifestations, changes in laboratory parameters, results of instrumental examinations of the joints and spine in seronegative spondyloarthritis, the axial, peripheral, and mixed form. To appreciate the significance of Chlamydia trachomatis in the development of SpA by detecting the presence of DNA using the polymerase chain reaction (PCR) in real time and by isothermal amplification of NASBA-PCR (Nucleic acid sequence-based amplification). Material and methods. During 2015-2021 were examined 138 patients with SpA hospitalized in the Republican Clinical Hospital „Timofei Moşneaga”. Chlamydia trachomatis in the form of monoinfection was detected in 87 (6.3%) patients, of which 52 (59.8%) were women and 35 (40.2%) men. Results. The results of the diagnosis of Chlamydia trachomatis infection in patients with arthritis: Chlamydia trachomatis infection was detected in 78 (89.7%) out of 87 patients examined by PCR, and in 9 (10.3%) cases by ELISA. The peripheral form begins mainly with inflammation of the joints of the lower extremities (81.8%), of which the knee joints are mainly involved in the pathological process (63.6%). SpA axial form associated with Chlamydia trachomatis infection occurs mainly in young men (85.7%). In more than half of the patients, large joints participate in the pathological process (58.8%), especially the lower extremities. The axial variant of the SpA can begin with an injury in any part of the spine. Discussions. SpA associated with Chlamydia trachomatis infection has more expressed clinical, laboratory and instrumental manifestations both in the onset and in the advanced stage of the disease.

Genital and Extragenital Gonorrhea and Chlamydia in Children and Adolescents Evaluated for Sexual Abuse.

The aim of this study was to describe the use of a nucleic acid amplification test in detecting genital and extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in children and adolescents assessed for sexual abuse/assault. The charts of children aged 0 to 17 years, consecutively evaluated for sexual victimization, in emergency department and outpatient settings were reviewed. Data extracted included age, sex, type of sexual contact, anogenital findings, previous sexual contact, toxicology results, and sites tested for NG and CT. Of the 1319 patients who were tested, 579 were tested at more than 1 site, and 120 had at least 1 infected site. Chlamydia trachomatis was identified in 104 patients, and NG was found in 33. In bivariate analysis, a positive test was associated with female sex, age older than 11 years, previous sexual contact, acute or healed genital injury, drug/alcohol intoxication, and examination within 72 hours of sexual contact. Fifty-one patients had positive anal tests, and 24 had positive oral tests. More than 75% of patients with positive extragenital tests had additional positive tests or anogenital injury. Most with a positive anal (59%) or oral (77%) test did not report that the assailant's genitals came into contact with that site. Positive tests for NG and CT in patients evaluated for sexual victimization may represent infection from sexual contact, contiguous spread of infection, or the presence of infected assailant secretions. Relying on patient reports of symptoms, or types of sexual contact, to determine need for testing may miss NG and CT infections in patients evaluated for sexual victimization.

Prevalence, risk factors, and medical costs of Chlamydia trachomatis infections in Shandong Province, China: a population-based, cross-sectional study

BackgroundA population-based study of Chlamydia trachomatis (CT) infections is essential in designing a specific control program; however, no large investigation of CT infections among the general population in mainland China has been conducted since 2000. We aimed to determine the prevalence, risk factors, and associated medical costs of CT among residents, 18–49 years of age, in Shandong, China.MethodsFrom May to August 2016, a multistage probability sampling survey involving 8074 individuals was distributed. Data were collected via face-to-face interviews, followed by self-administered questionnaire surveys. First-void urines were collected and tested for CT and Neisseria gonorrhoeae (NG) using nucleic acid amplification.ResultsThe weighted prevalence of CT infection was 2.3% (95% confidence interval [CI], 1.5–3.2) in females and 2.7% (1.6–3.8) in males. Women, 30–34 years of age, had the highest prevalence of CT infections (3.5%, 2.6–4.4), while the highest prevalence of CT infections in males was in those 18–24 years of age (4.3%, 0.0–8.8). Neisseria gonorrhoeae infection had a prevalence of 0.1% (0.0–0.3) in women and 0.03% (0.0–0.1) in men. Risk factors for CT infections among females included being unmarried, divorced, or widowed (odds ratio [OR], 95% CI 3.57, 1.54–8.24) and having two or more lifetime sex partners (3.72, 1.14–12.16). Among males, first intercourse before 20 years of age (1.83, 1.10–3.02) and having two or more lifetime sex partners (1.85, 1.14–3.02) were associated with CT infections. The estimated lifetime cost of CT infections in patients 18–49 years of age in Shandong was 273 million (range, 172–374 million) China Renminbi in 2016.ConclusionsThis study demonstrated a high burden of CT infections among females < 35 years of age and males < 25 years of age in Shandong. Thus, a CT infection control program should focus on this population, as well as others with identified risk factors.

Systemic Antibody Response to Chlamydia Trachomatis Infection in Patients Either Infected or Reinfected with Different Chlamydia Serovars

Introduction:Chlamydia trachomatis is the etiological agent for the most prevalent bacterial sexually transmitted infection in both developed and developing countries. The aim of present study was to characterize the antibody response between two groups of individuals, having either a single C. trachomatis infection and or repeated infections. Material and Methods: Current study consisted of two groups, one with an initial Chlamydia infection and a second with repeated infections. A titre based estimation of specific serum (IgG and IgA) levels using ELISA were performed, which further validated by western blot. In vitro neutralizing ability of each patient’s serum against both homologous and heterologous strains was also determined. Results: Individuals infected with one of the C. trachomatis serovars D, E or K exhibited a strong systemic antibody response as characterized by ELISA and western blot. These individuals may have developed at least some level of protection as they only represented single infection. By comparison, individuals infected with serovar D, E or F that exhibited low systemic antibody response often presented repeated C. trachomatis infections, suggesting an association with poor immune response. An in vitro neutralizing level of 60-90% was observed in the human sera against homologous serovar D and two heterologous C. trachomatis serovars E and K, compared to <40% against heterologous serovars F. Conclusion: Individuals infected with serovars D and K showed a potential association between circulating antibody response and re-infection risk. While the patients infected with serovars E showed a disconnection between systemic antibody response and re-infection risk.

High frequency of latent Chlamydia trachomatis infection in patients with rhegmatogenous retinal detachment.

To determine the frequency of detection of ocular and extraocular Chlamydia trachomatis (CT) infection in non-high myopes with rhegmatogenous retinal detachment (RRD). This was a single-center, nonrandomized, prospective, case-control study. One hundred and four patients were divided into a study group with RRD (n=63) and a control group with traumatic retinal detachment (n=41). Samples of subretinal fluid (SFR), conjunctival, urethral/cervical swabs, and blood were collected. The frequency of detection of CT infection in SRF samples was determined by polymerase chain reaction (PCR), direct fluorescence assay (DFA) and cell culture, whereas that in conjunctival swabs was determined by PCR and DFA, and those in urethral/cervical swabs and blood were determined by DFA. Yates Chi-square test (with Bonferroni correction) and two-tailed Student's t-test were used for statistical analysis. SRF CT infection was detected more frequently in the study group (50.8%-71.4%) than in the control group (9.8%-12.2%) by all the methods used (P<0.01). The frequency of detection of conjunctival CT infection by DFA was higher in the RRD patients compared with the controls (81.0% vs 24.4%, P=0.004). The PCR detected conjunctival CT infection more often in the study group than in the controls (46.0% vs 9.8%, P=0.007). The DFA detected CT in blood specimens almost as frequently as in urogenital specimens, for the RRD patients (61.2% vs 63.5%) and the controls (7.3% vs 9.8%). CT infection is detected with high frequency in non-high myopes with RRD.

Genital Mycoplasma and Chlamydia trachomatis infections in patients with genital tract infections attending a tertiary care hospital of North India.

Limited data are available on the prevalence of genital mycoplasmas and Chlamydia trachomatis (CT) among Indian patients with genital tract infections. The objectives of the study were to determine the prevalence of Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), and CT in patients with genital tract infections. The antimicrobial susceptibilities of UU and MH were also assessed. Endocervical swabs/urethral swabs and first void urine samples of patients (n = 164) were collected. UU and MH were detected by culture and multiplex polymerase chain reaction (PCR). MG and CT were identified by PCR. Ureaplasma isolates were further biotyped and serotyped. Antimicrobial susceptibility was done by microbroth dilution method. UU, MH, MG, and CT were detected in 15.2%, 5.4%, 1.2%, and 6% patients, respectively. Ureaplasma parvum serovar 3/14 was the most prevalent. All isolates of UU and MH were uniformly susceptible to doxycycline and josamycin. Routine screening for these pathogens and antimicrobial susceptibility testing is warranted to prevent sequel of infections and formulate treatment guidelines.

Incidence of Chlamydia trachomatis infection in patients with reactive arthritis.

ObjectivesThe aim of the study was to evaluate the incidence of Chlamydia trachomatis in patients with reactive arthritis (ReA) within the area of the Podlaskie province (north eastern Poland).Material and methodsThe study concerned 323 patients including 132 women and 191 men diagnosed with ReA. The material for C. trachomatis was collected from the urethra in men and the cervical canal in women. Also, every patient was tested for the presence of anti-C. trachomatis IgG class antibodies, while 121 individuals were additionally tested for IgA class antibodies. In the direct studies, the direct immunofluorescence (DIF) method or polymerase chain reaction (PCR) was used. The immunoenzymatic method was used to detect anti-C. trachomatis antibodies. The control group in the case of direct studies comprised 125 individuals, while in the case of serology research it included 127 (IgG) and 109 (IgA) persons.Results Chlamydia trachomatis infection in the urethral and cervical smears was found in 42 patients (13.0%) including 20 women (15.2%) and 22 men (11.5%). In the control group chlamydia was detected in 3 patients (2.4%) including 4% of women and 2% of men. IgA class antibodies were present in 10/121 (8.3%) patients, similarly in women and in men (8.2% and 8.3% respectively). In the control group the specific IgA class antibodies were found in 3/85 patients (3.5%). Anti-C. trachomatis IgG antibodies were found in 70/323 patients (21.7%), similarly in men and women.Conclusions Chlamydia trachomatis is a common bacterial factor observed in the genitourinary system of patients with ReA. The outcomes of studies within the Podlaskie province indicate less frequent presence of chlamydial infection compared with Dolnośląskie province.No correlations between detecting the presence of C. trachomatis in the urogenital tract and the presence of specific antibodies in the serum of ReA patients were observed.Concurrent direct studies of the urogenital tract and a serological blood test increase the chance of detecting C. trachomatis infection.

LOW PREVALENCE OF CHLAMYDIA TRACHOMATIS INFECTION IN WOMEN FROM SOUTHERN NIGERIA

Abstract Chlamydia trachomatis infections are the most common bacterial cause of sexually transmitted diseases (STDs) in the world. However, most Nigeria health care facilities do not screen for Chlamydia antigen in gynaecological and general out-patient clinics. This study was to document the prevalence of Chlamydia trachomatis infection in patients attending Family Planning Clinics and Gynaecology clinics in Southern Nigeria. Endocervical swabs were collected from a hundred and forty patients and were screened using Chlamydia Rapid Test Device –Swab / Urine (Interchemical Ltd. China). Out of 140 patients screened, 1 (0.7%) was positive for Chlamydia trachomatis antigen. There seem to be an association between Chlamydia infection and abortion thus screening for chlamydia trachomatis infection in asymptomatic patients to prevent the adverse consequences. This study presents an update in Chlamydia trachomatis in the Southern part of Nigeria.

The importance of using a test to detect Chlamydia trachomatis infection in patients undergoing counseling and testing for sexually transmitted diseases at a public health center

The importance of using a test to detect Chlamydia trachomatis infection in patients undergoing counseling and testing for sexually transmitted diseases at a public health center

Infecção por Chlamydia em pacientes com e sem lesões intra-epiteliais cervicais

To determine the frequency of Chlamydia trachomatis infection in patients with and without intraepithelial cervical lesions attended at specialized ambulatory in Recife (2007) and its association with biologic and demographic variables, habits, reproductive, clinical and gynecologic characteristics. A cross-sectional study was conducted including 70 women (35 with cytological cervical lesions and 35 with normal smears). Colposcopy and biopsy when necessary were performed and Chlamydia infection was determined by direct immunofluorescence. Analysis variables were age, race, precedence, schooling, marital status, menarche, age at first sexual intercourse, parity, number of sexual partners, vaginal discharge, previous Pap smear, STD episodes, cervical cauterization, contraceptive methods, familial antecedents of cervical cancer, alcohol intake, use of illicit and immunosuppressive drugs, Papanicolaou result and cervical Chlamydia l infection. To determine the strength of association prevalence ratio (PR) and its 95% confidence interval were calculated. Multivariate analysis was performed for controlling potentially confounding variables. the frequency of Chlamydia l infection was significantly greater in patients with intraepithelial cervical lesions (80.0% vs. 14.3%; PR=5.60; 95% CI=2.44-12.82). When the factors associated with Chlamydia l infection were analyzed, the only variable that remained significantly associated after multivariate analysis was previous episode of STD (OR=63.47; 95% CI=13.93-289.09). Chlamydia trachomatis infection is associated with intraepithelial cervical lesions and history of STD should be considered for treatment and follow-up of these patients.

Diagnóstico de la infección por Chlamydia trachomatis en un centro de diagnóstico y prevención de infecciones de transmisión sexual: evaluación de los exudados cervicales, uretrales y rectales mediante técnica de PCR

The aim of this study is to analyze the clinical and epidemiological characteristics of Chlamydia trachomatis infection in patients attended in a clinic for sexually transmitted disease in Seville (Spain). Microbiological diagnosis was performed in various types of samples. The study included 3854 patients (50.8% women and 49.2% men, mean age 30.1 years) seen from 2002 to 2004. Among the total, 50% belonged to groups engaging in high risk sexual practices: female commercial sex workers (CSWs) (47%), men who maintain sexual relationships with other men (MSM) (45%), users of prostitution (4%), promiscuous heterosexual men (4%), those with a risk partner (2.7%) and injection drug users (IDU) (2.2%). We analyzed a total of 5978 samples (2384 cervical exudates, 2645 urethral exudates and 949 rectal exudates), for the detection of C. trachomatis by PCR technique with the COBAS Amplicor CT System. Prevalence of C. trachomatis infection was 6% (4.3% in women and 7.8% in men). Among the total in women, 51.2% of positive samples were from women with high-risk sex factors and 73.8% of the women were asymptomatic. In men, the proportions were 70.5% and 36.9%, respectively. Cervical, urethral and rectal exudates yielded positive results in 4%, 4.9% and 4.3%, respectively. Systematic sampling for C. trachomatis detection is necessary in symptomatic and asymptomatic patients practicing high-risk sex; periodic follow-up studies are also needed for early detection of sexually transmitted infection. Rectal sample collection is important for detecting this infection in MSM and in patients whose sexual habits make it advisable.

Identification of Chlamydia trachomatis DNA in human papillomavirus (HPV) positive women with normal and abnormal cytology.

Insofar as infection with human papillomavirus (HPV) and Chlamydia trachomatis (CT) are associated with cervical intraepithelial neoplasia (CIN), the aim of this study was to assess the correlation of HPV and CT infection in patients with normal or abnormal cytology. Endocervical samples from patients (n=121; mean age 33.7+7.0) were assessed for HPV and CT DNA by PCR. While there was no statistically significant difference between HPV-positive (n=44) and HPV-negative (n=77) patients to age pregnancies, higher proportion of smokers, patients with multiple male sex partners, or with abnormal cytology was seen in HPV-positive vs. HPV-negative women, respectively. An infection rate of CT of 21/44 was seen in HPV-positive as compared to 11/77 in HPV-negative patients. Within HPV-positive patients, there was no significant difference between CT-positive and CT-negative patients with regards to the risk factors studied. Collectively, this suggests that a causal relationship between HPV and CT infection in the development of CIN disease.

Neisseria gonorrhoeae and Chlamydia trachomatis infections in patients attending STD and family planning clinics in Bissau, Guinea-Bissau

Accurate clinical and laboratory data about sexually transmitted diseases (STD) prevalence in Guinea-Bissau are not available. These data are important, since HIV2 is prevalent in this country, rates of HIV1 are increasing and STDs facilitate HIV transmission. Since DNA amplification methods have demonstrated to accurately diagnose chlamydial infections and gonorrhoea, the Amplicor CT/NG PCR Assay with Internal Control of Amplification (Roche Diagnostic System, Branchburg, NJ, USA) was used to estimate the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis genital infections in STDs and Family Planning Clinic attenders in Bissau, from March to July 1997. Two hundred and two cervical swabs and 31 urethral swabs were examined. Two women were excluded from this study because their cervical swabs contained inhibitory substances. N. gonorrhoeae was identified in 34/200 (17%) women and in 12/31 (38.7%) men. C. trachomatis was detected in 8/200 (4%) women there were no positive C. trachomatis results among the 31 men with urethritis. One woman presented a mixed infection with both organisms. The prevalence difference between men and women was not statistically significant ( P=0.6) for C. trachomatis infection, but it was significant for N. gonorrhoeae infection ( P=0.01). The prevalence rates of these infections found in this study, support the need for an urgent strategy to control STD in the region.

Chlamydia trachomatis infection in women with and without cervical intraepithelial neoplasia.

The aim of the study was to compare the frequency of Chlamydia trachomatis infection in patients with cervical intraepithelial neoplasia (CIN) and in women without cervical pathology. In a study group of 423 patients with histologically proven CIN and in 108 controls with normal cervical smear, cytological material for direct immunofluorescence analysis was obtained. Among 423 patients, 24 (5.7%) had CIN 1, 108 (25.5%) CIN 2 and 291 (68.8%) CIN 3. Among all patients with CIN, 27 (6.4%) were C. trachomatis positive and 396 (93.6%) C. trachomatis negative. In the control group 6 (5.6%) were C. trachomatis positive and 102 (94.4%) C. trachomatis negative. The difference between C. trachomatis infection incidence in patients with CIN and in women without cervical pathology was not significant (chi2=0.29; P>0.05). In this study, no difference in C. trachomatis infection incidence was detected between patients with CIN and women with normal cervical smears. The impact of C. trachomatis infection seems not to interfere with the development or even the promotion of CIN.

The Role of Chlamydia Trachomatis Infection in Female Infertility

The incidence of positive Chlamydia cultures in females undergoing laparoscopy for tubal patency is high. We advocate routine screening for Chlamydia infection in females with infertility. Of seventy-five patients undergoing laparoscopy for infertility, 49 grew Chlamydia on tissue culture of material from the cervix, an incidence of 65.3%. of these 49 cases, 33 (67.3%) had tubal blockage. In asymptomatic patients, 22 out of 50 had positive cultures from the cervix, an incidence of 44%. Peritoneal fluid culture was negative in all infertile patients. When compared to populations studied elsewhere, the incidence of Chlamydia appears to be high in our population and significantly higher in the infertile patients. In the management of infertility, pelvic inflammatory disease, and neonatal conjunctivitis, Chlamydia should be routinely investigated and treated.

Chlamydial Antigen Testing on Female Patients Presenting to the Emergency Department

We prospectively determined the prevalence of Chlamydia trachomatis infection in patients presenting to an emergency department over a 4-month period who received pelvic exams. We compared the percentage of cases of Chlamydia diagnosed by the Chlamydiazyme immunoassay with the percentage diagnosed clinically by emergency physicians. Over the study period, 326 pelvic exams were performed. Of 36 patients (11%) with positive tests, 16 (44%) were treated clinically for pelvic inflammatory disease. Twenty (56%) received neither appropriate antibiotic treatment nor a gynecology referral based on clinical exam alone. We statistically evaluated the data using the hypothesis test for two proportions from one group. The difference was significant (Z = 4.6, p less than 0.001).

Genital Chlamydia trachomatis infections in patients with abnormal cervical smears: Effect of tetracycline treatment on cell changes

A group of 1760 women aged 14-35 years were examined for the concurrent presence of Chlamydia trachomatis and cellular atypia of cervical smears. Positive tests for C trachomatis were found in 126 women (7.2%). Cell changes were found in 85 women (4.8%), and 25 of these were C trachomatis-positive. Slight cellular atypia was the major finding in the smears from 22 of the C trachomatis-positive women, whereas three patients had more pronounced cell changes. Smears reverted to normal in 18 of the 23 patients who returned for tetracycline treatment and follow-up cytology. All 18 patients had smears showing slight cellular atypia prior to therapy. In five patients who also had cellular changes suggesting a human papillomavirus infection, the smears did not revert to normal after antibiotic therapy during the observation period. These findings suggest that patients with C trachomatis and mild cellular atypia should have antibiotic therapy and repeat smears taken before further treatment is considered. More advanced cellular atypia is unlikely to be caused by C trachomatis.

Chlamydia trachomatis infection in patients with laparoscopically verified acute salpingitis: Results of isolation and antibody determinations

Culture and serology studies have shown Chlamydia trachomatis (CT) to be one of the causes of acute salpingitis (AS). In the present investigation, results of cervical cultures were correlated with serum antibody titers to CT in patients with laparoscopically verified AS. Serum samples from 206 patients, including paired sera from 80, were assayed. Of 206 patients, 118 had chlamydial lgG antibody titers of 1:64 or more. Patients with negative cultures for CT and an lgG titer of 1:64 or more had a significantly higher geometric mean titer than corresponding patients with positive cultures. In paired sera, a seroconversion or a fourfold or greater rise in lgG titer to CT was demonstrated in 35%, while a further 11% had detectable lgM antibody in a titer of 1:8 or more. The overall isolation frequency of CT was 33%, compared with 19% for Neisseria gonorrhoeae.