Chlamydial Culture Research Articles

Diagnosis and treatment outcomes of urethritis-like symptoms in young males: a retrospective cohort study

The study evaluated the prevalence of gonorrhoea and chlamydia infections and find out other non-infectious diseases in sexually active young males with urethritis-like symptoms and their treatment outcomes. We retrospectively reviewed the young adult males (aged 20–50 years) who visited our clinic with urethritis symptoms from March 2019 to April 2022. All patients underwent urinalysis, urine culture, and urinary polymerase chain reaction (PCR) testing for gonorrhoea and chlamydia. Student’s t-test and Pearson’s chi-square test were used to compare the differences between the triple-negative group (i.e., negative results in urinalysis, urine culture, and urinary PCR) and the any-positive group. Logistic regression analyses were used to evaluate the predictive factors for positive PCR results for gonorrhoea or chlamydia in patients with negative urinalysis and urine culture. Of the 365 participants with urethritis-like symptoms, 139 patients were diagnosed of gonococcal or chlamydia urethritis. Among the 202 patients with negative urinalysis and urine culture, 60 patients were diagnosed with gonorrhoea or chlamydia using PCR. Urethral discharge was an independent predictor. 142 patients with triple negative results were attributed to other non-infectious diseases. Empirical antibiotic treatment is recommended for patients with urethritis symptoms showing positive or negative urinalysis results but with urethral discharge.

Whole-genome sequencing of Chlamydia psittaci from Australasian avian hosts: A genomics approach to a pathogen that still ruffles feathers.

Chlamydia psittaci is a globally distributed veterinary pathogen with zoonotic potential. Although C. psittaci infections have been reported in various hosts, isolation and culture of Chlamydia is challenging, hampering efforts to produce contemporary global C. psittaci genomes. This is particularly evident in the lack of avian C. psittaci genomes from Australia and New Zealand. In this study, we used culture-independent probe-based whole-genome sequencing to expand the global C. psittaci genome catalogue. Here, we provide new C. psittaci genomes from two pigeons, six psittacines, and novel hosts such as the Australian bustard (Ardeotis australis) and sooty shearwater (Ardenna grisea) from Australia and New Zealand. We also evaluated C. psittaci genetic diversity using multilocus sequence typing (MLST) and major outer membrane protein (ompA) genotyping on additional C. psittaci-positive samples from various captive avian hosts and field isolates from Australasia. We showed that the first C. psittaci genomes sequenced from New Zealand parrots and pigeons belong to the clonal sequence type (ST)24 and diverse 'pigeon-type' ST27 clade, respectively. Australian parrot-derived strains also clustered in the ST24 group, whereas the novel ST332 strain from the Australian bustard clustered in a genetically diverse clade of strains from a fulmar, parrot, and livestock. MLST and ompA genotyping revealed ST24/ompA genotype A in wild and captive parrots and a sooty shearwater, whilst 'pigeon-types' (ST27/35 and ompA genotypes B/E) were found in pigeons and other atypical hosts, such as captive parrots, a little blue penguin/Kororā (Eudyptula minor) and a zebra finch (Taeniopygia guttata castanotis) from Australia and New Zealand. This study provides new insights into the global phylogenomic diversity of C. psittaci and further demonstrates the multi-host generalist capacity of this pathogen.

Anti-chlamydial effects of azelastine hydrochloride and the impact of the histamine H1 receptor on chlamydial development.

Introduction. Azelastine hydrochloride, a second-generation histamine H1 receptor (H1R) antagonist, exhibits anti-chlamydial effects against Chlamydia trachomatis (CT) in HeLa cells (genital infection model).Hypothesis/Gap Statement. Non-antibiotic pharmaceutical interactions with CT are an understudied field and the anti-chlamydial effects of azelastine are a potential interaction requiring further elucidation.Aim. To explore the underlying anti-chlamydial mechanisms of azelastine.Methodology. We assessed the specificity of azelastine for the chlamydial species and host cell type, the timing of azelastine application and whether the anti-chlamydial effects could be reproduced with different H1R-modulating compounds.Results. We observed similar anti-chlamydial azelastine effects for Chlamydia muridarum as well as for an ocular CT strain in human conjunctival epithelial cells (ocular infection model). Pre-incubating host cells with azelastine before infection mildly reduced chlamydial inclusion numbers and infectivity. Incubation of cells with azelastine initiated concomitantly with the chlamydial infection, or initiated several hours post-infection, reduced inclusion size, number and infectivity, and altered chlamydial morphology. These effects were strongest when azelastine was added shortly after or with the infection. Azelastine effects were not alleviated by increased concentrations of culture medium nutrients. Additionally, we did not observe anti-chlamydial effects when incubating cultures either with a different H1R antagonist or agonist, indicating that azelastine effects are probably H1R-independent.Conclusion. Accordingly, we conclude that azelastine anti-chlamydial effects are not restricted to a specific chlamydial species, strain or culture model, and are probably not mediated by H1R antagonism. Thus, it appears likely that off-target mechanisms of azelastine may explain our observations.

A rare case of recurrent group A streptococcal vulvovaginitis in a premenopausal woman.

A rare case of recurrent group A streptococcal vulvovaginitis in a premenopausal woman.

Prediction model for gonorrhea, chlamydia, and trichomoniasis in the emergency department.

History and physical examination findings can be unreliable for prediction of genitourinary tract infections and differentiation of urinary tract infections from sexually transmitted infections (STIs). The study objective was to develop a prediction tool to more accurately identify patients with STIs. A retrospective review of 64,490 emergency department (ED) encounters between April 18, 2014, and March 7, 2017, where patients age 18 years or older had urinalysis and urine culture or testing for gonorrhea, chlamydia, or trichomonas, was used to develop a prediction model for men and women with Neisseria gonorrhoeae or Chlamydia trachomatis, or both, and for women with Trichomonas vaginalis. The data set was randomly divided into two-thirds discovery and one-third validation. Groups were assigned through a random number generator. Backward step regression modeling was used to identify the best model for each outcome. With use of age, race, marital status, and findings from vaginal wet preparation (white blood cells [WBCs], clue cells, and yeast) and urinalysis (squamous epithelial cells, protein, leukocyte esterase, and WBCs), the models had areas under the receiver operating characteristic curve of 0.80 for men with N gonorrhoeae or C trachomatis, or both; 0.75 for women with N gonorrhoeae or C trachomatis, or both; and 0.73 for women with T vaginalis. The model estimated likelihood of ED patients having STIs was reasonably accurate with a limited number of demographic and laboratory variables. In the absence of point-of-care STI testing, use of a prediction tool for STIs may improve antimicrobial stewardship.

AAUS guidelines 2021 revision sexually transmitted infection (STIs) diagnostic strategy for STI

AAUS guidelines 2021 revision sexually transmitted infection (STIs) diagnostic strategy for STI

60. Twists and Turns: Paratubal Cysts and Bilateral Fallopian tube Torsion in Adolescents

<h3>Background</h3> Fallopian tube torsion secondary to paratubal cysts is a rare presentation of abdominal pain within pediatrics. Abdominal pain is the primary symptom, which may mimic other common pediatric pathologies such as appendicitis. This case highlights the importance of early clinical suspicion to preserve future fertility. <h3>Case</h3> A 10-year-old post-pubertal female presented to an emergency room with intermittent, sharp, right lower quadrant abdominal and flank pain for 24 hours. Imaging suggested possible tubal cysts. She was transferred to a regional children's hospital for advanced care. Upon arrival, her pain was improving. She denied nausea, vomiting, fever, vaginal bleeding, or discharge. On exam, her vitals were stable, and her abdomen was nontender to palpation. No genital exam was performed. Her hemoglobin was 11.7 and her white blood cell (WBC) count was 11.8. Urine microscopy was unremarkable. Gonorrhea and chlamydia PCR and cultures were negative. An abdominal sonography at the children's hospital revealed normal sonographic appearance of the uterus and bilateral ovaries with internal color Doppler flow. A prominent dilated tortuous tubular structure, most compatible with hydrosalpinx. CT abdomen with contrast from an outside hospital initially read as a 5 × 3.2 cm right ovarian cyst. An over-read of the same images by a radiologist at the children's hospital suggested a right-sided hydrosalpinx measuring 8.8 × 7.9 × 6.1 cm in addition to the right ovarian cyst. A diagnostic laparoscopy was performed to drain and possibly excise the suspected ovarian cysts. Upon initial inspection, the left fallopian tube had undergone one complete rotation and contained a 5 × 5 cm paratubal cyst with 30 cc of clear aspirate. The right fallopian tube appeared to have undergone three complete rotations with a similarly sized paratubal cyst. Both the left and right fallopian tubes were detorsed. Following detorsion, the right fallopian tube appeared hemorrhagic and necrotic from the mid-portion of the tube through the fimbria. The ovaries appeared normal bilaterally and no free fluid in the pelvis was noted. A right salpingectomy was performed to remove the necrotic tissue. Histopathology of the right fallopian tube revealed hemorrhage and necrosis with non-neoplastic cystic contents. The postoperative period was uneventful, and the patient was discharged home after surgery. <h3>Comments</h3> Current imaging modalities remain non-specific in diagnosis of tubal torsions, resulting in laparoscopy as the gold standard for definitive diagnosis. High clinical suspicion and early surgical intervention are necessary to preserve future fertility of these young women.

Chlamydia trachomatis L2c Infection in a Porcine Model Produced Urogenital Pathology and Failed to Induce Protective Immune Responses Against Re-Infection.

The current study was designed to evaluate the pathogenesis, pathology and immune response of female genital tract infection with Chlamydia trachomatis L2c, the most recently discovered lymphogranuloma venereum strain, using a porcine model of sexually transmitted infections. Pigs were mock infected, infected once or infected and re-infected intravaginally, and samples were obtained for chlamydial culture, gross and microscopic pathology, and humoral and cell-mediated immunity. Intravaginal inoculation of pigs with this bacterium resulted in an infection that was confined to the urogenital tract, where inflammation and pathology were caused that resembled what is seen in human infection. Re-infection resulted in more severe gross pathology than primary infection, and chlamydial colonization of the urogenital tract was similar for primary infected and re-infected pigs. This indicates that primary infection failed to induce protective immune responses against re-infection. Indeed, the proliferative responses of mononuclear cells from blood and lymphoid tissues to C. trachomatis strain L2c were never statistically different among groups, suggesting that C. trachomatis-specific lymphocytes were not generated following infection or re-infection. Nevertheless, anti-chlamydial antibodies were elicited in sera and vaginal secretions after primary infection and re-infection, clearly resulting in a secondary systemic and mucosal antibody response. While primary infection did not protect against reinfection, the porcine model is relevant for evaluating immune and pathogenic responses for emerging and known C. trachomatis strains to advance drug and/or vaccine development in humans.

IGG4-RELATED DISEASE WITH SEROSITIS MIMICKING CARCINOMATOSIS?

SESSION TITLE: Medical Student/Resident Pulmonary Manifestations of Systemic Disease 1 SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/09/2018 01:15 PM - 02:15 PM INTRODUCTION: IgG4-related disease (IgG4-RD) can involve multiple organs and mimic malignant, other autoimmune, or infectious processes. CASE PRESENTATION: A 66 year-old man with COPD chronically on 4L O2, Type 2 Diabetes, and a 30 pack-year smoking history, presented with 1 month of worsening dyspnea. Chest CT showed new pleural thickening, and an echocardiogram showed a loculated pericardial effusion. He received a course of steroids for presumed COPD exacerbation and improved. Pleural biopsy was considered but felt high risk given his poor functional status. The patient had multiple episodes of respiratory decompensation in the following months requiring hospitalization. He developed scrotal swelling, indurated skin plaques, abdominal distension and pain. Diagnostic workup included an ultrasound showing bilateral hydroceles and epididymo-orchitis. Urine gonorrhea and chlamydia PCR and culture were negative. A skin lesion was biopsied, and pathology showed panniculitis with many plasma cells. PET-CT showed activity in the pleura, pericardium, omentum, peritoneum, thoracic and abdominal lymph nodes. Abdominal CT showed carcinomatosis-like omental thickening with subcutaneous extension. Percutaneous omental biopsies were performed. Pathology showed a mixed inflammatory infiltrate and reactive changes with scattered giant cells but no malignancy. Stains for bacteria, mycobacteria, and fungi were negative. Rare plasma cells were positive for IgG4. The differential diagnosis still included carcinomatosis, IgG4-RD, and less likely disseminated infection. The consideration of an inflammatory disorder prompted empiric institution of prednisone. Serum IgG4 was elevated then at 238 mg/dL (normal 8-140 mg/dL). But after 6 months of struggling with the disease and now critically ill with decompensated respiratory and heart failure, the patient elected for hospice care. He was continued on prednisone 20mg and diuretics with modest improvement.The patient decompensated at hospice and required ICU admission. After 24 hours of IV methylprednisolone and aggressive diuresis, he transitioned to prednisone 60mg daily and standing diuresis. His abdominal pain and distension improved, as did his skin and scrotal swelling. His O2 requirement decreased from high flow at 80% FiO2 to 9L nasal cannula. After 1 month on prednisone, he had dramatic symptomatic improvement and his oxygen requirement decreased to 4L. PET-CT showed reduced thickening and activity of the pleura, pericardium, and omentum, but new lymphadenopathy. DISCUSSION: IgG4-RD can affect the pleura, pericardium, retroperitoneum, omentum, testicles, skin, and other sites. The disease typically responds well to glucocorticoids. A trial of steroids has both diagnostic and therapeutic utility when the distinction between IgG4-RD and carcinomatosis is unclear. CONCLUSIONS: Suspicion for IgG4-RD should remain high even if histopathologic criteria are not met. Reference #1: Kamisawa T, Zen Y, Pillai S, Stone JH. IgG4-related disease. Lancet. 2015;385(9976):1460-1471. DISCLOSURES: No relevant relationships by Mark Fuster, source=Web Response No relevant relationships by Matthew Light, source=Web Response No relevant relationships by Alexandra Rose, source=Web Response No relevant relationships by Cameron Wales, source=Web Response No relevant relationships by Hairan Zhu, source=Web Response

ACS in children with sickle cell anaemia in Uganda: prevalence, presentation and aetiology.

ACS (ACS) is a serious complication of sickle cell anaemia (SCA). We set out to describe the burden, presentation and organisms associated with ACS amongst children with SCA attending Mulago Hospital, Kampala, Uganda. In a cross-sectional study, 256 children with SCA and fever attending Mulago Hospital were recruited. Chest X-rays, blood cultures, complete blood count and sputum induction were performed. Sputum samples were investigated by Ziehl-Nielsen staining, culture and DNA polymerase chain reaction (PCR) for Chlamydia pneumoniae. Of the 256 children, 22·7% had ACS. Clinical and laboratory findings were not significantly different between children with ACS and those without, besides cough and abnormal signs on auscultation. Among the 83 sputum cultures Streptococcus pneumoniae (12%) and Moraxella spp (8%), were the commonest. Of the 59 sputa examined with DNA PCR, 59·3% were positive for Chlamydia pneumoniae. Mycobacterium tuberculosis was isolated in 6/83 sputa. These results show that one in 5 SCA febrile children had ACS. There were no clinical and laboratory characteristics of ACS, but cough and abnormalities on auscultation were associated with ACS. The high prevalence of Chlamydia pneumoniae in children with ACS in this setting warrants the addition of macrolides to treatment, and M.tuberculosis should be differential in sub-Saharan children with ACS.

ATYPICAL CHLAMYDIACEAE IN WILD POPULATIONS OF HAWKS ( BUTEO SPP.) IN CALIFORNIA.

Chlamydiaceae bacteria infect many vertebrate hosts, and previous reports based on polymerase chain reaction (PCR) assays and serologic assays that are prone to cross-reaction among chlamydial organisms have been used to describe the prevalence of either DNA fragments or antibodies to Chlamydia spp. in wild raptorial populations. This study reports the PCR-based prevalence of Chlamydiaceae DNA that does not 100% match any avian or mammalian Chlamydiaceae in wild populations of hawks in California Buteo species. In this study, multimucosal swab samples ( n = 291) for quantitative PCR (qPCR) and plasma ( n = 78) for serology were collected from wild hawks. All available plasma samples were negative for antibodies using a C. psittaci-specific elementary body agglutination test (EBA; n = 78). For IgY antibodies all 51 available samples were negative using the indirect immunofluorescent assay. The overall prevalence of Chlamydiaceae DNA detection in wild Buteo species sampled was 1.37% (4/291) via qPCR-based analysis. Two fledgling Swainson's hawks ( Buteo swainsoni) and two juvenile red-tailed hawks ( Buteo jamaicensis) were positive by qPCR-based assay for an atypical chlamydial sequence that did not 100% match any known C. psittaci genotype. Positive swab samples from these four birds were sequenced based on the ompA gene and compared by high-resolution melt analysis with all known avian and mammalian Chlamydiaceae. The amplicon sequence did not 100% match any known avian chlamydial sequence; however, it was most similar (98.6%) to C. psittaci M56, a genotype that is typically found in muskrats and hares. Culture and full genome sequence analysis of Chlamydia spp. isolated from diseased hawks will be necessary to classify this organism and to better understand its epizootiology and potential health impact on wild Buteo populations in California.

Sensitivity of the Standard Chlamydia trachomatis Culture Method Is Improved After One Additional In Vitro Passage.

Chlamydia trachomatis causes the most common bacterial sexually transmitted infection (STI) worldwide. Although highly sensitive nucleic acid amplification tests (NAATs) are used to routinely diagnose chlamydial infection, C. trachomatis isolation by cell culture is still preferred for legal cases and epidemiological studies because of its high specificity; however, the sensitivity of traditional two-passage diagnostic cultures is significantly lower than that of NAATs. Therefore, we sought to analyze if additional in vitro passaging of clinical samples would improve detection sensitivity of C. trachomatis. Clinical swabs (n = 428) were collected from Tianjin Medical University General Hospital, grown in McCoy cells for up to five passages, and analyzed for the presence of inclusions by iodine staining. Results were confirmed by routine PCR-based methods. Viable C. trachomatis organisms were detected in 91 (21.26%) swabs with the traditional two-passage protocol, which increased to 145 (33.88%) and 149 (34.81%) following three and four passages, respectively. Thus, the standard protocol yielded a false-negative rate of nearly 39%. Subsequent PCR-based diagnostics revealed a concordance rate of 80.98% between these two methods without any false negatives. The results of this study support the use of a three-passage Chlamydia culture procedure to increase the detection sensitivity of this method.

Assessment of Chlamydia suis Infection in Pig Farmers.

Chlamydia suis infections are endemic in domestic pigs in Europe and can lead to conjunctivitis, pneumonia, enteritis and reproductive failure. Currently, the knowledge on the zoonotic potential of C.suis is limited. Moreover, the last decades, porcine tetracycline resistant C.suis strains have been isolated, which interfere with treatment of chlamydial infections. In this study, the presence of C.suis was examined on nine Belgian pig farms, using Chlamydia culture and a C.suis specific real-time PCR in both pigs and farmers. In addition to diagnosis for C.suis, the farmers' samples were examined using a Chlamydia trachomatis PCR. Additionally, the Chlamydia isolates were tested for the presence of the tet(C) resistance gene. C. DNA was demonstrated in pigs on all farms, and eight of nine farmers were positive in at least one anatomical site. None of the farmers tested positive for C. trachomatis. Chlamydia suis isolates were obtained from pigs of eight farms. Nine porcine C.suis isolates possessing a tet(C) gene were retrieved, originating from three farms. Moreover, C.suis isolates were identified in three human samples, including one pharyngeal and two rectal samples. These findings suggest further research on the zoonotic transfer of C.suis from pigs to humans is needed.

Infectious Proctitis: A Case of a Clandestine Cause for Proctitis

We present the case of a male patient who described four months of painful defecation, tenesmus, pruritus, hematochezia and mucous per rectum. Initial work-up by the primary care physician (PCP) included negative stool culture and ova and parasite studies. Family history was notable for a first-degree relative with ulcerative colitis. The patient's medical history included adjustment disorder and acne. Social history was notable for sexual intercourse with men, including anal intercourse with inconsistent use of barrier protection. He had recent travel to the United Kingdom (UK) at which time he engaged in unprotected anal intercourse. He had no other systemic symptoms. Rectal exam was notable for visualization of bright red blood, without the presence of external hemorrhoids. Colonoscopy was performed for persistent symptoms, family history of inflammatory bowel disease (IBD), as well as risk for sexually transmitted infections (STIs). Multiple circumferential non-bleeding ulcers were found in the distal rectum and anal canal. Biopsies were negative for p16 protein, P63, CMV and HSV I and II. Pathology revealed ulceration and acute inflammation, with no viral inclusions. Recent rectal, throat and urine culture for gonorrhea and chlamydia were negative, however cultures were not obtained for these organisms via colonoscopy. Referral was made to colorectal surgery. Anoscopy revealed thick yellow drainage from anal crypt with associated ulcer. He was given a clinical diagnosis of infectious proctitis secondary to likely gonorrhea and empirically treated with ceftriaxone and doxycycline, with resolution of symptoms. Maintaining a wide differential is important when patients present with symptoms of proctitis. While IBD is a common etiology, social and clinical context provide information vital to making the correct diagnosis. Importantly, clinical suspicion should guide treatment, even when faced with negative test results. In the case of this patient, his initially negative rectal swabs for STIs likely delayed treatment. Finally, recognition of the current epidemiologic trends in specific patient populations, provides keys to diagnosis. Recent surges in infectious proctitis, including lymphogranuloma venereum (LGV) among men who have sex with men (MSM) in Europe have been documented. Consideration of this relevant data helps point to the correct diagnosis.

O15.4 Azithromycin treatment failure in women infected with genital chlamydia infection

Introduction Repeat infections of chlamydia are very common and may represent a new infection, re-infection from an untreated partner or treatment failure. The aim of this cohort study is to estimate the proportion of women infected with chlamydia who experience failure after treatment with 1 gram azithromycin. Methods Women diagnosed with chlamydia were followed for 8 weeks post treatment with 1 gram azithromycin and provided weekly genital specimens for further assay. The primary outcome was the proportion of women classified as having treatment failure at least 4 weeks after recruitment. Comprehensive sexual behaviour data collection and the detection of Y chromosome DNA in vaginal swabs and genome sequencing were used to differentiate between chlamydia re-infection and treatment failure. Chlamydia culture and MIC was also undertaken. Results There were 305 women recruited with a response rate of 66%. A total of 36 women were diagnosed with repeat chlamydia infection during follow up (11.8%; 95% CI: 8.4%, 16.0%). The median time till repeat infection was 7 weeks, with 25% of repeat infections diagnosed within 5 weeks. The risk of repeat infection increased with increasing organism load of initial infection (OR = 1.6; 95% CI: 1.2, 2.8 for each additional log increase in load). Of the 36 women with repeat infection, 16 (44.4%; 95% CI: 27.9%, 61.9%) were classified as treatment failure with an overall risk of treatment failure of 5.2% (95% CI: 3.0%, 8.4%). There was no detectable shift in MIC between initial and repeat infections with MIC within reported antimicrobial susceptibility ranges. Conclusion Using a combination of advanced laboratory techniques and comprehensive sexual behaviour data, we estimate that about 1 in 20 women with chlamydia infection treated with 1 gram of azithromycin will fail treatment. Further laboratory investigation will determine whether there are any genomic characteristics of the infections associated with treatment failure in our cohort. Disclosure of interest statement This study was funded by the NHMRC.

Ocular Chlamydia trachomatis in a tertiary hospital

Chlamydia trachomatis, a leading cause of blindness, remains hyperendemic in the poorer regions of the world. In Egypt, the disease represents a major health problem. The objective was to assess the active trachoma and actual ocular C.trachomatis infection as diagnosed by its isolation in the Vero cell line followed by its detection using Giemsa stain, iodine stain, enzyme-linked immunosorbent assay (ELISA) and Gen-Probe. Forty patients clinically diagnosed with chlamydial conjunctivitis were collected from the outpatient clinic of the Ophthalmology Centre, Mansoura University Hospital, Egypt. Two scrapings were taken, one fixed onto a slide for direct Giemsa stain and the other transported on sucrose phosphate medium to be cultured on the Vero cell line then identified by Giemsa and iodine stains, ELISA and Gen-Probe. C.trachomatis was detected by direct Giemsa stain in 1/40 (2.5%) of samples but isolated in the Vero cell line and identified in 4/40 samples (10%) by Giemsa and iodine stains or Gen-Probe. However, ELISA identified only 2/40 (5%) of total samples after culture. Direct Giemsa stain provided low sensitivity (25%) and a high specificity (100%) compared with cell cultures, with high statistically significant differences between both tests (P-value<0.001). All the indices for Gen-Probe in relation to Giemsa stain for chlamydial identification after culture were 100%. Sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) and efficiency of chlamydial culture identification by ELISA as related to Giemsa stain identification were 50%, 100%, 100%, 94.7% and 95%, respectively, with high statistically significant differences between both tests (P-value<0.001). C. trachomatis was detected in a relatively high rate of acute follicular conjunctivitis patients as detected with culture on the Vero cell line. Identification of C. trachomatis in culture was 100% by Giemsa and iodine stains or Gen-Probe but only 50% by ELISA. Direct Giemsa stain demonstrated low sensitivity (25%) and high specificity (100%).

Evaluation of the presence and zoonotic transmission of Chlamydia suis in a pig slaughterhouse.

BackgroundA significant number of studies on pig farms and wild boars worldwide, demonstrate the endemic presence of Chlamydia suis in pigs. However, the zoonotic potential of this pathogen, phylogenetically closely related to Chlamydia trachomatis, is still uninvestigated. Therefore, this study aims to examine the zoonotic transmission in a Belgian pig abattoir.MethodsPresence of Chlamydia suis in pigs, contact surfaces, air and employees was assessed using a Chlamydia suis specific real-time PCR and culture. Furthermore, Chlamydia suis isolates were tested for the presence of the tet(C) gene.ResultsChlamydia suis bacteria could be demonstrated in samples from pigs, the air and contact surfaces. Moreover, eye swabs of two employees were positive for Chlamydia suis by both PCR and culture. The tet(C) gene was absent in both human Chlamydia suis isolates and no clinical signs were reported.ConclusionsThese findings suggest the need for further epidemiological and clinical research to elucidate the significance of human ocular Chlamydia suis infections.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0560-x) contains supplementary material, which is available to authorized users.

Chronic Endometritis Due to Common Bacteria Is Prevalent in Women With Recurrent Miscarriage as Confirmed by Improved Pregnancy Outcome After Antibiotic Treatment

Recurrent miscarriage (RM) is defined as 3 or more miscarriages before 20 weeks' pregnancy. In recent years, interest has been focused on chronic endometritis (CE), a subtle inflammation thought to be associated with RM. We aimed to evaluate the relationships between CE and RM. The records of 360 women with unexplained RM were retrospectively analyzed. Data from hysteroscopy, endometrial histology, endometrial culture, and polymerase chain reaction for chlamydia, performed before and after antibiotic treatment for CE, were analyzed. The occurrence of successful pregnancies within 1 year after treatment was also evaluated. Results showed that 208 (57.8%) women with RM showed CE at hysteroscopy; 190 (91.3%), positive at hysteroscopy, were also positive at histology, and 142 (68.3%) had positive cultures. Common bacteria were found in 110 (77.5%) patients. Mycoplasma and Ureaplasma were found in 36 (25.3%) patients and Chlamydia in 18 patients (12.7%). In 102 (71%) women, antibiogram-based antibiotic treatment normalized hysteroscopy, histology, and cultures (group 1); while in 40 (28.2%) patients, CE was still present at hysteroscopy (group 2). In 16 of the 66 patients positive at hysteroscopy, but not at cultures, the hysteroscopy becomes normal (group 3) after a Centers for Disease Control and Prevention-based therapy; while in 50 women, CE was still present (group 4). One year after treatment, group 1 showed a significantly higher number of pregnancies (78.4%) compared to group 2 (17.5%; P < .001) and group 4 (15.3%; P = .005). The CE is frequent in women with RM. Antibiotic treatment seems to be associated with an improved reproductive outcome.

Clinical Analysis of 106 Cases of Mycoplasma Mixed Infections in Children with Pneumonia

To investigate the therapeutic measures and clinical efficacy of mycoplasma mixed infection in children with pneumonia. We selected the pediatric ward of our hospital from February 2010 to February 2012, 106 patients received hospital treatment MP pneumonia cases, the patient specimen collection and virus detection, analysis and its clinical manifestations and treatment. Different kind of different ages in children with mycoplasma pneumonia infection mixed. MP childhood pneumonia combined with other pathogens than a simple MP infectious pneumonia symptoms is heavier, duration longer. In terms of treatment, diagnosis of MP infection, should be applied as soon as possible the effects of the macrolide antibiotic azithromycin treatment, treatment was combined with other pathogens, done immediately virological testing, chlamydia and sputum culture examination should be considered, according to the corresponding inspection.

Chlamydia Infections in Children and Adolescents

1. Lorena M. Siqueira, MD, MSPH* 1. *Division of Adolescent Medicine, Miami Children’s Hospital, Miami, FL. * Abbreviations: CDC: : Centers for Disease Control and Prevention FDA: : Food and Drug Administration HIV: : human immunodeficiency virus LGV: : lymphogranuloma venereum MIF: : microimmunofluorescent MSM: : men who have sex with men NAAT: : nucleic acid amplification tests PID: : pelvic inflammatory disease STI: : sexually transmitted infection 1. The need for annual screening for chlamydia in sexually active adolescents and young adults is underrecognized because this infection is asymptomatic in most females (75%) and males (50%). 2. Difficulty in diagnosis arises from the range of possible symptoms at presentation of symptomatic infections and the type of testing that can be used in each situation. After completing this article the reader should be able to: 1. Recognize the spectrum of clinical manifestations of chlamydia infection in neonates, children, and adolescents. 2. Discuss the appropriate use of culture and nonculture diagnostic tests for chlamydia infections in various age groups. 3. List the current recommendations for screening and treatment of chlamydia infections. A 17-year-old girl presents with prolonged menstrual bleeding associated with severe menstrual cramping pain. Her menarche was at age 13 years. Subsequent menstrual cycles were monthly, lasting 5 days, with average flow associated with mild to moderate pain relieved by over-the-counter pain medications. The current cycle began a month ago and is associated with severe lower abdominal pain. She admits to sexual activity with one partner and uses condoms intermittently. On examination she is afebrile and in discomfort, with a heart rate of 120 beats per minute. She does not appear anemic and has good capillary refill. She has diffuse abdominal pain with significant tenderness in both the right lower and upper quadrants. Chlamydiae are small obligate, gram-negative, intracellular bacteria that contain both DNA and RNA and were formerly considered to be viruses. There are 3 species that are pathogenic to humans: Chlamydia trachomatis , Chlamydophilia pneumoniae, and Chlamydophilia psittaci . They fall within 2 genera in the family Chlamydiaceae . C trachomatis is in …