Chlamydia infection in individuals reporting contact with sexual partners with chlamydia: a cross-sectional study of sexual health clinic attendees.

PubMed

Huffam, Sarah; Chow, Eric P F; Fairley, Christopher K; Hocking, Jane; Peel, Joanne; Chen, Marcus

2015-09-01

We aimed to ascertain the proportion of positive, and predictive factors of chlamydia infection among females, heterosexual males and men who have sex with men (MSM) presenting to a sexual health service reporting contact with a chlamydia infected sexual partner. A cross-sectional analysis of patients attending the Melbourne Sexual Health Centre from October 2010 to September 2013. Behavioural data obtained using computer assisted self-interview were analysed to determine factors predictive of chlamydia. Of the 491 female, 808 heterosexual male, and 268 MSM chlamydia contacts, the proportion diagnosed with chlamydia were 39.9% (95% CI 35.7% to 44.3%), 36.1% (95% CI 32.9% to 39.9%) and 23.5% (95% CI 18.8% to 29.0%), respectively. Female chlamydia contacts were more likely to have chlamydia if age <25 (adjusted OR (AOR) 1.86, 95% CI 1.12 to 3.10) or if they reported inconsistent condom use during vaginal sex with a regular male partner (AOR 2.5, 95% CI 1.12 to 6.14). Heterosexual male contacts were more likely to have chlamydia if age <25 (AOR 1.69, 95% CI 1.25 to 2.28) or if they had a regular female sexual partner (AOR 1.38, 95% CI 1.03 to 1.85). In MSM urethral chlamydia was diagnosed in 8.8%, rectal chlamydia in 20.2%, and 3.9% at both sites. MSM were more likely to have chlamydia if they had a regular male sexual partner (OR 2.12, 95% CI 1.18 to 3.81). This study of female, heterosexual male, and MSM presentations with self-reported chlamydia contact provides insight into the likelihood and predictive factors of infection. The data may inform policy and individual clinical decision making regarding presumptive treatment of chlamydia contacts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Home-based chlamydia testing of young people attending a music festival--who will pee and post?

PubMed

Sacks-Davis, Rachel; Gold, Judy; Aitken, Campbell K; Hellard, Margaret E

2010-06-28

Chlamydia is most common among young people, but only a small proportion of Australian young people are tested annually. Home-based chlamydia testing has been piloted in several countries to increase testing rates, but uptake has been low. We aimed to identify predictors of uptake of home-based chlamydia testing to inform future testing programs. We offered home-based chlamydia testing kits to participants in a sexual behaviour cross-sectional survey conducted at a music festival in Melbourne, Australia. Those who consented received a testing kit and were asked to return their urine or vaginal swab sample via post. Nine hundred and two sexually active music festival attendees aged 16-29 completed the survey; 313 (35%) opted to receive chlamydia testing kits, and 67 of 313 (21%) returned a specimen for testing. One participant was infected with chlamydia (1% prevalence). Independent predictors of consenting to receive a testing kit included older age, knowing that chlamydia can make women infertile, reporting more than three lifetime sexual partners and inconsistent condom use. Independent predictors of returning a sample to the laboratory included knowing that chlamydia can be asymptomatic, not having had an STI test in the past six months and not living with parents. A low proportion of participants returned their chlamydia test, suggesting that this model is not ideal for reaching young people. Home-based chlamydia testing is most attractive to those who report engaging in sexual risk behaviours and are aware of the often asymptomatic nature and potential sequelae of chlamydia infection.

Home-based chlamydia testing of young people attending a music festival - who will pee and post?

PubMed Central

2010-01-01

Background Chlamydia is most common among young people, but only a small proportion of Australian young people are tested annually. Home-based chlamydia testing has been piloted in several countries to increase testing rates, but uptake has been low. We aimed to identify predictors of uptake of home-based chlamydia testing to inform future testing programs. Methods We offered home-based chlamydia testing kits to participants in a sexual behaviour cross-sectional survey conducted at a music festival in Melbourne, Australia. Those who consented received a testing kit and were asked to return their urine or vaginal swab sample via post. Results Nine hundred and two sexually active music festival attendees aged 16-29 completed the survey; 313 (35%) opted to receive chlamydia testing kits, and 67 of 313 (21%) returned a specimen for testing. One participant was infected with chlamydia (1% prevalence). Independent predictors of consenting to receive a testing kit included older age, knowing that chlamydia can make women infertile, reporting more than three lifetime sexual partners and inconsistent condom use. Independent predictors of returning a sample to the laboratory included knowing that chlamydia can be asymptomatic, not having had an STI test in the past six months and not living with parents. Conclusions A low proportion of participants returned their chlamydia test, suggesting that this model is not ideal for reaching young people. Home-based chlamydia testing is most attractive to those who report engaging in sexual risk behaviours and are aware of the often asymptomatic nature and potential sequelae of chlamydia infection. PMID:20584287

Risk of pelvic inflammatory disease after Chlamydia infection in a prospective cohort of sex workers.

PubMed

Davies, Bethan; Turner, Katy; Ward, Helen

2013-03-01

There is uncertainty in the risk of pelvic inflammatory disease (PID) after chlamydia infection. We analyzed a prospective cohort of sex workers recruited in London between 1985 and 1993 to estimate the risk of PID after a diagnosed case of chlamydia. Chlamydia and gonorrhea were defined as "recent" if they occurred during the most recent 6 months of follow-up or "previous" if they were more than 6 months ago, were the second infection during follow-up, or occurred before the study. Pelvic inflammatory disease was diagnosed using clinical criteria. We used Cox proportional hazards regression to estimate the association between chlamydia and PID controlled for gonorrhea. Three hundred seven women contributed 401.2 person-years of follow-up. The rate of PID in women with recent chlamydia was 27.4 per 100 person-years compared with 11.2 in those without recent chlamydia. Recent and previous chlamydia significantly increased the risk of PID; this association persisted but was no longer significant after controlling for age and history of gonorrhea: recent chlamydia (adjusted hazard ratio [aHR], 2.0; 95% confidence interval [CI], 0.7-5.5), previous chlamydia (aHR, 1.8; 95% CI, 1.0-3.5), previous gonorrhea (aHR, 2.3; 95% CI, 1.1-4.6), and age (HR, 0.9; 95% CI, 0.9-1.0). Women with recent or previous chlamydia are at increased risk for PID. However, this association may be explained by previous exposure to gonorrhea, which was found to increase the risk of PID after a future chlamydia infection.

Chlamydia prevalence in Polish pig herds.

PubMed

Rypuła, K; Kumala, A; Płoneczka-Janeczko, K; Karuga-Kuźniewska, E; Dudek, K; Chorbiński, P

2016-09-01

Chlamydiae are frequently encountered intracellular Gram-negative bacteria. In pigs, these bacteria in combination with other pathogens contribute to the induction of a multi-aetiological syndrome. One of the major characteristics of Chlamydia spp. is their ability to cause prolonged, often subclinical infections. While the economic consequences of Chlamydia spp. infections in pig farms are not fully established, we know that reproductive disorders and other syndromes correlated with Chlamydia infection can lead to financial loss as a result of a reduction in pork production. Additionally, Chlamydia spp. presents a potential zoonotic hazard, therefore determining the prevalence of Chlamydia in pig populations is critical. In the present study 97 pig herds from Poland were involved. To determine the prevalence of Chlamydia PCR and CFT tests were used. In total 797 vaginal samples, 797 conjunctival samples, and 235 serum samples were collected and tested. The study took place from 2011 to 2014. We found Chlamydia spp. present in 71·2% of all tested farms. The percentage of animals testing positive on any given farm varied from 20% to 100%.

Methods for Real-Time PCR-Based Diagnosis of Chlamydia pneumoniae, Chlamydia psittaci, and Chlamydia abortus Infections in an Opened Molecular Diagnostic Platform.

PubMed

Opota, Onya; Brouillet, René; Greub, Gilbert; Jaton, Katia

2017-01-01

The advances in molecular biology of the last decades have dramatically improved the field of diagnostic bacteriology. In particular, PCR-based technologies have impacted the diagnosis of infections caused by obligate intracellular bacteria such as pathogens from the Chlamydiacae family. Here, we describe a real-time PCR-based method using the Taqman technology for the diagnosis of Chlamydia pneumoniae, Chlamydia psittaci, and Chlamydia abortus infection. The method presented here can be applied to various clinical samples and can be adapted on opened molecular diagnostic platforms.

Prevalence of Chlamydia psittaci and Other Chlamydia Species in Wild Birds in Poland.

PubMed

Krawiec, Marta; Piasecki, Tomasz; Wieliczko, Alina

2015-11-01

Avian chlamydiosis is a zoonotic disease occurring in humans, poultry, and exotic birds. It has been suggested that some wild bird species play an important role as reservoirs for Chlamydia, especially Chlamydia psittaci. Whereas C. psittaci is the predominant chlamydial agent in birds, in the present study we have determined the prevalence of different species of Chlamydia among selected wild bird species in Poland using a rapid and sensitive real-time PCR method. In total, 369 free-living birds from 35 bird species and 15 orders were examined. Samples from 27 birds (7.3%) were positive for chlamydial DNA in the PCR; 22 positive samples (81.5%) belonged to C. psittaci, three to Chlamydia trachomatis (11.1%), and two (7.4%) classified only to the genus Chlamydia. Most of C. psittaci-positive samples belonged to five orders: Anseriformes, Columbiformes, Gruiformes, Phasianiformes, and Passeriformes. All C. trachomatis samples were obtained from Eurasian coots (Gruiformes). Two Chlamydia-positive samples not classified to any Chlamydia species were obtained from a common wood pigeon (Columbiformes) and a common buzzard (Accipitriformes). Detection of C. psittaci and C. trachomatis in free-living bird populations force to think on significance of birds as reservoir of varied Chlamydia species and their epidemiological importance.

Population-attributable fraction of tubal factor infertility associated with chlamydia.

PubMed

Gorwitz, Rachel J; Wiesenfeld, Harold C; Chen, Pai-Lien; Hammond, Karen R; Sereday, Karen A; Haggerty, Catherine L; Johnson, Robert E; Papp, John R; Kissin, Dmitry M; Henning, Tara C; Hook, Edward W; Steinkampf, Michael P; Markowitz, Lauri E; Geisler, William M

2017-09-01

Chlamydia trachomatis infection is highly prevalent among young women in the United States. Prevention of long-term sequelae of infection, including tubal factor infertility, is a primary goal of chlamydia screening and treatment activities. However, the population-attributable fraction of tubal factor infertility associated with chlamydia is unclear, and optimal measures for assessing tubal factor infertility and prior chlamydia in epidemiological studies have not been established. Black women have increased rates of chlamydia and tubal factor infertility compared with White women but have been underrepresented in prior studies of the association of chlamydia and tubal factor infertility. The objectives of the study were to estimate the population-attributable fraction of tubal factor infertility associated with Chlamydia trachomatis infection by race (Black, non-Black) and assess how different definitions of Chlamydia trachomatis seropositivity and tubal factor infertility affect population-attributable fraction estimates. We conducted a case-control study, enrolling infertile women attending infertility practices in Birmingham, AL, and Pittsburgh, PA, during October 2012 through June 2015. Tubal factor infertility case status was primarily defined by unilateral or bilateral fallopian tube occlusion (cases) or bilateral fallopian tube patency (controls) on hysterosalpingogram. Alternate tubal factor infertility definitions incorporated history suggestive of tubal damage or were based on laparoscopic evidence of tubal damage. We aimed to enroll all eligible women, with an expected ratio of 1 and 3 controls per case for Black and non-Black women, respectively. We assessed Chlamydia trachomatis seropositivity with a commercial assay and a more sensitive research assay; our primary measure of seropositivity was defined as positivity on either assay. We estimated Chlamydia trachomatis seropositivity and calculated Chlamydia trachomatis-tubal factor infertility odds ratios and population-attributable fraction, stratified by race. We enrolled 107 Black women (47 cases, 60 controls) and 620 non-Black women (140 cases, 480 controls). Chlamydia trachomatis seropositivity by either assay was 81% (95% confidence interval, 73-89%) among Black and 31% (95% confidence interval, 28-35%) among non-Black participants (P < .001). Using the primary Chlamydia trachomatis seropositivity and tubal factor infertility definitions, no significant association was detected between chlamydia and tubal factor infertility among Blacks (odds ratio, 1.22, 95% confidence interval, 0.45-3.28) or non-Blacks (odds ratio, 1.41, 95% confidence interval, 0.95-2.09), and the estimated population-attributable fraction was 15% (95% confidence interval, -97% to 68%) among Blacks and 11% (95% confidence interval, -3% to 23%) among non-Blacks. Use of alternate serological measures and tubal factor infertility definitions had an impact on the magnitude of the chlamydia-tubal factor infertility association and resulted in a significant association among non-Blacks. Low population-attributable fraction estimates suggest factors in addition to chlamydia contribute to tubal factor infertility in the study population. However, high background Chlamydia trachomatis seropositivity among controls, most striking among Black participants, could have obscured an association with tubal factor infertility and resulted in a population-attributable fraction that underestimates the true etiological role of chlamydia. Choice of chlamydia and tubal factor infertility definitions also has an impact on the odds ratio and population-attributable fraction estimates. Published by Elsevier Inc.

A recommendation for timing of repeat Chlamydia trachomatis test following infection and treatment in pregnant and nonpregnant women

PubMed Central

Lazenby, Gweneth B; Korte, Jeffrey E; Tillman, Sarah; Brown, Florence K; Soper, David E

2018-01-01

The objective of this study was to describe the time required to obtain a negative chlamydia test in pregnant and nonpregnant women following treatment to inform test-of-cure collection and recommend an abstinence period to avoid reinfection. Seventy-two women with Chlamydia trachomatis infection, 36 pregnant and 36 nonpregnant, were enrolled in a prospective cohort study. Women were excluded less than 18 years of age, if they had been treated for chlamydia, reported an allergy to macrolide antibiotics, or if they had Myasthenia Gravis. Women were treated for chlamydia with single-dose therapy and submitted weekly vaginal chlamydia nucleic acid amplification tests (NAATs). Once NAATwere negative, the participants completed the study. Forty-seven women completed the study per protocol. The primary outcome was to determine the time to a negative chlamydia NAAT following treatment, with secondary outcomes of determining the appropriate time to collect a test-of-cure following chlamydia treatment and to recommend an appropriate abstinence period following treatment to avoid reinfection. Results showed that the time to a negative chlamydia NAAT was significantly different between groups (log-rank p = 0.0013). The median number of days to obtain a negative chlamydia NAAT was 8 days (IQR 7–14) in pregnant and 7 days (IQR 6–10) in nonpregnant women (WRST p = 0.04). All participants had a negative chlamydia NAAT by day 29 post-treatment. Following single-dose treatment for chlamydia, both pregnant and nonpregnant women should test negative with NAAT by 30 days post-treatment. Clinicians should collect a test-of-cure in pregnant women no earlier than 1 month. To avoid reinfection, women should avoid condomless intercourse for at least 1 month. PMID:27864473

Chlamydia positivity in New Orleans public high schools, 1996-2005: implications for clinical and public health practices.

PubMed

Nsuami, M Jacques; Nsa, Musheni; Brennan, Christine; Cammarata, Catherine L; Martin, David H; Taylor, Stephanie N

2013-01-01

To describe the trends in chlamydia positivity among New Orleans high school students tested in a schoolwide screening between 1996 and 2005, and to determine factors associated with chlamydia positivity among students during the 10-year period. Between school years 1995-1996 and 2004-2005, students in New Orleans public high schools were tested for chlamydia using nucleic acid amplification tests (NAAT) in urine specimens (LCx assay until 1999-2000; BD assay from 2000-2001 to 2004-2005). For each year, we calculated chlamydia positivity by dividing the number of students testing positive by the total number of students tested. Data were analyzed separately by gender. Logistic regressions were performed to determine independent predictors of chlamydia positivity during the 10-year period. Between 1996 and 2005, the average chlamydia positivity was 7.0% (95% confidence interval 6.6-7.4) in boys and 13.1% (95% confidence interval 12.6-13.7) in girls (P < .001). Chlamydia detection increased with the switch from LCx to BD assay. In multivariate analyses, chlamydia positivity among boys and girls was significantly associated with age, black race, and gonorrhea coinfection. Additionally, positivity was significantly different by school year among boys (P = .03) and by NAAT used among girls (P = .008). The trends in chlamydia positivity observed between 1996 and 2005 more likely reflected a high and stable prevalence of chlamydia in the New Orleans school-age adolescent population. Any benefit of screening on individuals tested was likely to be mitigated by participants' uninterrupted social interactions with the dynamic forces that sustain the sexual transmission of chlamydia in the population. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Chlamydia prevalence in the general population: is there a sex difference? a systematic review

PubMed Central

2013-01-01

Background The focus of Chlamydia trachomatis screening and testing lies more on women than on men. The study aim was to establish by systematic review the prevalence of urogenital Chlamydia trachomatis infection in men and women in the general population. Methods Electronic databases and reference lists were searched from 2000 to 2013 using the key words “Chlamydia trachomatis”, “population-based study” and “disease prevalence”. Reference lists were checked. Studies were included in the analysis if Chlamydia trachomatis prevalence was reported for both men and women in a population-based study. Prevalence rates for men and women were described as well as highest prevalence rate by age and sex. The difference in prevalence between the sexes in each study was calculated. Results Twenty-five studies met the inclusion criteria and quality assessment for the review. In nine of the twenty-five studies there was a statistically significant sex difference in the chlamydia prevalence. In all nine studies the prevalence of chlamydia was higher in women than in men. The prevalence for women varied from 1.1% to 10.6% and for men from 0.1% to 12.1%. The average chlamydia prevalence is highly variable between countries. The highest prevalence of chlamydia occurred predominantly in younger age groups (< 25 years). The absence of symptoms in population-based urogenital chlamydia infection is common in men and women (mean 88.5% versus 68.3%). Conclusions The urogenital chlamydia trachomatis prevalence in the general population is more similar than dissimilar for men and women. A modest sex difference is apparent. The prevalence rates can be used to inform chlamydia screening strategies in general practice. PMID:24215287

A recommendation for timing of repeat Chlamydia trachomatis test following infection and treatment in pregnant and nonpregnant women.

PubMed

Lazenby, Gweneth B; Korte, Jeffrey E; Tillman, Sarah; Brown, Florence K; Soper, David E

2017-08-01

The objective of this study was to describe the time required to obtain a negative chlamydia test in pregnant and nonpregnant women following treatment to inform test-of-cure collection and recommend an abstinence period to avoid reinfection. Seventy-two women with Chlamydia trachomatis infection, 36 pregnant and 36 nonpregnant, were enrolled in a prospective cohort study. Women were excluded less than 18 years of age, if they had been treated for chlamydia, reported an allergy to macrolide antibiotics, or if they had Myasthenia Gravis. Women were treated for chlamydia with single-dose therapy and submitted weekly vaginal chlamydia nucleic acid amplification tests (NAATs). Once NAAT were negative, the participants completed the study. Forty-seven women completed the study per protocol. The primary outcome was to determine the time to a negative chlamydia NAAT following treatment, with secondary outcomes of determining the appropriate time to collect a test-of-cure following chlamydia treatment and to recommend an appropriate abstinence period following treatment to avoid reinfection. Results showed that the time to a negative chlamydia NAAT was significantly different between groups (log-rank p = 0.0013). The median number of days to obtain a negative chlamydia NAAT was 8 days (IQR 7-14) in pregnant and 7 days (IQR 6-10) in nonpregnant women (WRST p = 0.04). All participants had a negative chlamydia NAAT by day 29 post-treatment. Following single-dose treatment for chlamydia, both pregnant and nonpregnant women should test negative with NAAT by 30 days post-treatment. Clinicians should collect a test-of-cure in pregnant women no earlier than 1 month. To avoid reinfection, women should avoid condomless intercourse for at least 1 month.

Chlamydia testing and diagnosis following initiation of long-acting reversible contraception: A retrospective cohort study.

PubMed

Rose, Sally B; Garrett, Susan M; Stanley, James; Pullon, Susan R H

2017-12-01

Long-acting reversible contraception (LARC) effectively protects against pregnancy but provides no protection against sexually transmitted infections (STIs). To compare rates of chlamydia testing and diagnosis for women initiating long-acting versus oral contraception. Retrospective cohort study involving data collection for 6160 women initiating post-abortion contraception at a large New Zealand regional public hospital abortion clinic (2009-2012), with chlamydia testing data obtained from the local laboratory during two-year follow up. Negative binomial regression modelling examined the effect of contraceptive method on two outcome measures: chlamydia testing and chlamydia diagnosis (adjusting for potential covariates of age, ethnicity, past chlamydia infection, pregnancy history) in year one and two of follow up. Two thousand seven hundred and twenty nine women (44%) received a LARC and 1764 (28.6%) were prescribed oral contraception. Adjusted testing rates differed by contraceptive method only in year one (P < 0.01): with higher rates among copper intrauterine device users (relative risk (RR) 1.2, 95% CI 1.06-1.35), and lower rates for implant users (RR 0.84, 95% CI 0.72-0.99) compared with oral contraceptive users (reference group). No significant differences were observed in chlamydia diagnosis rates by contraceptive method (P > 0.05). Younger age, past chlamydia infection, Maori and Pacific ethnicity were associated with higher rates of chlamydia diagnosis (P < 0.01). Known STI-related risk factors (age, ethnicity, past infection) but not contraceptive method were independently related to rates of subsequent chlamydia diagnosis. This suggests that increased LARC uptake would not occur at the expense of chlamydia control. Regular screening and risk reduction advice (including condom use) are important chlamydia control measures for at-risk groups. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Female Reproductive Hormones and Biomarkers of Oxidative Stress in Genital Chlamydia Infection in Tubal Factor Infertility

PubMed Central

Nsonwu-Anyanwu, Augusta Chinyere; Charles-Davies, Mabel Ayebantoyo; Taiwo, Victor Olusegun; Li, Bin; Oni, Anthony Alabar; Bello, Folashade Adenike

2015-01-01

Background Genital Chlamydia infection (GCI) and the associated pathologies have been implicated in tubal infertility. Though the actual pathologic mechanisms are still uncertain, oxidative stress and other factors have been implicated. The purpose of the study was to determine the possible contribution of female reproductive hormones and biomarkers of oxidative stress in genital Chlamydial infection to tubal occlusion. Methods This prospective case control study was carried out by recruiting 150 age matched women grouped into infertile Chlamydia positive women (n = 50), fertile Chlamydia positive women (n = 50) and fertile Chlamydia negative women as controls (n = 50). High vaginal swabs and endocervical swabs were collected for screening Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Treponema pallidum, Staphylococcus aureus, and Candida albicans. Sera were collected for estimation of Chlamydia trachomatis antibody, female reproductive hormones [Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Oestradiol (E2), Progesterone (P4), Prolactin (PRL)] and biomarkers of oxidative stress [Total Antioxidant Capacity (TAC) and 8-hydroxyl-2-deoxyguanosine (8-OHdG)] by enzyme immunoassay (EIA). Data were analyzed using chi square, analysis of variance and LSD Post hoc to determine mean differences at p = 0.05. Results Among women with GCI, higher levels of LH and 8-OHdG were observed in infertile Chlamydia positive women compared to fertile Chlamydia positive women (p < 0.05). Higher levels of LH and 8-OHdG and lower TAC levels were observed in infertile Chlamydia positive women compared to fertile Chlamydia negative controls (p < 0.05). Conclusion Mechanisms including oxidative DNA damage and reduced antioxidant capacity may be involved in the pathology of Chlamydia induced tubal damage. PMID:25927024

Zinc and Chlamydia trachomatis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sugarman, B.; Epps, L.R.

1985-07-01

Zinc was noted to have significant effects upon the infection of McCoy cells by each of two strains of Chlamydia trachomatis. With a high or low Chlamydia inoculant, the number of infected cells increased up to 200% utilizing supplemental zinc (up to 1 x 10/sup -4/ M) in the inoculation media compared with standard Chlamydia cultivation media (8 x 10/sup -6/ M zinc). Ferric chloride and calcium chloride did not effect any such changes. Higher concentrations of zinc, after 2 hr of incubation with Chlamydia, significantly decreased the number of inclusions. This direct effect of zinc on the Chlamydia remainedmore » constant after further repassage of the Chlamydia without supplemental zinc, suggesting a lethal effect of the zinc. Supplemental zinc (up to 10/sup -4/ M) may prove to be a useful addition to inoculation media to increase the yield of culturing for Chlamydia trachomatis. Similarly, topical or oral zinc preparations used by people may alter their susceptibility to Chamydia trachomatis infections.« less

Genetic diversity of Chlamydia among captive birds from central Argentina.

PubMed

Frutos, María C; Monetti, Marina S; Vaulet, Lucia Gallo; Cadario, María E; Fermepin, Marcelo Rodríguez; Ré, Viviana E; Cuffini, Cecilia G

2015-01-01

To study the occurrence of Chlamydia spp. and their genetic diversity, we analysed 793 cloacal swabs from 12 avian orders, including 76 genera, obtained from 80 species of asymptomatic wild and captive birds that were examined with conventional nested polymerase chain reaction and quantitative polymerase chain reaction. Chlamydia spp. were not detected in wild birds; however, four species (Chlamydia psittaci, Chlamydia pecorum, Chlamydia pneumoniae and Chlamydia gallinacea) were identified among captive birds (Passeriformes, n = 20; Psittaciformes, n = 15; Rheiformes, n = 8; Falconiformes n = 2; Piciformes n = 2; Anseriformes n = 1; Galliformes n = 1; Strigiformes n = 1). Two pathogens (C. pneumoniae and C. pecorum) were identified simultaneously in samples obtained from captive birds. Based on nucleotide-sequence variations of the ompA gene, three C. psittaci-positive samples detected were grouped into a cluster with the genotype WC derived from mammalian hosts. A single positive sample was phylogenetically related to a new strain of C. gallinacea. This report contributes to our increasing understanding of the abundance of Chlamydia in the animal kingdom.

First Report of Chlamydia Seroprevalence in Farmed Wild Boars in China.

PubMed

Nie, Lan-Bi; Liang, Qin-Li; Zou, Yang; Gao, Yun-Hang; Zhao, Quan; Hu, Gui-Xue; Zhu, Xing-Quan

2018-04-24

Chlamydia is Gram-negative obligate bacterium, which can cause human diseases worldwide and has huge economic impact on animals. It is yet to know whether farmed wild boars are infected with Chlamydia in China. To assess risk factors of Chlamydia infection in farmed wild boars in China, from April 2015 to February 2016, a total of 837 serum samples of farmed wild boars were collected in Jilin province, northeastern China, and antibodies against Chlamydia were examined by the indirect hemagglutination assay. The investigation showed that antibodies to Chlamydia were detected in 332 (39.67%, 95% CI 33.36-42.98) of 837 serum samples of farmed wild boars, seroprevalence ranged from 33.71% to 44.42% among different regions and the differences were statistically significant by SPSS analysis (p = 0.0248). These results indicated that Chlamydia is highly prevalent in farmed wild boars in Jilin province, northeastern China, and may pose a potential risk for human health. To our knowledge, this is the first report of Chlamydia seroprevalence in farmed wild boars in China, which provided baseline data for preventing and controlling Chlamydia infection in wild boars in China.

High co-occurrence of anorectal chlamydia with urogenital chlamydia in women visiting an STI clinic revealed by routine universal testing in an observational study; a recommendation towards a better anorectal chlamydia control in women.

PubMed

van Liere, Geneviève A F S; Hoebe, Christian J P A; Wolffs, Petra F G; Dukers-Muijrers, Nicole H T M

2014-05-19

Symptom- and sexual history-based testing i.e., testing on indication, for anorectal sexually transmitted infections (STIs) in women is common. Yet, it is unknown whether this strategy is effective. Moreover, little is known about alternative transmission routes i.e. by fingers/toys. This study assesses anorectal STI prevalence and infections missed by current testing practice, thereby informing the optimal control strategy for anorectal STIs in women. Women (n = 663) attending our STI-clinic between May 2012-July 2013 were offered routine testing for anorectal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae. Data were collected on demographics, sexual behaviour and symptoms. Women were assigned to one of the categories: indication (reported anal sex/symptoms), fingers/toys (only reported use of fingers/toys), or without indication. Of women, 92% (n = 654) participated. There were 203 reports (31.0%) of anal sex and/or symptoms (indication), 48 reports (7.3%) of only using fingers/toys (fingers/toys), and 403 reports (61.6%) of no anal symptoms, no anal sex and no anal use of fingers/toys (without indication). The overall prevalence was 11.2% (73/654) for urogenital chlamydia and 8.4% (55/654) for anorectal chlamydia. Gonorrhoea infections were not observed. Prevalence of anorectal chlamydia was 7.9% (16/203) for women with indication and 8.6% (39/451) for all other women (P = 0.74). Two-thirds (39/55) of anorectal infections were diagnosed in women without indication. Isolated anorectal chlamydia was rare (n = 3): of all women with an anorectal infection, 94.5% (52/55) also had co-occurrence of urogenital chlamydia. Of all women with urogenital chlamydia, 71.2% (52/73) also had anorectal chlamydia. Current selective testing on indication of symptoms and sexual history is not an appropriate control strategy for anorectal chlamydia in women visiting an STI clinic. Routine universal anorectal testing is feasible and may be a possible control strategy in women. Yet costs may be a problem. When more restricted control measures are preferred, possible alternatives include (1) anorectal testing only in women with urogenital chlamydia (problem: treatment delay or loss to follow up), and (2) direct treatment for urogenital chlamydia that is effective for anorectal chlamydia as well.

Exploring Chlamydia Positivity among Females on College Campuses, 2008-2010

ERIC Educational Resources Information Center

Habel, Melissa A.; Leichliter, Jami S.; Torrone, Elizabeth

2016-01-01

Objective: Describe chlamydia positivity among young women tested at college health centers by student characteristics: age, race/ethnicity, and institution type. Participants: During 2008-2010, colleges participating in a national infertility prevention program provided chlamydia testing data from females aged 18-24. Methods: Chlamydia positivity…

The emerging role of ASC in dendritic cell metabolism during Chlamydia infection

PubMed Central

McKeithen, Danielle N.; Ryans, Khamia; Mu, Jing; Xie, Zhonglin; Simoneaux, Tankya; Blas-machado, Uriel; Eko, Francis O.; Black, Carolyn M.; Igietseme, Joseph U.; He, Qing

2017-01-01

Chlamydia trachomatis is a bacterial agent that causes sexually transmitted infections worldwide. The regulatory functions of dendritic cells (DCs) play a major role in protective immunity against Chlamydia infections. Here, we investigated the role of ASC in DCs metabolism and the regulation of DCs activation and function during Chlamydia infection. Following Chlamydia stimulation, maturation and antigen presenting functions were impaired in ASC-/- DCs compared to wild type (WT) DCs, in addition, ASC deficiency induced a tolerant phenotype in Chlamydia stimulated DCs. Using real-time extracellular flux analysis, we showed that activation in Chlamydia stimulated WT DCs is associated with a metabolic change in which mitochondrial oxidative phosphorylation (OXPHOS) is inhibited and the cells become committed to utilizing glucose through aerobic glycolysis for differentiation and antigen presenting functions. However, in ASC-/- DCs Chlamydia-induced metabolic change was prevented and there was a significant effect on mitochondrial morphology. The mitochondria of Chlamydia stimulated ASC-/- DCs had disrupted cristae compared to the normal narrow pleomorphic cristae found in stimulated WT DCs. In conclusion, our results suggest that Chlamydia-mediated activation of DCs is associated with a metabolic transition in which OXPHOS is inhibited, thereby dedicating the DCs to aerobic glycolysis, while ASC deficiency disrupts DCs function by inhibiting the reprogramming of DCs metabolism within the mitochondria, from glycolysis to electron transport chain. PMID:29216217

Evaluation of the Kodak Surecell Chlamydia test for the laboratory diagnosis of adult inclusion conjunctivitis.

PubMed

Tantisira, J G; Kowalski, R P; Gordon, Y J

1995-07-01

The Kodak Surecell Chlamydia test, a rapid enzyme immunoassay, has been reported to be highly sensitive (93%) and specific (96%) for detecting chlamydial lipopolysaccharide antigen in conjunctival specimens from infants, but has not been evaluated previously in adult conjunctival specimens. This study was designed to determine the efficacy of the Kodak Surecell Chlamydia test for the laboratory diagnosis of adult inclusion conjunctivitis. Twenty Chlamydia culture-positive conjunctival specimens from adults (true-positives) and 20 true-negative specimens were tested with the Kodak Surecell Chlamydia test. The Kodak Surecell Chlamydia test was 40% (8/20) sensitive, 100% (20/20) specific, and 70% (28/40) efficient. This study indicates that the Kodak Surecell Chlamydia test, though highly specific, is less sensitive in its ability to diagnose chlamydial conjunctivitis in adults than has been reported previously in infants.

Involvement of Lysosome Membrane Permeabilization and Reactive Oxygen Species Production in the Necrosis Induced by Chlamydia muridarum Infection in L929 Cells.

PubMed

Chen, Lixiang; Wang, Cong; Li, Shun; Yu, Xin; Liu, Xue; Ren, Rongrong; Liu, Wenwen; Zhou, Xiaojing; Zhang, Xiaonan; Zhou, Xiaohui

2016-04-28

Chlamydiae, obligate intracellular bacteria, are associated with a variety of human diseases. The chlamydial life cycle undergoes a biphasic development: replicative reticulate bodies (RBs) phase and infectious elementary bodies (EBs) phase. At the end of the chlamydial intracellular life cycle, EBs have to be released to the surrounded cells. Therefore, the interactions between Chlamydiae and cell death pathways could greatly influence the outcomes of Chlamydia infection. However, the underlying molecular mechanisms remain elusive. Here, we investigated host cell death after Chlamydia infection in vitro, in L929 cells, and showed that Chlamydia infection induces cell necrosis, as detected by the propidium iodide (PI)-Annexin V double-staining flow-cytometric assay and Lactate dehydrogenase (LDH) release assay. The production of reactive oxygen species (ROS), an important factor in induction of necrosis, was increased after Chlamydia infection, and inhibition of ROS with specific pharmacological inhibitors, diphenylene iodonium (DPI) or butylated hydroxyanisole (BHA), led to significant suppression of necrosis. Interestingly, live-cell imaging revealed that Chlamydia infection induced lysosome membrane permeabilization (LMP). When an inhibitor upstream of LMP, CA-074-Me, was added to cells, the production of ROS was reduced with concomitant inhibition of necrosis. Taken together, our results indicate that Chlamydia infection elicits the production of ROS, which is dependent on LMP at least partially, followed by induction of host-cell necrosis. To our best knowledge, this is the first live-cell-imaging observation of LMP post Chlamydia infection and report on the link of LMP to ROS to necrosis during Chlamydia infection.

Using Multiple Outcomes of Sexual Behavior to Provide Insights Into Chlamydia Transmission and the Effectiveness of Prevention Interventions in Adolescents.

PubMed

Enns, Eva Andrea; Kao, Szu-Yu; Kozhimannil, Katy Backes; Kahn, Judith; Farris, Jill; Kulasingam, Shalini L

2017-10-01

Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process. We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions. The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)]. While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.

Emendation of the family Chlamydiaceae: proposal of a single genus, Chlamydia, to include all currently recognized species.

PubMed

Sachse, Konrad; Bavoil, Patrik M; Kaltenboeck, Bernhard; Stephens, Richard S; Kuo, Cho-Chou; Rosselló-Móra, Ramon; Horn, Matthias

2015-03-01

The family Chlamydiaceae (order Chlamydiales, phylum Chlamydiae) comprises important, obligate intracellular bacterial pathogens of humans and animals. Subdivision of the family into the two genera Chlamydia and Chlamydophila has been discussed controversially during the past decade. Here, we have revisited the current classification in the light of recent genomic data and in the context of the unique biological properties of these microorganisms. We conclude that neither generally used 16S rRNA sequence identity cut-off values nor parameters based on genomic similarity consistently separate the two genera. Notably, no easily recognizable phenotype such as host preference or tissue tropism is available that would support a subdivision. In addition, the genus Chlamydophila is currently not well accepted and not used by a majority of research groups in the field. Therefore, we propose the classification of all 11 currently recognized Chlamydiaceae species in a single genus, the genus Chlamydia. Finally, we provide emended descriptions of the family Chlamydiaceae, the genus Chlamydia, as well as the species Chlamydia abortus, Chlamydia caviae and Chlamydia felis. Copyright © 2015 Elsevier GmbH. All rights reserved.

Isolation of single Chlamydia-infected cells using laser microdissection.

PubMed

Podgorny, Oleg V; Polina, Nadezhda F; Babenko, Vladislav V; Karpova, Irina Y; Kostryukova, Elena S; Govorun, Vadim M; Lazarev, Vassili N

2015-02-01

Chlamydia are obligate intracellular parasites of humans and animals that cause a wide range of acute and chronic infections. To elucidate the genetic basis of chlamydial parasitism, several approaches for making genetic modifications to Chlamydia have recently been reported. However, the lack of the available methods for the fast and effective selection of genetically modified bacteria restricts the application of genetic tools. We suggest the use of laser microdissection to isolate of single live Chlamydia-infected cells for the re-cultivation and whole-genome sequencing of single inclusion-derived Chlamydia. To visualise individual infected cells, we made use of the vital labelling of inclusions with the fluorescent Golgi-specific dye BODIPY® FL C5-ceramide. We demonstrated that single Chlamydia-infected cells isolated by laser microdissection and placed onto a host cell monolayer resulted in new cycles of infection. We also demonstrated the successful use of whole-genome sequencing to study the genomic variability of Chlamydia derived from a single inclusion. Our work provides the first evidence of the successful use of laser microdissection for the isolation of single live Chlamydia-infected cells, thus demonstrating that this method can help overcome the barriers to the fast and effective selection of Chlamydia. Copyright © 2014 Elsevier B.V. All rights reserved.

Incidence and persistence of carcinogenic genital human papillomavirus infections in young women with or without Chlamydia trachomatis co-infection

PubMed Central

Vriend, Henrike J; Bogaards, Johannes A; van Bergen, Jan E A M; Brink, Antoinette A T P; van den Broek, Ingrid V F; Hoebe, Christian J P A; King, Audrey J; van der Sande, Marianne A B; Wolffs, Petra F G; de Melker, Hester E

2015-01-01

We assessed whether infection with chlamydia increases the incidence of carcinogenic human papillomavirus (HPV) infections and if HPV persistence is affected by chlamydia co-infection. For 1982 women (16–29 years-old) participating in two consecutive rounds of a chlamydia screening implementation trial, swabs were polymerase chain reaction tested to detect chlamydia and 14 carcinogenic HPV genotypes. HPV type-specific incidence and persistence rates were stratified for chlamydia positivity at follow-up. Associations were assessed by multilevel logistic regression analyses with correction for sexual risk factors. HPV type-specific incidence ranged from 1.4% to 8.9% and persistence from 22.7% to 59.4% after a median follow-up of 11 months (interquartile range: 11–12). Differences in 1-year HPV persistence rates between chlamydia -infected and noninfected women were less distinct than differences in HPV incidence rates (pooled adjusted odds ratios of 1.17 [95% CI: 0.69–1.96] and 1.84 [95% CI: 1.36–2.47], respectively). The effect of chlamydia co-infection on HPV-infection risk did not significantly differ by HPV genotype. In conclusion, infection with chlamydia increases the risk of infection by carcinogenic HPV types and may enhance persistence of some HPV types. Although these findings could reflect residual confounding through unobserved risk factors, our results do give reason to explore more fully the association between chlamydia and HPV type-specific acquisition and persistence. PMID:26194784

Trends in chlamydia and gonorrhea positivity among heterosexual men and men who have sex with men attending a large urban sexual health service in Australia, 2002-2009

PubMed Central

2011-01-01

Background To determine whether chlamydia positivity among heterosexual men (MSW) and chlamydia and gonorrhea positivity among men who have sex with men (MSM), are changing. Methods Computerized records for men attending a large sexual health clinic between 2002 and 2009 were analyzed. Chlamydia and gonorrhea positivity were calculated and logistic regression used to assess changes over time. Results 17769 MSW and 8328 MSM tested for chlamydia and 7133 MSM tested for gonorrhea. In MSW, 7.37% (95% CI: 6.99-7.77) were chlamydia positive; the odds of chlamydia positivity increased by 4% per year (OR = 1.04; 95% CI: 1.01-1.07; p = 0.02) after main risk factors were adjusted for. In MSM, 3.70% (95% CI: 3.30-4.14) were urethral chlamydia positive and 5.36% (95% CI: 4.82-5.96) were anal chlamydia positive; positivity could not be shown to have changed over time. In MSM, 3.05% (95% CI: 2.63-3.53) tested anal gonorrhea positive and 1.83% (95% CI: 1.53-2.18) tested pharyngeal gonorrhea positive. Univariate analysis found the odds of anal gonorrhea positivity had decreased (OR = 0.93; 95% CI: 0.87-1.00; p = 0.05), but adjusting for main risk factors resulted in no change. Urethral gonorrhea cases in MSM as a percentage of all MSM tested for gonorrhea also fell (p < 0.001). Conclusions These data suggest that chlamydia prevalence in MSW is rising and chlamydia and gonorrhea prevalence among MSM is stable or declining. High STI testing rates among MSM in Australia may explain differences in STI trends between MSM and MSW. PMID:21639943

Health-related quality of life and Chlamydia trachomatis infection in sexually experienced female inner-city students: a community-based cross-sectional study.

PubMed

Sri, Trisha; Southgate, Eleanor; Kerry, Sarah R; Nightingale, Claire; Oakeshott, Pippa

2017-03-01

This cross-sectional study was undertaken to compare health-related quality of life (EQ-5D) in women with and without undiagnosed Chlamydia trachomatis infection. We analysed data from 2401 multi-ethnic sexually active female students aged 16-27 years who were recruited to a randomised controlled trial of chlamydia screening - the prevention of pelvic infection trial in 2004-2006. At recruitment, all participants were asked to provide self-taken vaginal swabs for chlamydia testing and to complete a sexual health questionnaire including quality of life (EQ-5D). Most women (69%) had an EQ-5D of one representing 'perfect health' in the five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. We therefore compared the proportion of women with an EQ-5D score < 1 implying 'less than perfect health' in women with and without chlamydia infection, and women with symptomatic chlamydia versus the remainder. The proportion of women with EQ-5D score < 1 was similar in women with and without undiagnosed chlamydia: 34% (47/138) versus 31% (697/2263; RR 1.11, 95% CI 0.87 to 1.41). However, more women with symptomatic chlamydia had EQ-5D score < 1 than the remainder: 45% (25/55) versus 31% (714/2319; RR 1.47, CI 1.10 to 1.98). In this community-based study, EQ-5D scores were similar in women with and without undiagnosed chlamydia. However, a higher proportion of women with symptomatic chlamydia infection had 'less than perfect health'. Undiagnosed chlamydia infection may not have a major short-term effect on health-related quality of life, but EQ-5D may not be the best tool to measure it in this group.

Testing-adjusted chlamydia notification trends in New South Wales, Australia, 2000 to 2010.

PubMed

Cretikos, Michelle; Mayne, Darren; Reynolds, Roderick; Spokes, Paula; Madeddu, Daniel

2014-01-01

Between 2005 and 2010, Australian notification rates for chlamydia infection increased by 64% from 203 to 333 per 100 000 population. Interpreting this trend is difficult without examining rates and local patterns of testing. We examined the effect of adjusting for local testing rates on chlamydia notification trends in New South Wales (NSW), Australia from 2000 to 2010. We used testing data for NSW residents for Medicare Benefits Schedule items for chlamydia from 1 July 1999 to 30 June 2005 and 1 July 2007 to 30 June 2010. This data set excluded testing by public sector laboratories. We also obtained laboratory-confirmed genital chlamydia notifications in NSW residents for 1 July 1999 to 30 June 2010 and excluded notifications from public laboratories. We used negative binomial regression to assess trends in chlamydia notification rates by age and sex after adjusting for local government area (LGA)-level Medicare-funded testing rates, socioeconomic disadvantage, remoteness and Medicare provider density. Testing-adjusted rates of chlamydia notifications declined by 5.2% per annum (rate ratio [RR] = 0.95, 95% confidence interval (CI) = 0.93-0.96) for women overall, and 2.3% (RR = 0.98, 95% CI = 0.96-1.00) and 5.0% per annum (RR = 0.95, 95% CI = 0.93-0.98) for men in LGAs with moderate and high densities of Medicare providers, respectively. Notification rates remained stable for men in low Medicare provider density LGAs (RR = 1.01, 95% CI = 0.96-1.07). It is likely that increased testing for chlamydia has driven increases in chlamydia notification in NSW over the last decade. Notification data provide no evidence for a general increase in the prevalence of chlamydia in the NSW community for this period. Notification-based chlamydia surveillance should be routinely adjusted for local testing rates.

Culture-independent genomic characterisation of Candidatus Chlamydia sanzinia, a novel uncultivated bacterium infecting snakes.

PubMed

Taylor-Brown, Alyce; Bachmann, Nathan L; Borel, Nicole; Polkinghorne, Adam

2016-09-05

Recent molecular studies have revealed considerably more diversity in the phylum Chlamydiae than was previously thought. Evidence is growing that many of these novel chlamydiae may be important pathogens in humans and animals. A significant barrier to characterising these novel chlamydiae is the requirement for culturing. We recently identified a range of novel uncultured chlamydiae in captive snakes in Switzerland, however, nothing is known about their biology. Using a metagenomics approach, the aim of this study was to characterise the genome of a novel chlamydial taxon from the choana of a captive snake. In doing so, we propose a new candidate species in the genus Chlamydia (Candidatus Chlamydia sanzinia) and reveal new information about the biological diversity of this important group of pathogens. We identified two chlamydial genomic contigs: a 1,113,073 bp contig, and a 7,504 bp contig, representing the chromosome and plasmid of Ca. Chlamydia sanzinia strain 2742-308, respectively. The 998 predicted coding regions include an expanded repertoire of outer membrane proteins (Pmps and Omps), some of which exhibited frameshift mutations, as well as several chlamydial virulence factors such as the translocating actin-recruitment phosphoprotein (Tarp) and macrophage inhibition potentiator (Mip). A suite of putative inclusion membrane proteins were also predicted. Notably, no evidence of a traditional chlamydial plasticity zone was identified. Phylogenetically, Ca. Chlamydia sanzinia forms a clade with C. pneumoniae and C. pecorum, distinct from former "Chlamydophila" species. Genomic characterisation of a novel uncultured chlamydiae from the first reptilian host has expanded our understanding of the diversity and biology of a genus that was thought to be the most well-characterised in this unique phylum. It is anticipated that this method will be suitable for characterisation of other novel chlamydiae.

Racial Differences in Receipt of Chlamydia Testing Among Medicaid-Insured Women in 2013.

PubMed

Patel, Chirag G; Chesson, Harrell W; Tao, Guoyu

2016-03-01

To estimate the percentage of young, sexually active Medicaid-insured women who were tested for chlamydia by age, race/ethnicity, and history of sexually transmitted disease (STD) diagnosis. We used the medical diagnostic and procedural codes from Truven Health MarketScan Medicaid claims data from 10 states in 2012 and 2013 to estimate the rates of chlamydia testing in 2013 and previous STD diagnosis (diagnosed in 2012) among Medicaid-insured women aged 15-25 years who were sexually active in 2013. We also used a logit model to assess the association between chlamydia testing and women's age, race/ethnicity, and previous STD diagnosis. Overall, among approximately 261,000 Medicaid-insured women aged 15-25 years in 2013 who were classified as sexually active, 50.2% were tested for chlamydia in 2013. The chlamydia testing rate was 45.6% for white women and 57.5% for black women. The chlamydia testing rate was 63.5% for women diagnosed as having an STD in 2012 and 46.8% for women not diagnosed as having an STD in 2012. The chlamydia testing rate was significantly (P < 0.05) associated with previous STD diagnosis, age, and race/ethnicity in our logit model. Higher chlamydia testing rates among black women can be explained in part by higher rates of previous STD diagnoses. Our finding that black women have the highest chlamydia testing rates is encouraging, as improved access to STD prevention services among racial/ethnic minorities can help to reduce racial/ethnic disparities in STDs. However, chlamydia screening remains an underused preventive health service for young women of all racial and ethnic groups.

Estimating chlamydia screening coverage: a comparison of self-report and health care effectiveness data and information set measures.

PubMed

Khosropour, Christine M; Broad, Jennifer M; Scholes, Delia; Saint-Johnson, Jacquelyn; Manhart, Lisa E; Golden, Matthew R

2014-11-01

Population-based surveys (self-report) and health insurance administrative data (Healthcare Effectiveness Data and Information Set [HEDIS]) are used to estimate chlamydia screening coverage in the United States. Estimates from these methods differ, but few studies have compared these 2 indices in the same population. In 2010, we surveyed a random sample of women aged 18 to 25 years enrolled in a Washington State-managed care organization. Respondents were asked if they were sexually active in last year and if they tested for chlamydia in that time. We linked survey responses to administrative records of chlamydia testing and reproductive/testing services used, which comprise the HEDIS definition of the screened population and the sexually active population, respectively. We compared self-report and HEDIS using 3 outcomes: (1) sexual activity (gold standard = self-report), (2) any chlamydia screening (no gold standard), and (3) within-plan chlamydia screening (gold standard = HEDIS). Of 954 eligible respondents, 377 (40%) completed the survey and consented to administrative record linkage. Chlamydia screening estimates for HEDIS and self-report were 47% and 53%, respectively. The sensitivity and specificity of HEDIS to define sexually active women were 84.8% (95% confidence interval [CI], 79.6%-89.1%) and 63.5% (95% CI, 52.4%-73.7%), respectively. Forty percent of women had a chlamydia test in their administrative record, but 53% self-reported being tested for chlamydia (κ = 0.35); 19% reported out-of-plan chlamydia testing. The sensitivity of self-reported within-plan chlamydia testing was 71.3% (95% CI, 61.0%-80.1%); the specificity was 80.6% (95% CI, 72.6%-87.2%). The Healthcare Effectiveness Data and Information Set does not accurately identify sexually active women and may underestimate chlamydia testing coverage. Self-reported testing may not be an accurate measure of true chlamydial testing coverage.

Racial/ethnic disparities in the lifetime risk of Chlamydia trachomatis diagnosis and adverse reproductive health outcomes among women in King County, Washington.

PubMed

Chambers, Laura C; Khosropour, Christine M; Katz, David A; Dombrowski, Julia C; Manhart, Lisa E; Golden, Matthew R

2018-02-06

Chlamydia trachomatis is the most common reportable infection in the US and can cause pelvic inflammatory disease (PID) and tubal factor infertility (TFI). We created lifetables to estimate the "lifetime" risk of chlamydia diagnosis among women age 15-34 in King County, Washington, US, 1992-2014. We estimated the lifetime risk of chlamydia-associated PID and TFI, incorporating published estimates of the risk of sequelae by chlamydia testing history. From 1992-2014, 51,464 first chlamydia diagnoses were reported among women age 15-34 in King County. For women born 1980-1984, the lifetime risk of chlamydia diagnosis was 19.8% overall and 14.0% for non-Hispanic white, 64.9% for non-Hispanic black, and 32.6% for Hispanic women. The cumulative risk of chlamydia by age 24 increased overall from 13.9% to 17.3% among birth cohorts born 1975-1994 but declined among non-Hispanic black women, among whom risk by age 24 peaked at 57.3% among women born 1980-1984 and declined to 38.6% among women born 1990-1994. The overall lifetime risk of chlamydia-associated PID among women born 1980-1984 ranged from 0.33-1.14%. Among non-Hispanic white, non-Hispanic black, and Hispanic women, the lifetime risk of chlamydia-associated TFI was 0.04%, 0.20%, and 0.10%, respectively. The lifetime risk of chlamydia varies dramatically by race/ethnicity, with over 60% of non-Hispanic black women diagnosed with at least one infection by age 34 in the birth cohorts most affected, a risk almost five times that in non-Hispanic whites. An estimated one in 500 non-Hispanic black women develops chlamydia-associated TFI. More effective control measures are needed. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

High co-occurrence of anorectal chlamydia with urogenital chlamydia in women visiting an STI clinic revealed by routine universal testing in an observational study; a recommendation towards a better anorectal chlamydia control in women

PubMed Central

2014-01-01

Background Symptom- and sexual history-based testing i.e., testing on indication, for anorectal sexually transmitted infections (STIs) in women is common. Yet, it is unknown whether this strategy is effective. Moreover, little is known about alternative transmission routes i.e. by fingers/toys. This study assesses anorectal STI prevalence and infections missed by current testing practice, thereby informing the optimal control strategy for anorectal STIs in women. Methods Women (n = 663) attending our STI-clinic between May 2012-July 2013 were offered routine testing for anorectal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae. Data were collected on demographics, sexual behaviour and symptoms. Women were assigned to one of the categories: indication (reported anal sex/symptoms), fingers/toys (only reported use of fingers/toys), or without indication. Results Of women, 92% (n = 654) participated. There were 203 reports (31.0%) of anal sex and/or symptoms (indication), 48 reports (7.3%) of only using fingers/toys (fingers/toys), and 403 reports (61.6%) of no anal symptoms, no anal sex and no anal use of fingers/toys (without indication). The overall prevalence was 11.2% (73/654) for urogenital chlamydia and 8.4% (55/654) for anorectal chlamydia. Gonorrhoea infections were not observed. Prevalence of anorectal chlamydia was 7.9% (16/203) for women with indication and 8.6% (39/451) for all other women (P = 0.74). Two-thirds (39/55) of anorectal infections were diagnosed in women without indication. Isolated anorectal chlamydia was rare (n = 3): of all women with an anorectal infection, 94.5% (52/55) also had co-occurrence of urogenital chlamydia. Of all women with urogenital chlamydia, 71.2% (52/73) also had anorectal chlamydia. Conclusions Current selective testing on indication of symptoms and sexual history is not an appropriate control strategy for anorectal chlamydia in women visiting an STI clinic. Routine universal anorectal testing is feasible and may be a possible control strategy in women. Yet costs may be a problem. When more restricted control measures are preferred, possible alternatives include (1) anorectal testing only in women with urogenital chlamydia (problem: treatment delay or loss to follow up), and (2) direct treatment for urogenital chlamydia that is effective for anorectal chlamydia as well. PMID:24885306

[Newer diagnostic procedures for chlamydial diseases (author's transl)].

PubMed

Edlinger, E; Ardoin, P

1982-06-17

Chlamydiales are bacteries showing a growth cycle unique among procaryotes. The two species Chlamydia trachomatis and Chlamydia psittaci are genetically very distant and their pathogenicity for man is very distinct. Human chlamydia infections by Chlamydia trachomatis are diseases chiefly sexually transmitted and their epidemiological importance is growing. The relationship between chlamydial infections, Reiter disease, and cat scratch disease are discussed. The various laboratory diagnostic procedures are reported, including the techniques and their indications; the method of choice is in the majority of cases the isolation of Chlamydia on cell culture.

Brief Report: Gonorrhea and Chlamydia Testing Increasing but Still Lagging in HIV Clinics in the United States.

PubMed

Berry, Stephen A; Ghanem, Khalil G; Mathews, William Christopher; Korthuis, Philip Todd; Yehia, Baligh R; Agwu, Allison L; Lehmann, Christoph U; Moore, Richard D; Allen, Sara L; Gebo, Kelly A

2015-11-01

Screening persons living with HIV for gonorrhea and chlamydia has been recommended since 2003. We compared annual gonorrhea/chlamydia testing to syphilis and lipid testing among 19,368 adults (41% men who have sex with men, 30% heterosexual men, and 29% women) engaged in HIV care. In 2004, 22%, 62%, and 70% of all patients were tested for gonorrhea/chlamydia, syphilis, and lipid levels, respectively. Despite increasing steadily [odds ratio per year (95% confidence interval): 1.14 (1.13 to 1.15)], gonorrhea/chlamydia testing in 2010 remained lower than syphilis and lipid testing (39%, 77%, 76%, respectively). Interventions to improve gonorrhea/chlamydia screening are needed. A more targeted screening approach may be warranted.

[Chlamydia trachomatis proteasome protein as one of the significant pathogenicity factors of exciter].

PubMed

Davydov, D Iu; Zigangirova, N A

2014-01-01

Sex-related infections are a global problem. Such infections may lead to acute or chronic diseases. Chlamydia trachomatis is a dangerous and widespread pathogenicity factor that is not sensitive to conventional drugs and has no obvious symptoms. Protein CPAF is leading factor of pathogenesis. This protein inhibits the signaling pathways of host cell and supports long survival of the pathogen in the host cell. The goal of this work was to review general properties of the proteasome Chlamydia protein CPAF, its functions, and role in pathology. The role of protein CPAF in the anti-chlamydia immune reaction is discussed. The prospects of the development of promising anti-chlamydia vaccine, as well as new effective anti-chlamydia drugs are also discussed.

Chlamydia Pneumoniae Infections

MedlinePlus

... Issues Listen Español Text Size Email Print Share Chlamydia Pneumoniae Infections Page Content Article Body When you hear the word chlamydia, you might think of the sexually transmitted disease ( ...

A cohort study of Chlamydia trachomatis treatment failure in women: a study protocol

PubMed Central

2013-01-01

Background Chlamydia trachomatis is the most commonly diagnosed bacterial sexually transmitted infection in the developed world and diagnosis rates have increased dramatically over the last decade. Repeat infections of chlamydia are very common and may represent 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 treatment failure after treatment with 1 gram azithromycin. Methods/design This cohort study will follow women diagnosed with chlamydia for up to 56 days post treatment. Women will provide weekly genital specimens for further assay. The primary outcome is the proportion of women who are classified as having treatment failure 28, 42 or 56 days after recruitment. Comprehensive sexual behavior data collection and the detection of Y chromosome DNA and high discriminatory chlamydial genotyping will be used to differentiate between chlamydia re-infection and treatment failure. Azithromycin levels in high-vaginal specimens will be measured using a validated liquid chromatography – tandem mass spectrometry method to assess whether poor azithromycin absorption could be a cause of treatment failure. Chlamydia culture and minimal inhibitory concentrations will be performed to further characterize the chlamydia infections. Discussion Distinguishing between treatment failure and re-infection is important in order to refine treatment recommendations and focus infection control mechanisms. If a large proportion of repeat chlamydia infections are due to antibiotic treatment failure, then international recommendations on chlamydia treatment may need to be re-evaluated. If most are re-infections, then strategies to expedite partner treatment are necessary. PMID:23957327

Novel approach to an effective community-based chlamydia screening program within the routine operation of a primary healthcare service.

PubMed

Buhrer-Skinner, Monika; Muller, Reinhold; Menon, Arun; Gordon, Rose

2009-03-01

A prospective study was undertaken to develop an evidence-based outreach chlamydia screening program and to assess the viability and efficiency of this complementary approach to chlamydia testing within the routine operations of a primary healthcare service. A primary healthcare service based in Townsville, Queensland, Australia, identified high-prevalence groups for chlamydia in the community. Subsequently, a series of outreach clinics were established and conducted between August 2004 and November 2005 at a defence force unit, a university, high school leavers' festivities, a high school catering for Indigenous students, youth service programs, and backpacker accommodations. All target groups were easily accessible and yielded high participation. Chlamydia prevalence ranged between 5 and 15% for five of the six groups; high school leavers had no chlamydia. All participants were notified of their results and all positive cases were treated (median treatment interval 7 days). Five of the six assessed groups were identified as viable for screening and form the basis for the ongoing outreach chlamydia screening program. The present study developed an evidence-based outreach chlamydia screening program and demonstrated its viability as a complementary approach to chlamydia testing within the routine operations of the primary healthcare service, i.e. without the need for additional funding. It contributes to the evidence base necessary for a viable and efficient chlamydia management program. Although the presented particulars may not be directly transferable to other communities or health systems, the general two-step approach of identifying local high-risk populations and then collaborating with community groups to access these populations is.

Chlamydia trachomatis Is Responsible for Lipid Vacuolation in the Amniotic Epithelium of Fetal Gastroschisis.

PubMed

Feldkamp, Marcia L; Ward, Diane M; Pysher, Theodore J; Chambers, Christina T

2017-07-17

Vacuolated amniotic epithelium with lipid droplets in gastroschisis placentas is an unusual finding. Mass spectrometry of lipid droplets identified triglycerides, ester-linked to an unusual pattern of fatty acids. We hypothesize that these findings result from a Chlamydia trachomatis infection during the periconceptional period. The rising incidence of chlamydia infections has paralleled the increasing prevalence of gastroschisis among women less than 25 years of age. Histologically, young women are at greatest risk for a chlamydia infection due to their immature columnar epithelium, the preferential site for attachment of Chlamydia trachomatis infectious particle (elementary body). Chlamydia trachomatis survive in an inclusion, relying on its host to acquire essential nutrients, amino acids, and nucleotides for survival and replication. If essential nutrients are not available, the bacteria cannot replicate and may be trafficked to the lysosome for degradation or remain quiescent, within the inclusion, subverting innate immunologic clearance. Chlamydiae synthesize several lipids (phosphatidylethanolamine, phosphatidylserine, and phosphoatidylglycerol); however, their lipid content reveal eukaryotic lipids (sphingomyelin, cholesterol, phosphatidylcholine, and phosphatidylinositol), evidence that chlamydiae "hijack" host lipids for expansion and replication. The abnormal amniotic epithelial findings are supported by experimental evidence of the trafficking of host lipids into the chlamydiae inclusion. If not lethal, what harm will elementary bodies inflict to the developing embryo? Do these women have a greater pro-inflammatory response to an environmental exposure, whether cigarette smoking, change in partner, or a pathogen? Testing the hypothesis that Chlamydia trachomatis is responsible for amniotic epithelium vacuoles will be a critical first step. Birth Defects Research 109:1003-1010, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Chlamydia trachomatis in non-specific urethritis.

PubMed Central

Terho, P

1978-01-01

Chlamydia trachomatis was isolated from 58.5% of 159 patients with non-specific urethritis (NSU) using irradiated McCoy cell cultures. Patients with persistent Chlamydia-positive NSU remained Chlamydia-positive each time they were examined before treatment and patients with Chlamydia-negative NSU remained Chlamydia-negative during the course of the illness. Neither the duration of symptoms of urethritis nor a history of previous urethritis affected the chlamydial isolation rate significantly. Of 40 patients with severe discharge 30 (75%) harboured C. trachomatis. One-third of the Chlamydia-positive patients had a severe urethral discharge, while this was present in only 15% of Chlamydia-negative patients. Complications--such as conjunctivitis, arthritis, and epididymitis--were more severe in men with Chlamdia-positive NSU than in those with Chlamydia-negative NSU. Of 64 men matched for sexual promiscuity but without urethritis, none harboured C. trachomatis in his urethra. This differs significantly (P less than 0.001) when compared with patients with NSU. C. trachomatis was isolated from the urogenital tract in 24 (42%) out of 57 female sexual contacts of patients with NSU. The presence of C. trachomatis in the women correlated significantly (P less than 0.001) with the isolation of the agent from their male contacts. These findings give further evidence for the aetiological role of C. trachomatis in non-specific urethritis and its sexual transmission. PMID:678958

Detection of Chlamydiaceae and Chlamydia-like organisms on the ocular surface of children and adults from a trachoma-endemic region.

PubMed

Ghasemian, Ehsan; Inic-Kanada, Aleksandra; Collingro, Astrid; Tagini, Florian; Stein, Elisabeth; Alchalabi, Hadeel; Schuerer, Nadine; Keše, Darja; Babiker, Balgesa Elkheir; Borel, Nicole; Greub, Gilbert; Barisani-Asenbauer, Talin

2018-05-09

Trachoma, the leading infectious cause of blindness, is caused by Chlamydia trachomatis (Ct), a bacterium of the phylum Chlamydiae. Recent investigations revealed the existence of additional families within the phylum Chlamydiae, also termed Chlamydia-like organisms (CLOs). In this study, the frequency of Ct and CLOs was examined in the eyes of healthy Sudanese (control) participants and those with trachoma (case). We tested 96 children (54 cases and 42 controls) and 93 adults (51 cases and 42 controls) using broad-range Chlamydiae and Ct-specific (omcB) real-time PCR. Samples positive by broad-range Chlamydiae testing were subjected to DNA sequencing. Overall Chlamydiae prevalence was 36%. Sequences corresponded to unclassified and classified Chlamydiae. Ct infection rate was significantly higher in children (31.5%) compared to adults (0%) with trachoma (p < 0.0001). In general, 21.5% of adults and 4.2% of children tested positive for CLOs (p = 0.0003). Our findings are consistent with previous investigations describing the central role of Ct in trachoma among children. This is the first study examining human eyes for the presence of CLOs. We found an age-dependent distribution of CLO DNA in human eyes with significantly higher positivity in adults. Further studies are needed to understand the impact of CLOs in trachoma pathogenicity and/or protection.

Which sexually active female students get themselves tested for Chlamydia trachomatis? A cohort study.

PubMed

Kerry, Sarah R; Nightingale, Claire M; Hay, Phillip; Oakeshott, Pippa

2016-06-01

Using data from the Prevention of Pelvic Infection (POPI) chlamydia screening trial, we compared the characteristics of female students who did or did not get tested for chlamydia outside the trial during 12 months' follow-up. Of the 2529 women in the trial, we excluded 68 chlamydia positives in the intervention group who were referred for treatment at baseline. Of the remaining 2461 women, 1980 (80%) answered the question about testing during follow-up on their 12 months' questionnaire and were included in the cohort. Of 1980 respondents, 529 (27%) reported having an independent chlamydia test, including 30 (48%) of 63 women with undiagnosed chlamydia at baseline. Predictors of testing included having undiagnosed chlamydia at baseline (adjusted odds ratio 2.44; 95% confidence interval 1.39-4.28), ≥2 sexual partners in the year prior to baseline (OR 1.99; 95% CI 1.60-2.48), history of sexually transmitted infection (1.63: 1.20-2.22); symptoms of pelvic discomfort, dyspareunia, abnormal vaginal discharge or inter-menstrual bleeding (1.38; 1.09-1.73); and black ethnicity (1.37, 1.06-1.76). Although more women with risk factors got tested, half of women with undiagnosed chlamydia did not get tested. To optimise detection of chlamydia, testing should be offered routinely. © The Author(s) 2015.

Epidemiology of incident chlamydia and gonorrhoea infections and population attributable fractions associated with living in the inner-core of Winnipeg, Canada.

PubMed

Shaw, Souradet Y; Nowicki, Deborah L; Schillberg, Erin; Green, Christopher G; Ross, Craig P; Reimer, Joss; Plourde, Pierre J; Elliott, Lawrence J

2017-05-01

Population attributable fractions help to convey public health significance of differential disease risk for chlamydia and gonorrhoea. Geographical residence serves as a useful proxy for complex processes creating ill health. Using population-based data, Poisson regression models were used to examine factors associated with chlamydia and gonorrhoea incidence. Population attributable fractions due to residency in the Winnipeg Health Region's inner-core were determined for chlamydia/gonorrhoea infections among 15-59-year olds (2005-2013), stratified by age group. For both chlamydia and gonorrhoea, it was found that the 15-24-year old age group had the highest incidence rates. There was also a stronger association between residency in the inner-core and incidence for gonorrhoea, compared to chlamydia. Overall, 24% (95% CI: 12-34%) of chlamydia infections were attributable to residency in the inner-core, compared to 46% (95% CI: 35-54%) for gonorrhoea ( p < .05). Within chlamydia/gonorrhoea, no statistically significant differences in population attributable fraction were observed by age group. The conclusion was that a concentration of efforts towards inner-core residents with gonorrhoea infections may result in a relatively larger decrease in incidence.

Immunoglobulin-specific responses to Chlamydia elementary bodies in individuals with and at risk for genital chlamydial infection.

PubMed

Geisler, William M; Morrison, Sandra G; Doemland, Martha L; Iqbal, Shehzad M; Su, Jin; Mancevski, Ausra; Hook, Edward W; Morrison, Richard P

2012-12-15

Renewed interest in chlamydia vaccination has revealed the need for a greater understanding of the seroprevalence of chlamydial infection in US populations. We used a Chlamydia trachomatis elementary body (EB)-based enzyme-linked immunosorbent assay to define the characteristics of the humoral immune response and to determine seroprevalence. Two groups were analyzed: one consisting of patients with current, laboratory confirmed, genital chlamydial infection (n = 98) and one group of individuals whose chlamydia infection history was unknown (n = 367). C. trachomatis seropositivity was detected in 90% of the infected group and in 31% of the chlamydia-unknown group. IgG1 and IgG3 comprised the predominant anti-Chlamydia serum antibody responses. Serum IgA1 responses were variably positive, and individuals were rarely positive for anti-chlamydia IgG2, IgG4 or IgA2. The magnitude of the IgG1 and IgG3 responses was greatest in female and African American individuals and was sustained for at least 6 months. Antibody responses were not serovar restricted or confounded by Chlamydia pneumoniae cross-reactivity.

Significant roles played by IL-10 in Chlamydia infections.

PubMed

Hakimi, Hamid; Zare-Bidaki, Mohammad; Zainodini, Nahid; Assar, Shokrollah; Arababadi, Mohammad Kazemi

2014-06-01

Chlamydia species are obligate intracellular parasites which cause usually asymptomatic genital tract infections and also are associated with several complications. Previous studies demonstrated that immune responses to Chlamydia species are different and the diseases will be limited to some cases. Additionally, Chlamydia species are able to modulate immune responses via regulating expression of some immune system molecules including cytokines. IL-10, as the main anti-inflammatory cytokine, plays important roles in the induction of immune-tolerance against self-antigen and also immune-homeostasis after microbe elimination. Furthermore, it has been documented that ectopic expression of IL-10 is associated with several chronic infectious diseases. Therefore, it can be hypothesized that changes in the regulation of this cytokine can be associated with infection with several species of Chlamydia and their associated complications. This review collected the recent information regarding the association and relationship of IL-10 with Chlamydia infections. Another aim of this review article is to address recent data regarding the association of genetic variations (polymorphisms) of IL-10 and Chlamydia infections.

When is the optimal time to screen for Chlamydia in adolescents and young adults with sickle cell disease?

PubMed

Bluett-Mills, Gabriella; Kanter, Julie

2015-02-01

Louisiana has a high rate of chlamydia, an easily identifiable and treatable sexually transmitted disease. Patients with chronic diseases, such as sickle cell disease (SCD) often forgo routine primary care visits. We hypothesized that patients with SCD have an increased percentage of asymptomatic chlamydia compared with a matched population. A retrospective cohort study was performed over a 12-month period on eligible patients with SCD (ages 15-30 years). Patients were screened for asymptomatic chlamydia by urine polymerase chain reaction during comprehensive care visits in the SCD clinic. Thirty-four patients underwent testing during the study period, and 4/34 patients (11.8%) tested positive for chlamydia. State data show a rate of 1791/100 000 (1.8%) among a demographically matched cohort. Patients with SCD had a larger percentage of asymptomatic chlamydia than a demographically matched control population. Patients with SCD should be screened by specialists for chlamydia in addition to undergoing routine primary care evaluations. © The Author(s) 2014.

Subunit vaccines for the prevention of mucosal infection with Chlamydia trachomatis

PubMed Central

Yu, Hong; Karunakaran, Karuna P.; Jiang, Xiaozhou; Brunham, Robert C.

2016-01-01

Chlamydia trachomatis is the most common preventable cause of tubal infertility in women. In high-income countries, despite public health control efforts, C. trachomatis case rates continue to rise. Most medium and low-income countries lack any Chlamydia control program; therefore, a vaccine is essential for the control of Chlamydia infections. A rationally designed Chlamydia vaccine requires understanding of the immunological correlates of protective immunity, pathological responses to this mucosal pathogen, identification of optimal vaccine antigens and selection of suitable adjuvant delivery systems that engender protective immunity. Fortunately, Chlamydia vaccinology is facilitated by genomic knowledge and by murine models that reproduce many of the features of human C. trachomatis infection. This article reviews recent progress in these areas with a focus on subunit vaccine development. PMID:26938202

Evidence of a conserved role for Chlamydia HtrA in the replication phase of the chlamydial developmental cycle.

PubMed

Patel, Pooja; De Boer, Leonore; Timms, Peter; Huston, Wilhelmina May

2014-08-01

Identification of the HtrA inhibitor JO146 previously enabled us to demonstrate an essential function for HtrA during the mid-replicative phase of the Chlamydia trachomatis developmental cycle. Here we extend our investigations to other members of the Chlamydia genus. C. trachomatis isolates with distinct replicative phase growth kinetics showed significant loss of viable infectious progeny after HtrA was inhibited during the replicative phase. Mid-replicative phase addition of JO146 was also significantly detrimental to Chlamydia pecorum, Chlamydia suis and Chlamydia cavie. These data combined indicate that HtrA has a conserved critical role during the replicative phase of the chlamydial developmental cycle. Copyright © 2014 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Dysuria in the emergency department: missed diagnosis of Chlamydia trachomatis.

PubMed

Wilbanks, Morgan D; Galbraith, James W; Geisler, William M

2014-03-01

The clinical presentation of genital Chlamydia trachomatis infection (chlamydia) in women is often indistinguishable from a urinary tract infection. While merited in the setting of dysuria, emergency department (ED) clinicians do not routinely test for chlamydia in women. The primary aim of our study was to evaluate the frequency of chlamydia testing among women presenting to the ED with dysuria. We conducted a retrospective chart review of women 19-25 years of age presenting with dysuria to an urban ED and who had been coded with urinary tract infection (UTI) as their primary diagnosis (ICD-9 599.0) from October 2005 to March 2011. We excluded women who were pregnant, had underlying anatomical or neurological urinary system pathology, had continuation of symptoms from UTI or a sexually transmitted infection (STI) diagnosed elsewhere, or were already on antibiotics for a UTI or STI. We identified the rates of sexual history screening, pelvic examination and chlamydia assay testing and evaluated predictors using univariate and multivariate analyses. Of 280 women with dysuria and a UTI diagnosis, 17% were asked about their sexual history, with 94% reporting recent sexual activity. Pelvic examination was performed in 23%. We were unable to determine the overall chlamydia prevalence as only 20% of women in the cohort were tested. Among the 20% of women tested for chlamydia infection, 21% tested positive. Only 42% of chlamydia-positive women were prescribed treatment effective for chlamydia (azithromycin or doxycycline) at their visit; the remaining were prescribed UTI treatment not effective against chlamydia. Predictors of sexual history screening included vaginal bleeding (OR 5.4, 95% CI=1.5 to 19.6) and discharge (OR 2.8, 95% CI=1.1 to 6.9). Predictors of a pelvic examination being performed included having a complaint of vaginal discharge (OR 11.8, 95% CI=4.2 to 32.9), a sexual history performed (OR 2.5, 95% CI=1.1 to 5.8), abdominal pain (OR 2.2, 95% CI=1.1 to 4.4), or pelvic pain (OR 15.3, 95% CI=2.5 to 92.2); a complaint of urinary frequency was associated with a pelvic examination not being performed (OR 0.34, 95% CI=0.13 to 0.86). Sexual histories, pelvic examinations, and chlamydia testing were not performed in the majority of women presenting with dysuria and diagnosed with UTI in the ED. The performance of a sexual history along with the availability of self-administered vaginal swab and first-void urine-based chlamydia tests may increase identification of chlamydia infection in women with dysuria.

Chlamydia Detection during the Menstrual Cycle: A Cross-Sectional Study of Women Attending a Sexual Health Service

PubMed Central

Forcey, Dana S.; Hocking, Jane S.; Tabrizi, Sepehr N.; Bradshaw, Catriona S.; Chen, Marcus Y.; Fehler, Glenda; Nash, Jessica L.; Fairley, Christopher K.

2014-01-01

Background We investigated the detection of chlamydia at different stages of the menstrual cycle. Methods Electronic medical records for women attending Melbourne Sexual Health Centre between March 2011 and 31st December 2012, who were tested for chlamydia by nucleic acid amplification of high vaginal, cervical, or urinary samples, and who recorded a date of last normal menstrual period (LNMP) between 0–28 days were included in the analysis. Logistic regression was used to calculate adjusted odds ratio (aOR) and 95% confidence intervals (CI) for the association of chlamydia with menstrual cycle adjusted by demographics and behavioural variables. Chlamydia and beta globin load were determined on those with stored samples. Results Of the 10,017 consultations that included a test for chlamydia and a valid LNMP, there were 417 in which chlamydia was detected. The proportion of samples with chlamydia was greater in the luteal phase (4.8%, 184/3831) than in the follicular phase (3.4%, 233/6816) both in the crude (OR 1.29 95%CI 1.1–1.6, p = 0.01) and adjusted odds ratio (aOR) 1.4 (95%CI 1.1–1.8, p = 0.004). Among women using hormonal contraception, there was no significant association with the luteal phase of the menstrual cycle (aOR 1.3, 95%CI 0.9, 1.8, p = 0.18). Among women not using hormonal contraception, there was a significant association with the luteal phase (aOR 1.6, (95% CI 1.1–2.3, p = 0.007). The chlamydia load was not significantly different in the 329 positive stored samples in weeks 3 and 4 vs weeks 1 and 2 for any site (P>0.12). Conclusions The higher detection of chlamydia detection in the luteal phase of the menstrual cycle in only those not taking hormonal contraception suggest that hormonal factors influence chlamydia detection. The absence of a significantly highly chlamydia load in women during the luteal phase raises questions about the mechanism. PMID:24475042

Sexual and testing behaviour associated with Chlamydia trachomatis infection: a cohort study in an STI clinic in Sweden

PubMed Central

Veličko, Inga; Ploner, Alexander; Sparén, Pär; Marions, Lena; Herrmann, Björn; Kühlmann-Berenzon, Sharon

2016-01-01

Background Genital chlamydia infection (chlamydia) is the most commonly reported sexually transmitted infection (STI) in Sweden. To guide prevention needs, we aimed to investigate factors associated with chlamydia. Methods A cohort of visitors aged 20–40 years at an urban STI clinic in Sweden was recruited. Behavioural data were collected using a self-administered questionnaire. Self-sampled specimens were tested for chlamydia by a DNA amplification assay. Statistically significant (p<0.05) and epidemiologically relevant covariates were entered in a multivariate Poisson model adjusted for potential confounders (age and gender). Backward stepwise elimination produced a final model. Multiple imputation was used to account for missing values. Results Out of 2814 respondents, 1436 were men with a chlamydia positivity rate of 12.6% vs 8.9% in women. Lifetime testing for chlamydia and HIV was high (82% and 60%, respectively). Factors significantly associated with chlamydia were: 20–24 years old (adjusted risk ratio (ARR)=2.10, 95% CI 1.21 to 3.65); testing reason: contact with a chlamydia case (ARR=6.55, 95% CI 4.77 to 8.98) and having symptoms (ARR=2.19, 95% CI 1.48 to 3.24); 6–10 sexual partners (ARR=1.53, 95% CI 1.06 to 2.21); last sexual activity ‘vaginal sex and oral sex and anal sex and petting’ (ARR=1.84, 95% CI 1.09 to 3.10); alcohol use before sex (ARR=1.98, 95% CI 1.10 to 3.57); men with symptoms (ARR=2.09, 95% CI 1.38 to 3.18); tested for chlamydia (ARR=0.72, 95% CI 0.55 to 0.94). Conclusions Risk factors associated with chlamydia were consistent with previous reports in similar settings and suggest no major changes over time. Increased risk for chlamydia infection associated with high-risk behaviour (eg, alcohol use, increased number of sexual partners) supports the need for behavioural interventions in this population such as promotion of safer sex behaviour (condom use) and testing. PMID:27566631

Population-level intervention to promote chlamydia screening. Moving toward implementation of chlamydia hedis 2000 measure

PubMed

Oh; Grimley; Heudebert

2000-05-01

Background: HEDIS 2000 measure includes chlamydia screening in women which is designed to assess the percentage of sexually active women 15 to 25 years who have received at least one screening test for chlamydia during the reporting year. This study is being undertaken to determine feasibility of implementing a population-level intervention within HMOs to promote chlamydia screening. This abstract presents preliminary findings from the Birmingham project of this multicenter study.Methods: In partnerships with two HMOs, series of outreach methods were used in a stepwise fashion to determine potential barriers and enabling factors for the implementation of chlamydia HEDIS measure in a conservative social environment. Mail outreach was sequentially combined with newspaper, TV, radio advertisements and poster displays. Both qualitative and quantitative impact of the outreach efforts were measured across the timeline. The measures included reporting for chlamydia screening (urine LCR) and infection rate, monitoring chlamydia hotline and staffed phoneline use, and assessment of untoward effects and cost-analysis of the chlamydia outreach campaign.Results: The key findings are: the benefit of chlamydia screening is not understood by general public, letters send by Health Plans to their members are not read by many subscribers, and there are wide gaps between adolescents and their parents, in knowledge, attitudes, beliefs in regard to obtaining information and accessing the screening services (teens prefer hotline, brochure in an envelop addressed to teens, incentives for reporting to the clinic for screening, vs. parents prefer staffed phone consults, "exposed" brochure addressed to parents, and no incentives). A month of sustained and repeat multi-media campaign resulted in 330 hotline calls, 83 phone calls and only 17 subjects being tested (3 were positive) though many more intended to come. Cumulative effects and cost of various outreach efforts are being monitored. Informational chlamydia brochures and free test cards mailed to the homes generated no negative response from the subscribers, contrary to the concerns of the HMOs. Conclusion: To be effective, investment in public education campaign and social marketing strategies must be integrated in population-level intervention for the implementation of the chlamydia HEDIS 2000 measure.

Validity of self-reported history of Chlamydia trachomatis infection.

PubMed

Frisse, Ann C; Marrazzo, Jeanne M; Tutlam, Nhial T; Schreiber, Courtney A; Teal, Stephanie B; Turok, David K; Peipert, Jeffrey F

2017-04-01

Chlamydia trachomatis infection is common and largely asymptomatic in women. If untreated, it can lead to sequelae such as pelvic inflammatory disease and infertility. It is unknown whether a patient's self-reported history of Chlamydia trachomatis infection is a valid marker of past infection. Our objective was to evaluate the validity of women's self-reported history of Chlamydia trachomatis infection compared with Chlamydia trachomatis serology, a marker for previous infection. We analyzed data from the Fertility After Contraception Termination study. We compared participants' survey responses with the question, "Have you ever been told by a health care provider that you had Chlamydia?" to serological test results indicating the presence or absence of antibodies to Chlamydia trachomatis as assessed by a microimmunofluorescence assay. Prevalence of past infection, sensitivity, specificity, predictive values, and likelihood ratios were calculated. The Cohen's kappa statistic was computed to assess agreement between self-report and serology. Among 409 participants, 108 (26%) reported having a history of Chlamydia trachomatis infection, whereas 146 (36%) had positive serological test results. Relative to positive microimmunofluorescence assay, the sensitivity and specificity of self-reported history of Chlamydia trachomatis infection were 52.1% (95% confidence interval, 43.6-60.4%) and 87.8% (95% confidence interval, 83.3-91.5%), respectively. The positive predictive value of the self-report was 70.4% (95% confidence interval, 60.8-78.8%), and the negative predictive value was 76.7% (95% confidence interval, 71.6-81.4%). The likelihood ratio was found to be 4.28. Agreement between self-report and serology was found to be moderate (kappa = 0.42, P < .001). Self-reported history of Chlamydia trachomatis infection commonly yields false-negative and false-positive results. When definitive status of past Chlamydia trachomatis infection is needed, serology should be obtained. Copyright © 2016 Elsevier Inc. All rights reserved.

Clueing in on Chlamydia.

ERIC Educational Resources Information Center

Gibbons, Wendy

1991-01-01

Chlamydia's role in female infertility is discussed. The relationship of this organism to other diseases such as leprosy and tuberculosis is explained. Conditions caused by Chlamydia such as Pelvic Inflammatory Disease (PID) are described. (KR)

Long-term trends in Chlamydia trachomatis infections and related outcomes in a U.S. managed care population.

PubMed

Scholes, Delia; Satterwhite, Catherine L; Yu, Onchee; Fine, David; Weinstock, Hillard; Berman, Stuart

2012-02-01

Given recent increasing case rates of Chlamydia trachomatis infection, we evaluated trends in chlamydia rates and related health outcomes in women and men aged 15 to 44 years who were enrolled in a Pacific Northwest health plan. We identified chlamydia, pelvic inflammatory disease (PID), ectopic pregnancy, and male urethritis cases occurring annually during 1997-2007 using computerized health plan databases, calculating rates per 100,000 person-years (py) by gender and 5-year age groups. We also calculated annual chlamydia testing rates. In women, chlamydia testing rates increased by approximately 23% (220 tests per 1000 py in 1997 to 270 tests per 1000 in 2007). Chlamydia diagnosis rates rose from 449 cases/100,000 py in 1997 to 806/100,000 in 2007, a 79% increase (P = 0.01). Increases were greatest during 2005-2007, also the period of major conversion to nucleic acid amplification test. PID rates in this interval declined steadily from 823 cases/100,000 py to 473/100,000 (P < 0.01). Ectopic pregnancy rates remained unchanged. In men, chlamydia testing rates increased nearly 3.5-fold, from 12 to 42 tests per 1000 py. Chlamydia rates for men also rose significantly throughout the study interval (from 91 cases/100,000 py to 218/100,000; P < 0.01) as did urethritis diagnosis rates (P < 0.01). Between 1997 and 2007, annual health plan chlamydia rates increased significantly for both women and men. These trends may be due in part to increased testing rates and increased use of more sensitive tests, but they likely do not explain the increased urethritis rates. During this same interval, we observed steady declines in PID rates, consistent with other national data sources.

Association of Bacterial Vaginosis With Chlamydia and Gonorrhea Among Women in the U.S. Army.

PubMed

Bautista, Christian T; Wurapa, Eyako K; Sateren, Warren B; Morris, Sara M; Hollingsworth, Bruce P; Sanchez, Jose L

2017-05-01

Bacterial vaginosis (BV) is a common vaginal condition in women of reproductive age, which has been associated with Chlamydia trachomatis and Neisseria gonorrhoeae among commercial sex workers and women attending sexually transmitted infection clinics. Pathogen-specific associations between BV and other sexually transmitted infections among U.S. military women have not been investigated. A population-based, nested case-control study was conducted of all incident chlamydia and gonorrhea cases reported to the Defense Medical Surveillance System during 2006-2012. Using a density sampling approach, for each chlamydia or gonorrhea case, 10 age-matched (±1 year) controls were randomly selected from those women who were never diagnosed with these infections. Incidence rate ratios were estimated using conditional logistic regression. Statistical analysis was carried out in December 2015. A total of 37,149 chlamydia cases and 4,987 gonorrhea cases were identified during the study period. Antecedent BV was associated with an increased risk of subsequent chlamydia (adjusted incidence rate ratio=1.51; 95% CI=1.47, 1.55) and gonorrhea (adjusted incidence rate ratio=2.42; 95% CI=2.27, 2.57) infections. For every one additional episode of BV, the risk of acquiring chlamydia and gonorrhea infections increased by 13% and 26%, respectively. A monotonic dose-response relationship was also noted between antecedent BV and subsequent chlamydia and gonorrhea infection. In addition, an effect modification on the additive scale was found between BV and African-American race for gonorrhea, but not for chlamydia. Among U.S. Army women, antecedent BV is associated with an increased risk of subsequent chlamydia and gonorrhea infection. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

IL-4-secreting eosinophils promote endometrial stromal cell proliferation and prevent Chlamydia-induced upper genital tract damage.

PubMed

Vicetti Miguel, Rodolfo D; Quispe Calla, Nirk E; Dixon, Darlene; Foster, Robert A; Gambotto, Andrea; Pavelko, Stephen D; Hall-Stoodley, Luanne; Cherpes, Thomas L

2017-08-15

Genital Chlamydia trachomatis infections in women typically are asymptomatic and do not cause permanent upper genital tract (UGT) damage. Consistent with this presentation, type 2 innate and T H 2 adaptive immune responses associated with dampened inflammation and tissue repair are elicited in the UGT of Chlamydia -infected women. Primary C. trachomatis infection of mice also causes no genital pathology, but unlike women, does not generate Chlamydia -specific T H 2 immunity. Herein, we explored the significance of type 2 innate immunity for restricting UGT tissue damage in Chlamydia -infected mice, and in initial studies intravaginally infected wild-type, IL-10 -/- , IL-4 -/- , and IL-4Rα -/- mice with low-dose C. trachomatis inoculums. Whereas Chlamydia was comparably cleared in all groups, IL-4 -/- and IL-4Rα -/- mice displayed endometrial damage not seen in wild-type or IL-10 -/- mice. Congruent with the aberrant tissue repair in mice with deficient IL-4 signaling, we found that IL-4Rα and STAT6 signaling mediated IL-4-induced endometrial stromal cell (ESC) proliferation ex vivo, and that genital administration of an IL-4-expressing adenoviral vector greatly increased in vivo ESC proliferation. Studies with IL-4-IRES-eGFP (4get) reporter mice showed eosinophils were the main IL-4-producing endometrial leukocyte (constitutively and during Chlamydia infection), whereas studies with eosinophil-deficient mice identified this innate immune cell as essential for endometrial repair during Chlamydia infection. Together, our studies reveal IL-4-producing eosinophils stimulate ESC proliferation and prevent Chlamydia -induced endometrial damage. Based on these results, it seems possible that the robust type 2 immunity elicited by Chlamydia infection of human genital tissue may analogously promote repair processes that reduce phenotypic disease expression.

Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing

PubMed Central

McNulty, Cliodna; Ricketts, Ellie J; Fredlund, Hans; Uusküla, Anneli; Town, Katy; Rugman, Claire; Tisler-Sala, Anna; Mani, Alix; Dunais, Brigitte; Folkard, Kate; Allison, Rosalie; Touboul, Pia

2017-01-01

Objective To determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England. Design Qualitative interviews. Setting European primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013. Participants 45 GP staff, 13 trainers and 18 stakeholders. Interviews The iterative interview schedule explored participants’ personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis. Results Findings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country’s health services. Conclusions A common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu. PMID:28951413

Associations between anorectal chlamydia and oro-anal sex or saliva use as a lubricant for anal sex: A cross-sectional survey.

PubMed

Cornelisse, Vincent J; Fairley, Christopher K; Read, Tim R H; Lee, David; Walker, Sandra; Hocking, Jane S; Chen, Marcus Y; Bradshaw, Catriona S; Chow, Eric P F

2018-01-30

Receptive condomless anal sex is a known risk factor for anorectal chlamydia, but it remains unclear whether oro-anal sex practices also contribute. We aimed to determine whether oro-anal sex ("rimming"), fingering or the use of saliva as anal lubricant are risk factors for anorectal chlamydia among men who have sex with men (MSM). This cross-sectional study was conducted at Melbourne Sexual Health Centre from July 2014 to June 2015. Routinely-collected computer-assisted self-interview data included demographics, number of sexual partners and condom use. We added questions on receptive rimming, receptive fingering or penis "dipping", and the use of a partner's saliva as anal lubricant. 1691 MSM completed the questionnaire and tested for anorectal chlamydia. In univariable analyses, anorectal chlamydia was associated with using a partner's saliva as lubricant (OR 1.97, 95%CI 1.26-3.09), receptive rimming (OR 1.59, 95%CI 1.04-2.45), and receptive fingering or dipping (OR 1.90, 95%CI 1.06-3.43). In multivariable analysis, anorectal chlamydia was not associated with these sexual practices, after adjusting for number of sexual partners, HIV status, known contact with chlamydia and condom use. However, collinearity between sexual practices likely obscured associations with anorectal chlamydia, and further analyses suggested weak associations between these sexual practices and anorectal chlamydia. The use of a partner's saliva during receptive anal sex practices such as rimming, fingering or penis dipping were weak risk factor for anorectal chlamydia in MSM. This contrasts with our previously reported findings that the use of saliva as anal lubricant is more strongly associated with anorectal gonorrhoea.

Socio-demographic and structural barriers to being tested for chlamydia in general practice.

PubMed

Lau, Andrew; Spark, Simone; Tomnay, Jane; Smith, Meredith T; Fairley, Christopher K; Guy, Rebecca J; Donovan, Basil; Hocking, Jane S

2016-02-15

To investigate socio-demographic and structural factors associated with not providing a specimen for chlamydia testing following a request by a general practitioner. Cross-sectional analysis of chlamydia testing data for men and women aged 16-29 years attending general practice clinics participating in a cluster randomised controlled trial evaluating the effectiveness of a chlamydia testing intervention. The study period was the 2013 calendar year. The proportion of chlamydia test requests for which the patient did not provide a specimen for testing. During the study period, there were 13 225 chlamydia test requests, for which a chlamydia test was not performed in 2545 instances (19.2%; 95% CI, 16.5-22.3%). Multivariate analysis indicated that the odds for not undertaking a requested test were higher for men (adjusted odds ratio [aOR], 1.4; 95% CI, 1.3-1.6), those aged 16-19 years (aOR, 1.3; 95% CI, 1.1-1.4), those living in areas of greater socio-economic disadvantage (aOR, 1.2; 95% CI, 1.1-1.4 for each additional quintile of Index of Relative Socio-economic Disadvantage), and those attending clinics without on-site pathology collection (aOR, 1.4; 95% CI, 1.0-1.9). One in five young people did not submit a specimen for chlamydia testing despite their GP requesting it. This highlights the need for clinics to establish systems which ensure that men and those aged 16-19 years undertake chlamydia tests requested by a GP.

Changes in chlamydia control activities in Europe between 2007 and 2012: a cross-national survey

PubMed Central

Sfetcu, Otilia; van der Sande, Marianne A.; Andersen, Berit; Herrmann, Björn; Ward, Helen; Götz, Hannelore M.; Uusküla, Anneli; Woodhall, Sarah C.; Redmond, Shelagh M.; Amato-Gauci, Andrew J.; Low, Nicola; van Bergen, Jan E.

2016-01-01

Background: In 2012, the levels of chlamydia control activities including primary prevention, effective case management with partner management and surveillance were assessed in 2012 across countries in the European Union and European Economic Area (EU/EEA), on initiative of the European Centre for Disease Control (ECDC) survey, and the findings were compared with those from a similar survey in 2007. Methods: Experts in the 30 EU/EEA countries were invited to respond to an online questionnaire; 28 countries responded, of which 25 participated in both the 2007 and 2012 surveys. Analyses focused on 13 indicators of chlamydia prevention and control activities; countries were assigned to one of five categories of chlamydia control. Results: In 2012, more countries than in 2007 reported availability of national chlamydia case management guidelines (80% vs. 68%), opportunistic chlamydia testing (68% vs. 44%) and consistent use of nucleic acid amplification tests (64% vs. 36%). The number of countries reporting having a national sexually transmitted infection control strategy or a surveillance system for chlamydia did not change notably. In 2012, most countries (18/25, 72%) had implemented primary prevention activities and case management guidelines addressing partner management, compared with 44% (11/25) of countries in 2007. Conclusion: Overall, chlamydia control activities in EU/EEA countries strengthened between 2007 and 2012. Several countries still need to develop essential chlamydia control activities, whereas others may strengthen implementation and monitoring of existing activities. PMID:26498953

Testing and screening for chlamydia in general practice: a cross-sectional analysis.

PubMed

Thomson, Allison; Morgan, Simon; Henderson, Kim; Tapley, Amanda; Spike, Neil; Scott, John; van Driel, Mieke; Magin, Parker

2014-12-01

Chlamydia screening is widely advocated. General practice registrars are an important stage of clinical behaviour development. This study aimed to determine rates of, and factors associated with, registrars' chlamydia testing including asymptomatic screening. A cross-sectional analysis of data from Registrars Clinical Encounters in Training (ReCEnT), a cohort study of registrars' consultations. Registrars record details of 60 consecutive consultations in each GP-term of training. Outcome factors were chlamydia testing, asymptomatic screening and doctor-initiated screening. Testing occurred in 2.5% of 29,112 consultations (398 registrars) and in 5.8% of patients aged 15-25. Asymptomatic screening comprised 47.5% of chlamydia tests, and 55.6% of screening tests were doctor-initiated. Chlamydia testing was associated with female gender of doctor and patient, younger patient age, and patients new to doctor or practice. Asymptomatic screening was associated with practices where patients incur no fees, and in patients new to doctor or practice. Screening of female patients was more often doctor-initiated. GP registrars screen for chlamydia disproportionately in younger females and new patients. Our findings highlight potential opportunities to improve uptake of screening for chlamydia, including targeted education and training for registrars, campaigns targeting male patients, and addressing financial barriers to accessing screening services. © 2014 Public Health Association of Australia.

Screening and treating Chlamydia trachomatis genital infection to prevent pelvic inflammatory disease: interpretation of findings from randomized controlled trials.

PubMed

Gottlieb, Sami L; Xu, Fujie; Brunham, Robert C

2013-02-01

We critically reviewed randomized controlled trials evaluating chlamydia screening to prevent pelvic inflammatory disease (PID) and explored factors affecting interpretation and translation of trial data into public health prevention. Taken together, data from these trials offer evidence that chlamydia screening and treatment is an important and useful intervention to reduce the risk of PID among young women. However, the magnitude of benefit to be expected from screening may have been overestimated based on the earliest trials. It is likely that chlamydia screening programs have contributed to declines in PID incidence through shortening prevalent infections, although the magnitude of their contribution remains unclear. Program factors such as screening coverage as well as natural history factors such as risk of PID after repeat chlamydia infection can be important in determining the impact of chlamydia screening on PID incidence in a population. Uptake of chlamydia screening is currently suboptimal, and expansion of screening among young, sexually active women remains a priority. To reduce transmission and repeat infections, implementation of efficient strategies to treat partners of infected women is also essential. Results of ongoing randomized evaluations of the effect of screening on community-wide chlamydia prevalence and PID will also be valuable.

Abortion and subsequent excretion of chlamydiae from the reproductive tract of sheep during estrus.

PubMed Central

Papp, J R; Shewen, P E; Gartley, C J

1994-01-01

Chlamydia psittaci serovar 1 infection in pregnant sheep typically causes abortion or the birth of weak lambs. Eight sheep that experienced chlamydia-induced abortion during their first pregnancy were successfully rebred yearly for the past 2 years. Chlamydia-specific lipopolysaccharide was detectable for approximately 3 weeks in vaginal swabs taken from the experimentally infected sheep following abortion. There was no evidence of chlamydiae in vaginal, placental, or neonatal samples obtained immediately after each subsequent successful pregnancy. Sera collected from the experimentally infected sheep had persistent, high antibody levels to C. psittaci, suggesting continued exposure of the immune system to the organism. Examination of vaginal specimens obtained during various stages of the estrus cycle revealed detectable levels of chlamydiae only when the animal was near ovulation. Chlamydiae were not detected in swabs from sheep that did not experience abortion. Enhanced chlamydial excretion during the periovulation period of sheep may provide sufficient stimulation of the immune system to account for the persistent antibody response. Furthermore, the association between estrus and chlamydial shedding has important implications for transmission of infection to other ewes during breeding. PMID:8063395

Rhabdochlamydia spp. in an Oregon raptor.

PubMed

Jouffroy, Sophie J; Schlueter, Andrew H; Bildfell, Robert J; Rockey, Daniel D

2016-07-01

PCR-based approach was used to examine the rate of Chlamydia positivity in raptors from wild bird rehabilitation centers in Oregon. Three of 82 birds were identified as positive for Chlamydia with this PCR. Sequence analysis of 16S ribosomal DNA from 2 of these birds confirmed the presence of DNA from phylum Chlamydiae. One bird was positive for Chlamydia psittaci in both choanal and cloacal swabs. The second bird, a louse-infested red-tailed hawk, had evidence of choanal colonization by "Candidatus Rhabdochlamydia" spp. Our study describes evidence of this Chlamydia-like organism in the United States. This survey also suggests that the carriage rate of C. psittaci is low in raptors in Oregon wild bird rehabilitation centers, and that care must be taken in the design of PCR primers for phylum Chlamydiae such that colonization by insect endosymbionts is not mistaken for an infection by known chlamydial pathogens. © 2016 The Author(s).

Pelvic inflammatory disease risk following negative results from chlamydia nucleic acid amplification tests (NAATs) versus non-NAATs in Denmark: A retrospective cohort

PubMed Central

Frølund, Maria; Westh, Henrik

2018-01-01

Background Nucleic Acid Amplification Tests (NAATs) are the recommended test type for diagnosing Chlamydia trachomatis (chlamydia). However, less sensitive diagnostic methods—including direct immunofluorescence (IF) and enzyme-linked immunoassay (ELISA)—remain in use in lower resourced settings. We estimate the risk of pelvic inflammatory disease (PID) following undiagnosed infection in women tested with non-NAATs and estimate the health gain from using accurate diagnostic tests. Methods and findings We used Denmark’s national Chlamydia Study dataset to extract all chlamydia tests performed in women aged 15–34 years (1998–2001). Tests were categorised as non-NAAT (IF/ELISA) or NAAT and limited to each woman’s first test in the study period. We linked test data to hospital presentations for PID within 12 months from the Danish National Patient Register. The study included 272,105 women with a chlamydia test, just under half (44.78%, n = 121,857) were tested using NAATs. Overall, 6.38% (n = 17,353) tested positive for chlamydia and 0.64% (n = 1,732) were diagnosed with PID within 12 months. The risk of PID following a positive chlamydia test did not differ by test type (NAAT 0.81% [95% CI 0.61–1.00], non-NAAT 0.78% [0.59–0.96]). The risk of PID following a negative test was significantly lower in women tested with NAATs compared to non-NAATs (0.55% [0.51–0.59] compared to 0.69% [0.64–0.73]; adjusted odds ratio (AOR) 0.83 [0.75–0.93]). We estimate that 18% of chlamydia infections in women tested with a non-NAAT were undiagnosed and that the risk of progression from undiagnosed chlamydia infection to PID within 12 months was 9.52% (9.30–9.68). Using non-NAATs could lead to an excess 120 cases of PID per 100,000 women tested compared to using NAATs. The key limitations of this study are under ascertainment of PID cases, misclassification bias in chlamydia and PID exposure status, bias to the association between clinical presentation and test type and the presence of unmeasured confounders (including other sexually transmitted infection [STI] diagnoses and clinical indication for chlamydia test). Conclusion This retrospective observational study estimates the positive impact on women’s reproductive health from using accurate chlamydia diagnostic tests and provides further evidence for restricting the use of inferior tests. Women with a negative chlamydia test have a 17% higher adjusted risk of PID by 12 months if they are tested using a non-NAAT compared to a NAAT. PMID:29293503

Increasing chlamydia diagnoses but little change in hospitalisations for ectopic pregnancy and infertility among women in New South Wales from 2001 to 2008.

PubMed

Liu, Bette; Donovan, Basil; Parker, Jim; Guy, Rebecca; Hocking, Jane; Kaldor, John M; Wand, Handan; Jorm, Louisa

2012-09-01

As genital chlamydia (Chlamydia trachomatis) notifications have increased in Australia, time trends in hospitalisations for ectopic pregnancy and female infertility between 2001 and 2008 in New South Wales (NSW), Australia, and their relationship to trends in chlamydia notifications in women were assessed. Annual rates of chlamydia notification, and hospitalisations for female infertility or ectopic pregnancy in women aged 15-44 years in NSW were calculated using routinely collected data. Chlamydia notifications and hospital separations occurring within each year belonging to the same woman were linked using probabilistic linkage of identifiers so that multiple notifications and admissions for one woman in each calendar year were only counted once. From 2001 to 2008, the annual rate of chlamydia diagnoses in women increased from 157 to 477 per 100000 population (P(trend)<0.001). Over the same period, the annual hospitalisation rate for women with an ectopic pregnancy decreased from 14.3 to 12.6 per 1000 births (P(trend)<0.001). This decrease was mostly in women aged 25-44 years, with no appreciable fall in women aged 15-24 years (P(trend)=0.8). Meanwhile, the hospitalisation rate for women with infertility of female origin did not follow a consistent trend: between 2001 and 2008, it fluctuated between a low of 479 and a high of 554 per 10000 women who were seeking pregnancy. These trends in ectopic pregnancy and female infertility suggest that the large increase in chlamydia notifications may not reflect hospitalisations for these two proposed chlamydia-related sequelae.

Clinic-based testing for rectal and pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections by community-based organizations--five cities, United States, 2007.

PubMed

2009-07-10

CDC recommends screening of at-risk men who have sex with men (MSM) at least annually for urethral and rectal gonorrhea and chlamydia, and for pharyngeal gonorrhea. Although the standard method for diagnosis is culture, nucleic acid amplification (NAA) testing is generally more sensitive and favored by most experts. NAA tests have not been cleared by the Food and Drug Administration (FDA) for the diagnosis of extragenital chlamydia or gonorrhea and may not be marketed for that purpose. However, under U.S. law, laboratories may offer NAA testing for diagnosis of extragenital chlamydia or gonorrhea after internal validation of the method by a verification study. To determine sexually transmitted disease (STD) testing practices among community-based organizations serving MSM, CDC and the San Francisco Department of Public Health gathered data on rectal and pharyngeal gonorrhea and chlamydia testing at screening sites managed by six gay-focused community-based organizations in five U.S. cities during 2007. This report summarizes the results of the study, which found that three organizations collected samples for NAA testing and three for culture. In total, approximately 30,000 tests were performed; 5.4% of rectal gonorrhea, 8.9% of rectal chlamydia, 5.3% of pharyngeal gonorrhea, and 1.6% of pharyngeal chlamydia tests were positive. These results demonstrate that gay-focused community-based organizations can detect large numbers of gonorrhea and chlamydia cases and might reach MSM not being tested elsewhere. Public health officials could consider providing support to certain community-based organizations to facilitate testing and treatment of gonorrhea and chlamydia.

Effect of time since exposure to Chlamydia trachomatis on chlamydia antibody detection in women: a cross-sectional study.

PubMed

Horner, Patrick J; Wills, Gillian S; Reynolds, Rosy; Johnson, Anne M; Muir, David A; Winston, Alan; Broadbent, Andrew J; Parker, David; McClure, Myra O

2013-08-01

To investigate what factors influence the detection of Chlamydia trachomatis antibody following genital tract infection. One hundred and sixty-four women with a previous history of C trachomatis infection contributed to an earlier report on the performance of chlamydia antibody ELISA assays. We undertook further analysis to explore how chlamydia antibody assay sensitivity changes with time since infection. Chlamydia antibody was detected in more women soon after the last detection of chlamydia at the lower genital tract than at later times. This holds true for all tests, but the Anilabsystems IgG EIA, Medac pELISA plus ELISA and the Savyon SeroCT-IgG ELISA were less sensitive than the pgp3 ELISA and the Anilabsystems microimmunofluorescence (MIF) assay at all time points except during current infection. Fall in seropositivity in women generally occurred in the early weeks and months following the last episode of chlamydia infection. There was no clear pattern of further reduction in seropositivity after 6 months. Multiple previous episodes were associated with increased seropositivity in the pgp3 assay (two or more vs one, OR 19, p<0.001) and other tests, but the effect was significantly smaller for the Anilabs, Medac and SeroCT MOMP peptide ELISAs, but not for the MIF assay. Chlamydia antibody detection decreases with time since infection and this is most apparent in the first 6 months. In women who have had more than one infection, antibody remained detectable longer for all tests, but this was more marked for the pgp3 ELISA and MIF assay.

A sexual health quality improvement program (SHIMMER) triples chlamydia and gonorrhoea testing rates among young people attending Aboriginal primary health care services in Australia.

PubMed

Graham, Simon; Guy, Rebecca J; Wand, Handan C; Kaldor, John M; Donovan, Basil; Knox, Janet; McCowen, Debbie; Bullen, Patricia; Booker, Julie; O'Brien, Chris; Garrett, Kristine; Ward, James S

2015-09-02

In Australia, chlamydia is the most commonly notifiable infection and over the past ten years chlamydia and gonorrhoea notification rates have increased. Aboriginal compared with non-Aboriginal Australians have the highest notifications rates of chlamydia and gonorrhoea. Regular testing of young people for chlamydia and gonorrhoea is a key prevention strategy to identify asymptomatic infections early, provide treatment and safe sex education. This study evaluated if a sexual health quality improvement program (QIP) known as SHIMMER could increase chlamydia and gonorrhoea testing among young people attending four Aboriginal primary health care services in regional areas of New South Wales, Australia. We calculated the proportion of 15-29 year olds tested and tested positivity for chlamydia and gonorrhoea in a 12-month before period (March 2010-February 2011) compared with a 12-month QIP period (March 2012-February 2013). Logistic regression was used to assess the difference in the proportion tested for chlamydia and gonorrhoea between study periods by gender, age group, Aboriginal status and Aboriginal primary health service. Odds ratios (OR) and their 95 % confidence intervals (CIs) were calculated with significance at p < 0.05. In the before period, 9 % of the 1881 individuals were tested for chlamydia, compared to 22 % of the 2259 individuals in the QIP period (OR): 1.43, 95 % CI: 1.22-1.67). From the before period to the QIP period, increases were observed in females (13 % to 25 %, OR: 1.32, 95 % CI: 1.10-1.59) and males (3 % to 17 %, OR: 1.85, 95 % CI: 1.36-2.52). The highest testing rate in the QIP period was in 15-19 year old females (16 % to 29 %, OR: 1.02, 95 % CI: 0.75-1.37), yet the greatest increase was in 20-24 year olds males (3 % to 19 %, OR: 1.65, 95 % CI: 1.01-2.69). Similar increases were seen in gonorrhoea testing. Overall, there were 70 (11 %) chlamydia diagnoses, increasing from 24 in the before to 46 in the QIP period. Overall, 4 (0.7 %) gonorrhoea tests were positive. The QIP used in SHIMMER almost tripled chlamydia and gonorrhoea testing in young people and found more than twice as many chlamydia infections. The QIP could be used by other primary health care centres to increase testing among young people.

Pilot study of a brief intervention based on the theory of planned behaviour and self-identity to increase chlamydia testing among young people living in deprived areas.

PubMed

Booth, Amy R; Norman, Paul; Goyder, Elizabeth; Harris, Peter R; Campbell, Michael J

2014-09-01

This study sought to estimate the effects of a novel intervention, compared with usual chlamydia testing promotion, on chlamydia test uptake and intentions among young people living in deprived areas. The intervention was based on the theory of planned behaviour, augmented with self-identity, and targeted the significant predictors of chlamydia testing intentions identified in the previous research. Cluster randomization was used to allocate college tutor groups (intervention n = 10; control n = 11) to the intervention or control group. The sample comprised 253 participants (intervention n = 145, control n = 108). The primary outcome was test offer uptake at the end of the session. Other outcomes measured at immediate follow-up were intention, attitude, subjective norm, perceived behavioural control, and self-identity. Generalized estimating equations, controlling for cluster effects and sexual activity, found a small but non-significant effect of condition on test offer uptake, OR = 1.65 (95% CI 0.70, 3.88) p = .25, with 57.5% of intervention participants accepting the offer of a test compared with 40.2% of control participants. Using the same analysis procedure, small-to-medium intervention effects were found on other outcome variables, including a significant effect on attitudes towards chlamydia testing, OR = 1.37 (95% CI 1.00, 1.87), p = .05. The results provide encouraging initial evidence that this theory-based intervention, targeting the key determinants of chlamydia testing, may help to improve chlamydia testing uptake in a high-risk group. They support the conduct of a larger trial to evaluate the effectiveness of the intervention. What is already known on this subject? Young people living in areas of increased socio-economic deprivation have been identified as a high-risk group for chlamydia. Previous research within an extended model of the theory of planned behaviour (TPB) found that attitude, subjective norm, perceived behavioural control, and self-identity all significantly predicted chlamydia testing intentions in this high-risk group. What does this study add? Development and testing of a novel, TPB-based intervention targeting predictors of chlamydia testing intentions. The intervention led to significantly more positive attitudes towards chlamydia testing. Preliminary indication that a TPB-based intervention may help to improve chlamydia testing in a high-risk group. © 2013 The British Psychological Society.

Chlamydia Trachomatis Infection and Tubal Infertility in Port Harcourt, Southern,Nigeria.

PubMed

Ojule, J D; Ibe, V C; Theophilus, J C

2015-01-01

Tubal occlusion remains one the commonest causes of infertility in our environment and previous pelvic infection have been implicated in the aetiology of the blockage Objective: To demonstrate prior chlamydia infection in women with tubal factor infertility and ascertain the relationship between chlamydia and tubal occlusion. This was a case-control study consisting of 188 patients drawn from the University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt, South-South Nigeria.The cases were 94 women with radiologically confirmed tubal occlusion and the controls were another 94 women with intrauterine pregnancy, all screened for the presence of chlamydia immunoglobin G antibody in the serum using Immunocomb Chlamydia Bivalent IgG kit, Orgenics, Israel.Their socio-demographic characteristics and the pattern of sexual behaviour were documented in the profoma provided. Statistical analysis was done using SPSS version 17 statistical software. The prevalence of Chlamydia antibodies was significantly higher in patients with tubal factor infertility (61.7%) than in the pregnant controls (34%) as p=0.001 and was associated with a three-fold risk of tubal factor infertility, with Odd's ratio (O.R) 3.12. There was a risk association between Chlamydia Trachomatis infection and tubal factor infertility. Early coitarche and previous pelvic inflammatory disease were other risk factors of Chlamydia trachomatis infection found to be positively associated with tubal factor infertility.

Using the theory of planned behaviour and self-identity to explain chlamydia testing intentions in young people living in deprived areas.

PubMed

Booth, Amy R; Norman, Paul; Harris, Peter R; Goyder, Elizabeth

2014-02-01

The study sought to (1) explain intentions to get tested for chlamydia regularly in a group of young people living in deprived areas using the theory of planned behaviour (TPB); and (2) test whether self-identity explained additional variance in testing intentions. A cross-sectional design was used for this study. Participants (N = 278, 53% male; M = 17.05 years) living in deprived areas of a UK city were recruited from a vocational education setting. Participants completed a self-administered questionnaire, including measures of attitude, injunctive subjective norm, descriptive norm, perceived behavioural control, self-identity, intention and past behaviour in relation to getting tested for chlamydia regularly. The TPB explained 43% of the variance in chlamydia testing intentions with all variables emerging as significant predictors. However, self-identity explained additional variance in intentions (ΔR(2)  = .22) and emerged as the strongest predictor, even when controlling for past behaviour. The study identified the key determinants of intention to get tested for chlamydia regularly in a sample of young people living in areas of increased deprivation: a hard-to-reach, high-risk population. The findings indicate the key variables to target in interventions to promote motivation to get tested for chlamydia regularly in equivalent samples, amongst which self-identity is critical. What is already known on this subject? Young people living in deprived areas have been identified as an at-risk group for chlamydia. Qualitative research has identified several themes in relation to factors affecting the uptake of chlamydia testing, which fit well with the constructs of the Theory of Planned Behaviour (TPB). Identity concerns have also been identified as playing an important part in young people's chlamydia testing decisions. What does this study add? TPB explained 43% of the variance in chlamydia testing intentions and all variables were significant predictors. Self-identity explained additional 22% of the variance in intentions and emerged as the strongest predictor. Indicates key variables to target in interventions to promote regular chlamydia testing in deprived young people. © 2013 The British Psychological Society.

Increased incidence of gonorrhoea and chlamydia in Greenland 1990-2012.

PubMed

Johansen, Mila Broby; Koch, Anders; Wohlfahrt, Jan; Kamper-Jørgensen, Mads; Hoffmann, Steen; Soborg, Bolette

2017-01-01

Since the 1970s, Greenland has presented the highest reported incidence rates of the sexually transmitted infections (STIs) gonorrhoea and chlamydia in the Arctic regions. This study aims to describe sex- and age-specific incidence rates of gonorrhoea and chlamydia from 1990 to 2012 in Greenland, and to evaluate if changes in case definitions, diagnostic procedures and implementation of STI interventions during the period coincide with rate changes. Gonorrhoea and chlamydia cases were identified from the national STI surveillance. For 1990-2008, STI cases were identified from weekly notified aggregated data. For 2009-2012, cases were identified in person-identifiable national registers. We used log-linear Poisson regression to calculate incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (95% CI). Analyses were stratified according to sex, age and calendar period. Gonorrhoea and chlamydia incidence rates have increased since 1995 to reach 2,555 per 100,000 person-years (PY) for gonorrhoea and 6,403 per 100,000 PY for chlamydia in 2012. From 2006 to 2012, the incidence rates among young adults aged 15-19 years were 8,187 and 22,515 per 100,000 PY for gonorrhoea and chlamydia, respectively. Changes in surveillance reporting did not seem to influence the incidence rates for either disease, whereas a change in diagnostic test coincided with an increased incidence of chlamydia. Overall, the incidence of chlamydia in Greenland increased during the study period, whereas the incidence of gonorrhoea decreased until 1995 but increased thereafter. Young adults aged 15-24 years were at highest risk of infection. The increase in incidence rates was independent of changes in case definitions, whereas an observed increase in chlamydia incidence in 2005 coincided with a change in diagnostic test. None of the STI interventions launched after 1995 seemed to coincide with decreasing national incidence rates.

Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing.

PubMed

McNulty, Cliodna; Ricketts, Ellie J; Fredlund, Hans; Uusküla, Anneli; Town, Katy; Rugman, Claire; Tisler-Sala, Anna; Mani, Alix; Dunais, Brigitte; Folkard, Kate; Allison, Rosalie; Touboul, Pia

2017-09-25

To determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England. Qualitative interviews. European primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013. 45 GP staff, 13 trainers and 18 stakeholders. The iterative interview schedule explored participants' personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis. Findings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country's health services. A common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

IL-4–secreting eosinophils promote endometrial stromal cell proliferation and prevent Chlamydia-induced upper genital tract damage

PubMed Central

Quispe Calla, Nirk E.; Dixon, Darlene; Foster, Robert A.; Gambotto, Andrea; Pavelko, Stephen D.; Hall-Stoodley, Luanne; Cherpes, Thomas L.

2017-01-01

Genital Chlamydia trachomatis infections in women typically are asymptomatic and do not cause permanent upper genital tract (UGT) damage. Consistent with this presentation, type 2 innate and TH2 adaptive immune responses associated with dampened inflammation and tissue repair are elicited in the UGT of Chlamydia-infected women. Primary C. trachomatis infection of mice also causes no genital pathology, but unlike women, does not generate Chlamydia-specific TH2 immunity. Herein, we explored the significance of type 2 innate immunity for restricting UGT tissue damage in Chlamydia-infected mice, and in initial studies intravaginally infected wild-type, IL-10−/−, IL-4−/−, and IL-4Rα−/− mice with low-dose C. trachomatis inoculums. Whereas Chlamydia was comparably cleared in all groups, IL-4−/− and IL-4Rα−/− mice displayed endometrial damage not seen in wild-type or IL-10−/− mice. Congruent with the aberrant tissue repair in mice with deficient IL-4 signaling, we found that IL-4Rα and STAT6 signaling mediated IL-4–induced endometrial stromal cell (ESC) proliferation ex vivo, and that genital administration of an IL-4–expressing adenoviral vector greatly increased in vivo ESC proliferation. Studies with IL-4-IRES-eGFP (4get) reporter mice showed eosinophils were the main IL-4–producing endometrial leukocyte (constitutively and during Chlamydia infection), whereas studies with eosinophil-deficient mice identified this innate immune cell as essential for endometrial repair during Chlamydia infection. Together, our studies reveal IL-4–producing eosinophils stimulate ESC proliferation and prevent Chlamydia-induced endometrial damage. Based on these results, it seems possible that the robust type 2 immunity elicited by Chlamydia infection of human genital tissue may analogously promote repair processes that reduce phenotypic disease expression. PMID:28765368

Repeat Chlamydia trachomatis testing among heterosexual STI outpatient clinic visitors in the Netherlands: a longitudinal study.

PubMed

Visser, Maartje; van Aar, Fleur; Koedijk, Femke D H; Kampman, Carolina J G; Heijne, Janneke C M

2017-12-20

Chlamydia infections are common in both men and women, are often asymptomatic and can cause serious complications. Repeat testing in high-risk groups is therefore indicated. In the Netherlands, guidelines on repeat chlamydia testing differ between testing facilities, and knowledge on repeat testing behaviour is limited. Here, we analyse the current repeat testing behaviour of heterosexual STI clinic visitors, and aim to identify groups for which repeat testing advice could be advantageous. Longitudinal surveillance data from all Dutch STI outpatient clinics were used, which included all STI clinic consultations carried out among heterosexual men and women between June 2014 and December 2015. Repeat testing was defined as returning to the same STI clinic between 35 days and 12 months after initial consultation. We calculated chlamydia positivity at repeat test stratified by initial test result and time between consultations. Logistic regression analyses were used to identify predictors of repeat testing, and predictors of having a chlamydia positive repeat test. In total, 140,486 consultations in 75,487 women and 46,286 men were available for analyses. Overall, 15.4% of women and 11.1% of men returned to the STI clinic within the study period. Highest chlamydia positivity at repeat test was seen 3-5 months after initial positive test. Among both women and men, repeat testing was associated with non-Western ethnicity, having had more than two sex partners in the past 6 months, reporting STI symptoms, having a history of STI, and having a chlamydia positive initial test. Among repeat testers, chlamydia positive repeat test was most strongly associated with younger age, followed by a chlamydia positive initial test. Repeat testing most often resulted in a positive test result among young heterosexuals (<25) and heterosexuals of any age with a chlamydia infection at the initial consultation. Further efforts are needed to determine optimal repeat testing strategies.

The Association between Insurance Status and Acceptance of Chlamydia Screening By Teenagers Who Present for Preventive Care Visits.

PubMed

Playforth, Krupa B; Coughlan, Alexandria; Upadhya, Krishna K

2016-02-01

The purpose of this study was to evaluate whether providers offer chlamydia screening to teenagers and/or whether screening is accepted at different rates depending on insurance type. Retrospective chart review. Academic center serving urban and suburban patients between April 2009 and October 2011. Nine hundred eighty-three health maintenance visits for asymptomatic, insured female adolescents aged 15-19 years. None. Dichotomous dependent variables of interest indicated whether chlamydia screening was: (1) offered; and (2) accepted. The key independent variable insurance type was coded as 'public' if Medicaid or Medicaid Managed Care and 'private' if a commercial plan. χ(2) and logistic regression analyses were used to assess the significance of differences in screening rates according to insurance type. Of asymptomatic health-maintenance visits 933 (95%) had a documented sexual history and 339 (34%) had a documented history of sexual activity. After excluding those who had a documented chlamydia screen in the 12 months before the visit (n = 79; 23%), 260 visits met eligibility for chlamydia screening. Only 169 (65%) of eligible visits had chlamydia screening offered and there was no difference in offer of screening according to insurance type. Significantly more visits covered by public insurance had chlamydia screening accepted (98%) than those covered by private insurance (82%). Controlling for demographic factors, the odds of accepted chlamydia screening was 8 times higher in visits covered by public insurance than those with private insurance. Although publically and privately insured teens were equally likely to be offered chlamydia screening, publically insured teens were significantly more likely to accept screening. Future research should investigate reasons for this difference in screening acceptance. These findings have implications for interventions to improve chlamydia screening because more adolescents are covered by parental insurance under the Affordable Care Act. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Urogenital Chlamydia trachomatis infections among ethnic groups in Paramaribo, Suriname; determinants and ethnic sexual mixing patterns.

PubMed

van der Helm, Jannie J; Bom, Reinier J M; Grünberg, Antoon W; Bruisten, Sylvia M; Schim van der Loeff, Maarten F; Sabajo, Leslie O A; de Vries, Henry J C

2013-01-01

Little is known about the epidemiology of urogenital Chlamydia trachomatis infection (chlamydia) in Suriname. Suriname is a society composed of many ethnic groups, such as Creoles, Maroons, Hindustani, Javanese, Chinese, Caucasians, and indigenous Amerindians. We estimated determinants for chlamydia, including the role of ethnicity, and identified transmission patterns and ethnic sexual networks among clients of two clinics in Paramaribo, Suriname. Participants were recruited at two sites a sexually transmitted infections (STI) clinic and a family planning (FP) clinic in Paramaribo. Urine samples from men and nurse-collected vaginal swabs were obtained for nucleic acid amplification testing. Logistic regression analysis was used to identify determinants of chlamydia. Multilocus sequence typing (MLST) was performed to genotype C. trachomatis. To identify transmission patterns and sexual networks, a minimum spanning tree was created, using full MLST profiles. Clusters in the minimum spanning tree were compared for ethnic composition. Between March 2008 and July 2010, 415 men and 274 women were included at the STI clinic and 819 women at the FP clinic. Overall chlamydia prevalence was 15% (224/1508). Age, ethnicity, and recruitment site were significantly associated with chlamydia in multivariable analysis. Participants of Creole and Javanese ethnicity were more frequently infected with urogenital chlamydia. Although sexual mixing with other ethnic groups did differ significantly per ethnicity, this mixing was not independently significantly associated with chlamydia. We typed 170 C. trachomatis-positive samples (76%) and identified three large C. trachomatis clusters. Although the proportion from various ethnic groups differed significantly between the clusters (P = 0.003), all five major ethnic groups were represented in all three clusters. Chlamydia prevalence in Suriname is high and targeted prevention measures are required. Although ethnic sexual mixing differed between ethnic groups, differences in prevalence between ethnic groups could not be explained by sexual mixing.

Urogenital Chlamydia trachomatis Infections among Ethnic Groups in Paramaribo, Suriname; Determinants and Ethnic Sexual Mixing Patterns

PubMed Central

van der Helm, Jannie J.; Bom, Reinier J. M.; Grünberg, Antoon W.; Bruisten, Sylvia M.; Schim van der Loeff, Maarten F.; Sabajo, Leslie O. A.; de Vries, Henry J. C.

2013-01-01

Background Little is known about the epidemiology of urogenital Chlamydia trachomatis infection (chlamydia) in Suriname. Suriname is a society composed of many ethnic groups, such as Creoles, Maroons, Hindustani, Javanese, Chinese, Caucasians, and indigenous Amerindians. We estimated determinants for chlamydia, including the role of ethnicity, and identified transmission patterns and ethnic sexual networks among clients of two clinics in Paramaribo, Suriname. Methods Participants were recruited at two sites a sexually transmitted infections (STI) clinic and a family planning (FP) clinic in Paramaribo. Urine samples from men and nurse-collected vaginal swabs were obtained for nucleic acid amplification testing. Logistic regression analysis was used to identify determinants of chlamydia. Multilocus sequence typing (MLST) was performed to genotype C. trachomatis. To identify transmission patterns and sexual networks, a minimum spanning tree was created, using full MLST profiles. Clusters in the minimum spanning tree were compared for ethnic composition. Results Between March 2008 and July 2010, 415 men and 274 women were included at the STI clinic and 819 women at the FP clinic. Overall chlamydia prevalence was 15% (224/1508). Age, ethnicity, and recruitment site were significantly associated with chlamydia in multivariable analysis. Participants of Creole and Javanese ethnicity were more frequently infected with urogenital chlamydia. Although sexual mixing with other ethnic groups did differ significantly per ethnicity, this mixing was not independently significantly associated with chlamydia. We typed 170 C. trachomatis-positive samples (76%) and identified three large C. trachomatis clusters. Although the proportion from various ethnic groups differed significantly between the clusters (P = 0.003), all five major ethnic groups were represented in all three clusters. Conclusion Chlamydia prevalence in Suriname is high and targeted prevention measures are required. Although ethnic sexual mixing differed between ethnic groups, differences in prevalence between ethnic groups could not be explained by sexual mixing. PMID:23874730

Synthesis of protein in host-free reticulate bodies of Chlamydia psittaci and Chlamydia trachomatis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hatch, T.P.; Miceli, M.; Silverman, J.A.

1985-06-01

Synthesis of protein by the obligate intracellular parasitic bacteria Chlamydia psittaci (6BC) and Chlamydia trachomatis (serovar L2) isolated from host cells (host-free chlamydiae) was demonstrated for the first time. Incorporation of (/sup 35/S)methionine and (/sup 35/S)cysteine into trichloroacetic acid-precipitable material by reticulate bodies of chlamydiae persisted for 2 h and was dependent upon a exogenous source of ATP, an ATP-regenerating system, and potassium or sodium ions. Magnesium ions and amino acids stimulated synthesis; chloramphenicol, rifampin, oligomycin, and carbonyl cyanide p-trifluoromethoxyphenylhydrazone (a proton ionophore) inhibited incorporation. Ribonucleoside triphosphates (other than ATP) had little stimulatory effect. The optimum pH for host-free synthesismore » was between 7.0 and 7.5. The molecular weights of proteins synthesized by host-free reticulate bodies closely resembled the molecular weights of proteins synthesized by reticulate bodies in an intracellular environment, and included outer membrane proteins. Elementary bodies of chlamydiae were unable to synthesize protein even when incubated in the presence of 10 mM dithiothreitol, a reducing agent which converted the highly disulfide bond cross-linked major outer membrane protein to monomeric form.« less

Chlamydia trachomatis Cellular Exit Alters Interactions with Host Dendritic Cells

PubMed Central

Sherrid, Ashley M.

2017-01-01

ABSTRACT The strategies utilized by pathogens to exit host cells are an area of pathogenesis which has received surprisingly little attention, considering the necessity of this step for infections to propagate. Even less is known about how exit through these pathways affects downstream host-pathogen interactions and the generation of an immune response. Chlamydia trachomatis exits host epithelial cells through two equally active mechanisms: lysis and extrusion. Studies have characterized the outcome of interactions between host innate immune cells, such as dendritic cells and macrophages, and free, extracellular Chlamydia bacteria, such as those resulting from lysis. Exit via extrusion generates a distinct, host-membrane-bound compartment of Chlamydia separate from the original infected cell. In this study, we assessed the effect of containment within extrusions upon the interaction between Chlamydia and host dendritic cells. Extrusion dramatically affected the outcome of Chlamydia-dendritic cell interactions for both the bacterium and the host cell. Dendritic cells rapidly underwent apoptosis in response to engulfment of an extrusion, while uptake of an equivalent dose of free Chlamydia had no such effect. Containment within an extrusion also prolonged bacterial survival within dendritic cells and altered the initial innate immune signaling by the dendritic cell. PMID:28223346

Toll like receptor 4: an important molecule in recognition and induction of appropriate immune responses against Chlamydia infection.

PubMed

Nosratababadi, Reza; Bagheri, Vahid; Zare-Bidaki, Mohammad; Hakimi, Hamid; Zainodini, Nahid; Kazemi Arababadi, Mohammad

2017-04-01

Chlamydia species are obligate intracellular pathogens causing different infectious diseases particularly asymptomatic genital infections and are also responsible for a wide range of complications. Previous studies showed that there are different immune responses to Chlamydia species and their infections are limited to some cases. Moreover, Chlamydia species are able to alter immune responses through modulating the expression of some immune system related molecules including cytokines. Toll like receptors (TLRs) belonge to pathogen recognition receptors (PRRs) and play vital roles in recognition of microbes and stimulation of appropriate immune responses. Therefore, it appears that TLRs may be considered as important sensors for recognition of Chlamydia and promotion of immune responses against these bacterial infections. Accordingly, TLR4 detects several microbial PAMPs such as bacterial lipopolysacharide (LPS) and subsequently activates transcription from pro-inflammatory cytokines in both MYD88 and TRIF pathways dependent manner. The purpose of this review is to provide the recent data about the status and major roles played by TLR4 in Chlamydia species recognition and promotion of immune responses against these infections and also the relationship between TLR4 activities and pathogenesis of Chlamydia infections. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prevalence and predictors of lymphogranuloma venereum among men who have sex with men at a Sydney metropolitan sexual health clinic.

PubMed

Templeton, David J; Sharp, Nicola; Gryllis, Sophie; O'Connor, Catherine C; Dubedat, Sally M

2013-05-01

During an 18-month period to June 2012, 1732 anal chlamydia (Chlamydia trachomatis) tests were performed among men who have sex with men (MSM) at RPA Sexual Health in Sydney's inner west. Positive anal chlamydia samples were subsequently tested for lymphogranuloma venereum (LGV). Seventy-five (4.3%) anal samples were positive for chlamydia among 67 men during the study period. Anal symptoms were reported for 16 out of 75 (21.3%) of anal chlamydia episodes overall. Three episodes of LGV (all serovar L2b) were identified, all three of whom reported anal symptoms (100%, 95% confidence interval (CI): 29.2-100%). In contrast, only 13/72 (18.1%, 95% CI: 10.0-28.9%) of those with non-LGV anal chlamydia reported anal symptoms. LGV was not identified in any of 59 episodes of asymptomatic anal chlamydia (0%, 95% CI: 0-6.1%). Of those with LGV, two were known to be HIV-positive and one subsequently seroconverted to HIV within a year of the LGV diagnosis. Our findings suggest that routine LGV testing among MSM is not warranted, except among those with anal symptoms.

Chlamydiae interaction with the endoplasmic reticulum: contact, function and consequences.

PubMed

Derré, Isabelle

2015-07-01

Chlamydiae and chlamydiae-related organisms are obligate intracellular bacterial pathogens. They reside in a membrane-bound compartment termed the inclusion and have evolved sophisticated mechanisms to interact with cellular organelles. This review focuses on the nature, the function(s) and the consequences of chlamydiae-inclusion interaction with the endoplasmic reticulum (ER). The inclusion membrane establishes very close contact with the ER at specific sites termed ER-inclusion membrane contact sites (MCSs). These MCSs are constituted of a specific set of factors, including the C. trachomatis effector protein IncD and the host cell proteins CERT and VAPA/B. Because CERT and VAPA/B have a demonstrated role in the non-vesicular trafficking of lipids between the ER and the Golgi, it was proposed that Chlamydia establish MCSs with the ER to acquire host lipids. However, the recruitment of additional factors to ER-inclusion MCSs, such as the ER calcium sensor STIM1, may suggest additional functions unrelated to lipid acquisition. Finally, chlamydiae interaction with the ER appears to induce the ER stress response, but this response is quickly dampened by chlamydiae to promote host cell survival. © 2015 John Wiley & Sons Ltd.

CXCL10, CXCL11, HLA-A and IL-1β are induced in peripheral blood mononuclear cells from women with Chlamydia trachomatis related infertility.

PubMed

Menon, Shruti; Alexander, Kimberly; Timms, Peter; Allan, John A; Huston, Wilhelmina M

2016-02-01

Chlamydia trachomatis infections can result in the development of serious sequelae such as pelvic inflammatory disease and tubal infertility. In this study, peripheral blood mononuclear cells from women who were undergoing or had recently undergone IVF treatment were cultured ex vivo with C. trachomatis to identify the immune responses associated with women who had serological evidence of a history of Chlamydia infection. Cytokines secreted into the supernatant from the cultures were measured using ELISA, and the level of IL-1β was found to be significantly higher in Chlamydia positive women than Chlamydia negative women. qRT-PCR analysis of the expression of 88 immune-related genes showed trends towards an upregulation of CXCL10, CXCL11 and HLA-A in Chlamydia positive women compared with Chlamydia negative women. These findings support that some women launch a more marked proinflammatory response upon infection with C. trachomatis and this may be associated with why C. trachomatis induces infertility in some infected women. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluating the chlamydia and gonorrhoea screening program in the Humanitarian Entrant Health Service, Western Australia.

PubMed

Hoad, Veronica C; Thambiran, Aesen

2012-07-02

To document the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in the refugee population settling in Western Australia from 1 January 2006 to 31 December 2009 and make recommendations for future screening for chlamydia and gonorrhoea in the refugee population. A prevalence and quality assurance study of 2610 refugees aged 15 years and older who attended the Humanitarian Entrant Health Service in Western Australia and were screened for chlamydia and gonorrhoea. Demographic details and results of C. trachomatis and N. gonorrhoeae tests on first void urine. The prevalence of chlamydia was found to be 0.8% (n = 21) in the refugee population. No gonorrhoea infections were detected. The prevalence of chlamydia was low (0.19%-1.23%) when analysed by sex, ethnicity or age and was considerably lower than other subpopulations considered high risk in Australia. The low prevalence rates of chlamydia and gonorrhoea found in the refugee population suggest that current screening guidelines should be updated. We recommend screening all refugees who are sexually active up to age 39 years, taking into account an appropriate sexual history; otherwise, screening guidelines should be as for the general Australian population.

Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

PubMed

Lallemand, Anne; Bremer, Viviane; Jansen, Klaus; Nielsen, Stine; Münstermann, Dieter; Lucht, Andreas; Tiemann, Carsten

2016-10-26

Patients asking for a free anonymous HIV test may have contracted other sexually transmitted infections (STIs) such as Chlamydia trachomatis, yet Chlamydia prevalence in that population is unknown. This study aimed to assess the prevalence and factors associated with Chlamydia infection in patients seeking HIV testing at local public health authorities (LPHA) in order to evaluate whether Chlamydia testing should be routinely offered to them. We conducted a cross-sectional study among patients (≥18 years) attending 18 LPHA in North Rhine-Westphalia from November 2012 to September 2013. LPHA collected information on participants' socio-demographic characteristics, sexual and HIV testing behaviours, previous STI history and clinical symptoms. Self-collected vaginal swabs and urine (men) were analysed by Transcription-Mediated Amplification. We assessed overall and age-stratified Chlamydia prevalence and 95 % confidence intervals (95 % CI). Using univariate and multivariable binomial regression, we estimated adjusted prevalence ratios (aPR) to identify factors associated with Chlamydia infection. The study population comprised 1144 (40.5 %) women, 1134 (40.1 %) heterosexual men and 549 (19.4 %) men who have sex with men (MSM); median age was 30 years. Chlamydia prevalence was 5.3 % (95 % CI: 4.1-6.8 %) among women, 3.2 % (95 % CI: 2.2-4.4) in heterosexual men and 3.5 % (95 % CI: 2.1-5.4) in MSM. Prevalence was highest among 18-24 year-old women (9 %; 95 % CI: 5.8-13) and heterosexual men (5.7 %; 95 % CI: 3.0-9.8 %), respectively. Among MSM, the prevalence was highest among 30-39 year-olds (4.4 %; 95 % CI: 1.9-8.5 %). Among those who tested positive, 76.7 % of women, 75.0 % of heterosexual men and 84.2 % of MSM were asymptomatic. Among women, factors associated with Chlamydia infection were young age (18-24 years versus ≥ 40 years, aPR: 3.0, 95 % CI: 1.2-7.8), having had more than 2 partners over the past 6 months (ref.: one partner, aPR: 2.1, 95 % CI: 1.1-4.0) and being born abroad (aPR: 1.9, 95 % CI: 1.0-3.5). Among heterosexual men, young age was associated with Chlamydia infection (18-24 years versus ≥ 40 years, aPR: 4.1, 95 % CI: 1.3-13). Among MSM, none of the variables were associated with Chlamydia infection. LPHA offering HIV tests should consider offering routine Chlamydia testing to women under 30 years. Women with multiple partners and those born abroad may also be considered for routine testing. Our results also suggest offering routine Chlamydia testing to heterosexual men under 25 years old. For MSM, we cannot draw specific recommendations based on our study as we estimated the prevalence of urethral Chlamydia infection, leaving out rectal and pharyngeal infections.

How can we eradicate chlamydia?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rousser, Margaret; He, Wei

Chlamydia is the most commonly contracted STI and affects millions of people worldwide, but it's not just hurting humans--it's also decimating koala populations! Find out how researches at the Lab are working toward developing the first vaccine against chlamydia--good news for humans and koalas.

Intracellular Survival and Persistence of Chlamydia muridarum Is Determined by Macrophage Polarization

PubMed Central

Gracey, Eric; Lin, Aifeng; Akram, Ali; Chiu, Basil; Inman, Robert D.

2013-01-01

Macrophages can display a number of distinct phenotypes, known collectively as polarized macrophages. The best defined of these phenotypes are the classically-activated, interferon gamma (IFNγ)/LPS induced (M1) and alternatively-activated, IL-4 induced (M2) macrophages. The goal of this study is to characterize macrophage- Chlamydia interactions in the context of macrophage polarization. Here we use Chlamydia muridarum and murine bone-marrow derived macrophages to show Chlamydia does not induce M2 polarization in macrophages as a survival strategy. Unexpectedly, the infection of macrophages was silent with no upregulation of M1 macrophage-associated genes. We further demonstrate that macrophages polarized prior to infection have a differential capacity to control Chlamydia . M1 macrophages harbor up to 40-fold lower inclusion forming units (IFU) than non-polarized or M2 polarized macrophages. Gene expression analysis showed an increase in 16sRNA in M2 macrophages with no change in M1 macrophages. Suppressed Chlamydia growth in M1 macrophages correlated with the induction of a bacterial gene expression profile typical of persistence as evident by increased Euo expression and decreased Omp1 and Tal expression. Observations of permissive Chlamydia growth in non-polarized and M2 macrophages and persistence in M1 macrophages were supported through electron microscopy. This work supports the importance of IFNγ in the innate immune response to Chlamydia . However, demonstration that the M1 macrophages, despite an antimicrobial signature, fail to eliminate intracellular Chlamydia supports the notion that host–pathogen co-evolution has yielded a pathogen that can evade cellular defenses against this pathogen, and persist for prolonged periods of time in the host. PMID:23967058

Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study

PubMed Central

Brabin, Loretta; Thomas, Grace; Hopkins, Mark; O'Brien, Karen; Roberts, Stephen A

2009-01-01

Background More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. Methods Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. Results 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). Conclusion Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group. PMID:19323804

Topical tenofovir protects against vaginal simian HIV infection in macaques coinfected with Chlamydia trachomatis and Trichomonas vaginalis.

PubMed

Makarova, Natalia; Henning, Tara; Taylor, Andrew; Dinh, Chuong; Lipscomb, Jonathan; Aubert, Rachael; Hanson, Debra; Phillips, Christi; Papp, John; Mitchell, James; McNicholl, Janet; Garcia-Lerma, Gerardo J; Heneine, Walid; Kersh, Ellen; Dobard, Charles

2017-03-27

Chlamydia trachomatis and Trichomonas vaginalis, two prevalent sexually transmitted infections, are known to increase HIV risk in women and could potentially diminish preexposure prophylaxis efficacy, particularly for topical interventions that rely on local protection. We investigated in macaques whether coinfection with Chlamydia trachomatis/Trichomonas vaginalis reduces protection by vaginal tenofovir (TFV) gel. Vaginal TFV gel dosing previously shown to provide 100 or 74% protection when applied either 30 min or 3 days before simian HIV(SHIV) challenge was assessed in pigtailed macaques coinfected with Chlamydia trachomatis/Trichomonas vaginalis and challenged twice weekly with SHIV162p3 for up to 10 weeks (two menstrual cycles). Three groups of six macaques received either placebo or 1% TFV gel 30 min or 3 days before each SHIV challenge. We additionally assessed TFV and TFV diphosphate concentrations in plasma and vaginal tissues in Chlamydia trachomatis/Trichomonas vaginalis coinfected (n = 4) and uninfected (n = 4) macaques. Chlamydia trachomatis/Trichomonas vaginalis coinfections were maintained during the SHIV challenge period. All macaques that received placebo gel were SHIV infected after a median of seven challenges (one menstrual cycle). In contrast, no infections were observed in macaques treated with TFV gel 30 min before SHIV challenge (P < 0.001). Efficacy was reduced to 60% when TFV gel was applied 3 days before SHIV challenge (P = 0.07). Plasma TFV and TFV diphosphate concentrations in tissues and vaginal lymphocytes were significantly higher in Chlamydia trachomatis/Trichomonas vaginalis coinfected compared with Chlamydia trachomatis/Trichomonas vaginalis uninfected macaques. Our findings in this model suggest that Chlamydia trachomatis/Trichomonas vaginalis coinfection may have little or no impact on the efficacy of highly effective topical TFV modalities and highlight a significant modulation of TFV pharmacokinetics.

Molecular prevalence and genotyping of Chlamydia spp. in wild birds from South Korea.

PubMed

Jeong, Jipseol; An, Injung; Oem, Jae-Ku; Wang, Seung-Jun; Kim, Yongkwan; Shin, Jeong-Hwa; Woo, Chanjin; Kim, Youngsik; Jo, Seong-Deok; Son, Kidong; Lee, Saemi; Jheong, Weonhwa

2017-07-07

Wild birds are reservoirs for Chlamydia spp. Of the total 225 samples from wild birds during January to September 2016 in Korea, 4 (1.8%) and 2 (0.9%) showed positive for Chlamydia psittaci and Chlamydia gallinacea, respectively. Phylogenetic analyses and comparisons of sequence identities for outer-membrane protein A (ompA) revealed that Korean C. psittaci fall into three previously known genotypes; genotype E, 1V and 6N, whereas the Korean C. gallinacea were classified as new variants of C. gallinacea. Our study demonstrates that wild birds in South Korea carry at least two Chlamydia species: C. psittaci and C. gallinacea, and provides new information on the epidemiology of avian chlamydiosis in wild birds.

[FEMALE STEROID HORMONES - MODULATORS OF IMMUNE RESPONSE TO GENITAL CHLAMYDIA TRACHOMATIS INFECTION.

PubMed

Kovachev, E; Ivanov, S; Bechev, B; Angelova, M; Grueva, E; Kolev, N; Ivanova, V

In the recent years according to WHO, genital chlamydia is the mos't common sexually transmitted infection. Chlamydia Trachomatis is an intracellular parasite which target are the tubular epithelial cells of the urethra, endocervix, endometrium, endosalpinx, conjunctiva, synovial lining of the joints, Glisson's capsule of the liver Our study, as well as some international researches, shows that in the cases of genital chlamydia there are changes in the ovarian hormones (estradiol and progesterone), their impact on the immune system and their importance for the development and the complications of the infection with Chlamydia trachomatis. The physiological level of the steroid hormones in its turn contributes for the normalization of the local immunity and reduces the possibility of recurrences.

Summary: The natural history and immunobiology of Chlamydia trachomatis genital infection and implications for Chlamydia control.

PubMed

Gottlieb, Sami L; Martin, David H; Xu, Fujie; Byrne, Gerald I; Brunham, Robert C

2010-06-15

In 2008, the US Centers for Disease Control and Prevention held the Chlamydia Immunology and Control Expert Advisory Meeting to foster a dialogue among basic scientists, clinical researchers, and epidemiologists studying genital Chlamydia trachomatis infection. The objectives of the meeting were to determine key questions related to C. trachomatis natural history and immunobiology, with implications for control programs;to review existing data on these key questions; and to delineate research needs to address remaining gaps in knowledge. The 9 articles in this supplement to The Journal of Infectious Diseases describe salient findings presented at the 2008 meeting, and this commentary summarizes and synthesizes these articles and discusses implications for chlamydia control efforts and future research priorities.

21 CFR 866.3120 - Chlamydia serological reagents.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Chlamydia serological reagents. 866.3120 Section 866.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Serological Reagents § 866.3120 Chlamydia...

21 CFR 866.3120 - Chlamydia serological reagents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Chlamydia serological reagents. 866.3120 Section 866.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Serological Reagents § 866.3120 Chlamydia...

21 CFR 866.3120 - Chlamydia serological reagents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Chlamydia serological reagents. 866.3120 Section 866.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Serological Reagents § 866.3120 Chlamydia...

21 CFR 866.3120 - Chlamydia serological reagents.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Chlamydia serological reagents. 866.3120 Section 866.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Serological Reagents § 866.3120 Chlamydia...

21 CFR 866.3120 - Chlamydia serological reagents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Chlamydia serological reagents. 866.3120 Section 866.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Serological Reagents § 866.3120 Chlamydia...

Neutrophils Are Central to Antibody-Mediated Protection against Genital Chlamydia.

PubMed

Naglak, Elizabeth K; Morrison, Sandra G; Morrison, Richard P

2017-10-01

Determining the effector populations involved in humoral protection against genital chlamydia infection is crucial to development of an effective chlamydial vaccine. Antibody has been implicated in protection studies in multiple animal models, and we previously showed that the passive transfer of immune serum alone does not confer immunity in the mouse. Using the Chlamydia muridarum model of genital infection, we demonstrate a protective role for both Chlamydia -specific immunoglobulin G (IgG) and polymorphonuclear neutrophils and show the importance of an antibody/effector cell interaction in mediating humoral immunity. While neutrophils were found to contribute significantly to antibody-mediated protection in vivo , natural killer (NK) cells were dispensable for protective immunity. Furthermore, gamma interferon (IFN-γ)-stimulated primary peritoneal neutrophils (PPNs) killed chlamydiae in vitro in an antibody-dependent manner. The results from this study support the view that an IFN-γ-activated effector cell population cooperates with antibody to protect against genital chlamydia and establish neutrophils as a key effector cell in this response. Copyright © 2017 Naglak et al.

Direct urine polymerase chain reaction for chlamydia and gonorrhoea: a simple means of bringing high-throughput rapid testing to remote settings?

PubMed

Rahimi, Frashta; Goire, Namraj; Guy, Rebecca; Kaldor, John M; Ward, James; Nissen, Michael D; Sloots, Theo P; Whiley, David M

2013-08-01

Background Rapid point-of-care tests (POCTs) for chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) have the potential to confer health benefits in certain populations even at moderate sensitivities; however, suitable POCTs for these organisms are currently lacking. In this study, we investigated the use of direct urine polymerase chain reaction (PCR), with the view of implementing a simplified PCR strategy for high-throughput chlamydia and gonorrhoea screening in remote settings. Briefly, a simple dilution of the urine was performed before adding it directly to a real-time PCR reaction. The method was evaluated using 134 stored urine specimens that had been submitted for chlamydia and gonorrhoea testing and had been tested using a commercial C. trachomatis and N. gonorrhoeae PCR method. These included samples that were PCR-positive for chlamydia (n=87), gonorrhoea (n=16) or both (n=2). Direct urine testing was conducted using previously described in-house real-time PCR methods for C. trachomatis and N. gonorrhoeae as well as for recognised N.gonorrhoeae antimicrobial resistance mechanisms. The overall sensitivities and specificities of the direct urine PCR were 78% and 100% for chlamydia, and 83% and 100% for gonorrhoea. N.gonorrhoeae penicillin and quinolone resistance mechanisms were characterised in 14 of the 18 N. gonorrhoeae-positive samples. The results of this study show that the simplified PCR strategy may be a feasible approach for rapid screening and improving chlamydia and gonorrhoea treatment in remote settings.

Study of the prevalence and association of ocular chlamydial conjunctivitis in women with genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans attending outpatient clinic.

PubMed

Khattab, Rania Abdelmonem; Abdelfattah, Maha Mohssen

2016-01-01

To determine the association between chlamydial conjunctivitis and genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans, in addition to the possible relationship between cultured bacterial pathogens and oculogenital chlamydial infection. This study was performed on 100 (50 symptomatic and 50 asymptomatic) women attending the Gynecological and Obstetric outpatient clinic of Alzahra hospital, Alazhar University. Simultaneously a conjunctival swab was taken from these patients. Polymerase chain reaction (PCR) was done on DNA extracted from both vaginal and conjunctival swab samples. Culture for both vaginal and conjunctival swabs was also done. Candida albicans was the predominant organism isolated by culture in 20% and 40% of conjunctival and vaginal swabs respectively. By the PCR method, ocular Chlamydia trachomatis was present in 60% of symptomatic women, while genital Chlamydia trachomatis infection was present in 30% of symptomatic women. The results of this method also indicated that 25/50 (50%) vaginal swabs were positive with PCR for Candida albicans versus 15/50 (30%) were PCR positive in conjunctival swab. Mycoplasma genitalium was present in only 10% of vaginal swabs. Concomitant oculogenital PCR positive results for Chlamydia trachomatis and Candida albicans were 30% and 28% respectively. Ocular Chlamydia trachomatis was associated with genital Chlamydia trachomatis in a high percentage of women followed by Candida albicans. Cultured bacterial organisms do not play a role in enhancement of Chlamydia trachomatis infection.

Mass media as a population-level intervention tool for Chlamydia trachomatis screening: report of a pilot study.

PubMed

Oh, M Kim; Grimley, Diane M; Merchant, Jeanne S; Brown, Pernell R; Cecil, Heather; Hook, Edward W

2002-07-01

To determine the feasibility and affect of mass media use in a population-level intervention for chlamydia screening promotion. A population-level chlamydia intervention protocol was field tested. The intervention, targeting 15-25-year-old individuals, was designed to: (a) increase awareness of personal risk for chlamydial infection; (b) facilitate dissemination of chlamydia knowledge by use of a telephone hot line; and (c) promote care-seeking behavior (report for a chlamydia screening program). The intervention activities included: (a) mail outreach, (b) a television and radio campaign, (c) a prerecorded Check-It-Out chlamydia hot line, (d) a staffed chlamydia Options information line, and (e) a free confidential urine ligase chain reaction (LCR) test for chlamydia. Mass mailings were scheduled at intervals, starting two-weeks before the beginning of the television advertisement. The 30-second television advertisement was aired on local television stations 130 times in a 6-week period. The outcome measures were quantity and characteristics of incoming calls to the automated hot line and staffed chlamydia information phone line in response to the chlamydia campaign, and response to the urine screening program. Descriptive and bivariate analyses were used to evaluate the outcomes. The hot line was called 642 times during the monitoring period (November 1, 1999 to March 8, 2000), the majority (92%) during the 6 weeks of television advertisement, with an average of 99 calls per week, compared with an average of 9 calls per week after the commercial ended. Each bulk mailing was accompanied by a boost in the incoming hot line calls. The research staff triaged 133 calls to the "Options" phone line, 81% in the 6 weeks of the TV ad. The mean age of the 133 callers was 23.9 +/- 7.7 years (range 14-49 years). A majority called for screening information; 67% of callers were females and 84% of female callers were under age 26 years. Five percent of callers identified themselves as a parent of a teenager. The majority credited the TV ad as their source of the hot line number. Thirty-one individuals reported for a confidential chlamydia screening, 27 of 31 (87%) during the 6 weeks of TV advertising. No negative responses regarding the chlamydia campaign were encountered. This report describes strategies used to implement and measure the effectiveness of a mass media campaign and demonstrates evidence that mass media is effective in delivering STD intervention messages to young people.

[Newer diagnostic procedures for chlamydial diseases (author's transl)].

PubMed

Edlinger, E; Ardoin, P

1981-12-01

Chlamydiales are bacteries showing a growth cycle unique among procaryotes. The two species Chlamydia trachomatis and Chlamydia psittaci are genetically very distant and their pathogenicity for man is very distinct. Human chlamydial infections by Chlamydia trachomatis are diseases chiefly sexually transmitted and their epidemiological importance is growing. The relationship between chlamydial infections, Reiter disease, and cat scratch disease are discussed. The various laboratory diagnostic procedures are reported, including the techniques and their indications; the method of choice is in the majority of cases the isolation of Chlamydia on cell culture.

Evaluation of Cortez OneStep Chlamydia Rapicard™ Insta Test for the Detection of Chlamydia trachomatis in Pregnant Women at Mbare Polyclinic in Harare, Zimbabwe.

PubMed

Stephen, Stephen; Muchaneta-Kubara, Chiwoneso Gwyneth Elizabeth; Munjoma, Marshall Wesley; Mandozana, Gibson

2017-01-01

Cervical chlamydia infection poses high risk of pregnancy complications and neonatal infection. Reference methods for the detection of chlamydia infection are not available for routine use in developing countries. Point-of-care (POC) tests can bridge this gap. This study evaluated Cortez Onestep Chlamydia Rapicard™ insta test for the detection of Chlamydia trachomatis in pregnant women at Mbare Polyclinic and determined the prevalence of C. trachomatis . This was a cross sectional study in 242 pregnant women aged ≥18 years attending their first ANC visit at Mbare polyclinic in Harare, Zimbabwe. Data collection form was used to obtain demographic and predisposing factors to Chlamydia infection and two endocervical swabs were collected from each patient. One specimen was examined by the POC test at the clinic and the other by SDA method in the laboratory. The sensitivity, specificity, positive and negative predictive values of the rapid kit were 71.4%, 99.6%, 90.9% and 98.3% respectively. Prevalence of C. trachomitis was 5.8% by SDA method. The kit's sensitivity (71.4%) and specificity (99.6%) implies that the rapid test is an important test which needs further evaluations. The prevalence of C. trichomitis of 5.8% is comparable to studies done elsewhere in Africa.

Striking ethnic variations in the epidemiology of Chlamydia trachomatis in Haifa District, Israel, throughout the years 2001-2015.

PubMed

Kridin, Khalaf; Khamaisi, Mogher; Rishpon, Shmuel; Grifat, Rami

2017-12-01

Our objectives were to examine trends in the incidence of chlamydia over an extended period and compare the epidemiology of the infection between two distinct ethnic groups in Israel: Jews and Arabs. We examined the incidence rate of Chlamydia trachomatis infection among residents of Haifa District, northern Israel from 2001 to 2015, by reviewing archives of the Department of Epidemiology, Ministry of Health. Notified cases were stratified by age group, gender, and ethnic group. The overall incidence rate of Chlamydia was 10.8 cases per 100,000 population per year. The annual rate increased dramatically from 5.1 per 100,000 population in 2001, to an all-time high of 18.5 cases per 100,000 population in 2015 (P < 0.001), representing an increase of 362.7%. The most affected age group was 25-34 years of age. The estimated rate among Jewish inhabitants was ninefold higher than among Arabs. Only 3% recurrent episodes of Chlamydia were registered. The prevalence of HIV positivity among Chlamydia-infected patients was similar to that of the general population. In conclusion, Chlamydia in Haifa has been continuously increasing since 2001 and the infection is much more prevalent among patients of Jewish ethnicity, mainly due to more hazardous sexual practices in this population.

Mixed-methods evaluation of a novel online STI results service.

PubMed

Gibbs, Jo; Aicken, Catherine R H; Sutcliffe, Lorna J; Gkatzidou, Voula; Tickle, Laura J; Hone, Kate; Sadiq, S Tariq; Sonnenberg, Pam; Estcourt, Claudia S

2018-01-11

Evidence on optimal methods for providing STI test results is lacking. We evaluated an online results service, developed as part of an eSexual Health Clinic (eSHC). We evaluated the online results service using a mixed-methods approach within large exploratory studies of the eSHC. Participants were chlamydia- positive and negative users of online postal self-sampling services in six National Chlamydia Screening Programme (NCSP) areas and chlamydia-positive patients from two genitourinary medicine (GUM) clinics between 21 July 2014 and 13 March 2015. Participants received a discreetly worded National Health Service 'NHS no-reply' text message (SMS) informing them that their test results were ready and providing a weblink to a secure website. Participants logged in with their date of birth and mobile telephone or clinic number. Chlamydia-positive patients were offered online management. All interactions with the eSHC system were automatically logged and their timing recorded. Post-treatment, a service evaluation survey (n=152) and qualitative interviews (n=36) were conducted by telephone. Chlamydia-negative patients were offered a short online survey (n=274). Data were integrated. 92% (134/146) of NCSP chlamydia-positive patients, 82% (161/197) of GUM chlamydia-positive patients and 89% (1776/1997) of NCSP chlamydia-negative participants accessed test results within 7 days. 91% of chlamydia-positive patients were happy with the results service; 64% of those who had tested previously found the results service better or much better than previous experiences. 90% of chlamydia-negative survey participants agreed they would be happy to receive results this way in the future. Interviewees described accessing results with ease and appreciated the privacy and control the two-step process gave them. A discreet SMS to alert users/patients that results are available, followed by provision of results via a secure website, was highly acceptable, irrespective of test result and testing history. The eSHC results service afforded users privacy and control over when they viewed results without compromising access. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Knowledge and acceptability of Chlamydia trachomatis screening among pregnant women and their partners; a cross-sectional study

PubMed Central

2014-01-01

Background Chlamydia trachomatis infections in pregnancy can cause maternal disease, adverse pregnancy outcomes and neonatal disease, which is why chlamydia screening during pregnancy has been advocated. The effectiveness of a screening program depends on the knowledge of health care professionals, women and partners and the acceptability for screening of the target population. We assessed the knowledge of chlamydia infection among pregnant women and their partners in the Netherlands, their attitudes towards testing, and their experiences of being offered a chlamydia test. In addition, we evaluated the association between participants’ background characteristics and knowledge of chlamydia. Methods Pregnant women aged ≤ 30 years and their partners (regardless of their age) attending one of the participating primary midwifery care practices in the Netherlands were invited to participate. All participants completed a questionnaire, pregnant women provided a vaginal swab and partners provided a urine sample to test for C. trachomatis. Results In total, 383 pregnant women and 282 partners participated in the study of whom 1.9% women and 2.6% partners tested chlamydia positive. Participants had high levels of awareness (92.8%) of chlamydial infection. They were knowledgeable about the risk of chlamydia infection; median knowledge score was 9.0 out of 12.0. Lower knowledge scores were found among partners (p-value <0.001), younger aged (p-value 0.02), non-western origin (p-value <0.001), low educational level (p-value <0.001), and no history of sexually transmitted infections (p-value <0.001). In total, 78% of respondents indicated that when pregnant women are tested for chlamydia, their partners should also be tested; 54% believed that all women should routinely be tested. Pregnant women more often indicated than partners that testing partners for chlamydial infection was not necessary (p-value <0.001). The majority of pregnant women (56.2%) and partners (59.2%) felt satisfied by being offered the test during antenatal care. Conclusion Pregnant women and their partners were knowledgeable about chlamydial infection, found testing, both pregnant women and their partners, for chlamydia acceptable and not stigmatizing. PMID:25011479

Knowledge and acceptability of Chlamydia trachomatis screening among pregnant women and their partners; a cross-sectional study.

PubMed

Pereboom, Monique T R; Spelten, Evelien R; Manniën, Judith; Rours, G Ingrid J G; Morré, Servaas A; Schellevis, François G; Hutton, Eileen K

2014-07-09

Chlamydia trachomatis infections in pregnancy can cause maternal disease, adverse pregnancy outcomes and neonatal disease, which is why chlamydia screening during pregnancy has been advocated. The effectiveness of a screening program depends on the knowledge of health care professionals, women and partners and the acceptability for screening of the target population. We assessed the knowledge of chlamydia infection among pregnant women and their partners in the Netherlands, their attitudes towards testing, and their experiences of being offered a chlamydia test. In addition, we evaluated the association between participants' background characteristics and knowledge of chlamydia. Pregnant women aged ≤ 30 years and their partners (regardless of their age) attending one of the participating primary midwifery care practices in the Netherlands were invited to participate. All participants completed a questionnaire, pregnant women provided a vaginal swab and partners provided a urine sample to test for C. trachomatis. In total, 383 pregnant women and 282 partners participated in the study of whom 1.9% women and 2.6% partners tested chlamydia positive. Participants had high levels of awareness (92.8%) of chlamydial infection. They were knowledgeable about the risk of chlamydia infection; median knowledge score was 9.0 out of 12.0. Lower knowledge scores were found among partners (p-value <0.001), younger aged (p-value 0.02), non-western origin (p-value <0.001), low educational level (p-value <0.001), and no history of sexually transmitted infections (p-value <0.001). In total, 78% of respondents indicated that when pregnant women are tested for chlamydia, their partners should also be tested; 54% believed that all women should routinely be tested. Pregnant women more often indicated than partners that testing partners for chlamydial infection was not necessary (p-value <0.001). The majority of pregnant women (56.2%) and partners (59.2%) felt satisfied by being offered the test during antenatal care. Pregnant women and their partners were knowledgeable about chlamydial infection, found testing, both pregnant women and their partners, for chlamydia acceptable and not stigmatizing.

The contribution of a urine-based jail screening program to citywide male Chlamydia and gonorrhea case rates in New York City.

PubMed

Pathela, Preeti; Hennessy, Robin R; Blank, Susan; Parvez, Farah; Franklin, Woodman; Schillinger, Julia A

2009-02-01

With noninvasive specimen types, males can be more easily screened for Chlamydia trachomatis and Neisseria gonorrhoeae infections. Long-standing universal screening of males attending New York City (NYC) sexually transmitted diseases (STD) clinics has yielded a substantial number of chlamydia cases. In 2005, screening was expanding to another large group at high risk for STD: males

A cross sectional study on Dutch layer farms to investigate the prevalence and potential risk factors for different Chlamydia species.

PubMed

Heijne, Marloes; van der Goot, Jeanet A; Fijten, Helmi; van der Giessen, Joke W; Kuijt, Eric; Maassen, Catharina B M; van Roon, Annika; Wit, Ben; Koets, Ad P; Roest, Hendrik I J

2018-01-01

In poultry several Chlamydia species have been detected, but Chlamydia psittaci and Chlamydia gallinacea appear to be most prevalent and important. Chlamydia psittaci is a well-known zoonosis and is considered to be a pathogen of poultry. Chlamydia gallinacea has been described more recently. Its avian pathogenicity and zoonotic potential have to be further elucidated. Within the Netherlands no data were available on the presence of Chlamydia on poultry farms. As part of a surveillance programme for zoonotic pathogens in farm animals, we investigated pooled faecal samples from 151 randomly selected layer farms. On a voluntary base, 69 farmers, family members or farm workers from these 151 farms submitted a throat swab. All samples were tested with a generic 23S Chlamydiaceae PCR followed by a species specific PCR for C. avium, C. gallinacea and C. psittaci. C. avium and psittaci DNA was not detected at any of the farms. At 71 farms the positive result could be confirmed as C. gallinacea. Variables significantly associated with the presence of C. gallinacea in a final multivariable model were 'age of hens,' 'use of bedding material' and 'the presence of horses.' The presence of C. gallinacea was associated with neither clinical signs, varying from respiratory symptoms, nasal and ocular discharges to diarrhoea, nor with a higher mortality rate the day before the visit. All throat swabs from farmers, family members or farm workers tested negative for Chlamydia DNA, giving no further indication for possible bird-to-human (or human-to-bird) transmission.

Comparison of doxycycline with azithromycin in treatment of pharyngeal chlamydia infection.

PubMed

Manavi, K; Hettiarachchi, N; Hodson, J

2016-12-01

Recent data suggest that azithromycin may not be as effective as doxycycline in eradication of genital chlamydial infection. The aim of this study was to compare the eradication rate of pharyngeal Chlamydia trachomatis infection after treatment with azithromycin 1 g stat with that of doxycycline 100 mg twice a day for seven days. A prospective open-label observational study was conducted on patients with pharyngeal Chlamydia trachomatis diagnosed at Whittall Street Clinic, University Hospitals Birmingham, Birmingham, UK, between July 2012 and July 2013. We confirmed eradication of pharyngeal Chlamydia trachomatis with a negative test of cure. We treated all our patients with azithromycin 1 g stat until February 2013. At that stage, we offered doxycycline to patients with pharyngeal Chlamydia trachomatis A total of 398 patients (52 men, 346 women) were diagnosed with pharyngeal Chlamydia trachomatis during the study period. Of the 172 patients included in the final analysis, 78 were treated with azithromycin and 64 with doxycycline. Treatment failure was identified among 8/78 (10%) patients treated with azithromycin and 1/64 (2%) treated with doxycycline (absolute difference: 8 percentage points, 95% CI: 0-17%, p = 0.041). In our study, doxycycline 100 mg twice a day for seven days was associated with less treatment failure of oropharyngeal chlamydia compared with azithromycin 1 g stat Future randomised studies should investigate whether patients with pharyngeal Chlamydia trachomatis should be followed up with a test of cure when treated with azithromycin, or be treated with doxycycline. © The Author(s) 2016.

The cost-effectiveness of an outreach clinical model in the management and prevention of gonorrhea and chlamydia among Chinese female sex workers in Hong Kong.

PubMed

You, Joyce H S; Wong, William C W; Sin, Chung Wah; Woo, Jean

2006-04-01

Social marginalization and stigmatization in usual medical care setting may refrain female sex workers (FSWs) from seeking usual medical care for sexually transmitted infections in Hong Kong. To evaluate the cost-effectiveness of using an outreach approach for treatment and prevention of gonorrhea and chlamydia among FSWs. A decision tree was designed to simulate the outcomes of 2 alternatives: (1) outreach service providing treatment of gonorrhea and chlamydia and counseling to FSWs (outreach arm) and (2) no outreach service (control arm). Five tiers of outcomes were estimated for each study arm: (1) total direct medical cost, (2) number of FSWs infected with gonorrhea, (3) number of new cases of gonorrhea in clients transmitted by FSWs, (4) number of FSWs infected with chlamydia, and (5) number of new cases of chlamydia in clients transmitted by FSWs. Clinical inputs were estimated from literature, and cost analysis was conducted from the perspective of a public health organization. Compared to the control group, the marginal savings per new case of infection averted (marginal cost divided by marginal cases of infection) of the outreach group were $10,988 (US dollars) per case of gonorrhea averted in FSWs, $685 per case of gonorrhea averted in clients, $9643 per case of chlamydia averted in FSWs, and $220 per case of chlamydia averted in clients ($1=7.8 Hong Kong dollars). An outreach clinic is potentially less costly and more effective in preventing transmission of gonorrhea and chlamydia between FSWs and their clients in Hong Kong.

Attitudes to Chlamydia screening elicited using the social networking site Facebook for subject recruitment.

PubMed

Ahmed, Navera; Jayasinghe, Yasmin; Wark, John D; Fenner, Yeshe; Moore, Elya E; Tabrizi, Sepehr N; Fletcher, Ashley; Garland, Suzanne M

2013-07-01

Chlamydia (Chlamydia trachomatis) is the commonest bacterial sexually transmissible infection worldwide and contributes to significant morbidity in females. We examined potential barriers and facilitating factors for screening in young Victorian women, using the social networking site, Facebook to recruit participants. This was part of a larger study on young women's health that assessed the feasibility of using social networking sites for recruitment. An advertisement was placed on Facebook between May and September 2010, and was visible to eligible women. Women who clicked on the advertisement and expressed their interest in participating were invited to complete a questionnaire either at a study site or online. In total, 278 participants completed the survey, with 76% reporting willingness to participate in chlamydia screening by recruitment via an online system. Overall, 73% of participants indicated they were comfortable providing a urine sample collected at home for chlamydia screening, with older participants less comfortable with this method (P=0.02, odds ratio (OR)=0.09, 95% confidence interval (CI)=0.01-0.7). Participants expressed comfort with their Pap smear and chlamydia screening being performed together (92.7%), especially those who were aware of human papillomavirus (P<0.01, OR=2.5, 95% CI=1.3-4.7). This study demonstrated willingness by young Victorian women using Facebook to participate in screening for chlamydia. There was strong acceptance of self-collected sampling, and of combined chlamydia and cervical cytology screening. Facebook may therefore be a feasible way for improving screening coverage at a population level.

Amoebal endosymbiont Parachlamydia acanthamoebae Bn9 can grow in immortal human epithelial HEp-2 cells at low temperature; an in vitro model system to study chlamydial evolution.

PubMed

Yamane, Chikayo; Yamazaki, Tomohiro; Nakamura, Shinji; Matsuo, Junji; Ishida, Kasumi; Yamazaki, Sumire; Oguri, Satoshi; Shouji, Natsumi; Hayashi, Yasuhiro; Yoshida, Mitsutaka; Yimin; Yamaguchi, Hiroyuki

2015-01-01

Ancient chlamydiae diverged into pathogenic and environmental chlamydiae 0.7-1.4 billion years ago. However, how pathogenic chlamydiae adapted to mammalian cells that provide a stable niche at approximately 37 °C, remains unknown, although environmental chlamydiae have evolved as endosymbionts of lower eukaryotes in harsh niches of relatively low temperatures. Hence, we assessed whether an environmental chlamydia, Parachlamydia Bn9, could grow in human HEp-2 cells at a low culture temperature of 30 °C. The assessment of inclusion formation by quantitative RT-PCR revealed that the numbers of bacterial inclusion bodies and the transcription level of 16SrRNA significantly increased after culture at 30 °C compared to at 37 °C. Confocal microscopy showed that the bacteria were located close to HEp-2 nuclei and were actively replicative. Transmission electron microscopy also revealed replicating bacteria consisting of reticular bodies, but with a few elementary bodies. Cytochalasin D and rifampicin inhibited inclusion formation. Lactacystin slightly inhibited bacterial inclusion formation. KEGG analysis using a draft genome sequence of the bacteria revealed that it possesses metabolic pathways almost identical to those of pathogenic chlamydia. Interestingly, comparative genomic analysis with pathogenic chlamydia revealed that the Parachlamydia similarly possess the genes encoding Type III secretion system, but lacking genes encoding inclusion membrane proteins (IncA to G) required for inclusion maturation. Taken together, we conclude that ancient chlamydiae had the potential to grow in human cells, but overcoming the thermal gap was a critical event for chlamydial adaptation to human cells.

Chlamydia Screening Decision Study

DTIC Science & Technology

2000-05-01

United States Center for Disease Control and Prevention (CDC) reports 3 million genital chlamydia infections annually (Eradication, 1998). Many infected...trachomatis infection of the genital tract Clinician A professional health care provider, regardless of educational preparation who has credentials to...available literature on genital chlamydia infection in women. Civilian population studies and military population studies are presented. Research

GRANULOMATOUS ENCEPHALOMYELITIS IN A FALSE GHARIAL (TOMISTOMA SCHLEGELII) ASSOCIATED WITH A NOVEL CHLAMYDIA SPECIES.

PubMed

Bercier, Marjorie; Heard, Darryl J; Goe, Alexandra M; Epperson, Ember; Abbott, Jeffrey R; Childress, April L; Wellehan, James F X

2017-06-01

A 5-yr-old, captive, hatched, female false gharial (Tomistoma schlegelii) presented with a 1-mo history of cervical spinal curvature. Antemortem diagnostics, including blood work, electromyography, muscle biopsies, and advanced imaging tests, were either within reference ranges or did not identify any specific etiology. Necropsy revealed extensive, marked, chronic granulomatous encephalomyelitis along with neuronal necrosis, rarefaction, gliosis, and astrocytosis of the white and gray matter of the cerebrum, cerebellum, brainstem, and spinal cord. Pan-chlamydiae polymerase chain reaction protocols for the 16S ribosomal RNA and ompA genes were performed on samples of spinal cord and brain, and both resulted in amplicons. Sequencing of the products revealed that they were positive for a novel Chlamydia species. Infections by members of the phylum Chlamydiae have been reported in a diverse range of vertebrate hosts, including crocodilians. Chlamydia spp. infections are likely underdiagnosed because of a paucity of diagnostic techniques specific for detection. This is the first case report of a novel Chlamydia species associated with severe granulomatous encephalomyelitis in a false gharial.

Incidence of Chlamydia trachomatis infections and screening compliance, U.S. Army active duty females under 25 years of age, 2011-2014.

PubMed

Tourdot, Laura E; Jordan, Nikki N; Leamer, Nicole K; Nowak, Gosia; Gaydos, Joel C

2016-02-01

Reported chlamydia infection rates among active duty U.S. Army females less than 25 years old declined by 20% from 2011 to 2014 (11,028 infections per 100,000 person-years [p-yrs] to 8,793 infections per 100,000 p-yrs, respectively). An overall decline in the proportions of high-risk female soldiers tested for chlamydia occurred during the same period, declining from a high of 85% in 2011 to a low of 71% in 2012, with an increase to 80% in 2014. Chlamydia laboratory testing volume also decreased from 2011 to 2013 but the test positivity rate remained stable at 6.0%-6.4%. By using projected incidence rates based on 100% of at-risk women being screened with a stable laboratory positivity rate, there was an estimated 15% decline in chlamydia incidence from 2011 to 2014 (12,794 to 10,991 infections per 100,000 p-yrs, respectively). Surveillance for chlamydia infections must include consideration of screening program performance in addition to passive reporting.

Chlamydia trachomatis screening in young women.

PubMed

Baraitser, Paula; Alexander, Sarah; Sheringham, Jessica

2011-10-01

As the number of chlamydia screening programmes implemented worldwide increases, we summarize current understanding of the epidemiology, natural history, and management of chlamydia, focusing on screening in young women. Chlamydia diagnoses continue to rise, with young women at high risk. Recently published trials show that the risk of serious reproductive health outcomes is lower than previously thought. They illustrate that significant barriers - both practical and cultural - remain to engaging young people and health professionals in routine testing for sexually transmitted infections. Chlamydia control efforts have driven innovative approaches to testing including new approaches to engaging young people in discussions of sexual health and screening accessed via the Internet. Chlamydia is highly prevalent among young women and may cause serious reproductive sequelae. Gaps in our knowledge of the epidemiology, natural history and immunology of this organism continue to hamper efforts to control it. Sexual health promotion and screening of young people remain the mainstay of population control, although there is as yet no strong evidence of health screening benefits. Control efforts will require new strategies to engage young people and health professionals to normalize sexual health testing. (C) 2011 Lippincott Williams & Wilkins, Inc.

Molecular Genetic Analysis of Chlamydia Species.

PubMed

Sixt, Barbara S; Valdivia, Raphael H

2016-09-08

Species of Chlamydia are the etiologic agent of endemic blinding trachoma, the leading cause of bacterial sexually transmitted diseases, significant respiratory pathogens, and a zoonotic threat. Their dependence on an intracellular growth niche and their peculiar developmental cycle are major challenges to elucidating their biology and virulence traits. The last decade has seen tremendous advances in our ability to perform a molecular genetic analysis of Chlamydia species. Major achievements include the generation of large collections of mutant strains, now available for forward- and reverse-genetic applications, and the introduction of a system for plasmid-based transformation enabling complementation of mutations; expression of foreign, modified, or reporter genes; and even targeted gene disruptions. This review summarizes the current status of the molecular genetic toolbox for Chlamydia species and highlights new insights into their biology and new challenges in the nascent field of Chlamydia genetics.

Emancipating Chlamydia: Advances in the Genetic Manipulation of a Recalcitrant Intracellular Pathogen

PubMed Central

Bastidas, Robert J.

2016-01-01

SUMMARY Chlamydia species infect millions of individuals worldwide and are important etiological agents of sexually transmitted disease, infertility, and blinding trachoma. Historically, the genetic intractability of this intracellular pathogen has hindered the molecular dissection of virulence factors contributing to its pathogenesis. The obligate intracellular life cycle of Chlamydia and restrictions on the use of antibiotics as selectable markers have impeded the development of molecular tools to genetically manipulate these pathogens. However, recent developments in the field have resulted in significant gains in our ability to alter the genome of Chlamydia, which will expedite the elucidation of virulence mechanisms. In this review, we discuss the challenges affecting the development of molecular genetic tools for Chlamydia and the work that laid the foundation for recent advancements in the genetic analysis of this recalcitrant pathogen. PMID:27030552

Screening for genital chlamydia infection.

PubMed

Low, Nicola; Redmond, Shelagh; Uusküla, Anneli; van Bergen, Jan; Ward, Helen; Andersen, Berit; Götz, Hannelore

2016-09-13

Genital infections caused by Chlamydia trachomatis are the most prevalent bacterial sexually transmitted infection worldwide. Screening of sexually active young adults to detect and treat asymptomatic infections might reduce chlamydia transmission and prevent reproductive tract morbidity, particularly pelvic inflammatory disease (PID) in women, which can cause tubal infertility and ectopic pregnancy. To assess the effects and safety of chlamydia screening versus standard care on chlamydia transmission and infection complications in pregnant and non-pregnant women and in men. We searched the Cochrane Sexually Transmitted Infections Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, CINAHL, DARE, PsycINFO and Web of Science electronic databases up to 14 February 2016, together with World Health Organization International Clinical Trials Registry (ICTRP) and ClinicalTrials.gov. We also handsearched conference proceedings, contacted trial authors and reviewed the reference lists of retrieved studies. Randomised controlled trials (RCTs) in adult women (non-pregnant and pregnant) and men comparing a chlamydia screening intervention with usual care and reporting on a primary outcome (C. trachomatis prevalence, PID in women, epididymitis in men or incidence of preterm delivery). We included non-randomised controlled clinical trials if there were no RCTs for a primary outcome. Two review authors independently assessed trials for inclusion, extracted data and assessed the risk of bias. We resolved disagreements by consensus or adjudication by a third reviewer. We described results in forest plots and conducted meta-analysis where appropriate using a fixed-effect model to estimate risk ratios (RR with 95% confidence intervals, CI) in intervention vs control groups. We conducted a pre-specified sensitivity analysis of the primary outcome, PID incidence, according to the risks of selection and detection bias. We included six trials involving 359,078 adult women and men. One trial was at low risk of bias in all six specific domains assessed. Two trials examined the effect of multiple rounds of chlamydia screening on C. trachomatis transmission. A cluster-controlled trial in women and men in the general population in the Netherlands found no change in chlamydia test positivity after three yearly invitations (intervention 4.1% vs control 4.3%, RR 0.96, 95% CI 0.84 to 1.09, 1 trial, 317,304 participants at first screening invitation, low quality evidence). Uptake of the intervention was low (maximum 16%). A cluster-randomised trial in female sex workers in Peru found a reduction in chlamydia prevalence after four years (adjusted RR 0.72, 95% CI 0.54 to 0.98, 1 trial, 4465 participants, low quality evidence).Four RCTs examined the effect of chlamydia screening on PID in women 12 months after a single screening offer. In analysis of four trials according to the intention-to-treat principle, the risk of PID was lower in women in intervention than control groups, with little evidence of between-trial heterogeneity (RR 0.68, 95% CI 0.49 to 0.94, I 2 7%, 4 trials, 21,686 participants, moderate quality evidence). In a sensitivity analysis, the estimated effect of chlamydia screening in two RCTs at low risk of detection bias (RR 0.80, 95% CI 0.55 to 1.17) was compatible with no effect and was lower than in two RCTs at high or unclear risk of detection bias (RR 0.42, 95% CI 0.22 to 0.83).The risk of epididymitis in men invited for screening, 12 months after a single screening offer, was 20% lower risk for epididymitis than in those not invited; the confidence interval was wide and compatible with no effect (RR 0.80, 95% CI 0.45 to 1.42, 1 trial, 14,980 participants, very low quality evidence).We found no RCTs of the effects of chlamydia screening in pregnancy and no trials that measured the harms of chlamydia screening. Evidence about the effects of screening on C. trachomatis transmission is of low quality because of directness and risk of bias. There is moderate quality evidence that detection and treatment of chlamydia infection can reduce the risk of PID in women at individual level. There is an absence of RCT evidence about the effects of chlamydia screening in pregnancy.Future RCTs of chlamydia screening interventions should determine the effects of chlamydia screening in pregnancy, of repeated rounds of screening on the incidence of chlamydia-associated PID and chlamydia reinfection in general and high risk populations.

Chlamydia and lymphogranuloma venereum in Canada: 2003-2012 Summary Report

PubMed Central

Totten, S; MacLean, R; Payne, E; Severini, A

2015-01-01

Background Chlamydia continues to be the most commonly reported sexually transmitted infection in Canada. Lymphogranuloma venereum (LGV), caused by certain serovars of Chlamydia trachomatis, is becoming established in some populations in a number of Western countries. Objective To identify trends in reported cases of chlamydia and LGV in Canada from January 1, 2003 to December 31, 2012. Methods Notifiable disease data on chlamydia were submitted to the Public Health Agency of Canada by provincial and territorial epidemiological units and summarized at the national level by age and sex. Confirmatory testing for suspected LGV cases and serovar subtyping were performed by the National Microbiology Laboratory (NML). Where possible, provincial/territorial health authorities use a standardized national case report form to collect enhanced epidemiological data on each case and to submit the data to the Agency. Results Rates of reported cases of chlamydia increased by 57.6%, from 189.6 to 298.7 per 100,000 between 2003 and 2012. The rate of reported cases of chlamydia among females (383.5 per 100,000) was almost twice as high as that among males (212.0 per 100,000), although the highest relative rate increase occurred among males. In both males and females, the rates of chlamydia were highest in those aged 20 to 24 years. From 2004 to 2012, 170 cases of LGV were reported to the Agency by provincial health authorities (including 104 confirmed and 66 probable cases). In 2012, case reports were received on 12 confirmed and probable cases, compared to 38 laboratory-positive cases confirmed by the NML. Conclusion In Canada, as in many countries, chlamydia rates have markedly increased over the last 10 years, in part due to improved diagnosis through nucleic acid amplification (NAAT) testing. Consistent with trends in Europe and other countries, LGV is emerging in Canada among men who have sex with men (MSM). PMID:29769927

Chlamydia Hijacks ARF GTPases To Coordinate Microtubule Posttranslational Modifications and Golgi Complex Positioning.

PubMed

Wesolowski, Jordan; Weber, Mary M; Nawrotek, Agata; Dooley, Cheryl A; Calderon, Mike; St Croix, Claudette M; Hackstadt, Ted; Cherfils, Jacqueline; Paumet, Fabienne

2017-05-02

The intracellular bacterium Chlamydia trachomatis develops in a parasitic compartment called the inclusion. Posttranslationally modified microtubules encase the inclusion, controlling the positioning of Golgi complex fragments around the inclusion. The molecular mechanisms by which Chlamydia coopts the host cytoskeleton and the Golgi complex to sustain its infectious compartment are unknown. Here, using a genetically modified Chlamydia strain, we discovered that both posttranslationally modified microtubules and Golgi complex positioning around the inclusion are controlled by the chlamydial inclusion protein CT813/CTL0184/InaC and host ARF GTPases. CT813 recruits ARF1 and ARF4 to the inclusion membrane, where they induce posttranslationally modified microtubules. Similarly, both ARF isoforms are required for the repositioning of Golgi complex fragments around the inclusion. We demonstrate that CT813 directly recruits ARF GTPases on the inclusion membrane and plays a pivotal role in their activation. Together, these results reveal that Chlamydia uses CT813 to hijack ARF GTPases to couple posttranslationally modified microtubules and Golgi complex repositioning at the inclusion. IMPORTANCE Chlamydia trachomatis is an important cause of morbidity and a significant economic burden in the world. However, how Chlamydia develops its intracellular compartment, the so-called inclusion, is poorly understood. Using genetically engineered Chlamydia mutants, we discovered that the effector protein CT813 recruits and activates host ADP-ribosylation factor 1 (ARF1) and ARF4 to regulate microtubules. In this context, CT813 acts as a molecular platform that induces the posttranslational modification of microtubules around the inclusion. These cages are then used to reposition the Golgi complex during infection and promote the development of the inclusion. This study provides the first evidence that ARF1 and ARF4 play critical roles in controlling posttranslationally modified microtubules around the inclusion and that Chlamydia trachomatis hijacks this novel function of ARF to reposition the Golgi complex. Copyright © 2017 Wesolowski et al.

Feasibility of Chlamydia trachomatis screening and treatment in pregnant women in Lima, Peru: a prospective study in two large urban hospitals.

PubMed

Cabeza, Jeanne; García, Patricia J; Segura, Eddy; García, Pedro; Escudero, Francisco; La Rosa, Sayda; León, Segundo; Klausner, Jeffrey D

2015-02-01

Chlamydia trachomatis, which is asymptomatic in most women, causes significant adverse effects for pregnant women and neonates. No programmes conduct antenatal screening in Latin America. We determined chlamydia prevalence, feasibility and acceptability of chlamydia screening, and adherence to treatment in pregnant women in two urban public hospitals in Lima, Peru. We offered chlamydia screening using self-collected vaginal swabs to pregnant women ≥ 16 years of age during their first antenatal visit. Chlamydia-infected women were contacted within 14 days and asked to bring partners for counselling and directly observed therapy with oral azithromycin. Unaccompanied women received counselling, directly observed therapy, and azithromycin to take to partners. Test of cure was performed ≥ 3 weeks after treatment. We approached 640 women for the study and enrolled 600 (93.8%). Median age was 27.3 years (range 16-47), median lifetime partners 2.3 (range 1-50), and median gestational age 26.1 weeks (range 4-41). Chlamydia prevalence was 10% (95% CI 7.7% to 12.7%). Of 60 infected patients, 59 (98%) were treated with one dose of azithromycin. Fifty-two of 59 (88%) returned for test of cure, all of whom were treated successfully, with 46 (86%) achieving negative test of cure with one dose of azithromycin, and 6 (12%) after retreatment with a second dose. C. trachomatis screening and treatment in pregnancy was feasible and highly acceptable in two urban hospitals in Peru. Chlamydia prevalence was high. Clinical trials to evaluate efficacy and cost-effectiveness of chlamydia screening, and treatment of pregnant women to prevent adverse pregnancy outcomes in low-resource settings, are warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chlamydial infection preceding the development of rheumatoid arthritis: a brief report.

PubMed

Jolly, Meenakshi; Curran, J J

2004-10-01

Chlamydia trachomatis-triggered reactive arthritis is a well-documented entity that has been extensively described. We do not have a clear understanding about the inflammatory oligoarthritis associated with the presence of this organism. It is rarely cultured from the synovial fluid, but is usually detectable by molecular biological techniques. Typically, Chlamydia trachomatis causes a sterile but inflammatory oligoarthritis. We report an unusual case of inflammatory monoarthritis in a young woman in whom Chlamydia was isolated from the synovial fluid. This is the first case of documented isolation of Chlamydia from synovial fluid, which subsequently was diagnosed as rheumatoid arthritis.

Evaluation of Cortez OneStep Chlamydia Rapicard™ Insta Test for the Detection of Chlamydia trachomatis in Pregnant Women at Mbare Polyclinic in Harare, Zimbabwe

PubMed Central

Stephen, Stephen; Muchaneta-Kubara, Chiwoneso Gwyneth Elizabeth; Munjoma, Marshall Wesley; Mandozana, Gibson

2017-01-01

Background: Cervical chlamydia infection poses high risk of pregnancy complications and neonatal infection. Reference methods for the detection of chlamydia infection are not available for routine use in developing countries. Point-of-care (POC) tests can bridge this gap. This study evaluated Cortez Onestep Chlamydia Rapicard™ insta test for the detection of Chlamydia trachomatis in pregnant women at Mbare Polyclinic and determined the prevalence of C. trachomatis. Methods: This was a cross sectional study in 242 pregnant women aged ≥18 years attending their first ANC visit at Mbare polyclinic in Harare, Zimbabwe. Data collection form was used to obtain demographic and predisposing factors to Chlamydia infection and two endocervical swabs were collected from each patient. One specimen was examined by the POC test at the clinic and the other by SDA method in the laboratory. Results: The sensitivity, specificity, positive and negative predictive values of the rapid kit were 71.4%, 99.6%, 90.9% and 98.3% respectively. Prevalence of C. trachomitis was 5.8% by SDA method. Conclusion and Global Health Implications: The kit’s sensitivity (71.4%) and specificity (99.6%) implies that the rapid test is an important test which needs further evaluations. The prevalence of C. trichomitis of 5.8% is comparable to studies done elsewhere in Africa. PMID:28798890

The Number, Organization, and Size of Polymorphic Membrane Protein Coding Sequences as well as the Most Conserved Pmp Protein Differ within and across Chlamydia Species.

PubMed

Van Lent, Sarah; Creasy, Heather Huot; Myers, Garry S A; Vanrompay, Daisy

2016-01-01

Variation is a central trait of the polymorphic membrane protein (Pmp) family. The number of pmp coding sequences differs between Chlamydia species, but it is unknown whether the number of pmp coding sequences is constant within a Chlamydia species. The level of conservation of the Pmp proteins has previously only been determined for Chlamydia trachomatis. As different Pmp proteins might be indispensible for the pathogenesis of different Chlamydia species, this study investigated the conservation of Pmp proteins both within and across C. trachomatis,C. pneumoniae,C. abortus, and C. psittaci. The pmp coding sequences were annotated in 16 C. trachomatis, 6 C. pneumoniae, 2 C. abortus, and 16 C. psittaci genomes. The number and organization of polymorphic membrane coding sequences differed within and across the analyzed Chlamydia species. The length of coding sequences of pmpA,pmpB, and pmpH was conserved among all analyzed genomes, while the length of pmpE/F and pmpG, and remarkably also of the subtype pmpD, differed among the analyzed genomes. PmpD, PmpA, PmpH, and PmpA were the most conserved Pmp in C. trachomatis,C. pneumoniae,C. abortus, and C. psittaci, respectively. PmpB was the most conserved Pmp across the 4 analyzed Chlamydia species. © 2016 S. Karger AG, Basel.

Bridging the Gap: Using School-Based Health Services to Improve Chlamydia Screening Among Young Women

PubMed Central

Provost, Jackie M.

2010-01-01

Objectives. We implemented a chlamydia screening program targeted at young women accessing reproductive health care services in a school-based setting, and we assessed racial/ethnic factors associated with infection. Methods. The California Family Health Council partnered with 9 health care agencies receiving federal Title X family planning funding and 19 educational institutions to implement the Educational Partnerships to Increase Chlamydia Screening (EPICS) program from January 2008 through December 2008. Results. EPICS agencies provided reproductive health services to 3396 unique sexually active females, 85% of whom self-reported no other source for reproductive health care. Chlamydia screening was provided to 3026 clients (89.1% chlamydia screening coverage). Of those screened for chlamydia, 5.6% tested positive. Clients who were African American (odds ratio [OR] = 7.5; 95% confidence interval [CI] = 3.9, 14.3), Pacific Islander (OR = 4.1; 95% CI = 1.1, 15.5), or Asian (OR = 3.3; 95% CI = 1.4, 8.1) were more likely to have a positive test than were White clients. Conclusions. Chlamydia screening programs implemented in school-based settings have the capacity to identify and treat a significant amount of asymptomatic infection in a population that otherwise may not be reached. To facilitate screening, school-based clinics should implement outreach strategies that target their school population and clinical strategies that maximize opportunities for screening. PMID:20634446

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 11, November 2010

DTIC Science & Technology

2010-11-01

2010 Reporting location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c...Reporting location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q...Reporting location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q

Identifying Relationships between High-Risk Sexual Behaviors and Screening Positive for Chlamydia and Gonorrhea in School-Wide Screening Events

ERIC Educational Resources Information Center

Salerno, Jennifer; Darling-Fisher, Cindy; Hawkins, Nicole M.; Fraker, Elizabeth

2013-01-01

Background: This article describes a school-wide sexually transmitted infection (STI) screening to identify adolescent high-risk sexual behaviors, STI history/incidence, and presence of chlamydia and gonorrhea, and examines relationships between high-risk behaviors and screening positive for chlamydia and gonorrhea in an alternative high school…

Chlamydia pecorum Infection in Free-ranging Koalas ( Phascolarctos cinereus ) on French Island, Victoria, Australia.

PubMed

Legione, Alistair R; Amery-Gale, Jemima; Lynch, Michael; Haynes, Leesa; Gilkerson, James R; Sansom, Fiona M; Devlin, Joanne M

2016-04-28

We detected Chlamydia pecorum in two koalas ( Phascolarctos cinereus ) from a closed island population in Victoria, Australia, previously free of Chlamydia infection. The ompA and multilocus sequence type were most closely related to published isolates of livestock rather than koala origin, suggesting potential cross-species transmission of C. pecorum .

Hospitalisations for pelvic inflammatory disease temporally related to a diagnosis of Chlamydia or gonorrhoea: a retrospective cohort study.

PubMed

Reekie, Joanne; Donovan, Basil; Guy, Rebecca; Hocking, Jane S; Jorm, Louisa; Kaldor, John M; Mak, Donna B; Preen, David; Pearson, Sallie; Roberts, Christine L; Stewart, Louise; Wand, Handan; Ward, James; Liu, Bette

2014-01-01

The presence and severity of pelvic inflammatory disease (PID) symptoms are thought to vary by microbiological etiology but there is limited empirical evidence. We sought to estimate and compare the rates of hospitalisation for PID temporally related to diagnoses of gonorrhoea and chlamydia. All women, aged 15-45 years in the Australian state of New South Wales (NSW), with a diagnosis of chlamydia or gonorrhoea between 01/07/2000 and 31/12/2008 were followed by record linkage for up to one year after their chlamydia or gonorrhoea diagnosis for hospitalisations for PID. Standardised incidence ratios compared the incidence of PID hospitalisations to the age-equivalent NSW population. A total of 38,193 women had a chlamydia diagnosis, of which 483 were hospitalised for PID; incidence rate (IR) 13.9 per 1000 person-years of follow-up (PYFU) (95%CI 12.6-15.1). In contrast, 1015 had a gonorrhoea diagnosis, of which 45 were hospitalised for PID (IR 50.8 per 1000 PYFU, 95%CI 36.0-65.6). The annual incidence of PID hospitalisation temporally related to a chlamydia or gonorrhoea diagnosis was 27.0 (95%CI 24.4-29.8) and 96.6 (95%CI 64.7-138.8) times greater, respectively, than the age-equivalent NSW female population. Younger age, socio-economic disadvantage, having a diagnosis prior to 2005 and having a prior birth were also associated with being hospitalised for PID. Chlamydia and gonorrhoea are both associated with large increases in the risk of PID hospitalisation. Our data suggest the risk of PID hospitalisation is much higher for gonorrhoea than chlamydia; however, further research is needed to confirm this finding.

Increased gonorrhoea and chlamydia testing did not increase case detection in an HIV clinical cohort 1999-2007.

PubMed

Berry, Stephen A; Ghanem, Khalil G; Page, Kathleen R; Gange, Stephen J; Thio, Chloe L; Moore, Richard D; Gebo, Kelly A

2011-10-01

Since 2003, US organisations have recommended universal screening, rather than targeted screening, of HIV-infected persons for gonorrhoea and chlamydia. The objective of this study was to determine whether wider testing resulting from these guidelines would produce an increase in gonorrhoea/chlamydia diagnoses. 3283 patients receiving HIV care in 1999-2007 in the Johns Hopkins Hospital HIV clinic were studied. The two primary outcomes were the occurrence of any gonorrhoea/chlamydia testing in each year of care and the occurrence of any positive result(s) in years of testing. The proportion of all patients in care who were diagnosed with gonorrhoea/chlamydia was defined as the number of patients with positive results divided by the number of patients in care. Trends were analysed with repeated measures logistic regression. The proportion of patients tested for gonorrhoea/chlamydia increased steadily from 0.12 in 1999 to 0.33 in 2007 (OR per year for being tested 1.17, 95% CI 1.15 to 1.19). The proportion positive among those tested decreased significantly after 2003 (OR per year 0.67, 95% CI 0.55 to 0.81). The proportion of all patients in care diagnosed with gonorrhoea/chlamydia therefore remained generally stable in 1999-2007 (OR per year 0.97, 95% CI 0.91 to 1.04). Universal annual screening, as implemented, did not increase the proportion of all patients in care who were diagnosed with gonorrhoea/chlamydia. Similarly low implementation rates have been reported in cross-sectional studies. If future efforts to enhance implementation do not yield increases in diagnoses, then guidelines focusing on targeted screening of high-risk groups rather than universal screening may be warranted.

Serosorting and recreational drug use are risk factors for diagnosis of genital infection with chlamydia and gonorrhoea among HIV-positive men who have sex with men: results from a clinical cohort in Ontario, Canada.

PubMed

Grewal, Ramandip; Allen, Vanessa G; Gardner, Sandra; Moravan, Veronika; Tan, Darrell H S; Raboud, Janet; Bayoumi, Ahmed M; Kaul, Rupert; Mazzulli, Tony; McGee, Frank; Rourke, Sean B; Burchell, Ann N

2017-02-01

Rates of chlamydia and gonorrhoea have been rising in urban centres in Canada, particularly among HIV-positive men who have sex with men (MSM). Our objective was to identify behavioural risk factors for diagnosis with chlamydia and gonorrhoea in this population, with a focus on the HIV status of sexual partners. The OHTN Cohort Study follows people in HIV care across Ontario. We restricted the analysis to 1997 MSM who completed questionnaires in 2010-2013 at one of seven clinics that submit all chlamydia and gonorrhoea tests to the provincial public health laboratory; we obtained test results via record linkage. We estimated cumulative incidences using Kaplan-Meier methods and identified risk factors for diagnosis of a composite outcome (chlamydia or gonorrhoea infection) using Cox regression. At follow-up, there were 74 new chlamydia/gonorrhoea diagnoses with a 12-month cumulative incidence of 1.7% (95% CI 1.1% to 2.2%). Risk factors for chlamydia/gonorrhoea diagnosis were: 5+ HIV-positive partners (HR=3.3, 95% CI 1.4 to 7.8; reference=none) and recreational drug use (HR=2.2, 95% CI 1.2 to 3.9). Heightened risks with recreational drug use and multiple HIV-positive partners suggest that chlamydia/gonorrhoea may have achieved high prevalence in certain sexual networks among HIV-positive MSM. Interventions to promote safer sex and timely testing among MSM are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Screening for Chlamydia trachomatis: a systematic review of the economic evaluations and modelling

PubMed Central

Roberts, T E; Robinson, S; Barton, P; Bryan, S; Low, N

2006-01-01

Objective To review systematically and critically, evidence used to derive estimates of costs and cost effectiveness of chlamydia screening. Methods Systematic review. A search of 11 electronic bibliographic databases from the earliest date available to August 2004 using keywords including chlamydia, pelvic inflammatory disease, economic evaluation, and cost. We included studies of chlamydia screening in males and/or females over 14 years, including studies of diagnostic tests, contact tracing, and treatment as part of a screening programme. Outcomes included cases of chlamydia identified and major outcomes averted. We assessed methodological quality and the modelling approach used. Results Of 713 identified papers we included 57 formal economic evaluations and two cost studies. Most studies found chlamydia screening to be cost effective, partner notification to be an effective adjunct, and testing with nucleic acid amplification tests, and treatment with azithromycin to be cost effective. Methodological problems limited the validity of these findings: most studies used static models that are inappropriate for infectious diseases; restricted outcomes were used as a basis for policy recommendations; and high estimates of the probability of chlamydia associated complications might have overestimated cost effectiveness. Two high quality dynamic modelling studies found opportunistic screening to be cost effective but poor reporting or uncertainty about complication rates make interpretation difficult. Conclusion The inappropriate use of static models to study interventions to prevent a communicable disease means that uncertainty remains about whether chlamydia screening programmes are cost effective or not. The results of this review can be used by health service managers in the allocation of resources, and health economists and other researchers who are considering further research in this area. PMID:16731666

Chlamydia sequelae cost estimates used in current economic evaluations: does one-size-fit-all?

PubMed

Ong, Koh Jun; Soldan, Kate; Jit, Mark; Dunbar, J Kevin; Woodhall, Sarah C

2017-02-01

Current evidence suggests that chlamydia screening programmes can be cost-effective, conditional on assumptions within mathematical models. We explored differences in cost estimates used in published economic evaluations of chlamydia screening from seven countries (four papers each from UK and the Netherlands, two each from Sweden and Australia, and one each from Ireland, Canada and Denmark). From these studies, we extracted management cost estimates for seven major chlamydia sequelae. In order to compare the influence of different sequelae considered in each paper and their corresponding management costs on the total cost per case of untreated chlamydia, we applied reported unit sequelae management costs considered in each paper to a set of untreated infection to sequela progression probabilities. All costs were adjusted to 2013/2014 Great British Pound (GBP) values. Sequelae management costs ranged from £171 to £3635 (pelvic inflammatory disease); £953 to £3615 (ectopic pregnancy); £546 to £6752 (tubal factor infertility); £159 to £3341 (chronic pelvic pain); £22 to £1008 (epididymitis); £11 to £1459 (neonatal conjunctivitis) and £433 to £3992 (neonatal pneumonia). Total cost of sequelae per case of untreated chlamydia ranged from £37 to £412. There was substantial variation in cost per case of chlamydia sequelae used in published chlamydia screening economic evaluations, which likely arose from different assumptions about disease management pathways and the country perspectives taken. In light of this, when interpreting these studies, the reader should be satisfied that the cost estimates used sufficiently reflect the perspective taken and current disease management for their respective context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Defining species-specific immunodominant B cell epitopes for molecular serology of Chlamydia species.

PubMed

Rahman, K Shamsur; Chowdhury, Erfan U; Poudel, Anil; Ruettger, Anke; Sachse, Konrad; Kaltenboeck, Bernhard

2015-05-01

Urgently needed species-specific enzyme-linked immunosorbent assays (ELISAs) for the detection of antibodies against Chlamydia spp. have been elusive due to high cross-reactivity of chlamydial antigens. To identify Chlamydia species-specific B cell epitopes for such assays, we ranked the potential epitopes of immunodominant chlamydial proteins that are polymorphic among all Chlamydia species. High-scoring peptides were synthesized with N-terminal biotin, followed by a serine-glycine-serine-glycine spacer, immobilized onto streptavidin-coated microtiter plates, and tested with mono-specific mouse hyperimmune sera against each Chlamydia species in chemiluminescent ELISAs. For each of nine Chlamydia species, three to nine dominant polymorphic B cell epitope regions were identified on OmpA, CT618, PmpD, IncA, CT529, CT442, IncG, Omp2, TarP, and IncE proteins. Peptides corresponding to 16- to 40-amino-acid species-specific sequences of these epitopes reacted highly and with absolute specificity with homologous, but not heterologous, Chlamydia monospecies-specific sera. Host-independent reactivity of such epitopes was confirmed by testing of six C. pecorum-specific peptides from five proteins with C. pecorum-reactive sera from cattle, the natural host of C. pecorum. The probability of cross-reactivity of peptide antigens from closely related chlamydial species or strains correlated with percent sequence identity and declined to zero at <50% sequence identity. Thus, phylograms of B cell epitope regions predict the specificity of peptide antigens for rational use in the genus-, species-, or serovar-specific molecular serology of Chlamydia spp. We anticipate that these peptide antigens will improve chlamydial serology by providing easily accessible assays to nonspecialist laboratories. Our approach also lends itself to the identification of relevant epitopes of other microbial pathogens. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Defining Species-Specific Immunodominant B Cell Epitopes for Molecular Serology of Chlamydia Species

PubMed Central

Rahman, K. Shamsur; Chowdhury, Erfan U.; Poudel, Anil; Ruettger, Anke; Sachse, Konrad

2015-01-01

Urgently needed species-specific enzyme-linked immunosorbent assays (ELISAs) for the detection of antibodies against Chlamydia spp. have been elusive due to high cross-reactivity of chlamydial antigens. To identify Chlamydia species-specific B cell epitopes for such assays, we ranked the potential epitopes of immunodominant chlamydial proteins that are polymorphic among all Chlamydia species. High-scoring peptides were synthesized with N-terminal biotin, followed by a serine-glycine-serine-glycine spacer, immobilized onto streptavidin-coated microtiter plates, and tested with mono-specific mouse hyperimmune sera against each Chlamydia species in chemiluminescent ELISAs. For each of nine Chlamydia species, three to nine dominant polymorphic B cell epitope regions were identified on OmpA, CT618, PmpD, IncA, CT529, CT442, IncG, Omp2, TarP, and IncE proteins. Peptides corresponding to 16- to 40-amino-acid species-specific sequences of these epitopes reacted highly and with absolute specificity with homologous, but not heterologous, Chlamydia monospecies-specific sera. Host-independent reactivity of such epitopes was confirmed by testing of six C. pecorum-specific peptides from five proteins with C. pecorum-reactive sera from cattle, the natural host of C. pecorum. The probability of cross-reactivity of peptide antigens from closely related chlamydial species or strains correlated with percent sequence identity and declined to zero at <50% sequence identity. Thus, phylograms of B cell epitope regions predict the specificity of peptide antigens for rational use in the genus-, species-, or serovar-specific molecular serology of Chlamydia spp. We anticipate that these peptide antigens will improve chlamydial serology by providing easily accessible assays to nonspecialist laboratories. Our approach also lends itself to the identification of relevant epitopes of other microbial pathogens. PMID:25761461

Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial

PubMed Central

2014-01-01

Background Chlamydia infection is the most common notifiable sexually transmitted infection (STI) in Australia and mostly affects young people (15 – 25 years). This paper presents baseline data from a randomised controlled trial that aimed to increase chlamydia testing among sexually active young people. The objectives were to identify associations between sexual behaviour, substance use and STI history and explore attitudes to chlamydia testing. Methods This study was conducted in cyberspace. Study recruitment, allocation, delivery of interventions and baseline and follow up data collection all took place online. Participants were 16 – 25 years old and resided in Australia. Substance use correlates of sexual activity; predictors of history of STIs; barriers to and facilitators of chlamydia testing were analysed. Results Of 856 participants (79.1% female), 704 had experienced penetrative intercourse. Sexually active participants were more likely to smoke regularly or daily, to drink alcohol, or to have binge drunk or used marijuana or other illicit substances recently. Risk factors for having a history of any STI were 3 or more sexual partners ever, 6 or more partners in the past 12 months, condom non-use and being 20 years or older. Almost all sexually active participants said that they would have a chlamydia test if their doctor recommended it. Conclusions Sexually active young people are at risk of STIs and may engage in substance use risk behaviours. Where one health risk behaviour is identified, it is important to seek information about others. Chlamydia testing can be facilitated by doctors and nurses recommending it. Primary care providers have a useful role in chlamydia control. Trial Registration Australian and New Zealand Trials Registry ACTRN12607000582459 PMID:24400743

Amoebal Endosymbiont Parachlamydia acanthamoebae Bn9 Can Grow in Immortal Human Epithelial HEp-2 Cells at Low Temperature; An In Vitro Model System to Study Chlamydial Evolution

PubMed Central

Nakamura, Shinji; Matsuo, Junji; Ishida, Kasumi; Yamazaki, Sumire; Oguri, Satoshi; Shouji, Natsumi; Hayashi, Yasuhiro; Yoshida, Mitsutaka; Yimin; Yamaguchi, Hiroyuki

2015-01-01

Ancient chlamydiae diverged into pathogenic and environmental chlamydiae 0.7–1.4 billion years ago. However, how pathogenic chlamydiae adapted to mammalian cells that provide a stable niche at approximately 37°C, remains unknown, although environmental chlamydiae have evolved as endosymbionts of lower eukaryotes in harsh niches of relatively low temperatures. Hence, we assessed whether an environmental chlamydia, Parachlamydia Bn9, could grow in human HEp-2 cells at a low culture temperature of 30°C. The assessment of inclusion formation by quantitative RT-PCR revealed that the numbers of bacterial inclusion bodies and the transcription level of 16SrRNA significantly increased after culture at 30°C compared to at 37°C. Confocal microscopy showed that the bacteria were located close to HEp-2 nuclei and were actively replicative. Transmission electron microscopy also revealed replicating bacteria consisting of reticular bodies, but with a few elementary bodies. Cytochalasin D and rifampicin inhibited inclusion formation. Lactacystin slightly inhibited bacterial inclusion formation. KEGG analysis using a draft genome sequence of the bacteria revealed that it possesses metabolic pathways almost identical to those of pathogenic chlamydia. Interestingly, comparative genomic analysis with pathogenic chlamydia revealed that the Parachlamydia similarly possess the genes encoding Type III secretion system, but lacking genes encoding inclusion membrane proteins (IncA to G) required for inclusion maturation. Taken together, we conclude that ancient chlamydiae had the potential to grow in human cells, but overcoming the thermal gap was a critical event for chlamydial adaptation to human cells. PMID:25643359

Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature

PubMed Central

Chan, Philip A.; Montgomery, Madeline; Almonte, Alexi; Lonks, John R.; Chapin, Kimberle C.; Kojic, Erna M.; Hardy, Erica J.

2016-01-01

In the United States, sexually transmitted diseases due to Chlamydia trachomatis and Neisseria gonorrhoeae continue to be a major public health burden. Screening of extragenital sites including the oropharynx and rectum is an emerging practice based on recent studies highlighting the prevalence of infection at these sites. We reviewed studies reporting the prevalence of extragenital infections in women, men who have sex with men (MSM), and men who have sex only with women (MSW), including distribution by anatomical site. Among women, prevalence was found to be 0.6–35.8% for rectal gonorrhea (median reported prevalence 1.9%), 0–29.6% for pharyngeal gonorrhea (median 2.1%), 2.0–77.3% for rectal chlamydia (median 8.7%), and 0.2–3.2% for pharyngeal chlamydia (median 1.7%). Among MSM, prevalence was found to be 0.2–24.0% for rectal gonorrhea (median 5.9%), 0.5–16.5% for pharyngeal gonorrhea (median 4.6%), 2.1–23.0% for rectal chlamydia (median 8.9%), and 0–3.6% for pharyngeal chlamydia (median 1.7%). Among MSW, the prevalence was found to be 0–5.7% for rectal gonorrhea (median 3.4%), 0.4–15.5% for pharyngeal gonorrhea (median 2.2%), 0–11.8% for rectal chlamydia (median 7.7%), and 0–22.0% for pharyngeal chlamydia (median 1.6%). Extragenital infections are often asymptomatic and found in the absence of reported risk behaviors, such as receptive anal and oral intercourse. We discuss current clinical recommendations and future directions for research. PMID:27366021

[Prevalence of Chlamydia trachomatis and Neisseria gonorrhoea infections in sexual actives young women at a southern Brazilian city].

PubMed

Piazzetta, Regina Celi Passagnolo Sérgio; de Carvalho, Newton Sérgio; de Andrade, Rosires Pereira; Piazzetta, Giovana; Piazzetta, Silvia Regina; Carneiro, Rosangela

2011-11-01

to determine the prevalence of Chlamydia and gonorrhea in a sample of women from Curitiba. this was a cross-sectional study with a sample of sexually active non-pregnant women aged between 16 and 23 years-old, with an intact uterus, with up to four sexual partners, without evidence of fever or purulent cervicitis, submitted to pelvic examination and PCR-based urine- testing for Chlamydia and gonorrhea. Exclusion criteria included: vaccination for HPV, vaccination history for the past 21 days, previous abnormal cytology, history of genital warts, splenectomy, immune disorders, and use of immunosuppressive drugs. An interview regarding sociodemographic and obstetric data and gynecological risk behavior for sexual transmitted diseases was applied. For statistical analysis, we used the χ(2) or Fisher's exact test to assess the association between variables. the prevalence of Chlamydia and gonorrhea infection in the study group was 10.7 and 1.5%, respectively, and the rate of coinfection was 0.9%. No correlation was found between the age range of the volunteers, the onset of sexual activity, the number of sexual partners and of new sexual partners in the last six months, and the presence of Chlamydia or gonorrhea. In women who had vaginal discharge or ectropion, the prevalence of Chlamydia infection was two times higher than in those without such signs. the results of this study were similar to national studies using PCR in urine samples for the detection of Chlamydia and gonorrhea in samples of non-pregnant women of the same age groups and with the same background. Since the volunteers with more than four sexual partners and those who had purulent endocervicitis were excluded, it is believed that the prevalence of Chlamydia and gonorrhea infection could have been greater in this population.

Risk factors for Chlamydia among young women in a northern california juvenile detention facility: implications for community intervention.

PubMed

McDonnell, Diana D; Levy, Vivian; Morton, Theresa J M

2009-02-01

Chlamydia infections are increasing in California, with rates highest in young women aged 15 to 24. Juvenile detention facilities are important venues for screening high-risk youth who may not otherwise access care. We, therefore, sought to identify risk factors for urogenital chlamydia among young women in a county juvenile detention facility between 2002 and 2005. With the state Chlamydia Screening Project (ClaSP), young women booked into the county detention facility were offered urine-based screening for urogenital chlamydia. Demographics, sexual history, and behavioral risk factors were self-reported through questionnaires completed during specimen collection. Nine hundred and thirty-nine young women were screened for chlamydia. The 5% positivity rate remained steady over the 33-month study. Vaginal sex was reported by 82% of women, oral sex by 50%, and anal sex by 30%. Only 9% reporting anal sex always used condoms. In multivariate analysis, little distinguished those with urogenital chlamydia. Women from the southern region of the county (adjusted odds ratio, 3.5; 1.4-8.7) and surrounding urban centers (3.7; 1.2-11.4) had higher odds of infection, as did those with 2 to 3 lifetime partners (3.2; 1.2-8.2)-although there was no linear relationship between partner number and infection. Those who had been in drug/alcohol treatment had lower odds of infection (0.1; 0.01-0.6). Our findings support universal chlamydia testing of young women detainees. The high prevalence of unprotected anal sex highlights an important modifiable HIV risk behavior in these adolescents. Risk factors reported here should inform the integration of prevention and treatment services in correctional settings and substance abuse treatment centers.

Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial.

PubMed

Kang, Melissa; Rochford, Arlie; Skinner, S Rachel; Mindel, Adrian; Webb, Marianne; Peat, Jenny; Usherwood, Tim

2014-01-08

Chlamydia infection is the most common notifiable sexually transmitted infection (STI) in Australia and mostly affects young people (15 - 25 years). This paper presents baseline data from a randomised controlled trial that aimed to increase chlamydia testing among sexually active young people. The objectives were to identify associations between sexual behaviour, substance use and STI history and explore attitudes to chlamydia testing. This study was conducted in cyberspace. Study recruitment, allocation, delivery of interventions and baseline and follow up data collection all took place online. Participants were 16 - 25 years old and resided in Australia. Substance use correlates of sexual activity; predictors of history of STIs; barriers to and facilitators of chlamydia testing were analysed. Of 856 participants (79.1% female), 704 had experienced penetrative intercourse. Sexually active participants were more likely to smoke regularly or daily, to drink alcohol, or to have binge drunk or used marijuana or other illicit substances recently. Risk factors for having a history of any STI were 3 or more sexual partners ever, 6 or more partners in the past 12 months, condom non-use and being 20 years or older. Almost all sexually active participants said that they would have a chlamydia test if their doctor recommended it. Sexually active young people are at risk of STIs and may engage in substance use risk behaviours. Where one health risk behaviour is identified, it is important to seek information about others. Chlamydia testing can be facilitated by doctors and nurses recommending it. Primary care providers have a useful role in chlamydia control. Australian and New Zealand Trials Registry ACTRN12607000582459.

High Titers ofChlamydia trachomatis Antibodies in Brazilian Women with Tubal Occlusion or Previous Ectopic Pregnancy

PubMed Central

Machado, A. C. S.; Guimarães, E. M. B.; Sakurai, E.; Fioravante, F. C. R.; Amaral, W. N.; Alves, M. F. C.

2007-01-01

Objective. To evaluate serum chlamydia antibody titers (CATs) in tubal occlusion or previous ectopic pregnancy and the associated risk factors.Methods. The study population consisted of 55 women wih tubal damage and 55 parous women. CAT was measured using the whole-cell inclusion immunofluorescence test and cervical chlamydial DNA detected by PCR. Odds ratios were calculated to assess variables associated withC. trachomatis infection.Results. The prevalence of chlamydial antibodies and antibody titers in women with tubal occlusion or previous ectopic pregnancy was significantly higher (P < .01) than in parous women. Stepwise logistic regression analysis showed that chlamydia IgG antibodies were associated with tubal damage and with a larger number of lifetime sexual partners.Conclusions. Chlamydia antibody titers were associated with tubal occlusion, prior ectopic pregnancy, and with sexual behavior, suggesting that a chlamydia infection was the major contributor to the tubal damage in these women. PMID:17541464

Emancipating Chlamydia: Advances in the Genetic Manipulation of a Recalcitrant Intracellular Pathogen.

PubMed

Bastidas, Robert J; Valdivia, Raphael H

2016-06-01

Chlamydia species infect millions of individuals worldwide and are important etiological agents of sexually transmitted disease, infertility, and blinding trachoma. Historically, the genetic intractability of this intracellular pathogen has hindered the molecular dissection of virulence factors contributing to its pathogenesis. The obligate intracellular life cycle of Chlamydia and restrictions on the use of antibiotics as selectable markers have impeded the development of molecular tools to genetically manipulate these pathogens. However, recent developments in the field have resulted in significant gains in our ability to alter the genome of Chlamydia, which will expedite the elucidation of virulence mechanisms. In this review, we discuss the challenges affecting the development of molecular genetic tools for Chlamydia and the work that laid the foundation for recent advancements in the genetic analysis of this recalcitrant pathogen. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Using the Theory of Planned Behavior to identify key beliefs underlying chlamydia testing intentions in a sample of young people living in deprived areas.

PubMed

Booth, Amy R; Norman, Paul; Harris, Peter R; Goyder, Elizabeth

2015-09-01

The Theory of Planned Behavior was used to identify the key behavioural, normative and control beliefs underlying intentions to test regularly for chlamydia among young people living in socially and economically deprived areas - a high-risk group for infection. Participants (N = 278, 53% male; mean age 17 years) were recruited from a vocational college situated in an area in the most deprived national quintile (England). Participants completed measures of behavioural, normative and control beliefs, plus intention to test regularly for chlamydia. The behavioural, normative and control beliefs most strongly correlated with intentions to test regularly for chlamydia were beliefs about stopping the spread of infection, partners' behaviour and the availability of testing. These beliefs represent potential targets for interventions to increase chlamydia testing among young people living in deprived areas. © The Author(s) 2013.

Chlamydia-induced septic polyarthritis in a dog.

PubMed

Lambrechts, N; Picard, J; Tustin, R C

1999-03-01

A systemic disease associated with pyrexia, lymphadenopathy, and arthropathy of several joints of the appendicular skeleton in a dog is described. Chlamydia-like organisms were detected on light-microscopic examination of a smear made from joint fluid aspirated from one of the affected joints. A group-specific lipopolysaccharide antigen shared by all Chlamydia spp. was demonstrated by direct fluorescent antibody staining of joint fluid, which also proved positive for chlamydia by means of the relevant polymerase chain reaction test. An indirect fluorescent antibody test on serum was also positive, although the complement fixation test was negative. Attempts to grow the organism from joint aspirates in the yolk sac of embryonating hens' eggs and on appropriate tissue cultures, however, failed. Chlamydia spp. are considered to have played an aetiological role in this case, making it the first substantiated case of naturally-occurring arthropathy in a dog due to chlamydiosis. The origin of the infection could not be traced.

Chlamydia Infection Across Host Species Boundaries Promotes Distinct Sets of Transcribed Anti-Apoptotic Factors

PubMed Central

Messinger, Joshua E.; Nelton, Emmalin; Feeney, Colleen; Gondek, David C.

2015-01-01

Chlamydiae, obligate intracellular bacteria, cause significant human and veterinary associated diseases. Having emerged an estimated 700-million years ago, these bacteria have twice adapted to humans as a host species, causing sexually transmitted infection (C. trachomatis) and respiratory associated disease (C. pneumoniae). The principle mechanism of host cell defense against these intracellular bacteria is the induction of cell death via apoptosis. However, in the “arms race” of co-evolution, Chlamydiae have developed mechanisms to promote cell viability and inhibit cell death. Herein we examine the impact of Chlamydiae infection across multiple host species on transcription of anti-apoptotic genes. We found mostly distinct patterns of gene expression (Mcl1 and cIAPs) elicited by each pathogen-host pair indicating Chlamydiae infection across host species boundaries does not induce a universally shared host response. Understanding species specific host-pathogen interactions is paramount to deciphering how potential pathogens become emerging diseases. PMID:26779446

Risk factors associated with Chlamydia and gonorrhea infection among female sex workers in two Mexico-U.S. border cities

PubMed Central

Loza, Oralia; Strathdee, Steffanie A.; Martinez, Gustavo A.; Lozada, Remedios; Ojeda, Victoria D.; Staines-Orozco, Hugo; Patterson, Thomas L.

2011-01-01

Female sex workers (FSWs) aged ≥18 years without known HIV infection living in Tijuana and Ciudad Juarez who had recent unprotected sex with clients underwent interviews and testing for Chlamydia and gonorrhea using nucleic acid amplification. Correlates of each infection were identified with logistic regression. Among 798 FSWs, prevalence of Chlamydia and gonorrhea was 13.0% and 6.4%. Factors independently associated with Chlamydia were being younger, working in Tijuana versus Ciudad Juarez, and recent methamphetamine injection. Factors independently associated with gonorrhea were working in Tijuana versus Ciudad Juarez, using illegal drugs before or during sex, and having a recent male partner who injects drugs. Chlamydia and gonorrhea infection were more closely associated with FSWs’ drug use behaviors and that of their sexual partners than with sexual behaviors. Prevention should focus on subgroups of FSWs and their partners who use methamphetamine and who inject drugs. PMID:20852194

Medical Surveillance Monthly Report (MSMR). Volume 15, Number 10, December 2008

DTIC Science & Technology

2008-12-01

gonococcal (NGU). Reporting locations Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold...gonococcal (NGU). Reporting location Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis...Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2007 2008 2007 2008 2007 2008 2007 2008 2007 2008 2007 2008 2007 2008 2007

Two more species of Chlamydia-does it make a difference?

PubMed

Sachse, Konrad; Laroucau, Karine

2015-02-01

The recent description of Chlamydia (C.) avium and C. gallinacea as new species of the reunited genus Chlamydia can be expected to have implications on the perception of avian chlamydiosis. We discuss possible effects on epidemiology, diagnosis and our understanding of aetiopathogenesis resulting from this discovery. © FEMS 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Tissue-Resident T Cells as the Central Paradigm of Chlamydia Immunity

PubMed Central

Johnson, Raymond M.

2016-01-01

For almost 2 decades, results from Chlamydia pathogenesis investigations have been conceptualized using a cytokine polarization narrative. Recent viral immunity studies identifying protective tissue-resident memory T cells (Trm) suggest an alternative paradigm based on localized immune networks. As Chlamydia vaccines enter the preclinical pipeline and, in the case of an attenuated trachoma vaccine, are given to human subjects, it may be useful to ask whether cytokine polarization is the appropriate framework for understanding and evaluating vaccine efficacy. In this review, we revisit C. trachomatis pathogenesis data from mice and humans using a Trm narrative and note a comfortable concordance with the Chlamydia pathogenesis literature. PMID:26787715

Chlamydia cell biology and pathogenesis.

PubMed

Elwell, Cherilyn; Mirrashidi, Kathleen; Engel, Joanne

2016-06-01

Chlamydia spp. are important causes of human disease for which no effective vaccine exists. These obligate intracellular pathogens replicate in a specialized membrane compartment and use a large arsenal of secreted effectors to survive in the hostile intracellular environment of the host. In this Review, we summarize the progress in decoding the interactions between Chlamydia spp. and their hosts that has been made possible by recent technological advances in chlamydial proteomics and genetics. The field is now poised to decipher the molecular mechanisms that underlie the intimate interactions between Chlamydia spp. and their hosts, which will open up many exciting avenues of research for these medically important pathogens.

Chlamydia cell biology and pathogenesis

PubMed Central

Elwell, Cherilyn; Mirrashidi, Kathleen; Engel, Joanne

2016-01-01

Chlamydia spp. are important causes of human disease for which no effective vaccine exists. These obligate intracellular pathogens replicate in a specialized membrane compartment and use a large arsenal of secreted effectors to survive in the hostile intracellular environment of the host. In this Review, we summarize the progress in decoding the interactions between Chlamydia spp. and their hosts that has been made possible by recent technological advances in chlamydial proteomics and genetics. The field is now poised to decipher the molecular mechanisms that underlie the intimate interactions between Chlamydia spp. and their hosts, which will open up many exciting avenues of research for these medically important pathogens. PMID:27108705

The potential influence of a social media intervention on risky sexual behavior and Chlamydia incidence.

PubMed

Jones, Krista; Baldwin, Kathleen A; Lewis, Patricia Ryan

2012-01-01

The purpose of this descriptive pilot study was to evaluate an evidence-based social-networking intervention aimed at reducing the incidence of Chlamydia among 15- to 24-year-olds. The intervention consists of a Facebook site that addresses signs, symptoms, treatment, screening, and prevention of Chlamydia infection. Findings included a 23% self-reported increase in condom utilization, and a 54% reduction in positive Chlamydia cases among 15- to 17-year-olds. Study results support that social media may be an effective mechanism for information dissemination and the promotion of positive behavioral changes among this population. Copyright © Taylor & Francis Group, LLC

Factors affecting urine EIA sensitivity in the detection of Chlamydia trachomatis in men.

PubMed Central

Talbot, H; Romanowski, B

1994-01-01

OBJECTIVE--This study examined the effects of four variables on the detection of Chlamydia trachomatis in urine from men by enzyme immunoassay (EIA). These variables were: symptoms and signs of urethritis, urine polymorphonuclear leucocytes (PMN), inclusion counts from urethral chlamydia cell cultures and the time between testing and last voiding. METHODS--Included were patients with and without symptoms and/or signs of urethritis attending the Edmonton Sexually Transmitted Disease Clinic. Men were asked to submit a 20 ml volume urine sample. Urethral swabs were collected for gram stain, chlamydia and gonorrhea culture. RESULTS--A total of 318 men were evaluated of whom 47 had chlamydia. Excluding six men who were coinfected with gonorrhoea, sensitivities and specificities of the Microtrak, Chlamydiazyme and IDEIA systems were 78.1% and 99.6%, 75.6% and 100%, and 80.5% and 97.8% respectively. Last void time did not affect the sensitivity. However, sensitivity was best when applied to men with severe evidence of urethritis. CONCLUSION--There is evidence that urine EIA could be used to detect chlamydia in men with acute urethritis but not in those without signs of urethritis. PMID:8206466

Using urinary leucocyte esterase tests as an indicator of infection with gonorrhoea or chlamydia in asymptomatic males in a primary health care setting.

PubMed

Rahman, Md Saifur; Beever, Warwick; Skov, Steven; Boffa, John

2014-02-01

To evaluate a leucocyte esterase test as a predictor of gonorrhoea or chlamydia in asymptomatic Aboriginal males at the Central Australian Aboriginal Congress Male Clinic (Ingkintja), first-void urine samples and clinical information were collected from consecutive asymptomatic males presenting to the Ingkintja in Alice Springs between March 2008 and December 2009. Urine was tested immediately with a leucocyte esterase test dipstick and then by polymerase chain reaction for gonorrhoea and chlamydia. Among the 292 specimens from asymptomatic males, 15.4% were positive for gonorrhoea or chlamydia. In this group, compared with polymerase chain reaction result for gonorrhoea or chlamydia, leucocyte esterase test alone and in combination with age ≤35 years showed sensitivities of 66.7% and 60%, specificities of 90.7% and 94.7%, positive predictive values of 56.6% and 67.5%, negative predictive values of 93.7% and 92.8% and the area under receiver operating characteristics curve values of 0.79 and 0.85, respectively. Leucocyte esterase tests can reasonably be used as a basis for immediate empirical treatment for gonorrhoea or chlamydia in asymptomatic central Australian Aboriginal men under 35 years of age.

Improved Plaque Assay Identifies a Novel Anti-Chlamydia Ceramide Derivative with Altered Intracellular Localization

PubMed Central

Banhart, Sebastian; Saied, Essa M.; Martini, Andrea; Koch, Sophia; Aeberhard, Lukas; Madela, Kazimierz; Arenz, Christoph

2014-01-01

Chlamydia trachomatis is a medically important human pathogen causing different diseases, including trachoma, the leading cause of preventable blindness in developing countries, and sexually transmitted infections that can lead to infertility and ectopic pregnancies. There is no vaccine against C. trachomatis at present. Broad-spectrum antibiotics are used as standard therapy to treat the infection but have unwanted side effects, such as inducing persistent or recurring infections and affecting the host microbiome, necessitating the development of novel anti-Chlamydia therapies. Here, we describe the establishment of a robust, fast, and simple plaque assay using liquid overlay medium (LOM) for the identification of anti-Chlamydia compounds. Using the LOM plaque assay, we identified nitrobenzoxadiazole (NBD)-labeled 1-O-methyl-ceramide-C16 as a compound that efficiently inhibits C. trachomatis replication without affecting the viability of the host cell. Further detailed analyses indicate that 1-O-methyl-NBD-ceramide-C16 acts outside the inclusion. Thereby, 1-O-methyl-NBD-ceramide-C16 represents a lead compound for the development of novel anti-Chlamydia drugs and furthermore constitutes an agent to illuminate sphingolipid trafficking pathways in Chlamydia infections. PMID:25001308

The Use of Mathematical Models of Chlamydia Transmission to Address Public Health Policy Questions: A Systematic Review.

PubMed

Rönn, Minttu M; Wolf, Emory E; Chesson, Harrell; Menzies, Nicolas A; Galer, Kara; Gorwitz, Rachel; Gift, Thomas; Hsu, Katherine; Salomon, Joshua A

2017-05-01

Mathematical models of chlamydia transmission can help inform disease control policy decisions when direct empirical evaluation of alternatives is impractical. We reviewed published chlamydia models to understand the range of approaches used for policy analyses and how the studies have responded to developments in the field. We performed a literature review by searching Medline and Google Scholar (up to October 2015) to identify publications describing dynamic chlamydia transmission models used to address public health policy questions. We extracted information on modeling methodology, interventions, and key findings. We identified 47 publications (including two model comparison studies), which reported collectively on 29 distinct mathematical models. Nine models were individual-based, and 20 were deterministic compartmental models. The earliest studies evaluated the benefits of national-level screening programs and predicted potentially large benefits from increased screening. Subsequent trials and further modeling analyses suggested the impact might have been overestimated. Partner notification has been increasingly evaluated in mathematical modeling, whereas behavioral interventions have received relatively limited attention. Our review provides an overview of chlamydia transmission models and gives a perspective on how mathematical modeling has responded to increasing empirical evidence and addressed policy questions related to prevention of chlamydia infection and sequelae.

Genital tract lesions in sexually mature Göttingen minipigs during the initial stages of experimental vaginal infection with Chlamydia trachomatis serovar D.

PubMed

Erneholm, Karin; Lorenzen, Emma; Bøje, Sarah; Olsen, Anja Weinreich; Andersen, Peter; Cassidy, Joseph P; Follmann, Frank; Jensen, Henrik E; Agerholm, Jørgen S

2016-09-10

Chlamydia is one of the most common sexually transmitted diseases in humans worldwide, causing chronic lesions in the reproductive tract. Due to its often asymptomatic course, there is limited knowledge about the initial changes in the genital tract following infection. This study employs a novel sexually mature minipig model to investigate the initial histopathological changes following vaginal infection with Chlamydia trachomatis serovar D. A vaginal inoculation resulted in an infection primarily affecting the lower genital tract. The histopathological changes were characterized by a subepithelial inflammation consisting of neutrophils and mononuclear cells, followed by an increase in the number of plasma cells within the sub-epithelial stroma of the vagina. Detection of Chlamydia was associated with expression of cyclooxygenase-2 and interleukin-8 by superficial epithelial cells. The infection was self-limiting, with a duration of 7 days. Neutrophils, plasma cells and IL-8 have been linked with Chlamydia genital infection of unknown duration in human patients. In this study, we observe a similar pattern of local immune response/inflammation following experimental inoculation suggesting this porcine model shows promise as a model for translational chlamydia research.

[Chlamydia trachomatis and Neisseria gonorrhoeae infection: factors associated with infertility in women treated at a human reproduction public service].

PubMed

Fernandes, Liliam Borges; Arruda, Jalsi Tacon; Approbato, Mário Silva; García-Zapata, Marco Tulio Antonio

2014-08-01

To evaluate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in women undergoing assisted reproduction in a public reference service in the midwestern region of Brazil. A cross-sectional study was conducted on 340 women aged from 20 to 47 years with a history of infertility, undergoing assisted reproduction techniques. Infections with Chlamydia trachomatis and Neisseria gonorrhoeae identified in urine specimens by PCR, and the profile of infertility were analyzed. We used the χ(2) test or Fisher's exact test to evaluate the association between infection and variables. The prevalence of Chlamydia trachomatis infection was 10.9%, and Neisseria gonorrhoeae co-infection was observed in 2 cases. Women infected with Chlamydia trachomatis had more than 10 years of infertility (54.1%; p<0.0001). The tubal factor was the main cause in infected cases (56.8%; p=0.047). Tubal occlusion was found in 67.6% of cases with positive infection (p=0.004). There was an association of tubal obstruction with infection by Chlamydia trachomatis and Neisseria gonorrhoeae, reinforcing the need for effective strategies for an early detection of sexually transmitted diseases, especially in asymptomatic women of childbearing age.

Evaluation of a new amplified enzyme immunoassay (EIA) for the detection of Chlamydia trachomatis in male urine, female endocervical swab, and patient obtained vaginal swab specimens

PubMed Central

Tanaka, M.; Nakayama, H.; Sagiyama, K.; Haraoka, M.; Yoshida, H.; Hagiwara, T.; Akazawa, K.; Naito, S.

2000-01-01

Aims—To compare the performance of a new generation dual amplified enzyme immunoassay (EIA) with a molecular method for the diagnosis of Chlamydia trachomatis, using a range of urogenital samples, and to assess the reliability of testing self collected vaginal specimens compared with clinician collected vaginal specimens. Methods—Two population groups were tested. For the first population group, first void urine samples were collected from 193 male patients with urethritis, and endocervical swabs were collected from 187 high risk commercial sex workers. All urine and endocervical specimens were tested by a conventional assay (IDEIA chlamydia), a new generation amplified immunoassay (IDEIA PCE chlamydia), and the Amplicor polymerase chain reaction (PCR). Discrepant results obtained among the three sample types were confirmed using a nested PCR test with a different plasmid target region. For the second population group, four swab specimens, including one patient obtained vaginal swab, two clinician obtained endocervical swabs, and one clinician obtained vaginal swab, were collected from 91 high risk sex workers. Self collected and clinician collected vaginal swabs were tested by IDEIA PCE chlamydia. Clinician obtained endocervical swabs were assayed by IDEIA PCE chlamydia and Amplicor PCR. Results—The performance of the IDEIA PCE chlamydia test was comparable to that of the Amplicor PCR test when male urine and female endocervical swab specimens were analysed. The relative sensitivities of IDEIA, IDEIA PCE, and Amplicor PCR on male first void urine specimens were 79.3%, 91.4%, and 100%, respectively. The relative sensitivities of the three tests on female endocervical specimens were 85.0%, 95.0%, and 100%, respectively. The positivity rates for patient collected vaginal specimens and clinician collected vaginal specimens by IDEIA PCE were 25.2% and 23.1%, respectively, whereas those for clinician collected endocervical swabs by PCR and IDEIA PCE were both 27.5%. Conclusions—IDEIA PCE chlamydia is a lower cost but sensitive alternative test to PCR for testing male urine samples and female endocervical swabs. In addition, self collected or clinician collected vaginal specimens tested by IDEIA PCE chlamydia are a reliable alternative to analysing endocervical specimens. Key Words: Chlamydia trachomatis • enzyme immunoassay • clinical specimens PMID:10889816

Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? ACCEPt-able: a cluster randomised controlled trial protocol.

PubMed

Hocking, Jane S; Temple-Smith, Meredith; van Driel, Mieke; Law, Matthew; Guy, Rebecca; Bulfone, Liliana; Wood, Anna; Low, Nicola; Donovan, Basil; Fairley, Christopher K; Kaldor, John; Gunn, Jane

2016-09-13

Financial incentives and audit plus feedback on performance are two strategies commonly used by governments to motivate general practitioners (GP) to undertake specific healthcare activities. However, in recent years, governments have reduced or removed incentive payments without evidence of the potential impact on GP behaviour and patient outcomes. This trial (known as ACCEPt-able) aims to determine whether preventive care activities in general practice are sustained when financial incentives and/or external audit plus feedback on preventive care activities are removed. The activity investigated is annual chlamydia testing for 16- to 29-year-old adults, a key preventive health strategy within this age group. ACCEPt-able builds on a large cluster randomised controlled trial (RCT) that evaluated a 3-year chlamydia testing intervention in general practice. GPs were provided with a support package to facilitate annual chlamydia testing of all sexually active 16- to 29-year-old patients. This package included financial incentive payments to the GP for each chlamydia test conducted and external audit plus feedback on each GP's chlamydia testing rates. ACCEPt-able is a factorial cluster RCT in which general practices are randomised to one of four groups: (i) removal of audit plus feedback-continue to receive financial incentive payments for each chlamydia test; (ii) removal of financial incentive payments-continue to receive audit plus feedback; (iii) removal of financial incentive payments and audit plus feedback; and (iv) continue financial incentive payments and audit plus feedback. The primary outcome is chlamydia testing rate measured as the proportion of sexually active 16- to 29-year-olds who have a GP consultation within a 12-month period and at least one chlamydia test. This will be the first RCT to examine the impact of removal of financial incentive payments and audit plus feedback on the chlamydia testing behaviour of GPs. This trial is particularly timely and will increase our understanding about the impact of financial incentives and audit plus feedback on GP behaviour when governments are looking for opportunities to control healthcare budgets and maximise clinical outcomes for money spent. The results of this trial will have implications for supporting preventive health measures beyond the content area of chlamydia. The trial has been registered on the Australian and New Zealand Clinical Trials Registry ( ACTRN12614000595617 ).

"...they should be offering it": a qualitative study to investigate young peoples' attitudes towards chlamydia screening in GP surgeries

PubMed Central

2010-01-01

Background Despite the known health and healthcare costs of untreated chlamydia infection and the efforts of the National Chlamydia Screening Programme (NCSP) to control chlamydia through early detection and treatment of asymptomatic infection, the rates of screening are well below the 2010-2011 target rate of 35%. General Practitioner (GP) surgeries are a key venue within the NCSP however; previous studies indicate that GP surgery staff are concerned that they may offend their patients by offering a screen. This study aimed to identify the attitudes to, and preferences for, chlamydia screening in 15-24 year old men and women attending GP surgeries (the target group). Methods We undertook 36 interviews in six surgeries of differing screening rates. Our participants were 15-24 year olds attending a consultation with a staff member. Data were analysed thematically. Results GP surgeries are acceptable to young people as a venue for opportunistic chlamydia screening and furthermore they think it is the duty of GP surgery staff to offer it. They felt strongly that it is important for surgery staff to have a non-judgemental attitude and they did not want to be singled out as 'needing' a chlamydia screen. Furthermore, our sample reported a strong preference for being offered a screen by staff and providing the sample immediately at the surgery rather than taking home a testing kit. The positive attitude and subjective norms demonstrated by interviewees suggest that young peoples' behaviour would be to accept a screen if it was offered to them. Conclusion Young people attending GP surgeries have a positive attitude towards chlamydia screening and given the right environment are likely to take up the offer in this setting. The right environment involves normalising screening by offering a chlamydia screen to all 15-24 year olds at every interaction with staff, offering screening with a non-judgemental attitude and minimising barriers to screening such as embarrassment. The GP surgery is the ideal place to screen young people for chlamydia as it is not a threatening place for them and our study has shown that they think it is the normal place to go to discuss health matters. PMID:20955570

Promoting chlamydia screening with posters and leaflets in general practice--a qualitative study.

PubMed

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-10-12

General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. The NCSP should consider developing a range of more discrete but eye catching posters and small leaflets specifically to promote chlamydia screening in different scenarios within general practice; coordinators should audit their use. Practice staff need to discuss, with their screening co-ordinator, how different practice staff can promote chlamydia screening most effectively using the NCSP promotional materials, and change them regularly so that they do not loose their impact. Education to change all practice staff's attitudes towards sexual health is needed to reduce their worries about displaying the chlamydia materials, and how they may follow up the advertising up with a verbal offer of screening opportunistically to 15-24 year olds whenever they visit the practice.

Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

PubMed Central

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-01-01

Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP should consider developing a range of more discrete but eye catching posters and small leaflets specifically to promote chlamydia screening in different scenarios within general practice; coordinators should audit their use. Practice staff need to discuss, with their screening co-ordinator, how different practice staff can promote chlamydia screening most effectively using the NCSP promotional materials, and change them regularly so that they do not loose their impact. Education to change all practice staff's attitudes towards sexual health is needed to reduce their worries about displaying the chlamydia materials, and how they may follow up the advertising up with a verbal offer of screening opportunistically to 15-24 year olds whenever they visit the practice. PMID:19821964

Chlamydia trachomatis and the risk of spontaneous preterm birth, babies who are born small for gestational age, and stillbirth: a population-based cohort study.

PubMed

Reekie, Joanne; Roberts, Christine; Preen, David; Hocking, Jane S; Donovan, Basil; Ward, James; Mak, Donna B; Liu, Bette

2018-04-01

Chlamydia trachomatis is one of the most commonly diagnosed sexually transmitted infections worldwide, but reports in the medical literature of an association between genital chlamydia infection and adverse obstetric outcomes are inconsistent. The Western Australia Data Linkage Branch created a cohort of women of reproductive age by linking records of birth registrations with the electoral roll for women in Western Australia who were born from 1974 to 1995. The cohort was then linked to both chlamydia testing records and the state perinatal registry for data on preterm births and other adverse obstetric outcomes. We determined associations between chlamydia testing, test positivity, and adverse obstetric outcomes using multivariate logistic regression analyses. From 2001 to 2012, 101 558 women aged 15 to 38 years had a singleton birth. Of these women, 3921 (3·9%) had a spontaneous preterm birth, 9762 (9·6% of 101 371 women with available data) had a baby who was small for gestational age, and 682 (0·7%) had a stillbirth. During their pregnancy, 21 267 (20·9%) of these women had at least one chlamydia test record, and 1365 (6·4%) of those tested were positive. Before pregnancy, 19 157 (18·9%) of these women were tested for chlamydia, of whom 1595 (8·3%) tested positive for chlamydia. Among all women with a test record, after adjusting for age, ethnicity, maternal smoking, and history of other infections, we found no significant association between a positive test for chlamydia and spontaneous preterm birth (adjusted odds ratio 1·08 [95% CI 0·91-1·28]; p=0·37), a baby who was small for gestational age (0·95 [0·85-1·07]; p=0·39), or stillbirth (0·93 [0·61-1·42]; p=0·74). A genital chlamydia infection that is diagnosed and, presumably, treated either during or before pregnancy does not substantially increase a woman's risk of having a spontaneous preterm birth, having a baby who is small for gestational age, or having a stillbirth. Australian National Health and Medical Research Council. Copyright © 2018 Elsevier Ltd. All rights reserved.

Etude séro-epidémiologique de trois infections sexuellement transmissibles (Chlamydia Trachomatis, Hépatite B, Syphilis): cas de l’Hôpital de District de Nkoldongo à Yaoundé

PubMed Central

Essome, Marie Chantal Ngonde; Nsawir, Bonglaisin Julius; Nana, Rodrigue Dongang; Molu, Patrick; Mohamadou, Mansour

2016-01-01

Introduction Les infections sexuellement transmissibles sévissent toujours dans les pays en voie de développement et particulièrement au Cameroun. Le but de notre étude est de déterminer la distribution des infections sexuellement transmissibles suivantes: l’hépatite virale B, le Chlamydia trachomatis et de la syphilis dans une population de femmes venant consulter spontanément à l’Hôpital de District de Nkoldongo à Yaoundé, d’évaluer d’éventuelles coïnfections entre ces trois affections et de ressortir les connaissances de ces femmes sur leur mode de transmission sexuelle. Méthodes Notre étude prospective et descriptive a porté sur 182 femmes dont l’âge variait entre 18 et 48 ans. Les femmes ont été testées sérologiquement pour le Chlamydia trachomatis par une méthode ELISA (kit des laboratoires General Biological Corp). L’hépatite virale B a été dépistée par une méthode immunochromatographique (kit des laboratoires Human) et la syphilis par une méthode d’agglutination en ce qui concerne le RPR (Kit des laboratoires Biocentric) et le TPHA (kit des laboratoires Human). Résultats Nos résultats ont montré que: la distribution du Chlamydia trachomatis, de l’hépatite virale B et la syphilis a été respectivement de 22,52%, 4,39%, 0,54%.De plus, nous avons observé une coinfection Chlamydia trachomatis hépatite virale B avec un taux de 2,74%. Par ailleurs la réinfection au Chlamydia trachomatis a été rencontrée dans 4,94% de cas. S’agissant du mode de transmission de ces affections 67,57% et 70,87% de femmes ne connaissaient pas la voie de transmission sexuelle pour le Chlamydia trachomatis et pour l’hépatite virale B respectivement, tandis que 91,2 % des femmes connaissaient la voie de transmission sexuelle pour la syphilis. Conclusion Le diagnostic d’une infection à Chlamydia trachomatis chez une patiente doit susciter le dépistage de l’hépatite virale B. Introduction Sexually transmitted infections are still frequent in developing countries and particularly in Cameroon. The aim of this study was to determine the distribution of the following sexually transmitted infections: viral hepatitis B, Chlamydia trachomatis and syphilis in a population of women spontaneously visiting the Nkoldongo District Hospital in Yaoundé as well as to evaluate possible co-infections among these three conditions and to bring out women’s prior knowledge of how sexual transmission occurs. Methods We conducted a prospective and descriptive study including 182 women aged between 18 and 48 years. These women underwent serologic testing for Chlamydia trachomatis with ELISA (General Biological Corp laboratory test kit. Hepatitis B virus was detected using immunochromatographic method (Human laboratory kit) while syphilis was detected using RPR agglutination (Biocentric Laboratories kit )and TPHA agglutination (Human laboratory kit) method. Results Our results showed that the distribution of Chlamydia trachomatis, viral hepatitis B and syphilis was 22.52%, 4.39%, 0.54% respectively. Moreover, we reported a Chlamydia trachomatis and Viral hepatitis B coinfection rate of 2.74%. In addition, Chlamydia trachomatis reinfection was detected in 4.94% of cases. Regarding the mode of transmission of these infections, 67.57% and 70.87% of women didn’t know how Chlamydia trachomatis and viral hepatitis sexual transmission could occur respectively, while 91.2% of women knew how was syphilis spread. Conclusion The diagnosis of chlamydia trachomatis infection should prompt screening for viral hepatitis B. PMID:28293360

Knowledge of Chlamydia trachomatis among men and women approached to participate in community-based screening, Scotland, UK.

PubMed

Lorimer, Karen; Hart, Graham J

2010-12-30

Poor awareness and knowledge of Chlamydia trachomatis could be a barrier to uptake of screening. This study aimed to determine the level of awareness and knowledge of chlamydia among young people who were being approached in a variety of community settings and offered opportunistic screening. Men and women aged 16-24 years were approached in education, health and fitness, and workplace settings and invited to complete a self-administered questionnaire then provide a urine sample for chlamydia testing. Follow-up semi-structured interviews with 24 respondents were carried out after test results were received. 363 questionnaires were completed (43.5% from men). Whilst awareness of chlamydia was high, knowledge decreased as questions became increasingly focussed so that around half of respondents were unaware of the asymptomatic nature of chlamydia infections. Men's knowledge of symptoms was consistently lower than women's, with most men failing to identify unusual discharge as a symptom in men (men 58.3%, female 45.8%, p = 0.019); fewer men knew unusual discharge was a symptom among women (men 65.3% female 21.4%, p < 0.001). The asymptomatic nature of the infection resonated with respondents and was the commonest piece of information they picked up from their participation in the study. Despite scientific gains in understanding chlamydia infection, public understanding remains limited. Greater efforts are required to translate scientific evidence to the public. An improvement in knowledge may maximise gains from interventions to improve detection.

Attachment and internalization of a Chlamydia trachomatis lymphogranuloma venereum strain by McCoy cells: kinetics of infectivity and effect of lectins and carbohydrates.

PubMed Central

Söderlund, G; Kihlström, E

1983-01-01

The kinetics of attachment and ingestion of Chlamydia trachomatis serotype L1 by monolayers of McCoy cells were studied by using a method that discriminated between attachment and uptake. When about 1% of the McCoy cells was infected, the proteinase K-resistant chlamydial fraction, regarded as ingested chlamydiae, reached a constant value after about 3 h of incubation at 37 degrees C. Uptake of chlamydiae at 4 degrees C could not be demonstrated. The attached and ingested chlamydial fractions were constant over an eightfold increase in chlamydial inoculum. Chitobiose and chitotriose, the di- and trisaccharides of N-acetyl-D-glucosamine, reduced the association of C. trachomatis serotype L1 with McCoy cells. Higher concentrations of chitobiose also selectively inhibited ingestion of chlamydiae. A corresponding effect of chitobiose was also observed on the number of chlamydial inclusions. Wheat germ agglutinin, specific for N-acetyl-D-glucosamine residues, reduced the association of chlamydiae when incubated at 4 degrees C, but not at 37 degrees C. A small inhibiting effect of concanavalin A on association of chlamydiae, but no effect of the corresponding carbohydrates, indicates a nonspecific effect on chlamydial attachment of this lectin. These results suggest that beta 1 leads to 4-linked oligomers of N-acetyl-D-glucosamine are important in the specificity of attachment of C. trachomatis to McCoy cells. PMID:6642670

Biodiversity of amoebae and amoeba-associated bacteria in water treatment plants.

PubMed

Corsaro, Daniele; Pages, Gemma Saucedo; Catalan, Vicente; Loret, Jean-François; Greub, Gilbert

2010-06-01

In this study, we enlarged our previous investigation focusing on the biodiversity of chlamydiae and amoebae in a drinking water treatment plant, by the inclusion of two additional plants and by searching also for the presence of legionellae and mycobacteria. Autochthonous amoebae were recovered onto non-nutritive agar, identified by 18S rRNA gene sequencing, and screened for the presence of bacterial endosymbionts. Bacteria were also searched for by Acanthamoeba co-culture. From a total of 125 samples, we recovered 38 amoebae, among which six harboured endosymbionts (three chlamydiae and three legionellae). In addition, we recovered by amoebal co-culture 11 chlamydiae, 36 legionellae (no L. pneumophila), and 24 mycobacteria (all rapid-growers). Two plants presented a similar percentage of samples positive for chlamydiae (11%), mycobacteria (20%) and amoebae (27%), whereas in the third plant the number of recovered bacteria was almost twice higher. Each plant exhibited a relatively high specific microbiota. Amoebae were mainly represented by various Naegleria species, Acanthamoeba species and Hartmannella vermiformis. Parachlamydiaceae were the most abundant chlamydiae (8 strains in total), and in this study we recovered a new genus-level strain, along with new chlamydiae previously reported. Similarly, about 66% of the recovered legionellae and 47% of the isolated mycobacteria could represent new species. Our work highlighted a high species diversity among legionellae and mycobacteria, dominated by putative new species, and it confirmed the presence of chlamydiae in these artificial water systems. Copyright 2010 Elsevier GmbH. All rights reserved.

Functional and Biochemical Analysis of Chlamydia trachomatis MurC, an Enzyme Displaying UDP-N-Acetylmuramate:Amino Acid Ligase Activity

PubMed Central

Hesse, Lars; Bostock, Julieanne; Dementin, Sebastien; Blanot, Didier; Mengin-Lecreulx, Dominique; Chopra, Ian

2003-01-01

Chlamydiae are unusual obligate intracellular bacteria that cause serious infections in humans. Chlamydiae contain genes that appear to encode products with peptidoglycan biosynthetic activity. The organisms are also susceptible to antibiotics that inhibit peptidoglycan synthesis. However, chlamydiae do not synthesize detectable peptidoglycan. The paradox created by these observations is known as the chlamydial anomaly. The MurC enzyme of chlamydiae, which is synthesized as a bifunctional MurC-Ddl product, is expected to possess UDP-N-acetylmuramate (UDP-MurNAc):l-alanine ligase activity. In this paper we demonstrate that the MurC domain of the Chlamydia trachomatis bifunctional protein is functionally expressed in Escherichia coli, since it complements a conditional lethal E. coli mutant possessing a temperature-sensitive lesion in MurC. The recombinant MurC domain was overexpressed in and purified from E. coli. It displayed in vitro ATP-dependent UDP-MurNAc:l-alanine ligase activity, with a pH optimum of 8.0 and dependence upon magnesium ions (optimum concentration, 20 mM). Its substrate specificity was studied with three amino acids (l-alanine, l-serine, and glycine); comparable Vmax/Km values were obtained. Our results are consistent with the synthesis of a muramic acid-containing polymer in chlamydiae with UDP-MurNAc-pentapeptide as a precursor molecule. However, due to the lack of specificity of MurC activity in vitro, it is not obvious which amino acid is present in the first position of the pentapeptide. PMID:14594822

Functional and biochemical analysis of Chlamydia trachomatis MurC, an enzyme displaying UDP-N-acetylmuramate:amino acid ligase activity.

PubMed

Hesse, Lars; Bostock, Julieanne; Dementin, Sebastien; Blanot, Didier; Mengin-Lecreulx, Dominique; Chopra, Ian

2003-11-01

Chlamydiae are unusual obligate intracellular bacteria that cause serious infections in humans. Chlamydiae contain genes that appear to encode products with peptidoglycan biosynthetic activity. The organisms are also susceptible to antibiotics that inhibit peptidoglycan synthesis. However, chlamydiae do not synthesize detectable peptidoglycan. The paradox created by these observations is known as the chlamydial anomaly. The MurC enzyme of chlamydiae, which is synthesized as a bifunctional MurC-Ddl product, is expected to possess UDP-N-acetylmuramate (UDP-MurNAc):L-alanine ligase activity. In this paper we demonstrate that the MurC domain of the Chlamydia trachomatis bifunctional protein is functionally expressed in Escherichia coli, since it complements a conditional lethal E. coli mutant possessing a temperature-sensitive lesion in MurC. The recombinant MurC domain was overexpressed in and purified from E. coli. It displayed in vitro ATP-dependent UDP-MurNAc:L-alanine ligase activity, with a pH optimum of 8.0 and dependence upon magnesium ions (optimum concentration, 20 mM). Its substrate specificity was studied with three amino acids (L-alanine, L-serine, and glycine); comparable Vmax/Km values were obtained. Our results are consistent with the synthesis of a muramic acid-containing polymer in chlamydiae with UDP-MurNAc-pentapeptide as a precursor molecule. However, due to the lack of specificity of MurC activity in vitro, it is not obvious which amino acid is present in the first position of the pentapeptide.

Healthcare and patient costs of a proactive chlamydia screening programme: the Chlamydia Screening Studies project.

PubMed

Robinson, Suzanne; Roberts, Tracy; Barton, Pelham; Bryan, Stirling; Macleod, John; McCarthy, Anne; Egger, Matthias; Sanford, Emma; Low, Nicola

2007-07-01

Most economic evaluations of chlamydia screening do not include costs incurred by patients. The objective of this study was to estimate both the health service and private costs of patients who participated in proactive chlamydia screening, using mailed home-collected specimens as part of the Chlamydia Screening Studies project. Data were collected on the administrative costs of the screening study, laboratory time and motion studies and patient-cost questionnaire surveys were conducted. The cost for each screening invitation and for each accepted offer was estimated. One-way sensitivity analysis was conducted to explore the effects of variations in patient costs and the number of patients accepting the screening offer. The time and costs of processing urine specimens and vulvo-vaginal swabs from women using two nucleic acid amplification tests were similar. The total cost per screening invitation was 20.37 pounds (95% CI 18.94 pounds to 24.83). This included the National Health Service cost per individual screening invitation 13.55 pounds (95% CI 13.15 pounds to 14.33) and average patient costs of 6.82 pounds (95% CI 5.48 pounds to 10.22). Administrative costs accounted for 50% of the overall cost. The cost of proactive chlamydia screening is comparable to those of opportunistic screening. Results from this study, which is the first to collect private patient costs associated with a chlamydia screening programme, could be used to inform future policy recommendations and provide unique primary cost data for economic evaluations.

Prevalence and characterization of Chlamydia DNA in zoo animals in Japan.

PubMed

Kabeya, Hidenori; Sato, Shingo; Maruyama, Soichi

2015-09-01

Because many people visit zoos, prevention of zoonoses is important from the standpoint of public health. This study examined the prevalence of Chlamydia among zoo animals in Japan by PCR and characterized these bacteria by performing phylogenetic analyses of the sequences of the variable domain (VD) 2 and VD4 regions of the ompA gene, which encodes the Chlamydia major outer membrane protein. Fecal samples were collected from 1150 zoo animals in five zoos and examined for Chlamydia DNA. Chlamydia psittaci DNA was found in 3.9% of mammals, 7.2% of birds and 8.1% of reptiles. The prevalence of Chlamydia pneumoniae DNA was significantly higher in reptiles (5.8%) than in mammals (0.3%) and birds (0.3%). Phylogenetic analysis of the ompA VD2 region from 18 samples showed that nine were in three different clusters containing C. psittaci strains, six were in a cluster containing C. pneumoniae strains and three each formed a distinct branch. Furthermore, phylogenetic analysis of the ompA VD4 region showed that C. pneumoniae DNAs from reptiles were close to those from human patients. The C. pneumoniae DNAs from the European glass lizard, Emerald tree boa, and Panther chameleon were classified in clusters that were distinct from other strains, suggesting that these reptiles had each been infected with a specific C. pneumoniae genotype. This study showed that diverse Chlamydia strains have been prevalent among a variety of zoo animals. © 2015 The Societies and Wiley Publishing Asia Pty Ltd.

Chlamydia trachomatis IgM seropositivity during pregnancy and assessment of its risk factors.

PubMed

Rahman, M; Chowdhury, S B; Akhtar, N; Jahan, M; Jahan, M K; Jebunnahar, S

2014-01-01

The study was undertaken to determine socio-demographic and reproductive risk factors associated with Chlamydia trachomaties IgM seropositivity during pregnancy. This cross sectional comparative study was carried out in the obstetrics outdoor of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in collaboration with the department of Virology between the periods from July 2007 to December 2008. Pregnant women at their first visit to the hospital were approached consecutively and asked to complete a questionnaire and 2cc blood was collected from each subject for Chlamydia trachomatis IgM antibody testing using ELISA method. The study population was divided into two groups according to the presence and absence of serum Chlamydia trachomatis IgM antibody. Finally socio-demographic and reproductive risk factors were compared between the groups. Among 172 women the sero-prevalence of Chlamydia IgM was 41%. The multiple logistic regression model (step wise) finally extracted for characteristics correlated with seropositivity. Ten years or less (≤SSC) education (OR 2.6 95% CI 1.1to 5.9), history of adverse pregnancy outcome (OR 2.8 95% CI 1.2 to 6.5) and multiple sex partner of husband (OR 4.1 95% CI 1.2 to 14.8) were associated with chlamydia infection. The use of condom (OR 0.28 95% CI 0.12 to 0.63) was associated with decreased risk of infection. Chlamydia trachomatis infection during pregnancy is associated with risk factors on the basis of which selective screening can be done.

Trachoma

MedlinePlus

Granular conjunctivitis; Egyptian ophthalmia; Conjunctivitis - granular; Conjunctivitis - chlamydia ... Trachoma is caused by infection with the bacteria Chlamydia trachomatis . The condition occurs around the world. It ...

Medical Surveillance Monthly Report (MSMR). Volume 16, Number 2, February 2009

DTIC Science & Technology

2009-02-01

Urethritis, non-gonococcal (NGU). Reporting location Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis...transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008...Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008

Using of methods of speckle optics for Chlamydia trachomatis typing

NASA Astrophysics Data System (ADS)

Ulyanov, Sergey S.; Zaytsev, Sergey S.; Ulianova, Onega V.; Saltykov, Yury V.; Feodorova, Valentina A.

2017-03-01

Specific method of transformation of nucleotide of gene into speckle pattern is suggested. Reference speckle pattern of omp1 gene of typical wild strains of Chlamydia trachomatis of genovars D, E, F, G, J and K and Chlamydia psittaci as well is generated. Perspectives of proposed technique in the gene identification and detection of natural genetic mutations as single nucleotide polymorphism (SNP) are demonstrated.

Disparities in chlamydia testing among young women with sexually transmitted infection symptoms.

PubMed

Wiehe, Sarah E; Rosenman, Marc B; Wang, Jane; Fortenberry, J Dennis

2010-12-01

Diagnostic chlamydia testing is recommended for all young women demonstrating sexually transmitted infection (STI) symptoms. Differential testing among symptomatic women may contribute to disparities in chlamydia rates. Our objective was to determine whether providers test young women with STI symptoms for chlamydia differently by age, race/ethnicity, or insurance status, and whether testing patterns differ by documentation of previous STI. Retrospective cohort analysis using electronic medical records and billing data of women 14 to 25 years old with one or more diagnostic or procedure codes indicative of STI symptoms (N = 61,498 women). Random effects logistic regression analysis was performed to assess the odds of chlamydia testing given a woman presented for a nonpregnancy-related visit with STI symptoms. All analyses controlled for history of STI, setting, and year, and adjusted for within-person correlation. A chlamydia test was performed in 38% of visits with codes indicating STI symptoms. Women aged <18 or >19 were less likely to be tested than women aged 18 to 19, with young women aged 14 to 15 having the lowest odds of being tested (Odd Ratio [OR]: 0.52). Providers were more likely to test minority (ORblack: 2.87; ORLatina: 2.10) compared with white women. Women were also more likely to be tested if they had public insurance (OR: 2.41) or were self-pay (OR: 2.35) compared with if they had private insurance. Women aged 14 to 15 and 16 to 17 with prior history of STI had increased odds of chlamydia testing (OR: 1.79 and 1.43, respectively) compared with women aged 18 to 19, changing the overall direction of association compared with women with no history of STI. The odds of testing were dramatically reduced for minority and nonprivately insured young women with history of STI, although significant differences persisted. Provider chlamydia testing differs by age, race/ethnicity, and insurance status when a woman presents with STI symptoms and no prior history of STI. This bias may contribute to higher reported rates of chlamydia among younger, minority, and poor women.

High Proportion of Anorectal Chlamydia trachomatis and Neisseria gonorrhoeae After Routine Universal Urogenital and Anorectal Screening in Women Visiting the Sexually Transmitted Infection Clinic.

PubMed

van Liere, Geneviève A F S; Dukers-Muijrers, Nicole H T M; Levels, Luuk; Hoebe, Christian J P A

2017-06-15

Testing on indication of self-reported anal sex or symptoms is used to manage anorectal Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) infections in women. Little is known about the impact of another testing strategy, routine universal anorectal screening with respect to chlamydia and gonorrhea prevalence and risk factors. All women (n = 1012) aged ≥16 years attending our sexually transmitted infection clinic in 2015 were offered routine universal screening. In total, 19.5% (n = 185) of women had an indication (reported anal sex or symptoms), 72.5% (n = 689) did not have an indication, and 8.0% (n = 76) had missing information on indication. Logistic regression analyses were used to identify determinants associated with anorectal chlamydia and gonorrhea. Of all women who visited our clinic, 94% (n = 950) participated in the study. Overall anorectal chlamydia/gonorrhea positivity was 13.4% (n = 127)/1.3% (n = 12). Self-reported anal sex and anal symptoms were independently associated with anorectal gonorrhea (odds ratios [ORs], 3.3 [95% confidence interval {CI}, 1.01-10.7] and 14.5 [95% CI, 2.8-75.0], respectively), but not with anorectal chlamydia. Of all anorectal chlamydia/gonorrhea cases, 72% (n = 92)/33% (n = 4) were diagnosed in women without an indication, of which 19% (n = 19)/0% (n = 0) were anorectal only. For women with missing indication, this was 7% (n = 9)/8% (n = 1) and 44% (n = 4)/100% (n = 1). Anorectal screening in women without an indication is feasible and highly acceptable. Selective testing on indication could be an appropriate control strategy for anorectal gonorrhea, as few infections would be missed. In contrast, selective testing is a suboptimal control strategy for anorectal chlamydia, as we found a high prevalence in women both with and without indication for anorectal testing, along with a substantial amount of anorectal-only infections. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

The IL-6 response to Chlamydia from primary reproductive epithelial cells is highly variable and may be involved in differential susceptibility to the immunopathological consequences of chlamydial infection

PubMed Central

2013-01-01

Background Chlamydia trachomatis infection results in reproductive damage in some women. The process and factors involved in this immunopathology are not well understood. This study aimed to investigate the role of primary human cellular responses to chlamydial stress response proteases and chlamydial infection to further identify the immune processes involved in serious disease sequelae. Results Laboratory cell cultures and primary human reproductive epithelial cultures produced IL-6 in response to chlamydial stress response proteases (CtHtrA and CtTsp), UV inactivated Chlamydia, and live Chlamydia. The magnitude of the IL-6 response varied considerably (up to 1000 pg ml-1) across different primary human reproductive cultures. Thus different levels of IL-6 production by reproductive epithelia may be a determinant in disease outcome. Interestingly, co-culture models with either THP-1 cells or autologous primary human PBMC generally resulted in increased levels of IL-6, except in the case of live Chlamydia where the level of IL-6 was decreased compared to the epithelial cell culture only, suggesting this pathway may be able to be modulated by live Chlamydia. PBMC responses to the stress response proteases (CtTsp and CtHtrA) did not significantly vary for the different participant cohorts. Therefore, these proteases may possess conserved innate PAMPs. MAP kinases appeared to be involved in this IL-6 induction from human cells. Finally, we also demonstrated that IL-6 was induced by these proteins and Chlamydia from mouse primary reproductive cell cultures (BALB/C mice) and mouse laboratory cell models. Conclusions We have demonstrated that IL-6 may be a key factor for the chlamydial disease outcome in humans, given that primary human reproductive epithelial cell culture showed considerable variation in IL-6 response to Chlamydia or chlamydial proteins, and that the presence of live Chlamydia (but not UV killed) during co-culture resulted in a reduced IL-6 response suggesting this response may be moderated by the presence of the organism. PMID:24238294

Uptake of Biotin by Chlamydia Spp. through the Use of a Bacterial Transporter (BioY) and a Host-Cell Transporter (SMVT)

PubMed Central

Fisher, Derek J.; Fernández, Reinaldo E.; Adams, Nancy E.; Maurelli, Anthony T.

2012-01-01

Chlamydia spp. are obligate intracellular Gram-negative bacterial pathogens that cause disease in humans and animals. Minor variations in metabolic capacity between species have been causally linked to host and tissue tropisms. Analysis of the highly conserved genomes of Chlamydia spp. reveals divergence in the metabolism of the essential vitamin biotin with genes for either synthesis (bioF_2ADB) and/or transport (bioY). Streptavidin blotting confirmed the presence of a single biotinylated protein in Chlamydia. As a first step in unraveling the need for divergent biotin acquisition strategies, we examined BioY (CTL0613) from C. trachomatis 434/Bu which is annotated as an S component of the type II energy coupling-factor transporters (ECF). Type II ECFs are typically composed of a transport specific component (S) and a chromosomally unlinked energy module (AT). Intriguingly, Chlamydia lack recognizable AT modules. Using 3H-biotin and recombinant E. coli expressing CTL0613, we demonstrated that biotin was transported with high affinity (a property of Type II ECFs previously shown to require an AT module) and capacity (apparent K(m) of 3.35 nM and V(max) of 55.1 pmol×min−1×mg−1). Since Chlamydia reside in a host derived membrane vacuole, termed an inclusion, we also sought a mechanism for transport of biotin from the cell cytoplasm into the inclusion vacuole. Immunofluorescence microscopy revealed that the mammalian sodium multivitamin transporter (SMVT), which transports lipoic acid, biotin, and pantothenic acid into cells, localizes to the inclusion. Since Chlamydia also are auxotrophic for lipoic and pantothenic acids, SMVT may be subverted by Chlamydia to move multiple essential compounds into the inclusion where BioY and another transporter(s) would be present to facilitate transport into the bacterium. Collectively, our data validates the first BioY from a pathogenic organism and describes a two-step mechanism by which Chlamydia transport biotin from the host cell into the bacterial cytoplasm. PMID:23029384

Tissue-Resident T Cells as the Central Paradigm of Chlamydia Immunity.

PubMed

Johnson, Raymond M; Brunham, Robert C

2016-04-01

For almost 2 decades, results from Chlamydia pathogenesis investigations have been conceptualized using a cytokine polarization narrative. Recent viral immunity studies identifying protective tissue-resident memory T cells (Trm) suggest an alternative paradigm based on localized immune networks. As Chlamydia vaccines enter the preclinical pipeline and, in the case of an attenuated trachoma vaccine, are given to human subjects, it may be useful to ask whether cytokine polarization is the appropriate framework for understanding and evaluating vaccine efficacy. In this review, we revisit C. trachomatis pathogenesis data from mice and humans using a Trm narrative and note a comfortable concordance with the Chlamydia pathogenesis literature. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Follicular Conjunctivitis due to Chlamydia felis-Case Report, Review of the Literature and Improved Molecular Diagnostics.

PubMed

Wons, Juliana; Meiller, Ralph; Bergua, Antonio; Bogdan, Christian; Geißdörfer, Walter

2017-01-01

A 29-year-old woman presented with unilateral, chronic follicular conjunctivitis since 6 weeks. While the conjunctival swab taken from the patient's eye was negative in a Chlamydia (C.) trachomatis -specific PCR, C. felis was identified as etiological agent using a pan- Chlamydia TaqMan-PCR followed by sequence analysis. A pet kitten of the patient was found to be the source of infection, as its conjunctival and pharyngeal swabs were also positive for C. felis . The patient was successfully treated with systemic doxycycline. This report, which presents one of the few documented cases of human C. felis infection, illustrates that standard PCR tests are designed to detect the most frequently seen species of a bacterial genus but might fail to be reactive with less common species. We developed a modified pan- Chlamydia / C. felis duplex TaqMan-PCR assay that detects C. felis without the need of subsequent sequencing. The role of chlamydiae-specific serum antibody titers for the diagnosis of follicular conjunctivitis is discussed.

Chlamydia trachomatis infection: the efficacy and safety of a fast-track referral and treatment system.

PubMed

Sethupathi, M; Blackwell, A

2009-03-01

We introduced a Nurse/Health Advisor-led fast-track service for treating patients diagnosed with chlamydia outside a genitourinary medicine setting and contacts of chlamydia/non-specific urethritis/cervicitis wherever diagnosed. Asymptomatic patients were treated without initial testing and asked to return for full screening at four to six weeks. We assessed the efficacy and safety of the system and need for follow-up after treatment. Case-notes of 226 patients (121 men and 105 women) were analysed, of whom 140 attended follow-up. With the exception of one case of gonorrhoea, no other serious sexually transmitted infection was detected. Twenty-seven (19.2%) patients were re-treated for either chlamydia (six patients, 4.4%) or non-specific genital infection or because of having unprotected intercourse with untreated or partially treated partners. We conclude that in our relatively low-risk population, our fast-track service is safe and effective. Test of cure for chlamydia seems essential because of the high percentage of patients requiring re-treatment.

Screening for asymptomatic lymphogranuloma venereum co-infection in men who have sex with men newly diagnosed with HIV, hepatitis C or syphilis.

PubMed

Pallawela, Sns; Bradshaw, D; Hodson, L; Rehill, K; Wong, F; Rockwood, N; Gedela, K; Hardie, J; Price, H; Alexander, S; McLean, K; Dean, G; Smith, A; Sullivan, A K

2016-07-01

Patients diagnosed with lymphogranuloma venereum have high rates of co-infection with HIV, syphilis and hepatitis C. The aim of this enhanced surveillance was to screen all men who have sex with men (MSM) newly diagnosed with HIV, syphilis or hepatitis C for co-infection with asymptomatic lymphogranuloma venereum as part of the recommended sexual health screen. Of the 145 patients screened, 21 patients were diagnosed with rectal Chlamydia trachomatis, one with both rectal and urethral chlamydia and six with urethral chlamydia. One rectal chlamydia-positive sample, when tested, was equivocal for lymphogranuloma venereum. Our data suggested that there was not a pool of asymptomatic lymphogranuloma venereum infection in MSM recently diagnosed with HIV, hepatitis C and syphilis. However, there have been recent reports of an increased incidence of asymptomatic lymphogranuloma venereum, raising the question whether lymphogranuloma venereum should be screened for in high risk asymptomatic MSM. The prevalence of asymptomatic rectal chlamydia infections was 19%. © The Author(s) 2015.

Serological cross-reactions between Bartonella and Chlamydia species: implications for diagnosis.

PubMed Central

Maurin, M; Eb, F; Etienne, J; Raoult, D

1997-01-01

Diagnosis of Chlamydia or Bartonella infections continues to rely mainly on serology. However, serological cross-reactions between members of these genera have recently been described. Sera from eight patients originally diagnosed as having Chlamydia pneumoniae endocarditis reacted with both Chlamydia sp. and Bartonella quintana antigens (microimmunofluorescence technique). Adsorption of sera with B. quintana or C. pneumoniae antigens removed anti-C. pneumoniae antibodies, whereas adsorption with C. pneumoniae antigens did not change antibody titers to B. quintana. Western blot analysis confirmed the presence of cross-reacting antigens and showed antibody patterns in all sera to be compatible with a Bartonella infection. These patients were therefore probably suffering from Bartonella-induced rather than Chlamydia-induced endocarditis. In contrast, sera from 10 patients presumed to be suffering from C. pneumoniae pneumonia did not display anti-B. quintana antibodies, although cross-reacting antigens were revealed by Western blotting. This work highlights the possibility that cases of infective Bartonella endocarditis are erroneously diagnosed as chlamydial infections. PMID:9276403

Seroprevalence and genotype of Chlamydia in pet parrots in China.

PubMed

Zhang, N-Z; Zhang, X-X; Zhou, D-H; Huang, S-Y; Tian, W-P; Yang, Y-C; Zhao, Q; Zhu, X-Q

2015-01-01

Parrots are one of the most popular pet birds in China, and can harbour Chlamydia which has significance for human and animal health. We investigated, by indirect haemagglutination assay, the seroprevalence of Chlamydia infection in four species of parrots, namely budgerigars (Melopsittacus undulatus), lovebirds (Agapornis sp.), cockatiels (Nymphicus hollandicus) and Alexandrine parakeets (Psittacula eupatria) that were collected from Weifang and Beijing cities, North China and explored the association between potential risk factors and chlamydial seropositivity. We further determined the genotype of Chlamydia in 21 fresh faecal samples based on the ompA sequence by reconstruction of phylogenetic relationships. Of the 311 parrots examined, 35·37% (95% confidence interval 30·06-40·68) were seropositive, and species, gender, age, season and geographical location were identified as risk factors. Two PCR-positive samples represented Chlamydia psittaci genotype A. The occurrence of C. psittaci genotype A in the droppings of two pet parrots in China suggests potential environmental contamination with Chlamydiaceae and may raise a public health concern.

Spontaneous Resolution of Genital Chlamydia trachomatis Infection in Women and Protection from Reinfection

PubMed Central

Geisler, William M.; Lensing, Shelly Y.; Press, Christen G.; Hook, Edward W.

2013-01-01

The natural history of chlamydia is variable and may include persisting asymptomatic infection, complications, or spontaneous resolution before treatment. Reinfection is common. We evaluated whether spontaneous resolution was associated with decreased reinfection in women returning for treatment of a positive chlamydia screening test. At enrollment, participants were tested for chlamydia, treated with azithromycin, and scheduled for a 6-month follow-up visit for repeat testing. Two hundred participants returned 1 to 12 months after treatment. Spontaneous resolution at enrollment was demonstrated in 44 (22.0%). Reinfection at follow-up occurred in 33 (16.5%), being more frequent in those with persisting infection at enrollment versus spontaneous resolution (31 of 156 [19.9%] vs 2 of 44 [4.5%]; P = .016). Adjusting for age, the odds of reinfection was 4 times higher for participants with persisting infection at enrollment (odds ratio 4.0, 95% confidence interval, 1.1–25.6; P = .034). Chlamydia treatment may attenuate protective immunity in some patients. PMID:23470847

Spontaneous resolution of genital Chlamydia trachomatis infection in women and protection from reinfection.

PubMed

Geisler, William M; Lensing, Shelly Y; Press, Christen G; Hook, Edward W

2013-06-15

The natural history of chlamydia is variable and may include persisting asymptomatic infection, complications, or spontaneous resolution before treatment. Reinfection is common. We evaluated whether spontaneous resolution was associated with decreased reinfection in women returning for treatment of a positive chlamydia screening test. At enrollment, participants were tested for chlamydia, treated with azithromycin, and scheduled for a 6-month follow-up visit for repeat testing. Two hundred participants returned 1 to 12 months after treatment. Spontaneous resolution at enrollment was demonstrated in 44 (22.0%). Reinfection at follow-up occurred in 33 (16.5%), being more frequent in those with persisting infection at enrollment versus spontaneous resolution (31 of 156 [19.9%] vs 2 of 44 [4.5%]; P = .016). Adjusting for age, the odds of reinfection was 4 times higher for participants with persisting infection at enrollment (odds ratio 4.0, 95% confidence interval, 1.1-25.6; P = .034). Chlamydia treatment may attenuate protective immunity in some patients.

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 07, July 2010

DTIC Science & Technology

2010-07-01

associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010...Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009...Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009

Medical Surveillance Monthly Report (MSMR). Volume 16, Number 12, December 2009

DTIC Science & Technology

2009-12-01

disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008...Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009...6 6 Reporting location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold

Antigenic specificity and morphologic characteristics of Chlamydia trachomatis, strain SFPD, isolated from hamsters with proliferative ileitis.

PubMed

Fox, J G; Stills, H F; Paster, B J; Dewhirst, F E; Yan, L; Palley, L; Prostak, K

1993-10-01

Profound diarrhea associated with proliferating intestinal cells containing intraepithelial campylobacter-like organisms (ICLO) occurs in a variety of mammalian hosts, particularly swine and hamsters. Recently, intracellular bacteria were isolated from proliferative intestinal tissue of hamsters and propagated in intestine cell line 407. Oral inoculation of hamsters with cell culture lysates containing these organisms reproduced the disease in susceptible hamsters. In the present study, an intracellular bacterium from the INT 407 cell line was shown by a variety of techniques to be a member of the genus Chlamydia and has been designated Chlamydia sp. strain SFPD. McCoy cells infected with Chlamydia sp. strain SFPD demonstrated bright fluorescent-stained intracytoplasmic inclusions when examined with fluorescein-labeled species-specific C. trachomatis monoclonal antibodies. The organism also reacted to fluorescein-labeled polyclonal but not monoclonal ICLO "omega" antisera. Ultrastructural examination of the Chlamydia sp. strain SFPD from McCoy cells revealed electrondense elementary bodies and a less electron-dense reticulate-like body that was circular; both features are consistent in morphology to developmental forms of Chlamydia and do not conform to ICLO morphology. Molecular studies, 16S ribosomal sequence analysis, and sequencing of the outer membrane protein confirmed that the isolate is a C. trachomatis closely related to the mouse pneumonitis strain of C. trachomatis.

Chlamydia Inhibit Host Cell Apoptosis by Degradation of Proapoptotic BH3-only Proteins

PubMed Central

Fischer, Silke F.; Vier, Juliane; Kirschnek, Susanne; Klos, Andreas; Hess, Simone; Ying, Songmin; Häcker, Georg

2004-01-01

Chlamydia are obligate intracellular bacteria that replicate in a vacuole inside a host cell. Chlamydial infection has been shown to protect the host cell against apoptotic stimuli. This is likely important for the ability of Chlamydia to reproduce in human cells. Here we show that resistance to apoptosis is conveyed by the destruction of the proapoptotic BH3-only proteins Bim/Bod, Puma, and Bad during infection. Apoptotic stimuli were blocked upstream of the mitochondrial activation of Bax/Bak. During infection with both species, Chlamydia trachomatis and Chlamydia pneumoniae, Bim protein gradually disappeared without noticeable changes in Bim mRNA. The disappearance was blocked by inhibitors of the proteasome. Infected cells retained sensitivity to Bim expressed by transfection, indicating functional relevance of the Bim disappearance. Fusion to Bim targeted the green fluorescent protein for destruction during infection. Analysis of truncation mutants showed that a short region of Bim containing the BH3 domain was sufficient for destruction during chlamydial infection. Like Bim, Puma and Bad proteins disappeared during infection. These results reveal a novel way by which microbes can interfere with the host cell's apoptotic machinery, and provide a molecular explanation of the cellular resistance to apoptosis during infection with Chlamydia. PMID:15452181

Assessment of Chlamydia suis Infection in Pig Farmers.

PubMed

De Puysseleyr, L; De Puysseleyr, K; Braeckman, L; Morré, S A; Cox, E; Vanrompay, D

2017-06-01

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. © 2015 Blackwell Verlag GmbH.

Approach to lymphogranuloma venereum

PubMed Central

O’Byrne, Patrick; MacPherson, Paul; DeLaplante, Stephane; Metz, Gila; Bourgault, Andree

2016-01-01

Objective To review the literature about lymphogranuloma venereum (LGV) and to provide an overview and discussion of practice guidelines. Sources of information The terms Chlamydia trachomatis and lymphogranuloma venereum were searched separately in PubMed. Empirical studies, practice reviews, and clinical guidelines were included. All reference lists were reviewed for additional articles. Main message Since 2003, there has been a resurgence of LGV among men who have sex with men in many Western countries, including Canada. Although LGV is a serovar of Chlamydia trachomatis (serovar L), it can invade regional lymph nodes, and consequently presents with different symptoms than the other subtypes of chlamydia (serovars A through K). Specifically, LGV transitions through 3 phases: a painless papule or ulcer at the site of inoculation; invasion of the regional lymph nodes, which can present with an inguinal or rectal syndrome; and irreversible destruction of lymph tissue. In contrast, chlamydia serovars A to K exclusively produce superficial mucosal infections. Lymphogranuloma venereum also requires a different treatment regimen than other chlamydia serovars. Conclusion In light of the current resurgence of LGV, its unique symptoms and clinical course, and its requirement for a different treatment than other chlamydia serovars, it is important for primary care providers to recognize when LGV should be included as an appropriate differential diagnosis. PMID:27412206

Approach to lymphogranuloma venereum.

PubMed

O'Byrne, Patrick; MacPherson, Paul; DeLaplante, Stephane; Metz, Gila; Bourgault, Andree

2016-07-01

To review the literature about lymphogranuloma venereum (LGV) and to provide an overview and discussion of practice guidelines. The terms Chlamydia trachomatis and lymphogranuloma venereum were searched separately in PubMed. Empirical studies, practice reviews, and clinical guidelines were included. All reference lists were reviewed for additional articles. Since 2003, there has been a resurgence of LGV among men who have sex with men in many Western countries, including Canada. Although LGV is a serovar of Chlamydia trachomatis (serovar L), it can invade regional lymph nodes, and consequently presents with different symptoms than the other subtypes of chlamydia (serovars A through K). Specifically, LGV transitions through 3 phases: a painless papule or ulcer at the site of inoculation; invasion of the regional lymph nodes, which can present with an inguinal or rectal syndrome; and irreversible destruction of lymph tissue. In contrast, chlamydia serovars A to K exclusively produce superficial mucosal infections. Lymphogranuloma venereum also requires a different treatment regimen than other chlamydia serovars. In light of the current resurgence of LGV, its unique symptoms and clinical course, and its requirement for a different treatment than other chlamydia serovars, it is important for primary care providers to recognize when LGV should be included as an appropriate differential diagnosis. Copyright© the College of Family Physicians of Canada.

Extragenital Chlamydia and Gonorrhea in Young Black Men Who Have Sex With Men: Missed Treatment Opportunities for Human Immunodeficiency Virus-Infected Men Who Have Sex With Men?

PubMed

Mena, Leandro; Crosby, Richard A; Chamberlain, Nicholas

2018-05-01

This study of young black men who have sex with men (YBMSM) assessed the prevalence of extragenital chlamydia and gonorrhea among those testing negative for urethral infections, and compared prevalence of both by human immunodeficiency virus (HIV) status. A convenience sample of 609 YBMSM was recruited for a cross-sectional study from 2 sexual health clinics located in Jackson, MS. To detect Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), nucleic acid amplification testing was performed on urine, rectal swabs, and oral swabs. OraSure was used to detect HIV. Seventy-three percent of all chlamydia infections and 77% of gonorrhea infections were found from anal and oral swabs in the absence of urethral positivity. Compared with HIV-uninfected men, HIV-infected men were significantly more likely to have pharyngeal chlamydia (P = 0.03), multiple CT infections (P = 0.02), rectal NG (P < 0.001), multiple NG infections (P = 0.04), both CT/NG rectal infections (P = 0.001). As much as three quarters of all chlamydia and gonorrhea infections may be missed when only urine-based nucleic acid amplification testing is used to screen YBMSM for bacterial sexually transmitted infections. These missed opportunities for diagnosis may be particularly likely among HIV-infected YBMSM.

Fierce Competition between Toxoplasma and Chlamydia for Host Cell Structures in Dually Infected Cells

PubMed Central

Romano, Julia D.; de Beaumont, Catherine; Carrasco, Jose A.; Ehrenman, Karen; Bavoil, Patrik M.

2013-01-01

The prokaryote Chlamydia trachomatis and the protozoan Toxoplasma gondii, two obligate intracellular pathogens of humans, have evolved a similar modus operandi to colonize their host cell and salvage nutrients from organelles. In order to gain fundamental knowledge on the pathogenicity of these microorganisms, we have established a cell culture model whereby single fibroblasts are coinfected by C. trachomatis and T. gondii. We previously reported that the two pathogens compete for the same nutrient pools in coinfected cells and that Toxoplasma holds a significant competitive advantage over Chlamydia. Here we have expanded our coinfection studies by examining the respective abilities of Chlamydia and Toxoplasma to co-opt the host cytoskeleton and recruit organelles. We demonstrate that the two pathogen-containing vacuoles migrate independently to the host perinuclear region and rearrange the host microtubular network around each vacuole. However, Toxoplasma outcompetes Chlamydia to the host microtubule-organizing center to the detriment of the bacterium, which then shifts to a stress-induced persistent state. Solely in cells preinfected with Chlamydia, the centrosomes become associated with the chlamydial inclusion, while the Toxoplasma parasitophorous vacuole displays growth defects. Both pathogens fragment the host Golgi apparatus and recruit Golgi elements to retrieve sphingolipids. This study demonstrates that the productive infection by both Chlamydia and Toxoplasma depends on the capability of each pathogen to successfully adhere to a finely tuned developmental program that aims to remodel the host cell for the pathogen's benefit. In particular, this investigation emphasizes the essentiality of host organelle interception by intravacuolar pathogens to facilitate access to nutrients. PMID:23243063

Fierce competition between Toxoplasma and Chlamydia for host cell structures in dually infected cells.

PubMed

Romano, Julia D; de Beaumont, Catherine; Carrasco, Jose A; Ehrenman, Karen; Bavoil, Patrik M; Coppens, Isabelle

2013-02-01

The prokaryote Chlamydia trachomatis and the protozoan Toxoplasma gondii, two obligate intracellular pathogens of humans, have evolved a similar modus operandi to colonize their host cell and salvage nutrients from organelles. In order to gain fundamental knowledge on the pathogenicity of these microorganisms, we have established a cell culture model whereby single fibroblasts are coinfected by C. trachomatis and T. gondii. We previously reported that the two pathogens compete for the same nutrient pools in coinfected cells and that Toxoplasma holds a significant competitive advantage over Chlamydia. Here we have expanded our coinfection studies by examining the respective abilities of Chlamydia and Toxoplasma to co-opt the host cytoskeleton and recruit organelles. We demonstrate that the two pathogen-containing vacuoles migrate independently to the host perinuclear region and rearrange the host microtubular network around each vacuole. However, Toxoplasma outcompetes Chlamydia to the host microtubule-organizing center to the detriment of the bacterium, which then shifts to a stress-induced persistent state. Solely in cells preinfected with Chlamydia, the centrosomes become associated with the chlamydial inclusion, while the Toxoplasma parasitophorous vacuole displays growth defects. Both pathogens fragment the host Golgi apparatus and recruit Golgi elements to retrieve sphingolipids. This study demonstrates that the productive infection by both Chlamydia and Toxoplasma depends on the capability of each pathogen to successfully adhere to a finely tuned developmental program that aims to remodel the host cell for the pathogen's benefit. In particular, this investigation emphasizes the essentiality of host organelle interception by intravacuolar pathogens to facilitate access to nutrients.

Screening for gonorrhoea using samples collected through the English National Chlamydia Screening Programme and risk of false positives: a national survey of Local Authorities

PubMed Central

Field, Nigel; Kennedy, Iain; Folkard, Kate; Duffell, Stephen; Town, Katy; Ison, Catherine A; Hughes, Gwenda

2014-01-01

Objectives To investigate use of dual tests for Chlamydia trachomatis and Neisseria gonorrhoeae on samples collected through the National Chlamydia Screening Programme (NCSP) in England. Design and setting During May–July 2013, we delivered an online survey to commissioners of sexual health services in the 152 upper-tier English Local Authorities (LAs) who were responsible for commissioning chlamydia screening in people aged 15–24 years. Main outcome measures (1) The proportion of English LAs using dual tests on samples collected by the NCSP; (2) The estimated number of gonorrhoea tests and false positives from samples collected by the NCSP, calculated using national surveillance data on the number of chlamydia tests performed, assuming the gonorrhoea prevalence to range between 0.1% and 1%, and test sensitivity and specificity of 99.5%. Results 64% (98/152) of LAs responded to this national survey; over half (53% (52/98)) reported currently using dual tests in community settings. There was no significant difference between LAs using and not using dual tests by chlamydia positivity, chlamydia diagnosis rate or population screening coverage. Although positive gonorrhoea results were confirmed with supplementary tests in 93% (38/41) of LAs, this occurred after patients were notified about the initial positive result in 63% (26/41). Approximately 450–4500 confirmed gonorrhoea diagnoses and 2300 false-positive screens might occur through use of dual tests on NCSP samples each year. Under reasonable assumptions, the positive predictive value of the screening test is 17–67%. Conclusions Over half of English LAs already commission dual tests for samples collected by the NCSP. Gonorrhoea screening has been introduced alongside chlamydia screening in many low prevalence settings without a national evidence review or change of policy. We question the public health benefit here, and suggest that robust testing algorithms and clinical management pathways, together with rigorous evaluation, be implemented wherever dual tests are deployed. PMID:25324326

Trends in adult chlamydia and gonorrhoea prevalence, incidence and urethral discharge case reporting in Mongolia from 1995 to 2016 - estimates using the Spectrum-STI model.

PubMed

Badrakh, Jugderjav; Zayasaikhan, Setsen; Jagdagsuren, Davaalkham; Enkhbat, Erdenetungalag; Jadambaa, Narantuya; Munkhbaatar, Sergelen; Taylor, Melanie; Rowley, Jane; Mahiané, Guy; Korenromp, Eline

2017-01-01

To estimate Mongolia's prevalence and incidence trends of gonorrhoea and chlamydia in women and men 15-49 years old to inform control of STIs and HIV, a national health sector priority. We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhoea screening of pregnant women in antenatal care (1997 to 2016) adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Gonorrhoea prevalence was estimated at 3.3% (95% confidence interval, 1.6-3.9%) in women and 2.9% (1.6-4.1%) in men in 2016; chlamydia prevalence levels were 19.5% (17.3-21.9%) and 15.6% (10.0-21.2%), respectively. Corresponding new incident cases in women and men in 2016 totalled 60 334 (36 147 to 121 933) and 76 893 (35 639 to 254 913) for gonorrhoea and 131 306 (84 232 to 254 316) and 148 162 (71 885 to 462 588) for chlamydia. Gonorrhoea and chlamydia prevalence declined by an estimated 33% and 11%, respectively from 2001 to 2016.Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhoea case reports suggests that 15% of symptomatic treated gonorrhoea cases were reported in 2016; only a minority of chlamydia episodes were reported as male urethral discharge cases. Gonorrhoea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001 and scale up of HIV/STI prevention interventions since 2003. However, prevalence remains high with most gonorrhoea and chlamydia cases not treated or recorded in the public health system.

Rationale and design of REACT: a randomised controlled trial assessing the effectiveness of home-collection to increase chlamydia retesting and detect repeat positive tests.

PubMed

Smith, Kirsty S; Hocking, Jane S; Chen, Marcus; Fairley, Christopher K; McNulty, Anna; Read, Phillip; Bradshaw, Catriona S; Tabrizi, Sepehr N; Wand, Handan; Saville, Marion; Rawlinson, William; Garland, Suzanne M; Donovan, Basil; Kaldor, John M; Guy, Rebecca

2014-04-24

Repeat infection with Chlamydia trachomatis is common and increases the risk of sequelae in women and HIV seroconversion in men who have sex with men (MSM). Despite guidelines recommending chlamydia retesting three months after treatment, retesting rates are low. We are conducting the first randomised controlled trial to assess the effectiveness of home collection combined with short message service (SMS) reminders on chlamydia retesting and reinfection rates in three risk groups. The REACT (retest after Chlamydia trachomatis) trial involves 600 patients diagnosed with chlamydia: 200 MSM, 200 women and 200 heterosexual men recruited from two Australian sexual health clinics where SMS reminders for retesting are routine practice. Participants will be randomised to the home group (3-month SMS reminder and home-collection) or the clinic group (3-month SMS reminder to return to the clinic). Participants in the home group will be given the choice of attending the clinic if they prefer. The mailed home-collection kit includes a self-collected vaginal swab (women), UriSWAB (Copan) for urine collection (heterosexual men), and UriSWAB plus rectal swab (MSM). The primary outcome is the retest rate at 1-4 months after a chlamydia diagnosis, and the secondary outcomes are: the repeat positive test rate; the reinfection rate; the acceptability of home testing with SMS reminders; and the cost effectiveness of home testing. Sexual behaviour data collected via an online survey at 4-5 months, and genotyping of repeat infections, will be used to discriminate reinfections from treatment failures. The trial will be conducted over two years. An intention to treat analysis will be conducted. This study will provide evidence about the effectiveness of home-collection combined with SMS reminders on chlamydia retesting, repeat infection and reinfection rates in three risk groups. The trial will determine client acceptability and cost effectiveness of this strategy. Australian and New Zealand Clinical Trials Registry ACTRN12611000968976.

Self-perceived risk and prevalent chlamydia infection among adolescents in Norway: a population-based cross-sectional study.

PubMed

Gravningen, Kirsten; Braaten, Tonje; Schirmer, Henrik

2016-03-01

Risk judgements are key factors in adolescents' decisions related to sexual health. We examine the associations between self-perceived risk and prevalent chlamydia infection, and sexual behaviours related to risk perception in a general adolescent population in Norway. Population-based cross-sectional study among 1028 sexually experienced girls and boys, age 15-20 years (85% participation), including web questionnaires and urine samples for Chlamydia trachomatis PCR testing. Participants rated self-perceived risk as: no/low/medium/high/very high. We used binary and ordinal logistic regressions to examine associations with chlamydia prevalence and self-perceived risk, respectively, adjusting for potentially confounding variables. Chlamydia prevalence increased with increasing risk perception. Although girls had twice the chlamydia prevalence of boys (7.3% vs 3.9%), their risk distribution was similar and 65% of both genders rated their risk as no/low with half of infections detected in this group. In multivariable analyses, reporting multiple sexual risk behaviours, non-steady relationship, previous chlamydia testing and treatment, and urogenital symptoms increased self-perceived risk. More boys overestimated their personal risk whereas more girls underestimated it (52% vs 30%, respectively, and 15% vs 31%, p<0.001). The main reasons for perceiving no/low risk were: 'I have a steady partner' and 'I trust my partner will tell me about an infection'. These sexually experienced adolescents acknowledged their chlamydia infection risk, but wrong beliefs were incorporated in their assessments, and more than half had incorrect risk perception. We suggest that sexually transmitted infection prevention programmes should be directed at closing the gap between perceived and actual risk and focus on how context may bias personal judgement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Systematic screening with information and home sampling for genital Chlamydia trachomatis infections in young men and women in Norway: a randomized controlled trial.

PubMed

Kløvstad, Hilde; Natås, Olav; Tverdal, Aage; Aavitsland, Preben

2013-01-23

As most genital Chlamydia trachomatis infections are asymptomatic, many patients do not seek health care for testing. Infections remain undiagnosed and untreated. We studied whether screening with information and home sampling resulted in more young people getting tested, diagnosed and treated for chlamydia in the three months following the intervention compared to the current strategy of testing in the health care system. We conducted a population based randomized controlled trial among all persons aged 18-25 years in one Norwegian county (41 519 persons). 10 000 persons (intervention) received an invitation by mail with chlamydia information and a mail-back urine sampling kit. 31 519 persons received no intervention and continued with usual care (control). All samples from both groups were analysed in the same laboratory. Information on treatment was obtained from the Norwegian Prescription Database (NorPD). We estimated risk ratios and risk differences of being tested, diagnosed and treated in the intervention group compared to the control group. In the intervention group 16.5% got tested and in the control group 3.4%, risk ratio 4.9 (95% CI 4.5-5.2). The intervention led to 2.6 (95% CI 2.0-3.4) times as many individuals being diagnosed and 2.5 (95% CI 1.9-3.4) times as many individuals receiving treatment for chlamydia compared to no intervention in the three months following the intervention. In Norway, systematic screening with information and home sampling results in more young people being tested, diagnosed and treated for chlamydia in the three months following the intervention than the current strategy of testing in the health care system. However, the study has not established that the intervention will reduce the chlamydia prevalence or the risk of complications from chlamydia.

Interleukin-10 Modulates Antigen Presentation by Dendritic Cells through Regulation of NLRP3 Inflammasome Assembly during Chlamydia Infection

PubMed Central

Omosun, Yusuf; McKeithen, Danielle; Ryans, Khamia; Kibakaya, Caroline; Blas-Machado, Uriel; Li, Duo; Singh, Rajesh; Inoue, Koichi; Xiong, Zhi-Gang; Eko, Francis; Black, Carolyn; Igietseme, Joseph

2015-01-01

Interleukin-10 (IL-10) has been implicated in susceptibility to genital chlamydial infection and the development of tubal pathologies. IL-10 limitation also resulted in the rapid elicitation of immune responses against Chlamydia, and decreased levels of IL-10 correlated with protective anti-Chlamydia immunity. To investigate the molecular basis for these effects, we compared the reproductive pathologies and fertility rates in Chlamydia-infected wild-type (WT) and IL-10-knockout (IL-10−/−) mice; we also analyzed the expression of the Toll-like receptor (TLR)/interleukin-1 receptor (IL-1R) superfamily, IL-1β production, NLRP3 inflammasome assembly and activation, and the immunostimulatory capacity and apoptotic predilection of Chlamydia-exposed dendritic cells (DCs) from WT and IL-10−/− mice. Our results revealed that, in addition to the rapid clearance of infection, genitally infected IL-10−/− mice were protected from tubal pathologies and infertility, whereas WT (IL-10+/+) mice were not. Chlamydia-pulsed IL-10−/− DCs expressed larger numbers of TLR4/IL-1R molecules and had enhanced IL-1β production. In addition, NLRP3 inflammasome assembly was suppressed in IL-10−/− DCs through the inhibition of the P2X purinoceptor 7 (P2X7) receptor (P2X7R), an ATP-gated ion channel, and a decrease in intracellular Ca2+ levels, which inhibited DC apoptosis. Thus, the potent immunostimulatory capacity of IL-10-deficient DCs is due, at least in part, to the suppression of the intracellular inflammasome assembly, which prevents DC apoptosis, allowing efficient antigen presentation. The results indicate that IL-10 deficiency enables efficient antigen presentation by DCs for rapid and enhanced immune activation against Chlamydia, which results in rapid microbial clearance, which prevents tubal pathologies during infection. Our finding has important implications for the induction of protective immunity against Chlamydia and other infectious and noninfectious diseases by vaccines. PMID:26371131

Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco over 1995-2015-Estimates Using the Spectrum-Sexually Transmitted Infection Model.

PubMed

El-Kettani, Amina; Mahiané, Guy; Bennani, Aziza; Abu-Raddad, Laith; Smolak, Alex; Rowley, Jane; Nagelkerke, Nico; El-Rhilani, Houssine; Alami, Kamal; Hançali, Amina; Korenromp, Eline

2017-09-01

Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation. The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with urethral discharge (UD) case reports, to estimate reporting completeness among treated UD cases. Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14-1.0%) in women and 0.32% (0.12-0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1-6.4%) and 3.0% (95% CI, 1.7-5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918-256,206) and 112,013 (95% CI, 28,700-307,433) for gonorrhea, and 291,908 (95% CI, 161,064-524,270) and 314,032 (95% CI, 186,076-559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases. STI declines and improvements in treatment coverage are consistent with Morocco's introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.

Genital warts and chlamydia in Australian women: comparison of national population-based surveys in 2001 and 2011.

PubMed

Liu, Bette; Donovan, Basil; Brotherton, Julia M L; Saville, Marion; Kaldor, John M

2014-11-01

Australia introduced a nationwide human papillomavirus (HPV) vaccination programme for women aged 12-26 years in 2007 and has implemented various chlamydia control strategies over the last 10 years. We compared reported diagnoses of warts and chlamydia in two national population-based samples surveyed 10 years apart. An Australia-wide survey of women aged 18-39 years was conducted by random-digit dialling mobile phone numbers in 2011. The proportion of women self-reporting genital warts and chlamydia was compared with that in equivalent-aged women interviewed in another national telephone survey conducted 10 years earlier using logistic regression adjusting for age, and other factors. 2394 women were included in the 2011 survey. 88 (3.7%) reported a genital warts diagnosis, and 127 (5.3%) had at least one chlamydia diagnosis. For women with warts and chlamydia, the majority were seen in general practice (63.3% and 70.0%, respectively). Comparing women surveyed in 2011 to 4874 women surveyed in 2001, among women eligible for free HPV vaccine through the national programme (women aged 18-30 years), there was a 41% decrease in warts (adjusted OR 0.59, 95% CI 0.39 to 0.89) but among ineligible women (31-39 years) there was a 64% increase (aOR 1.64, 95% CI 1.05 to 2.54). Over the same period chlamydia diagnoses increased by 97% (aOR 1.97, 95% CI 1.15 to 3.37) in women aged 18-24 years. Our results add to evidence from clinic-based studies showing a significant reduction in genital warts among HPV vaccine-eligible women in the general community and increases in the proportion of Australian women diagnosed with chlamydia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Heterogeneity in Risk of Pelvic Inflammatory Diseases After Chlamydia Infection: A Population-Based Study in Manitoba, Canada

PubMed Central

Davies, Bethan; Ward, Helen; Leung, Stella; Turner, Katy M. E.; Garnett, Geoff P.; Blanchard, James F.; Yu, B. Nancy

2014-01-01

Background. The association between chlamydia infection and pelvic inflammatory disease (PID) is a key parameter for models evaluating the impact of chlamydia control programs. We quantified this association using a retrospective population-based cohort. Methods. We used administrative health data sets to construct a retrospective population-based cohort of women and girls aged 12–24 years who were resident in Manitoba, Canada, between 1992 and 1996. We performed survival analysis on a subcohort of individuals who were tested for chlamydia to estimate the risk of PID diagnosed in a primary care, outpatient, or inpatient setting after ≥1 positive chlamydia test. Results. A total of 73 883 individuals contributed 625 621 person years of follow-up. Those with a diagnosis of chlamydia had an increased risk of PID over their reproductive lifetime compared with those who tested negative (adjusted hazard ratio [AHR], 1.55; 95% confidence interval [CI], 1.43–1.70). This risk increased with each subsequent infection: the AHR was 1.17 for first reinfection (95% CI, 1.06–1.30) and 1.35 for the second (95% CI, 1.04–1.75). The increased risk of PID from reinfection was highest in younger individuals (AHR, 4.55 (95% CI, 3.59–5.78) in individuals aged 12–15 years at the time of their second reinfection, compared with individuals older than 30 years). Conclusions. There is heterogeneity in the risk of PID after a chlamydia infection. Describing the progression to PID in mathematical models as an average rate may be an oversimplification; more accurate estimates of the cost-effectiveness of screening may be obtained by using an individual-based measure of risk. Health inequalities may be reduced by targeting health promotion interventions at sexually active girls younger than 16 years and those with a history of chlamydia. PMID:25381374

Heterogeneity in risk of pelvic inflammatory diseases after chlamydia infection: a population-based study in Manitoba, Canada.

PubMed

Davies, Bethan; Ward, Helen; Leung, Stella; Turner, Katy M E; Garnett, Geoff P; Blanchard, James F; Yu, B Nancy

2014-12-01

The association between chlamydia infection and pelvic inflammatory disease (PID) is a key parameter for models evaluating the impact of chlamydia control programs. We quantified this association using a retrospective population-based cohort. We used administrative health data sets to construct a retrospective population-based cohort of women and girls aged 12-24 years who were resident in Manitoba, Canada, between 1992 and 1996. We performed survival analysis on a subcohort of individuals who were tested for chlamydia to estimate the risk of PID diagnosed in a primary care, outpatient, or inpatient setting after ≥ 1 positive chlamydia test. A total of 73 883 individuals contributed 625 621 person years of follow-up. Those with a diagnosis of chlamydia had an increased risk of PID over their reproductive lifetime compared with those who tested negative (adjusted hazard ratio [AHR], 1.55; 95% confidence interval [CI], 1.43-1.70). This risk increased with each subsequent infection: the AHR was 1.17 for first reinfection (95% CI, 1.06-1.30) and 1.35 for the second (95% CI, 1.04-1.75). The increased risk of PID from reinfection was highest in younger individuals (AHR, 4.55 (95% CI, 3.59-5.78) in individuals aged 12-15 years at the time of their second reinfection, compared with individuals older than 30 years). There is heterogeneity in the risk of PID after a chlamydia infection. Describing the progression to PID in mathematical models as an average rate may be an oversimplification; more accurate estimates of the cost-effectiveness of screening may be obtained by using an individual-based measure of risk. Health inequalities may be reduced by targeting health promotion interventions at sexually active girls younger than 16 years and those with a history of chlamydia. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

The eSexual Health Clinic system for management, prevention, and control of sexually transmitted infections: exploratory studies in people testing for Chlamydia trachomatis.

PubMed

Estcourt, Claudia S; Gibbs, Jo; Sutcliffe, Lorna J; Gkatzidou, Voula; Tickle, Laura; Hone, Kate; Aicken, Catherine; Lowndes, Catherine M; Harding-Esch, Emma M; Eaton, Sue; Oakeshott, Pippa; Szczepura, Ala; Ashcroft, Richard E; Copas, Andrew; Nettleship, Anthony; Sadiq, S Tariq; Sonnenberg, Pam

2017-04-01

Self-directed and internet-based care are key elements of eHealth agendas. We developed a complex online clinical and public health intervention, the eSexual Health Clinic (eSHC), in which patients with genital chlamydia are diagnosed and medically managed via an automated online clinical consultation, leading to antibiotic collection from a pharmacy. Partner notification, health promotion, and capture of surveillance data are integral aspects of the eSHC. We aimed to assess the safety and feasibility of the eSHC as an alternative to routine care in non-randomised, exploratory proof-of-concept studies. Participants were untreated patients with chlamydia from genitourinary medicine clinics, untreated patients with chlamydia from six areas in England in the National Chlamydia Screening Programme's (NCSP) online postal testing service, or patients without chlamydia tested in the same six NCSP areas. All participants were aged 16 years or older. The primary outcome was the proportion of patients with chlamydia who consented to the online chlamydia pathway who then received appropriate clinical management either exclusively through online treatment or via a combination of online management and face-to-face care. We captured adverse treatment outcomes. Between July 21, 2014, and March 13, 2015, 2340 people used the eSHC. Of 197 eligible patients from genitourinary medicine clinics, 161 accessed results online. Of the 116 who consented to be included in the study, 112 (97%, 95% CI 91-99) received treatment, and 74 of those were treated exclusively online. Of the 146 eligible NCSP patients, 134 accessed their results online, and 105 consented to be included. 93 (89%, 95% CI 81-94) received treatment, and 60 were treated exclusively online. In both groups, median time to collection of treatment was within 1 day of receiving their diagnosis. 1776 (89%) of 1936 NCSP patients without chlamydia accessed results online. No adverse events were recorded. The eSHC is safe and feasible for management of patients with chlamydia, with preliminary evidence of similar treatment outcomes to those in traditional services. This innovative model could help to address growing clinical and public health needs. A definitive trial is needed to assess the efficacy, cost-effectiveness, and public health impact of this intervention. UK Clinical Research Collaboration. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 10, October 2010

DTIC Science & Technology

2010-10-01

Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009...Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009...Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold d Heatd Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 02, February 2010

DTIC Science & Technology

2010-02-01

Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010...2010 Navy Reporting location Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis...disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009

In vitro activity of a partially purified and characterized bark extract of Castanea sativa Mill. (ENC®) against Chlamydia spp.

PubMed

Papa, Valentina; Ginocchietti, Laura; Budriesi, Roberta; Micucci, Matteo; Costa, Roberta; Biondi, Roberta; Cevenini, Roberto; Chiarini, Alberto; Aldini, Rita; Donati, Manuela; Pollini, Gian Matteo; Cenacchi, Giovanna

2017-01-01

Castanea sativa Mill (ENC®), containing tannins against 33 Chlamydia strains, was compared to SMAP-29 with inhibitory effect against C. trachomatis and C. pneumoniae. The ENC® activity against Chlamydia spp. was evaluated determining the lowest concentration to achieve more than half reduction of intact chlamydial inclusions versus controls. ENC® reduced all Chlamydia strains tested at 1 µg/mL, while SMAP-29 induced reductions of C. trachomatis and C. pneumoniae infectivity at 10 µg/mL. A great reduction of C. trachomatis, C. pneumoniae, and C. abortus infectivity was achieved with a 10 µg/mL ENC® concentration, whereas their infectivity was almost inhibited at 100 µg/mL ENC® concentration.

Chlamydia trachomatis Is Resistant to Inclusion Ubiquitination and Associated Host Defense in Gamma Interferon-Primed Human Epithelial Cells.

PubMed

Haldar, Arun K; Piro, Anthony S; Finethy, Ryan; Espenschied, Scott T; Brown, Hannah E; Giebel, Amanda M; Frickel, Eva-Maria; Nelson, David E; Coers, Jörn

2016-12-13

The cytokine gamma interferon (IFN-γ) induces cell-autonomous immunity to combat infections with intracellular pathogens, such as the bacterium Chlamydia trachomatis The present study demonstrates that IFN-γ-primed human cells ubiquitinate and eliminate intracellular Chlamydia-containing vacuoles, so-called inclusions. We previously described how IFN-γ-inducible immunity-related GTPases (IRGs) employ ubiquitin systems to mark inclusions for destruction in mouse cells and, furthermore, showed that the rodent pathogen Chlamydia muridarum blocks ubiquitination of its inclusions by interfering with mouse IRG function. Here, we report that ubiquitination of inclusions in human cells is independent of IRG and thus distinct from the murine pathway. We show that C. muridarum is susceptible to inclusion ubiquitination in human cells, while the closely related human pathogen C. trachomatis is resistant. C. muridarum, but not C. trachomatis, inclusions attract several markers of cell-autonomous immunity, including the ubiquitin-binding protein p62, the ubiquitin-like protein LC3, and guanylate-binding protein 1. Consequently, we find that IFN-γ priming of human epithelial cells triggers the elimination of C. muridarum, but not C. trachomatis, inclusions. This newly described defense pathway is independent of indole-2,3-dioxygenase, a known IFN-γ-inducible anti-Chlamydia resistance factor. Collectively, our observations indicate that C. trachomatis evolved mechanisms to avoid a human-specific, ubiquitin-mediated response as part of its unique adaptation to its human host. Chlamydia trachomatis is the leading cause of sexually transmitted bacterial infections and responsible for significant morbidity, including pelvic inflammatory disease, infertility, and ectopic pregnancies in women. As an obligate intracellular pathogen, C. trachomatis is in perpetual conflict with cell-intrinsic defense programs executed by its human host. Our study defines a novel anti-Chlamydia host resistance pathway active in human epithelial cells. This defense program promotes the deposition of the small antimicrobial protein ubiquitin on vacuoles containing Chlamydia We show that this ubiquitin-based resistance pathway of human cells is highly effective against a Chlamydia species adapted to rodents but ineffective against human-adapted C. trachomatis This observation indicates that C. trachomatis evolved strategies to avoid entrapment within ubiquitin-labeled vacuoles as part of its adaptation to the human innate immune system. Copyright © 2016 Haldar et al.

Genital Chlamydia Prevalence in Europe and Non-European High Income Countries: Systematic Review and Meta-Analysis

PubMed Central

Redmond, Shelagh M.; Alexander-Kisslig, Karin; Woodhall, Sarah C.; van den Broek, Ingrid V. F.; van Bergen, Jan; Ward, Helen; Uusküla, Anneli; Herrmann, Björn; Andersen, Berit; Götz, Hannelore M.; Sfetcu, Otilia; Low, Nicola

2015-01-01

Background Accurate information about the prevalence of Chlamydia trachomatis is needed to assess national prevention and control measures. Methods We systematically reviewed population-based cross-sectional studies that estimated chlamydia prevalence in European Union/European Economic Area (EU/EEA) Member States and non-European high income countries from January 1990 to August 2012. We examined results in forest plots, explored heterogeneity using the I2 statistic, and conducted random effects meta-analysis if appropriate. Meta-regression was used to examine the relationship between study characteristics and chlamydia prevalence estimates. Results We included 25 population-based studies from 11 EU/EEA countries and 14 studies from five other high income countries. Four EU/EEA Member States reported on nationally representative surveys of sexually experienced adults aged 18–26 years (response rates 52–71%). In women, chlamydia point prevalence estimates ranged from 3.0–5.3%; the pooled average of these estimates was 3.6% (95% CI 2.4, 4.8, I2 0%). In men, estimates ranged from 2.4–7.3% (pooled average 3.5%; 95% CI 1.9, 5.2, I2 27%). Estimates in EU/EEA Member States were statistically consistent with those in other high income countries (I2 0% for women, 6% for men). There was statistical evidence of an association between survey response rate and estimated chlamydia prevalence; estimates were higher in surveys with lower response rates, (p = 0.003 in women, 0.018 in men). Conclusions Population-based surveys that estimate chlamydia prevalence are at risk of participation bias owing to low response rates. Estimates obtained in nationally representative samples of the general population of EU/EEA Member States are similar to estimates from other high income countries. PMID:25615574

Role of STAT1 in Chlamydia-Induced Type-1 Interferon Production in Oviduct Epithelial Cells

PubMed Central

Hosey, Kristen Lynette; Hu, Sishun

2015-01-01

We previously reported that Chlamydia muridarum-infected murine oviduct epithelial cells (OE cells) secrete interferon β (IFN-β) in a mostly TLR3-dependent manner. However, C. muridarum-infected TLR3-deficient OE cells were still able to secrete detectable levels of IFN-β into the supernatants, suggesting that other signaling pathways contribute to Chlamydia-induced IFN-β synthesis in these cells. We investigated the role of STAT1 as a possible contributor in the Chlamydia-induced type-1 IFN production in wild-type (WT) and TLR3-deficient OE cells to ascertain its putative role at early- and late-times during Chlamydia infection. Our data show that C. muridarum infection significantly increased STAT1 gene expression and protein activation in WT OE cells; however, TLR3-deficient OE cells showed diminished STAT1 protein activation and gene expression. There was significantly less IFN-β detected in the supernatants of C. muridarum-infected OE cells derived from mice deficient in STAT1 when compared with WT OE cells, which suggest that STAT1 is required for the optimal synthesis of IFN-β during infection. Real-time quantitative polymerase chain reaction analyses of signaling components of the type-1 IFN signaling pathway demonstrated equal upregulation in the expression of STAT2 and IRF7 genes in the WT and TLR3-deficient OE cells, but no upregulation in these genes in the STAT1-deficient OE cells. Finally, experiments in which INFAR1 was blocked with neutralizing antibody revealed that IFNAR1-mediated signaling was critical to the Chlamydia-induced upregulation in IFN-α gene transcription, but had no role in the Chlamydia-induced upregulation in IFN-β gene transcription. PMID:26262558

High rates of chlamydia found among 12- to 16-year-olds attending a rural sexual health clinic: implications for practice.

PubMed

Tomnay, Jane Elizabeth; Coelli, Lauren; Hocking, Jane Simone

2016-04-01

Background Chlamydia is the most commonly diagnosed bacterial sexually transmissible infection (STI) and is asymptomatic in ~80% of women. If untreated, potential consequences include pelvic inflammatory disease, ectopic pregnancy and infertility. In 2014, a retrospective audit was undertaken at a rural service to determine what proportion of patients were aged 12-16 years, infected with chlamydia and their reasons for attending the clinic. There were 111 patients aged 12-16 years attending during 2011-2014; 104 (95%) were female. One hundred and ninety-four chlamydia tests were conducted, with the proportion of patients having at least one test annually being 100% in 2011, 81% in 2012, 72% in 2013 and 78% in 2014. There was no difference in the proportion tested by age during the study (P=0.59). Forty-six tests were positive for chlamydia (23.7%; 95%CI: 17.8%, 30.9%) with proportions decreasing with increasing age from 46.7% (95%CI: 16.4%, 79.5%) in 12- or 13-year-olds to 15.5% (95%CI: 9.4%, 24.2%) in 16-year-olds (P=0.02). The reasons for attending when a chlamydia test was ordered included: (i) fear of pregnancy (18.3%, 34/185); (ii) symptoms (16.7%, 31/185); (iii) STI test/treatment (32.4%, 60/185); and (iv) contraception (32.4%, 60/185). Only 29.7% (33/111) would have been tested if symptoms or requesting a test were impetus. Sexually active 12- to 16-year-olds should be tested for chlamydia, and establishing their sexual history is crucial. Amending the current Australian guidelines to annual testing of any sexually active person under the age of 30 years should be considered.

Chlamydia pneumoniae effector chlamydial outer protein N sequesters fructose bisphosphate aldolase A, providing a benefit to bacterial growth.

PubMed

Ishida, Kasumi; Matsuo, Junji; Yamamoto, Yoshimasa; Yamaguchi, Hiroyuki

2014-12-21

Pathogenic chlamydiae are obligate intracellular pathogens and have adapted successfully to human cells, causing sexually transmitted diseases or pneumonia. Chlamydial outer protein N (CopN) is likely a critical effector protein secreted by the type III secretion system in chlamydiae, which manipulates host cells. However, the mechanisms of its action remain to be clarified. In this work, we aimed to identify previously unidentified CopN effector target in host cells. We first performed a pull-down assay with recombinant glutathione S-transferase (GST) fusion CopN proteins (GST-CpCopN: Chlamydia pneumoniae TW183, GST-CtCopN: Chlamydia trachomatis D/UW-3/CX) as "bait" and soluble lysates obtained from human immortal epithelial HEp-2 cells as "prey", followed by SDS-PAGE with mass spectroscopy (MS). We found that a host cell protein specifically bound to GST-CpCopN, but not GST-CtCopN. MS revealed the host protein to be fructose bisphosphate aldolase A (aldolase A), which plays a key role in glycolytic metabolism. We also confirmed the role of aldolase A in chlamydia-infected HEp-2 cells by using two distinct experiments for gene knockdown with an siRNA specific to aldolase A transcripts, and for assessment of glycolytic enzyme gene expression levels. As a result, both the numbers of chlamydial inclusion-forming units and RpoD transcripts were increased in the chlamydia-infected aldolase A knockdown cells, as compared with the wild-type HEp-2 cells. Meanwhile, chlamydial infection tended to enhance expression of aldolase A. We discovered that one of the C. pneumoniae CopN targets is the glycolytic enzyme aldolase A. Sequestering aldolase A may be beneficial to bacterial growth in infected host cells.

Evaluation of patients with dry eye disease for conjunctival Chlamydia trachomatis and Ureaplasma urealyticum.

PubMed

Abdelfattah, Maha Mohssen; Khattab, Rania Abdelmonem; Mahran, Magda H; Elborgy, Ebrahim S

2016-01-01

To determine the possibility of the development of dry eye disease (DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients. This study was conducted on 58 patients of age range 20-50y, diagnosed with DED confirmed by Schirmer I test and tear breakup time. The non-dry eye control group included 27 subjects of the same age. Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture, the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody (DFA) assay and polymerase chain reaction (PCR) method. Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively. Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method. Both organisms were identified in only 37.9% of DED patients found to be infected. Control subjects had a 22% detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method. The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common (50%) followed by Staphylococcus aureus (20%), whereas gram negative microorganisms occurred in 25% of cases, isolating Moraxella spp. as the most frequent organism. Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED, and could be a fair possibility for its development. PCR is more reliable in detecting Chlamydia trachomatis than DFA technique. The presence of isolated conjunctival bacterial microflora can be of some potential value.

Screening tests for Chlamydia trachomatis or Neisseria gonorrhoeae using the cobas 4800 PCR system do not require a second test to confirm: an audit of patients issued with equivocal results at a sexual health clinic in the Northwest of England, U.K.

PubMed

Hopkins, Mark J; Smith, Godfrey; Hart, Ian J; Alloba, Fath

2012-11-01

To assess the clinical utility of supplementary PCRs following a positive cobas 4800 CT/NG PCR screening test result. Laboratory reports, for Chlamydia trachomatis or Neisseria gonorrhoeae, issued to genitourinary medicine patients between April 2010 and April 2011 were reviewed retrospectively. Positive reports were routinely confirmed by supplementary PCRs and N gonorrhoeae culture. Clinical records of patients with unconfirmed positive (equivocal) reports were retrieved to determine if the infection was confirmed by a second sample obtained at patient recall and the impact of this process on antibiotic management. Over 15 000 patients were tested during the study period. The prevalence of chlamydia and gonorrhoea was 972 (5.75%) and 76 (0.50%), respectively. A further 78 chlamydia and 2 gonorrhoea equivocal reports were issued. Only 56 (72%) patients with an equivocal chlamydia report returned to the clinic, and of these, only 41 (73%) gave a second sample to retest. Positive predictive value (PPV) of the PCR screening test was calculated at 98.0% and 97.5% for detection of chlamydia infection from urine and rectal swabs, respectively. Most patients accepted antibiotic treatment before their infection status had been confirmed. Prevalence of gonorrhoea infection was low but the PPV of the screening PCR in urine specimens remained high (98.75%). Equivocal reports introduce delays to patient management, while the risk of unnecessary antibiotic therapy appears acceptable to most patients. The cobas 4800 CT/NG PCR screening assay can achieve UK testing standards (PPV >90%) for chlamydia, and low prevalence gonorrhoea in urine without supplementary tests. A patient-led confirmation algorithm is proposed.

Comparison of chlamydia infection prevalence between patients with and without ectopic pregnancy using the PCR method.

PubMed

Naderi, Tayebeh; Kazerani, Fatemeh; Bahraminpoor, Abbas

2012-11-01

Damage of the fallopian tube after sexually transmitted diseases like Chlamydia trachomatis, is an important risk factor for ectopic pregnancy (EP). The study was designed to assess the prevalence of C. trachomatis infection in patients with EP in the southeastern part of Iran. The polymerase chain reaction (PCR) on fallopian tube tissue was applied to detect Chlamydia DNA in 42 patients with EP (EP group) and 87 patients without EP (control group) who underwent tubal ligation. The same protocol was performed with urine samples taken from the husbands in both groups. Out of all studied females, 5 patients in the EP group were PCR-positive for C. trachomatis and none of the control group subjects was PCR-positive for C. trachomatis infection (P<0.05). Among the husbands, the PCR result was positive in the urine of 19 males (9 in the EP group and 10 in the control group). All PCR-positive women had husbands with PCR positive urine samples. No significant difference was found between Chlamydia infection in the EP and the control groups regarding age, duration of marriage, contraceptive method and history of infertility surgery and pelvic pain. There was no significant difference between prevalence of EP in women based on the PCR outcome in the husbands. The Chlamydia infection in men did not show any relation to the number of marriages. Based on our findings, it can be concluded that Chlamydia is an important risk factor of the fallopian tube damage and EP in our society. Therefore, screening programs and treatment of Chlamydia infection are recommended in young women and high risk women and men.

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 09, September 2010

DTIC Science & Technology

2010-09-01

Chlamydia Gonorrhea Syphilis Cold d Heatd Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 Air...Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010...borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009

The value of testing multiple anatomic sites for gonorrhoea and chlamydia in sexually transmitted infection centres in the Netherlands, 2006-2010.

PubMed

Koedijk, F D H; van Bergen, J E A M; Dukers-Muijrers, N H T M; van Leeuwen, A P; Hoebe, C J P A; van der Sande, M A B

2012-09-01

National surveillance data from 2006 to 2010 of the Dutch sexually transmitted infection (STI) centres were used to analyse current practices on testing extragenital sites for chlamydia and gonorrhoea in men who have sex with men (MSM) and women. In MSM, 76.0% and 88.9% were tested at least at one extragenital site (pharyngeal and/or anorectal) for chlamydia and gonorrhoea, respectively; for women this was 20.5% and 30.2%. Testing more than one anatomic site differed by STI centre, ranging from 2% to 100%. In MSM tested at multiple sites, 63.0% and 66.5% of chlamydia and gonorrhoea diagnoses, respectively, would have been missed if screened at the urogenital site only, mainly anorectal infections. For women tested at multiple sites, the proportions of missed chlamydia and gonorrhoea diagnoses would have been 12.9% and 30.0%, respectively. Testing extragenital sites appears warranted, due to the numerous infections that would have been missed. Adding anorectal screening to urogenital screening for all MSM visiting an STI centre should be recommended. Since actual testing practices differ by centre, there is a need for clearer guidelines. Routine gonorrhoea and chlamydia screening at multiple sites in STI centres should be investigated further as this might be a more effective approach to reduce transmission than current practice.

Chlamydia trachomatis serotype A infections in the Amazon region of Brazil: prevalence, entry and dissemination.

PubMed

Ishak, Marluísa de Oliveira Guimarães; Costa, Maurimélia Mesquita; Almeida, Núbia Caroline Costa de; Santiago, Angélica Menezes; Brito, William Botelho de; Vallinoto, Antonio Carlos Rosário; Azevedo, Vânia Nakauth; Ishak, Ricardo

2015-01-01

Chlamydia infection is associated with debilitating human diseases including trachoma, pneumonia, coronary heart disease and urogenital diseases. Serotypes of C. trachomatis show a fair correlation with the group of diseases they cause, and their distribution follows a well-described geographic pattern. Serotype A, a trachoma-associated strain, is known for its limited dissemination in the Middle East and Northern Africa. However, knowledge on the spread of bacteria from the genus Chlamydia as well as the distribution of serotypes in Brazil is quite limited. Blood samples of 1,710 individuals from ten human population groups in the Amazon region of Brazil were examined for antibodies to Chlamydia using indirect immunofluorescence and microimmunofluorescence assays. The prevalence of antibodies to Chlamydia ranged from 23.9% (Wayana-Apalai) to 90.7% (Awa-Guaja) with a mean prevalence of 50.2%. Seroreactivity was detected to C. pneumoniae and to all serotypes of C. trachomatis tested; furthermore, we report clear evidence of the as-yet-undescribed occurrence of serotype A of C. trachomatis. Specific seroreactivity not only accounts for the large extent of dissemination of C. trachomatis in the Amazon region of Brazil but also shows an expanded area of occurrence of serotype A outside the epidemiological settings previously described. Furthermore, these data suggest possible routes of Chlamydia introduction into the Amazon region from the massive human migration that occurred during the 1,700s.

Valuing experience factors in the provision of Chlamydia screening: an application to women attending the family planning clinic.

PubMed

Watson, Verity; Ryan, Mandy; Watson, Emma

2009-06-01

To examine women's preferences for characteristics of chlamydia screening. Chlamydia trachomatis is the most common curable sexually transmitted disease. To design effective screening programs, it is important to fully capture the benefits of screening to patients. Thus, the value of experience factors must be considered alongside health outcomes. A self-complete discrete choice experiment questionnaire was administered to women attending a family planning clinic. Chlamydia screening was described by five characteristics: location of screening; type of screening test; cost of screening test; risk of developing pelvic inflammatory disease if chlamydia is untreated; and support provided when receiving results. One hundred twenty-six women completed the questionnaire. Respondents valued characteristics of the care experience. Screening was valued at 15 pound; less invasive screening tests increase willingness to pay by 7 pound, and more invasive tests reduce willingness to pay by 3.50 pound. The most preferred screening location was the family planning clinic, valued at 5 pound. The support of a trained health-care professional when receiving results was valued at 4 pound. Respondents under 25 years and those in a casual relationship were less likely to be screened. Women valued experience factors in the provision of chlamydia screening. To correctly value these screening programs and to predict uptake, cost-effectiveness studies should take such values into account. Failure to do this may result in incorrect policy recommendations.

Identification of phylogenetic position in the Chlamydiaceae family for Chlamydia strains released from monkeys and humans with chlamydial pathology.

PubMed

Karaulov, Alexander; Aleshkin, Vladimir; Slobodenyuk, Vladimir; Grechishnikova, Olga; Afanasyev, Stanislav; Lapin, Boris; Dzhikidze, Eteri; Nesvizhsky, Yuriy; Evsegneeva, Irina; Voropayeva, Elena; Afanasyev, Maxim; Aleshkin, Andrei; Metelskaya, Valeria; Yegorova, Ekaterina; Bayrakova, Alexandra

2010-01-01

Based on the results of the comparative analysis concerning relatedness and evolutional difference of the 16S-23S nucleotide sequences of the middle ribosomal cluster and 23S rRNA I domain, and based on identification of phylogenetic position for Chlamydophila pneumoniae and Chlamydia trichomatis strains released from monkeys, relatedness of the above stated isolates with similar strains released from humans and with strains having nucleotide sequences presented in the GenBank electronic database has been detected for the first time ever. Position of these isolates in the Chlamydiaceae family phylogenetic tree has been identified. The evolutional position of the investigated original Chlamydia and Chlamydophila strains close to analogous strains from the Gen-Bank electronic database has been demonstrated. Differences in the 16S-23S nucleotide sequence of the middle ribosomal cluster and 23S rRNA I domain of plasmid and nonplasmid Chlamydia trachomatis strains released from humans and monkeys relative to different genotype groups (group B-B, Ba, D, Da, E, L1, L2, L2a; intermediate group-F, G, Ga) have been revealed for the first time ever. Abnormality in incA chromosomal gene expression resulting in Chlamydia life development cycle disorder, and decrease of Chlamydia virulence can be related to probable changes in the nucleotide sequence of the gene under consideration.

Molecular prevalence of Chlamydia and Chlamydia-like bacteria in Tunisian domestic ruminant farms and their influencing risk factors.

PubMed

Barkallah, M; Jribi, H; Ben Slima, A; Gharbi, Y; Mallek, Z; Gautier, M; Fendri, I; Gdoura, R

2018-04-01

Chlamydia and Chlamydia-like bacteria are well known to infect several organisms and may cause a wide range of diseases, particularly in ruminants. To gain insight into the prevalence and diversity of these intracellular bacteria, we applied a pan-Chlamydiales real-time PCR to 1,134 veterinary samples taken from 130 Tunisian ruminant herds. The true adjusted animal population-level prevalence was 12.9% in cattle, against 8.7% in sheep. In addition, the true adjusted herd-level prevalence of Chlamydiae was 80% in cattle and 25.5% in sheep. Chlamydiales from three family-level lineages were detected indicating a high biodiversity of Chlamydiales in ruminant herds. Our results showed that Parachlamydia acanthamoebae could be responsible for bovine and ovine chlamydiosis in central-eastern Tunisia. Multivariable logistic regression analysis at the animal population level indicated that strata and digestive disorders variables were the important risk factors of bovine and ovine chlamydiosis. However, origin and age variables were found to be associated with bovine and ovine chlamydiosis, respectively. At the herd level, risk factors for Chlamydia positivity were as follows: abortion and herd size for cattle against breeding system, cleaning frequency, quarantine, use of disinfectant and floor type for sheep. Paying attention to these risk factors will help improvement of control programs against this harmful zoonotic disease. © 2017 Blackwell Verlag GmbH.

Chlamydial infections - male

MedlinePlus

... Swelling and tenderness of the testicles Chlamydia and gonorrhea often occur together. The symptoms of chlamydia infection may be similar to symptoms of gonorrhea, but they continue even after treatment for gonorrhea ...

Urethritis

MedlinePlus

... that cause this condition are E coli, chlamydia , gonorrhea . These bacteria also cause urinary tract infections and ... women only) Urinalysis and urine cultures Tests for gonorrhea , chlamydia , and other sexually transmitted illnesses (STI) Urethral ...

Chlamydia

MedlinePlus

In men, chlamydia may cause symptoms similar to gonorrhea . Symptoms may include: Burning feeling during urination Discharge ... of sexually transmitted infection (STIs). Common STIs are gonorrhea, HIV, syphilis, hepatitis, and herpes . Even if you ...

Chlamydia

MedlinePlus

... single type of STI. Can women who have sex with women get chlamydia? Yes. It is possible ... Awareness Day National Women's Health Week Supporting Nursing Moms at Work Popular Topics Autoimmune diseases Breastfeeding Carpal ...

Estimating the positive predictive value of opportunistic population testing for gonorrhoea as part of the English Chlamydia Screening Programme.

PubMed

Fowler, T; Edeghere, O; Inglis, N; Bradshaw, S

2013-03-01

Advances in technology have raised the possibility of including gonorrhoea testing as part of chlamydia screening. In England this is recommended only where the positive predictive value (PPV) of the test is ≥90%. This study assessed the PPV for gonorrhoea testing using routine testing data. Routine data (including gonorrhoea testing) from the Greater Manchester Chlamydia Screening Programme (GMCSP) in 2009/2010, were used to estimate the PPV for gonorrhoea testing. Of those screened, 0.3% (59/18044) of men and 0.4% (174/41873) of women tested positive for gonorrhoea. The PPV was 82.3% in women and 73.6% in men, in those who also tested positive for chlamydia. For women and men testing negative for chlamydia the PPV for a positive gonorrhoea test was incalculable. The low PPV observed in most groups suggests that where population testing for gonorrhoea occurs there is a need for further confirmatory testing of positive results before treatment decisions are made. Clinicians should be aware of screening test result limitations in this context.

Chlamydia Hijacks ARF GTPases To Coordinate Microtubule Posttranslational Modifications and Golgi Complex Positioning

PubMed Central

Wesolowski, Jordan; Weber, Mary M.; Nawrotek, Agata; Dooley, Cheryl A.; Calderon, Mike; St. Croix, Claudette M.; Hackstadt, Ted; Cherfils, Jacqueline

2017-01-01

ABSTRACT The intracellular bacterium Chlamydia trachomatis develops in a parasitic compartment called the inclusion. Posttranslationally modified microtubules encase the inclusion, controlling the positioning of Golgi complex fragments around the inclusion. The molecular mechanisms by which Chlamydia coopts the host cytoskeleton and the Golgi complex to sustain its infectious compartment are unknown. Here, using a genetically modified Chlamydia strain, we discovered that both posttranslationally modified microtubules and Golgi complex positioning around the inclusion are controlled by the chlamydial inclusion protein CT813/CTL0184/InaC and host ARF GTPases. CT813 recruits ARF1 and ARF4 to the inclusion membrane, where they induce posttranslationally modified microtubules. Similarly, both ARF isoforms are required for the repositioning of Golgi complex fragments around the inclusion. We demonstrate that CT813 directly recruits ARF GTPases on the inclusion membrane and plays a pivotal role in their activation. Together, these results reveal that Chlamydia uses CT813 to hijack ARF GTPases to couple posttranslationally modified microtubules and Golgi complex repositioning at the inclusion. PMID:28465429

Lipooligosaccharide is required for the generation of infectious elementary bodies in Chlamydia trachomatis

PubMed Central

Nguyen, Bidong D.; Cunningham, Doreen; Liang, Xiaofei; Chen, Xin; Toone, Eric J.; Raetz, Christian R. H.; Zhou, Pei; Valdivia, Raphael H.

2011-01-01

Lipopolysaccharides (LPS) and lipooligosaccharides (LOS) are the main lipid components of bacterial outer membranes and are essential for cell viability in most Gram-negative bacteria. Here we show that small molecule inhibitors of LpxC [UDP-3-O-(R-3-hydroxymyristoyl)-GlcNAc deacetylase], the enzyme that catalyzes the first committed step in the biosynthesis of lipid A, block the synthesis of LOS in the obligate intracellular bacterial pathogen Chlamydia trachomatis. In the absence of LOS, Chlamydia remains viable and establishes a pathogenic vacuole (“inclusion”) that supports robust bacterial replication. However, bacteria grown under these conditions were no longer infectious. In the presence of LpxC inhibitors, replicative reticulate bodies accumulated in enlarged inclusions but failed to express selected late-stage proteins and transition to elementary bodies, a Chlamydia developmental form that is required for invasion of mammalian cells. These findings suggest the presence of an outer membrane quality control system that regulates Chlamydia developmental transition to infectious elementary bodies and highlights the potential application of LpxC inhibitors as unique class of antichlamydial agents. PMID:21628561

Epididymitis

MedlinePlus

... infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia. Sometimes, a testicle also becomes inflamed — ... you urinate. Causes Causes of epididymitis include: STIs. Gonorrhea and chlamydia are the most common causes of ...

Prevalence and predictors of chlamydia co-infection among patients infected with gonorrhoea at a sexual health clinic in Sydney.

PubMed

Templeton, David J; Manokaran, Niveditha; O'Connor, Catherine C

2012-09-01

Anogenital gonorrhoea (Neisseria gonorrhoeae) is commonly diagnosed at sexual health clinics by on-site microscopy. Whether to add anti-chlamydial therapy in such situations is unclear. The medical records of all patients diagnosed with gonorrhoea between May 2005 and April 2010 at RPA Sexual Health were reviewed. Of 165 patients diagnosed with anogenital gonorrhoea, 27 (16.4%, 95% confidence interval (CI) 11.1-22.9%) were co-infected with chlamydia (Chlamydia trachomatis). Compared with those only infected with anogenital gonorrhoea, there was no correlation of anogenital gonorrhoea-chlamydia co-infection with any demographic, behavioural or clinical variables examined. Anti-chlamydial therapy should be considered for all patients with gram stain diagnosed anogenital gonorrhoea at the initial clinic visit.

Candidatus Syngnamydia Venezia, a Novel Member of the Phylum Chlamydiae from the Broad Nosed Pipefish, Syngnathus typhle

PubMed Central

Schmidt-Posthaus, Heike; Nufer, Lisbeth; Wilson, Anthony; Svercel, Miroslav; Richter, Denis; Segner, Helmut; Pospischil, Andreas; Vaughan, Lloyd

2013-01-01

Chlamydia are obligate intracellular bacteria and important pathogens of humans and animals. Chlamydia-related bacteria are also major fish pathogens, infecting epithelial cells of the gills and skin to cause the disease epitheliocystis. Given the wide distribution, ancient origins and spectacular diversity of bony fishes, this group offers a rich resource for the identification and isolation of novel Chlamydia. The broad-nosed pipefish (Syngnathus typhle) is a widely distributed and genetically diverse temperate fish species, susceptible to epitheliocystis across much of its range. We describe here a new bacterial species, Candidatus Syngnamydia venezia; epitheliocystis agent of S. typhle and close relative to other chlamydial pathogens which are known to infect diverse hosts ranging from invertebrates to humans. PMID:23951025

Urethral discharge culture

MedlinePlus

... can detect sexually transmitted infections (STIs), such as gonorrhea and chlamydia . Normal Results A negative culture, or ... in the genital tract. These infections can include gonorrhea or chlamydia. Risks Fainting may occur when the ...

Using of dynamic speckled speckles with a small number of scatterers for study of suspension of Chlamydia

NASA Astrophysics Data System (ADS)

Ulyanov, Sergey; Filonova, Nadezhda; Ulianova, Onega; Utz, Sergey; Moiseeva, Yulia; Subbotina, Irina; Kalduzova, Irina; Larionova, Olga; Feodorova, Valentina

2018-04-01

Theory of formation of speckled speckles at diffraction of focused Gaussian beam in the suspension, containing of Chlamydia trachomatis (CT) is presented. Optical model of scattering of light in suspension of Chlamydia is suggested. Formula for bandwidth of spectrum of intensity fluctuations in speckled speckles is derived. It has been demonstrated, that speckle-microscopy can be used for detection of CT bacteria for any concentration of the relevant cells in suspension.

Chlamydia infections in women

MedlinePlus

... other types of STIs. Most common STIs are: Gonorrhea HIV/AIDS Syphilis Hepatitis Herpes Even if you ... you from passing the STIs back and forth. Gonorrhea often occurs with chlamydia. Therefore, treatment for gonorrhea ...

Chlamydia - CDC Fact Sheet

MedlinePlus

... behaviors and biological factors common among young people. Gay, bisexual, and other men who have sex with ... should get a test for chlamydia every year. Gay, bisexual, and other men who have sex with ...

Screening for gonorrhoea using samples collected through the English national chlamydia screening programme and risk of false positives: a national survey of local authorities.

PubMed

Field, Nigel; Kennedy, Iain; Folkard, Kate; Duffell, Stephen; Town, Katy; Ison, Catherine A; Hughes, Gwenda

2014-10-16

To investigate use of dual tests for Chlamydia trachomatis and Neisseria gonorrhoeae on samples collected through the National Chlamydia Screening Programme (NCSP) in England. During May-July 2013, we delivered an online survey to commissioners of sexual health services in the 152 upper-tier English Local Authorities (LAs) who were responsible for commissioning chlamydia screening in people aged 15-24 years. (1) The proportion of English LAs using dual tests on samples collected by the NCSP; (2) The estimated number of gonorrhoea tests and false positives from samples collected by the NCSP, calculated using national surveillance data on the number of chlamydia tests performed, assuming the gonorrhoea prevalence to range between 0.1% and 1%, and test sensitivity and specificity of 99.5%. 64% (98/152) of LAs responded to this national survey; over half (53% (52/98)) reported currently using dual tests in community settings. There was no significant difference between LAs using and not using dual tests by chlamydia positivity, chlamydia diagnosis rate or population screening coverage. Although positive gonorrhoea results were confirmed with supplementary tests in 93% (38/41) of LAs, this occurred after patients were notified about the initial positive result in 63% (26/41). Approximately 450-4500 confirmed gonorrhoea diagnoses and 2300 false-positive screens might occur through use of dual tests on NCSP samples each year. Under reasonable assumptions, the positive predictive value of the screening test is 17-67%. Over half of English LAs already commission dual tests for samples collected by the NCSP. Gonorrhoea screening has been introduced alongside chlamydia screening in many low prevalence settings without a national evidence review or change of policy. We question the public health benefit here, and suggest that robust testing algorithms and clinical management pathways, together with rigorous evaluation, be implemented wherever dual tests are deployed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Trends in adult chlamydia and gonorrhoea prevalence, incidence and urethral discharge case reporting in Mongolia from 1995 to 2016 – estimates using the Spectrum-STI model

PubMed Central

Badrakh, Jugderjav; Zayasaikhan, Setsen; Jagdagsuren, Davaalkham; Enkhbat, Erdenetungalag; Jadambaa, Narantuya; Munkhbaatar, Sergelen; Taylor, Melanie; Rowley, Jane; Mahiané, Guy

2017-01-01

Objective To estimate Mongolia’s prevalence and incidence trends of gonorrhoea and chlamydia in women and men 15–49 years old to inform control of STIs and HIV, a national health sector priority. Methods We applied the Spectrum-STI estimation model, fitting data from two national population surveys (2001 and 2008) and from routine gonorrhoea screening of pregnant women in antenatal care (1997 to 2016) adjusted for diagnostic test performance, male/female differences and missing high-risk populations. Prevalence and incidence estimates were then used to assess completeness of national case reporting. Results Gonorrhoea prevalence was estimated at 3.3% (95% confidence interval, 1.6–3.9%) in women and 2.9% (1.6–4.1%) in men in 2016; chlamydia prevalence levels were 19.5% (17.3–21.9%) and 15.6% (10.0–21.2%), respectively. Corresponding new incident cases in women and men in 2016 totalled 60 334 (36 147 to 121 933) and 76 893 (35 639 to 254 913) for gonorrhoea and 131 306 (84 232 to 254 316) and 148 162 (71 885 to 462 588) for chlamydia. Gonorrhoea and chlamydia prevalence declined by an estimated 33% and 11%, respectively from 2001 to 2016. Comparing numbers of symptomatic and treated cases estimated by Spectrum with gonorrhoea case reports suggests that 15% of symptomatic treated gonorrhoea cases were reported in 2016; only a minority of chlamydia episodes were reported as male urethral discharge cases. Discussion Gonorrhoea and chlamydia prevalence are estimated to have declined in Mongolia during the early 2000s, possibly associated with syndromic management in primary care facilities and improving treatment coverage since 2001 and scale up of HIV/STI prevention interventions since 2003. However, prevalence remains high with most gonorrhoea and chlamydia cases not treated or recorded in the public health system. PMID:29487760

Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco over 1995–2015—Estimates Using the Spectrum-Sexually Transmitted Infection Model

PubMed Central

El-Kettani, Amina; Mahiané, Guy; Bennani, Aziza; Abu-Raddad, Laith; Smolak, Alex; Rowley, Jane; Nagelkerke, Nico; El-Rhilani, Houssine; Alami, Kamal; Hançali, Amina; Korenromp, Eline

2017-01-01

Background Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation. Methods The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with urethral discharge (UD) case reports, to estimate reporting completeness among treated UD cases. Results Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14–1.0%) in women and 0.32% (0.12–0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1–6.4%) and 3.0% (95% CI, 1.7–5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918–256,206) and 112,013 (95% CI, 28,700–307,433) for gonorrhea, and 291,908 (95% CI, 161,064–524,270) and 314,032 (95% CI, 186,076–559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases. Conclusions STI declines and improvements in treatment coverage are consistent with Morocco’s introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations. PMID:28806354

Frequency and risk factors for incident and redetected Chlamydia trachomatis infection in sexually active, young, multi-ethnic women: a community based cohort study.

PubMed

Aghaizu, Adamma; Reid, Fiona; Kerry, Sally; Hay, Phillip E; Mallinson, Harry; Jensen, Jorgen S; Kerry, Sarah; Kerry, Sheila; Oakeshott, Pippa

2014-11-01

To investigate the frequency and risk factors for incident and redetected Chlamydia trachomatis infection in sexually active, young, multi-ethnic women in the community. Cohort study. 20 London universities and Further Education colleges. 954 sexually experienced women, mean age 21.5 years (range 16-27), 26% from ethnic minorities, who were recruited to the Prevention of Pelvic Infection (POPI) chlamydia screening trial between 2004 and 2006, and returned repeat postal self-taken vaginal swabs 11-32 (median 16) months after recruitment. The estimated annual incidence of chlamydia infection among 907 women who tested negative at baseline was 3.4 per 100 person-years (95% CI 2.5 to 4.6 per 100 person-years), but 6.6 per 100 person-years (95% CI 4.5 to 9.3 per 100 person-years) in the 326 teenagers (<20 years). Predictors of incident chlamydia infection were age <20 years (relative risk (RR) 4.0, 95% CI 2.1 to 7.5), and (after adjusting for age) a new sexual partner during 12 months follow-up (RR 4.4, 95% CI 2.0 to 9.9), smoking (RR 2.2 95% CI 1.2 to 3.9), concurrent bacterial vaginosis (RR 2.0 95% CI 1.1 to 3.9) and high risk carcinogenic human papillomavirus (RR 2.2, 95% CI 1.1 to 4.3). Of 47 women positive for chlamydia at baseline, 12 (25.5%, 95% CI 13.9% to 40.3%) had redetected infection at a median of 16 months follow-up. Taking into account follow-up time (65 person-years), the annual redetection rate was 18.5 per 100 person-years (95% CI 9.9 to 30.0 per 100 person-years). One in four women with chlamydia infection at baseline retested positive, supporting recent recommendations to routinely retest chlamydia positives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pelvic Inflammatory Disease (For Teens)

MedlinePlus

... sexually transmitted disease (STD) , such as chlamydia or gonorrhea. Girls who have sex with different partners or ... signs of infection, including STDs like chlamydia and gonorrhea. Sometimes doctors need an ultrasound or CAT scan ...

Condom Fact Sheet in Brief

MedlinePlus

... transmitted only by genital fluids (STDs such as gonorrhea, chlamydia, trichomoniasis, and HIV infection) than against infections ... transmitted by genital fluids (STDs such as chlamydia, gonorrhea, and trichomoniasis). Consistent and correct use of latex ...

Chlamydia (For Parents)

MedlinePlus

... the risk of STDs, including chlamydia. Latex condoms provide greater protection than natural-membrane condoms. The female condom, made ... pills offer no protection against STDs, they may provide some protection against PID by causing the body to create ...

Pelvic Inflammatory Disease (PID) Treatment and Care

MedlinePlus

... Care Archive STDs Home Page Bacterial Vaginosis (BV) Chlamydia Genital Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human ... 1, 2017) STDs Home Page Bacterial Vaginosis (BV) Chlamydia Genital Herpes Gonorrhea Hepatitis HIV/AIDS & STDs Human ...

[THE ROLE OF SYSTEM QUORUM SENSING UNDER CHRONIC UROGENITAL CHLAMYDIA INFECTION].

PubMed

2015-10-01

It is established that system quorum sensing (QS) assure social behavior of bacteria in regulation of genes of virulence and generalization of inflectional inflammatory process under chronic urogenital chlamydia infection. The techniques of gas chromatography and mass-spectrometry were applied to detect molecular markers of generalization of infectious process under urogenital chlamydiasis--activators of QS microbes (lactones, quinolones, furan ethers). The developed diagnostic gas chromatography and mass-spectrometry criteria of indexation of molecular markers under chronic urogenital chlamydia infection have high level of diagnostic sensitivity, specificity and prognostic value of positive and negative result. The application of techniques of gas chromatography and mass-spectrometry permits enhancing effectiveness of diagnostic of chronic inflectional inflammatory diseases of urogenital system of chlamydia etiology with identification of prognostic criteria of generalization of infectious process and subsequent prescription of timely and appropriate therapy

Phosphoproteomic analysis of the Chlamydia caviae elementary body and reticulate body forms

PubMed Central

Adams, Nancy E.; Maurelli, Anthony T.

2015-01-01

Chlamydia are Gram-negative, obligate intracellular bacteria responsible for significant diseases in humans and economically important domestic animals. These pathogens undergo a unique biphasic developmental cycle transitioning between the environmentally stable elementary body (EB) and the replicative intracellular reticulate body (RB), a conversion that appears to require extensive regulation of protein synthesis and function. However, Chlamydia possess a limited number of canonical mechanisms of transcriptional regulation. Ser/Thr/Tyr phosphorylation of proteins in bacteria has been increasingly recognized as an important mechanism of post-translational control of protein function. We utilized 2D gel electrophoresis coupled with phosphoprotein staining and MALDI-TOF/TOF analysis to map the phosphoproteome of the EB and RB forms of Chlamydia caviae. Forty-two non-redundant phosphorylated proteins were identified (some proteins were present in multiple locations within the gels). Thirty-four phosphorylated proteins were identified in EBs, including proteins found in central metabolism and protein synthesis, Chlamydia-specific hypothetical proteins and virulence-related proteins. Eleven phosphorylated proteins were identified in RBs, mostly involved in protein synthesis and folding and a single virulence-related protein. Only three phosphoproteins were found in both EB and RB phosphoproteomes. Collectively, 41 of 42 C. caviae phosphoproteins were present across Chlamydia species, consistent with the existence of a conserved chlamydial phosphoproteome. The abundance of stage-specific phosphoproteins suggests that protein phosphorylation may play a role in regulating the function of developmental-stage-specific proteins and/or may function in concert with other factors in directing EB–RB transitions. PMID:25998263

Chlamydia co-opts the rod shape-determining proteins MreB and Pbp2 for cell division.

PubMed

Ouellette, Scot P; Karimova, Gouzel; Subtil, Agathe; Ladant, Daniel

2012-07-01

Chlamydiae are obligate intracellular bacterial pathogens that have extensively reduced their genome in adapting to the intracellular environment. The chlamydial genome contains only three annotated cell division genes and lacks ftsZ. How this obligate intracellular pathogen divides is uncharacterized. Chlamydiae contain two high-molecular-weight (HMW) penicillin binding proteins (Pbp) implicated in peptidoglycan synthesis, Pbp2 and Pbp3/FtsI. We show here, using HMW Pbp-specific penicillin derivatives, that both Pbp2 and Pbp3 are essential for chlamydial cell division. Ultrastructural analyses of antibiotic-treated cultures revealed distinct phenotypes: Pbp2 inhibition induced internal cell bodies within a single outer membrane whereas Pbp3 inhibition induced elongated phenotypes with little internal division. Each HMW Pbp interacts with the Chlamydia cell division protein FtsK. Chlamydiae are coccoid yet contain MreB, a rod shape-determining protein linked to Pbp2 in bacilli. Using MreB-specific antibiotics, we show that MreB is essential for chlamydial growth and division. Importantly, co-treatment with MreB-specific and Pbp-specific antibiotics resulted in the MreB-inhibited phenotype, placing MreB upstream of Pbp function in chlamydial cell division. Finally, we showed that MreB also interacts with FtsK. We propose that, in Chlamydia, MreB acts as a central co-ordinator at the division site to substitute for the lack of FtsZ in this bacterium. © 2012 Blackwell Publishing Ltd.

Phosphoproteomic analysis of the Chlamydia caviae elementary body and reticulate body forms.

PubMed

Fisher, Derek J; Adams, Nancy E; Maurelli, Anthony T

2015-08-01

Chlamydia are Gram-negative, obligate intracellular bacteria responsible for significant diseases in humans and economically important domestic animals. These pathogens undergo a unique biphasic developmental cycle transitioning between the environmentally stable elementary body (EB) and the replicative intracellular reticulate body (RB), a conversion that appears to require extensive regulation of protein synthesis and function. However, Chlamydia possess a limited number of canonical mechanisms of transcriptional regulation. Ser/Thr/Tyr phosphorylation of proteins in bacteria has been increasingly recognized as an important mechanism of post-translational control of protein function. We utilized 2D gel electrophoresis coupled with phosphoprotein staining and MALDI-TOF/TOF analysis to map the phosphoproteome of the EB and RB forms of Chlamydia caviae. Forty-two non-redundant phosphorylated proteins were identified (some proteins were present in multiple locations within the gels). Thirty-four phosphorylated proteins were identified in EBs, including proteins found in central metabolism and protein synthesis, Chlamydia-specific hypothetical proteins and virulence-related proteins. Eleven phosphorylated proteins were identified in RBs, mostly involved in protein synthesis and folding and a single virulence-related protein. Only three phosphoproteins were found in both EB and RB phosphoproteomes. Collectively, 41 of 42 C. caviae phosphoproteins were present across Chlamydia species, consistent with the existence of a conserved chlamydial phosphoproteome. The abundance of stage-specific phosphoproteins suggests that protein phosphorylation may play a role in regulating the function of developmental-stage-specific proteins and/or may function in concert with other factors in directing EB-RB transitions.

The Roles of Unfolded Protein Response Pathways in Chlamydia Pathogenesis.

PubMed

George, Zenas; Omosun, Yusuf; Azenabor, Anthony A; Partin, James; Joseph, Kahaliah; Ellerson, Debra; He, Qing; Eko, Francis; Bandea, Claudiu; Svoboda, Pavel; Pohl, Jan; Black, Carolyn M; Igietseme, Joseph U

2017-02-01

Chlamydia is an obligate intracellular bacterium that relies on host cells for essential nutrients and adenosine triphosphate (ATP) for a productive infection. Although the unfolded protein response (UPR) plays a major role in certain microbial infectivity, its role in chlamydial pathogenesis is unknown. We hypothesized that Chlamydia induces UPR and exploits it to upregulate host cell uptake and metabolism of glucose, production of ATP, phospholipids, and other molecules required for its replicative development and host survival. Using a combination of biochemical and pathway inhibition assays, we showed that the 3 UPR pathway transducers-protein kinase RNA-activated (PKR)-like ER kinase (PERK), inositol-requiring enzyme-1α (IRE1α), and activating transcription factor-6α (ATF6α)-were activated during Chlamydia infection. The kinase activity of PERK and ribonuclease (RNase) of IRE1α mediated the upregulation of hexokinase II and production of ATP via substrate-level phosphorylation. In addition, the activation of PERK and IRE1α promoted autophagy formation and apoptosis resistance for host survival. Moreover, the activation of IRE1α resulted in the generation of spliced X-box binding protein 1 (sXBP1) and upregulation of lipid production. The vital role of UPR pathways in Chlamydia development and pathogenesis could lead to the identification of potential molecular targets for therapeutics against Chlamydia. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Randomized Clinical Trial of Azithromycin vs. Erythromycin for the Treatment of Chlamydia Cervicitis in Pregnancy

PubMed Central

Edwards, M. S.; Carter, S. G.; LeBoeuf, F. W.; Menard, M. K.; Rainwater, K. P.

1996-01-01

Objective: The purpose of this study was to prospectively test the null hypothesis that there is no difference in the clinical effectiveness of azithromycin and erythromycin for the treatment of chlamydia cervicitis in pregnancy. Methods: All antepartum obstetrical patients underwent routine screening for chlamydia cervicitis using a DNA probe assay (Gen-Probe Pace, San Diego, CA). Women who tested positive for chlamydia cervicitis were prospectively randomized to receive either azithromycin 1 g orally at enrollment, or erythromycin 500 mg orally 4 times a day for 7 days. Sexual partners were referred to the county health department for evaluation and treatment. A test of cure was repeated in 2 weeks. Results were analyzed by chi-square analysis and Fisher's exact test when indicated. Results: One hundred forty women tested positive for chlamydia cervicitis and agreed to randomization. There were 4 (6.2%) treatment failures in the azithromycin group and 18 (27.7%) in the erythromycin group (P = 0.005). Gastrointestinal side effects were reported by 42 (65.5%) of the women taking erythromycin, but only 12 (19.4%) of those taking azithromycin (P < 0.002). Gastrointestinal side effects and resultant noncompliance were significantly related to treatment failure with erythromycin. Conclusions: The findings of this study support the conclusion that a single dose of azithromycin is a significantly more effective and better tolerated treatment regimen for chlamydia cervicitis in pregnancy than erythromycin which is currently recommended. PMID:18476121

Filling in the gaps: estimating numbers of chlamydia tests and diagnoses by age group and sex before and during the implementation of the English National Screening Programme, 2000 to 2012.

PubMed

Chandra, Nastassya L; Soldan, Kate; Dangerfield, Ciara; Sile, Bersabeh; Duffell, Stephen; Talebi, Alireza; Choi, Yoon H; Hughes, Gwenda; Woodhall, Sarah C

2017-02-02

To inform mathematical modelling of the impact of chlamydia screening in England since 2000, a complete picture of chlamydia testing is needed. Monitoring and surveillance systems evolved between 2000 and 2012. Since 2012, data on publicly funded chlamydia tests and diagnoses have been collected nationally. However, gaps exist for earlier years. We collated available data on chlamydia testing and diagnosis rates among 15-44-year-olds by sex and age group for 2000-2012. Where data were unavailable, we applied data- and evidence-based assumptions to construct plausible minimum and maximum estimates and set bounds on uncertainty. There was a large range between estimates in years when datasets were less comprehensive (2000-2008); smaller ranges were seen hereafter. In 15-19-year-old women in 2000, the estimated diagnosis rate ranged between 891 and 2,489 diagnoses per 100,000 persons. Testing and diagnosis rates increased between 2000 and 2012 in women and men across all age groups using minimum or maximum estimates, with greatest increases seen among 15-24-year-olds. Our dataset can be used to parameterise and validate mathematical models and serve as a reference dataset to which trends in chlamydia-related complications can be compared. Our analysis highlights the complexities of combining monitoring and surveillance datasets. This article is copyright of The Authors, 2017.

Chlamydia trachomatis infection in males in a juvenile detention facility in Switzerland.

PubMed

Haller, Dagmar M; Steiner, Anne-Sylvie S; Sebo, Paul; Gaspoz, Jean-Michel; Wolff, Hans

2011-07-18

Young offenders represent a group for which Chlamydia trachomatis infection screening is recommended in the US. In the absence of local epidemiological data it is difficult to assess whether such recommendations apply to the Swiss context. Our aim was to obtain local prevalence data for Chlamydia trachomatis infection among young male offenders as a basis for screening strategies in Swiss juvenile detention centres. This cross-sectional study was conducted in a juvenile detention facility in Geneva, Switzerland. Adolescent males aged 15-18 years admitted to the detention facility were invited to participate during a consultation with a nurse conducted within 48 hours of admission. Participants were asked to provide a first void urine sample for PCR detection of Chlamydia trachomatis infection and to complete a questionnaire on reproductive health behaviours. 72 males were considered for participation in the study. 13 were excluded (mainly due to the language barrier or a shorter than 3 days' stay in the facility) and 9 (15%) declined participation. Not being sexually active was the most common reason for declining participation. Most participants originated from Switzerland or the European Union and 68% reported having ≥2 sexual partners in the past year. Only one participant (18 years, asymptomatic) had Chlamydia trachomatis infection (2%; 95%CI: 0-6%). This study does not support screening for Chlamydia trachomatis among young offenders admitted to detention centres in Switzerland. Studies in other European detention centres should document the extent to which our findings are generalisable to the European context.

Ironing Out the Unconventional Mechanisms of Iron Acquisition and Gene Regulation in Chlamydia

PubMed Central

Pokorzynski, Nick D.; Thompson, Christopher C.; Carabeo, Rey A.

2017-01-01

The obligate intracellular pathogen Chlamydia trachomatis, along with its close species relatives, is known to be strictly dependent upon the availability of iron. Deprivation of iron in vitro induces an aberrant morphological phenotype termed “persistence.” This persistent phenotype develops in response to various immunological and nutritional insults and may contribute to the development of sub-acute Chlamydia-associated chronic diseases in susceptible populations. Given the importance of iron to Chlamydia, relatively little is understood about its acquisition and its role in gene regulation in comparison to other iron-dependent bacteria. Analysis of the genome sequences of a variety of chlamydial species hinted at the involvement of unconventional mechanisms, being that Chlamydia lack many conventional systems of iron homeostasis that are highly conserved in other bacteria. Herein we detail past and current research regarding chlamydial iron biology in an attempt to provide context to the rapid progress of the field in recent years. We aim to highlight recent discoveries and innovations that illuminate the strategies involved in chlamydial iron homeostasis, including the vesicular mode of acquiring iron from the intracellular environment, and the identification of a putative iron-dependent transcriptional regulator that is synthesized as a fusion with a ABC-type transporter subunit. These recent findings, along with the noted absence of iron-related homologs, indicate that Chlamydia have evolved atypical approaches to the problem of iron homeostasis, reinvigorating research into the iron biology of this pathogen. PMID:28951853

Staff views of an opportunistic chlamydia testing pilot in a primary health organisation.

PubMed

McKernon, Stephen; Azariah, Sunita

2013-12-01

The Auckland chlamydia pilot was one of three pilots funded by the Ministry of Health to trial implementation of the 2008 Chlamydia Management Guidelines prior to national roll-out. To assess what elements in the testing programme pilot worked best for staff and to determine how an opportunistic testing programme could be better configured to meet staff needs and preferences. A staff survey listed key chlamydia testing tasks in chronological order, and service interventions supporting these tasks. Staff were asked to rate each task on its difficulty prior to the pilot, and then on the difference the pilot had made to each task. They were also asked to rate service interventions on their usefulness during the pilot implementation. The survey had a response rate of 94%. The testing tasks posing the greatest difficulties to staff were those involving patient interactions (41%) and management of follow-up (52%). About 70% of staff felt tasks were improved by the pilot. Staff considered the three most useful service interventions to be a chlamydia-specific template created for the practice management system, provision of printed patient resources, and regular team discussions with other staff. A significant proportion of staff reported difficulties with routine tasks required for opportunistic testing for chlamydia, highlighting the need to involve staff during programme design. Practice nurse-led approaches to future opportunistic testing programmes should be considered as nurses had a more positive response to the pilot and nurse-led approaches have been shown to be successful overseas.

Service evaluation of an educational intervention to improve sexual health services in primary care implemented using a step-wedge design: analysis of chlamydia testing and diagnosis rate changes.

PubMed

Town, Katy; McNulty, Cliodna A M; Ricketts, Ellie J; Hartney, Thomas; Nardone, Anthony; Folkard, Kate A; Charlett, Andre; Dunbar, J Kevin

2016-08-02

Providing sexual health services in primary care is an essential step towards universal provision. However they are not offered consistently. We conducted a national pilot of an educational intervention to improve staff's skills and confidence to increase chlamydia testing rates and provide condoms with contraceptive information plus HIV testing according to national guidelines, known as 3Cs&HIV. The effectiveness of the pilot on chlamydia testing and diagnosis rates in general practice was evaluated. The pilot was implemented using a step-wedge design over three phases during 2013 and 2014 in England. The intervention combined educational workshops with posters, testing performance feedback and continuous support. Chlamydia testing and diagnosis rates in participating general practices during the control and intervention periods were compared adjusting for seasonal trends in chlamydia testing and differences in practice size. Intervention effect modification was assessed for the following general practice characteristics: chlamydia testing rate compared to national median, number of general practice staff employed, payment for chlamydia screening, practice urban/rurality classification, and proximity to sexual health clinics. The 460 participating practices conducted 26,021 tests in the control period and 18,797 tests during the intervention period. Intention-to-treat analysis showed no change in the unadjusted median tests and diagnoses per month per practice after receiving training: 2.7 vs 2.7; 0.1 vs 0.1. Multivariable negative binomial regression analysis found no significant change in overall testing or diagnoses post-intervention (incidence rate ratio (IRR) 1.01, 95 % confidence interval (CI) 0.96-1.07, P = 0.72; 0.98 CI 0.84-1.15, P = 0.84, respectively). Stratified analysis showed testing increased significantly in practices where payments were in place prior to the intervention (IRR 2.12 CI 1.41-3.18, P < 0.001) and in practices with 6-15 staff (6-10 GPs IRR 1.35 (1.07-1.71), P = 0.012; 11-15 GPs IRR 1.37 (1.09-1.73), P = 0.007). This national pilot of short educational training sessions found no overall effect on chlamydia testing in primary care. However, in certain sub-groups chlamydia testing rates increased due to the intervention. This demonstrates the importance of piloting and evaluating any service improvement intervention to assess the impact before widespread implementation, and the need for detailed understanding of local services in order to select effective interventions.

Pathogenic Chlamydia Lack a Classical Sacculus but Synthesize a Narrow, Mid-cell Peptidoglycan Ring, Regulated by MreB, for Cell Division

PubMed Central

Packiam, Mathanraj; Hsu, Yen-Pang; Tekkam, Srinivas; Hall, Edward; Rittichier, Jonathan T.; VanNieuwenhze, Michael; Brun, Yves V.; Maurelli, Anthony T.

2016-01-01

The peptidoglycan (PG) cell wall is a peptide cross-linked glycan polymer essential for bacterial division and maintenance of cell shape and hydrostatic pressure. Bacteria in the Chlamydiales were long thought to lack PG until recent advances in PG labeling technologies revealed the presence of this critical cell wall component in Chlamydia trachomatis. In this study, we utilize bio-orthogonal D-amino acid dipeptide probes combined with super-resolution microscopy to demonstrate that four pathogenic Chlamydiae species each possess a ≤ 140 nm wide PG ring limited to the division plane during the replicative phase of their developmental cycles. Assembly of this PG ring is rapid, processive, and linked to the bacterial actin-like protein, MreB. Both MreB polymerization and PG biosynthesis occur only in the intracellular form of pathogenic Chlamydia and are required for cell enlargement, division, and transition between the microbe’s developmental forms. Our kinetic, molecular, and biochemical analyses suggest that the development of this limited, transient, PG ring structure is the result of pathoadaptation by Chlamydia to an intracellular niche within its vertebrate host. PMID:27144308

Pathogenic Chlamydia Lack a Classical Sacculus but Synthesize a Narrow, Mid-cell Peptidoglycan Ring, Regulated by MreB, for Cell Division.

PubMed

Liechti, George; Kuru, Erkin; Packiam, Mathanraj; Hsu, Yen-Pang; Tekkam, Srinivas; Hall, Edward; Rittichier, Jonathan T; VanNieuwenhze, Michael; Brun, Yves V; Maurelli, Anthony T

2016-05-01

The peptidoglycan (PG) cell wall is a peptide cross-linked glycan polymer essential for bacterial division and maintenance of cell shape and hydrostatic pressure. Bacteria in the Chlamydiales were long thought to lack PG until recent advances in PG labeling technologies revealed the presence of this critical cell wall component in Chlamydia trachomatis. In this study, we utilize bio-orthogonal D-amino acid dipeptide probes combined with super-resolution microscopy to demonstrate that four pathogenic Chlamydiae species each possess a ≤ 140 nm wide PG ring limited to the division plane during the replicative phase of their developmental cycles. Assembly of this PG ring is rapid, processive, and linked to the bacterial actin-like protein, MreB. Both MreB polymerization and PG biosynthesis occur only in the intracellular form of pathogenic Chlamydia and are required for cell enlargement, division, and transition between the microbe's developmental forms. Our kinetic, molecular, and biochemical analyses suggest that the development of this limited, transient, PG ring structure is the result of pathoadaptation by Chlamydia to an intracellular niche within its vertebrate host.

Seroprevalence and risk factors of Chlamydia abortus infection in free-ranging white yaks in China.

PubMed

Qin, Si-Yuan; Huang, Si-Yang; Yin, Ming-Yang; Tan, Qi-Dong; Liu, Guang-Xue; Zhou, Dong-Hui; Zhu, Xing-Quan; Zhou, Ji-Zhang; Qian, Ai-Dong

2015-01-20

Chlamydia is gram-negative obligate bacteria which causes a wide variety of diseases in humans and animals. To date, there are a few reports about the seroprevalence of Chlamydia and the risk factors associated with Chlamydia infection in yaks in the world. In this study, 974 blood samples were collected from white yaks (Bos grunniens) in Tianzhu Tibetan Autonomous County, Gansu province, northwest China from June 2013 to April 2014. Antibodies against Chlamydia abortus were examined by the indirect hemagglutination (IHA) test, and 158 of 974 (16.22%) white yaks were seropositive for C. abortus antibodies at the cut-off of 1:16. The risk factors associated with seroprevalence were evaluated by a multivariate logistic regression analysis. Region, gender and age of white yak were left out of the final model, due to its insignificance in the logistic regression analysis (P > 0.05). However, season was considered as a major risk factor associated with C. abortus infection in white yaks. To our knowledge, this is the first survey of C. abortus seroprevalence in white yaks in China, which extends the host range for C. abortus and has important implications for public health and the local Tibetan economy.

Beliefs about chlamydia testing amongst young people living in relatively deprived areas.

PubMed

Booth, A R; Harris, P R; Goyder, E; Norman, P

2013-06-01

This study uses the theory of planned behaviour (TPB) as a framework to investigate salient beliefs about chlamydia testing, amongst young people living in relatively deprived areas. These beliefs may form targets for intervention to increase testing in this high-risk population. Participants recruited from colleges in deprived areas of a UK city, completed open-ended questions designed to elicit salient beliefs. Responses were content analysed and categorized as describing behavioural, normative or control beliefs. Beliefs were elicited from 128 respondents (51% male; median age = 17). The commonest behavioural belief, which could have a positive or negative impact on screening intentions, was that testing provides information about health status. Partners were referred to most commonly amongst the normative beliefs. Practical aspects and concerns about social implications of testing were common control beliefs. References to several negative emotions emerged throughout. This study indicates that raising awareness of chlamydia as a serious sexual health problem may not be the best way to increase the uptake of testing in a high-risk population. Promoting chlamydia testing as potentially providing reassurance may be an alternative. It may also be important to reduce perceptions of social disapproval as well as negative emotion regarding chlamydia testing.

High Prevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in Children with Acute Respiratory Infections from Lima, Peru

PubMed Central

del Valle-Mendoza, Juana; Orellana-Peralta, Fiorella; Marcelo-Rodríguez, Alvaro; Verne, Eduardo; Esquivel-Vizcarra, Mónica; Silva-Caso, Wilmer; Aguilar-Luis, Miguel Angel; Weilg, Pablo; Casabona-Oré, Verónica; Ugarte, Claudia; del Valle, Luis J.

2017-01-01

Background Mycoplasma pneumoniae and Chlamydia pneumoniae are atypical pathogens responsible for pneumonia and a leading cause of morbidity and mortality in low income countries. The study objective is to determine the prevalence of this pathogens in Peruvian children with acute respiratory infections. Methods A consecutive cross-sectional study was conducted in Lima, Peru from May 2009 to September 2010. A total of 675 children admitted with clinical diagnoses of acute respiratory infections were tested for Mycoplasma pneumoniae and Chlamydia pneumoniae detection by polymerase chain reaction (PCR), and clinical symptoms were registered by the attending physician. Results Mycoplasma pneumonia was detected in 25.19% (170/675) of nasopharyngeal samples and Chlamydia pneumonia in 10.52% (71/675). The most common symptoms in patients with these atypical pathogens were rhinorrhea, cough and fever. A higher prevalence of Mycoplasma pneumoniae cases were registered in summer, between December 2009 and March 2010. Conclusions Mycoplasma pneumoniae and Chlamydia pneumonia are a significant cause of morbidity in Peruvian children with acute respiratory infections (ARI). Further studies should evaluate the use of reliable techniques such as PCR in Peru in order to avoid underdiagnoses of these atypical pathogens. PMID:28129377

Optimization of algorithm of coding of genetic information of Chlamydia

NASA Astrophysics Data System (ADS)

Feodorova, Valentina A.; Ulyanov, Sergey S.; Zaytsev, Sergey S.; Saltykov, Yury V.; Ulianova, Onega V.

2018-04-01

New method of coding of genetic information using coherent optical fields is developed. Universal technique of transformation of nucleotide sequences of bacterial gene into laser speckle pattern is suggested. Reference speckle patterns of the nucleotide sequences of omp1 gene of typical wild strains of Chlamydia trachomatis of genovars D, E, F, G, J and K and Chlamydia psittaci serovar I as well are generated. Algorithm of coding of gene information into speckle pattern is optimized. Fully developed speckles with Gaussian statistics for gene-based speckles have been used as criterion of optimization.

[Biochemical characteristics and antigenic structures of Chlamydia].

PubMed

Puy, H; Fuentes, V; Eb, F; Orfila, J

1989-01-01

New biotechnology in immunology and molecular biology has enabled the identification and definition of the structure of glycolipids and especially membrane proteins of Chlamydia. Chlamydia antigen lipopolysaccharide, major outer membrane protein, protein 74 kDa, eukaryotic cell binding protein and cysteine rich proteins are all carriers of antigenic determinants, genus, species or type specific. They are very usefull for diagnosis of Chlamydial infections and epidemiological studies. These membranous antigens have an important role in the pathogenesis of these bacteries. Finally these studies have contributed to the isolation of a new species: C. pneumoniae (TWAR strains).

Substantial increases in chlamydia and gonorrhea positivity unexplained by changes in individual-level sexual behaviors among men who have sex with men in an Australian sexual health service from 2007 to 2013.

PubMed

Chow, Eric P F; Tomnay, Jane; Fehler, Glenda; Whiley, David; Read, Tim R H; Denham, Ian; Bradshaw, Catriona S; Chen, Marcus Y; Fairley, Christopher K

2015-02-01

To determine the risk-adjusted temporal trend of gonorrhea and chlamydia positivity and associated risk behaviors among men who have sex with men (MSM) attending a sexual health clinic in Melbourne in Australia. Gonorrhea and chlamydia positivity by anatomical site adjusted for year of test, age, number of sexual partners, and condom use among MSM attending Melbourne Sexual Health Centre from 2007 to 2013 were calculated using generalized estimating equation regression models. A total of 12,873 MSM were included with a median age of 30.0 years. The proportion with pharyngeal, urethral, and anal gonorrhea was 1.7%, 2.3%, and 2.9%, respectively. The adjusted odds of gonorrhea positivity increased by 9% (95% confidence interval [CI], 3%-15%), 11% (95% CI, 6%-17%), and 12% (95% CI, 7%-17%) per year, respectively. The proportion of MSM who were infected with anal chlamydia was 5.6%, with an average increase of 6% (95% CI, 3%-10%) per year; however, no significant change was observed in urethral chlamydia positivity (adjusted odds ratio, 1.02; 95% CI, 0.98-1.06). Increases in gonorrhea and chlamydia positivity were primarily restricted to MSM who reported more than 10 partners in 12 months. The number of partners in the last 12 months fell from 16.6 to 10.5, whereas consistent condom use with casual partners decreased from 64.6% to 58.9% over the study period. Gonorrhea and chlamydia have increased among MSM despite the decrease in the number of sexual partners and are occurring primarily in MSM with high numbers of partners and persist after adjusting for known risk factors, suggesting that unmeasured factors (e.g., more assortative mixing patterns) may explain the observed changes.

Cell-free production of a functional oligomeric form of a Chlamydia major outer-membrane protein (MOMP) for vaccine development

DOE PAGES

He, Wei; Felderman, Martina; Evans, Angela C.; ...

2017-07-24

Chlamydia is a prevalent sexually transmitted disease that infects more than 100 million people worldwide. Although most individuals infected with Chlamydia trachomatis are initially asymptomatic, symptoms can arise if left undiagnosed. Long-term infection can result in debilitating conditions such as pelvic inflammatory disease, infertility, and blindness. Chlamydia infection, therefore, constitutes a significant public health threat, underscoring the need for a Chlamydia-specific vaccine. Chlamydia strains express a major outer-membrane protein (MOMP) that has been shown to be an effective vaccine antigen. However, approaches to produce a functional recombinant MOMP protein for vaccine development are limited by poor solubility, low yield, andmore » protein misfolding. For this study, we used an Escherichia coli-based cell-free system to express a MOMP protein from the mouse-specific species Chlamydia muridarum (MoPn-MOMP or mMOMP). The codon-optimized mMOMP gene was co-translated with Δ49apolipoprotein A1 (Δ49ApoA1), a truncated version of mouse ApoA1 in which the N-terminal 49 amino acids were removed. This co-translation process produced mMOMP supported within a telodendrimer nanolipoprotein particle (mMOMP–tNLP). The cell-free expressed mMOMP–tNLPs contain mMOMP multimers similar to the native MOMP protein. This cell-free process produced on average 1.5 mg of purified, water-soluble mMOMP–tNLP complex in a 1-ml cell-free reaction. The mMOMP–tNLP particle also accommodated the co-localization of CpG oligodeoxynucleotide 1826, a single-stranded synthetic DNA adjuvant, eliciting an enhanced humoral immune response in vaccinated mice. Using our mMOMP–tNLP formulation, we demonstrate a unique approach to solubilizing and administering membrane-bound proteins for future vaccine development. This method can be applied to other previously difficult-to-obtain antigens while maintaining full functionality and immunogenicity.« less

Treatment efficacy of azithromycin 1 g single dose versus doxycycline 100 mg twice daily for 7 days for the treatment of rectal chlamydia among men who have sex with men - a double-blind randomised controlled trial protocol.

PubMed

Lau, Andrew; Kong, Fabian; Fairley, Christopher K; Donovan, Basil; Chen, Marcus; Bradshaw, Catriona; Boyd, Mark; Amin, Janaki; Timms, Peter; Tabrizi, Sepehr; Regan, David G; Lewis, David A; McNulty, Anna; Hocking, Jane S

2017-01-06

Rectal infection with Chlamydia trachomatis is one of the most common bacterial sexually transmissible infections among men who have sex with men (MSM) with diagnosis rates continuing to rise. Current treatment guidelines recommend either azithromycin 1 g single dose or doxycycline 100 mg twice daily for 7 days. However, there are increasing concerns about treatment failure with azithromycin. We are conducting the first randomised controlled trial (RCT) to compare treatment efficacy of azithromycin versus doxycycline for the treatment of rectal chlamydia in MSM. The Rectal Treatment Study will recruit 700 MSM attending Australian sexual health clinics for the treatment of rectal chlamydia. Participants will be asked to provide rectal swabs and will be randomised to either azithromycin 1 g single dose or doxycycline 100 mg twice daily for 7 days. Participants will be asked to complete questionnaires about adverse drug reactions, sexual behaviour and drug adherence via short message service and online survey. The primary outcome is the treatment efficacy as determined by a negative chlamydia nucleic acid amplification test at 4 weeks post treatment. Secondary outcomes will utilise whole genome sequencing and mRNA assay to differentiate between treatment failure, reinfection or false positive results. Rectal chlamydia is an increasing public health concern as use of pre-exposure prophylaxis against HIV becomes commonplace. Optimal, evidence-based treatment is critical to halting ongoing transmission. This study will provide the first RCT evidence comparing azithromycin and doxycycline for the treatment of rectal chlamydia. The results of this trial will establish which treatment is more efficacious and inform international management guidelines. Australian New Zealand Clinical Trials Registry ACTRN12614001125617.

Cell-free production of a functional oligomeric form of a Chlamydia major outer-membrane protein (MOMP) for vaccine development

DOE Office of Scientific and Technical Information (OSTI.GOV)

He, Wei; Felderman, Martina; Evans, Angela C.

Chlamydia is a prevalent sexually transmitted disease that infects more than 100 million people worldwide. Although most individuals infected with Chlamydia trachomatis are initially asymptomatic, symptoms can arise if left undiagnosed. Long-term infection can result in debilitating conditions such as pelvic inflammatory disease, infertility, and blindness. Chlamydia infection, therefore, constitutes a significant public health threat, underscoring the need for a Chlamydia-specific vaccine. Chlamydia strains express a major outer-membrane protein (MOMP) that has been shown to be an effective vaccine antigen. However, approaches to produce a functional recombinant MOMP protein for vaccine development are limited by poor solubility, low yield, andmore » protein misfolding. For this study, we used an Escherichia coli-based cell-free system to express a MOMP protein from the mouse-specific species Chlamydia muridarum (MoPn-MOMP or mMOMP). The codon-optimized mMOMP gene was co-translated with Δ49apolipoprotein A1 (Δ49ApoA1), a truncated version of mouse ApoA1 in which the N-terminal 49 amino acids were removed. This co-translation process produced mMOMP supported within a telodendrimer nanolipoprotein particle (mMOMP–tNLP). The cell-free expressed mMOMP–tNLPs contain mMOMP multimers similar to the native MOMP protein. This cell-free process produced on average 1.5 mg of purified, water-soluble mMOMP–tNLP complex in a 1-ml cell-free reaction. The mMOMP–tNLP particle also accommodated the co-localization of CpG oligodeoxynucleotide 1826, a single-stranded synthetic DNA adjuvant, eliciting an enhanced humoral immune response in vaccinated mice. Using our mMOMP–tNLP formulation, we demonstrate a unique approach to solubilizing and administering membrane-bound proteins for future vaccine development. This method can be applied to other previously difficult-to-obtain antigens while maintaining full functionality and immunogenicity.« less

Orchitis and Epididymitis in Koalas (Phascolarctos cinereus) Infected With Chlamydia pecorum.

PubMed

Johnston, S D; Deif, H H; McKinnon, A; Theilemann, P; Griffith, J E; Higgins, D P

2015-11-01

Although Chlamydia causes disease of the urethra and prostate of male koalas, its impact on the testis and epididymis has not been examined. This study describes chronic-active and granulomatous orchitis and epididymitis with interstitial fibrosis associated with infection by Chlamydia pecorum in 2 of 18 adult male koalas being euthanized at a koala hospital, 8 of which also had chlamydial prostatitis. By immunohistochemistry and transmission electron microscopy, chlamydial inclusions were demonstrated within Sertoli cells directly associated with mild inflammation surrounding intact seminiferous and epididymal tubules, marked pyogranulomatous inflammation around disrupted tubules, replacement of tubules by interstitial fibrosis, and aspermia. The presence of C. pecorum but not Chlamydia pneumoniae was detected by quantitative polymerase chain reaction of formalin-fixed tissues of the left and right testes and right epididymis in 1 animal. This is the first report of orchitis and epididymitis in a koala infected with C. pecorum. © The Author(s) 2015.

Chlamydia trachomatis elementary bodies possess proteins which bind to eucaryotic cell membranes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenman, W.M.; Meuser, R.U.

1986-02-01

Chlamydia trachomatis proteins were electrophoresed and then transferred to nitrocellulose paper to detect chlamydial proteins which bind to eucaryotic cell membranes. Resolved polypeptides of C. trachomatis serovars J and L/sub 2/ were reacted with iodinated HeLa cell membranes and autoradiographed. Infectious elementary bodies of both serovars possess 31,000- and 18,000-dalton proteins which bind to HeLa cells. In contrast, noninfectious reticulate bodies do not possess eucaryotic cell-binding proteins. Both proteins are antigenic when reacted with hyperimmune rabbit antisera in immunoblots and antisera raised against the 31,000- and 18,000-dalton proteins are inhibitory to chlamydia-host cell association. In addition, these antisera exhibit neutralizingmore » activity. These data suggest that these putative chlamydial adhesions play a key role in the early steps of chlamydia-host cell interaction and that antibody directed against them may be protective.« less

Man Up Monday: An integrated public health approach to increase sexually transmitted infection awareness and testing among male students at a midwest university.

PubMed

Anderson, Elizabeth A; Eastman-Mueller, Heather P; Henderson, Scott; Even, Susan

2016-01-01

This campaign sought to (a) increase awareness of sexual health and chlamydia testing; (b) motivate students, particularly sexually active men who do not pursue regular sexually transmitted infection (STI) testing, to get tested; and (c) improve the capacity of the student health center to provide free chlamydia testing and treatment for all students. Students enrolled at a 4-year public research university (N = 333). Collaborative partnerships formed the foundation of a campus marketing and testing campaign, with treatment for students testing positive for chlamydia. A total of 333 students were tested over 5 consecutive Mondays, showing a chlamydia incidence of 9.6%. The incidence for females and males were 8.6% and 10.8%, respectively. The campaign was effective in reaching men, an at-risk population not traditionally emphasized in STI testing.

Evaluation of the anatomical site distribution of chlamydia and gonorrhoea in men who have sex with men and in high-risk women by routine testing: cross-sectional study revealing missed opportunities for treatment strategies.

PubMed

van Liere, Geneviève A F S; Hoebe, Christian J P A; Dukers-Muijrers, Nicole H T M

2014-02-01

Current strategies for controlling non-urogenital chlamydia and gonorrhoea are not uniform. It is assumed that present anorectal/oropharyngeal infections are coincidentally treated with urogenital infections. However, it is not clear whether this control strategy is effective. To inform current debate, we evaluated the anatomical site distribution of chlamydia and gonorrhoea by routine testing in men who have sex with men (hereafter men) and in high-risk women (prostitutes and swingers, hereafter women). Between January 2010 and November 2012, all men (n=2436) and women (n=1321) attending our sexually transmitted infection clinic were routinely tested for anorectal, oropharyngeal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae. Data were collected on demographics and sexual behaviour. Overall chlamydia positivity was 10.4% (254/2436) in men and 7.0% (92/1321) in women, for gonorrhoea this was 6.3% (154/2436) and 3.1% (41/1321), respectively. Isolated non-urogenital infections amounted to 76% of all infections in men and for up to 59% of all infections in women. For combined urogenital and anorectal infections, this amounted to 14% for men and up to 54% for women. Testing only for non-urogenital infections is insufficient, as it overlooks many infections. The use of coincidental treatment is therefore a suboptimal control strategy in high-risk groups for halting complications and transmission. There is an urgent need to optimise the testing guidelines for chlamydia and gonorrhoea at different anatomical sites.

Chlamydial Pre-Infection Protects from Subsequent Herpes Simplex Virus-2 Challenge in a Murine Vaginal Super-Infection Model

PubMed Central

Slade, Jessica; Hall, Jennifer V.; Kintner, Jennifer; Schoborg, Robert V.

2016-01-01

Chlamydia trachomatis and Herpes Simplex Virus-2 (HSV-2) genital tract co-infections have been reported in humans and studied in vitro but the clinical consequences are unknown. Limited epidemiologic evidence suggests that these co-infections could be more severe than single infections of either pathogen, but the host-pathogen interactions during co-infection remain uncharacterized. To determine whether disease progression and/or pathogen shedding differs between singly-infected and super-infected animals, we developed an in vivo super-infection model in which female BALB/c mice were vaginally infected with Chlamydia muridarum (Cm) followed later by HSV-2. Pre-infection with Chlamydia 3 or 9 days prior to HSV-2 super-infection conferred significant protection from HSV-2-induced neurologic disease and significantly reduced viral recovery compared to HSV-2 singly-infected controls. Neither protection from mortality nor reduced viral recovery were observed when mice were i) super-infected with HSV-2 on day 27 post Cm; ii) infected with UV-irradiated Cm and super-infected with HSV-2; or iii) azithromycin-treated prior to HSV-2 super-infection. Therefore, protection from HSV-2-induced disease requires active infection with viable chlamydiae and is not observed after chlamydial shedding ceases, either naturally or due to antibiotic treatment. Thus, Chlamydia-induced protection is transient and requires the continued presence of chlamydiae or their components. These data demonstrate that chlamydial pre-infection can alter progression of subsequent HSV-2 infection, with implications for HSV-2 transmission from co-infected humans. PMID:26726882

Evidence for increased Chlamydia case finding after the introduction of rectal screening among women attending 2 Canadian sexually transmitted infection clinics.

PubMed

Gratrix, Jennifer; Singh, Ameeta E; Bergman, Joshua; Egan, Caroline; Plitt, Sabrina S; McGinnis, Justin; Bell, Christopher A; Drews, Steven J; Read, Ron

2015-02-01

Chlamydia trachomatis is the most common notifiable disease in Canada, and extragenital sites are believed to serve as hidden reservoirs for ongoing transmission of infection. There are no specific Canadian screening guidelines for asymptomatic individuals from extragenital sites. We sought to determine the prevalence and factors associated with rectal C. trachomatis among female sexually transmitted infection (STI) clinic attendees in Alberta, Canada. Between 20 July and 31 December 2012, all female attendees at 2 Provincial STI clinics receiving a pelvic examination, regardless of a history of anal intercourse, were screened for rectal C. trachomatis using the Gen-Probe Aptima COMBO 2 Assay. Demographic and behavior variables were compared between rectal-only chlamydia cases and genitourinary cases using χ(2) or Fisher exact test, Mann-Whitney test, and logistic regression. A total of 3055 women were screened for rectal chlamydia. The prevalence of rectal chlamydia ranged from 11.7% to 13.5%. There were 133 rectal-only cases, increasing case detection by 44.3% from 300 genitourinary cases to 433 total cases, ranging from 21.7% to 88.2% by clinic. Women who were a contact to an STI were less likely to have rectal-only chlamydia for both clinics (P ≤ .001). Our findings add to the growing body of evidence supporting universal rectal screening in high-risk women such as those undergoing pelvic exams at STI clinics. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Direct and indirect effects of screening for Chlamydia trachomatis on the prevention of pelvic inflammatory disease: a mathematical modeling study.

PubMed

Herzog, Sereina A; Heijne, Janneke C M; Scott, Pippa; Althaus, Christian L; Low, Nicola

2013-11-01

Pelvic inflammatory disease (PID) results from the ascending spread of microorganisms, including Chlamydia trachomatis, to the upper genital tract. Screening could improve outcomes by identifying and treating chlamydial infections before they progress to PID (direct effect) or by reducing chlamydia transmission (indirect effect). We developed a compartmental model that represents a hypothetical heterosexual population and explicitly incorporates progression from chlamydia to clinical PID. Chlamydia screening was introduced, with coverage increasing each year for 10 years. We estimated the separate contributions of the direct and indirect effects of screening on PID cases prevented per 100,000 women. We explored the influence of varying the time point at which clinical PID could occur and of increasing the risk of PID after repeated chlamydial infections. The probability of PID at baseline was 3.1% by age 25 years. After 5 years, the intervention scenario had prevented 187 PID cases per 100,000 women and after 10 years 956 PID cases per 100,000 women. At the start of screening, most PID cases were prevented by the direct effect. The indirect effect produced a small net increase in PID cases, which was outweighed by the effect of reduced chlamydia transmission after 2.2 years. The later that progression to PID occurs, the greater the contribution of the direct effect. Increasing the risk of PID with repeated chlamydial infection increases the number of PID cases prevented by screening. This study shows the separate roles of direct and indirect PID prevention and potential harms, which cannot be demonstrated in observational studies.

Internet testing for Chlamydia trachomatis in England, 2006 to 2010.

PubMed

Woodhall, Sarah C; Sile, Bersabeh; Talebi, Alireza; Nardone, Anthony; Baraitser, Paula

2012-12-19

In recent years there has been interest in websites as a means of increasing access to free chlamydia tests through the National Chlamydia Screening Programme (NCSP) in England. We aimed to describe and evaluate online access to chlamydia testing within the NCSP. We analysed NCSP chlamydia testing data (2006-2010) for 15-24 year olds from the 71/95 programme areas in England where site codes were available to identify tests ordered through the internet. The characteristics of people using online testing services in 2010 were compared with those testing in general practice (GP) or community sexual and reproductive health (SRH) services. We evaluated 58 websites offering free chlamydia tests through the NCSP, and 32 offering kits on a commercial basis for signposting to clinical service and health promotion advice offered. Between 2006 and 2010, 5% of all tests in the included programme areas were accessed through the internet. The number of internet tests increased from 18 (<1% of all tests) in 2006 to 59,750 in 2010 (6% of all NCSP tests). In 2010 the proportion of NCSP tests accessed online by programme area ranged from <1% to 38%. The proportion of tests with a positive result on the internet was higher than tests from general practice and comparable to those from community SRH services (internet 7.6%; GP 5.6%; Community SRH 8.2%). A higher proportion of people accessing online testing were male, aged 20-24 and reported >1 sexual partner in the past year. Provision of sexual health information and appropriate signposting for those in need of clinical services varied between websites. Service provision within the NCSP was fragmented with multiple providers serving specific geographical catchment areas. Internet testing reaches a population with a relatively high risk of chlamydia infection and appears acceptable to young men, a group that has been difficult to engage with chlamydia testing. In order to maximise the potential benefit of these services, websites should be consistent with national guidelines and adhere to minimum standards for signposting to clinical care and health promotion information. The current system with multiple providers servicing geographically specific catchment areas is contrary to the geographically unrestricted nature of the internet and potentially confusing for clients.

Dual Intervention to Increase Chlamydia Retesting: A Randomized Controlled Trial in Three Populations.

PubMed

Smith, Kirsty S; Hocking, Jane S; Chen, Marcus Y; Fairley, Christopher K; McNulty, Anna M; Read, Phillip; Bradshaw, Catriona S; Tabrizi, Sepehr N; Wand, Handan; Saville, Marion; Rawlinson, William; Garland, Suzanne M; Donovan, Basil; Kaldor, John M; Guy, Rebecca J

2015-07-01

Chlamydia retesting 3 months after treatment is recommended to detect reinfections, but retesting rates are typically low. The purpose of this study is to determine if the addition of a postal home collection kit to a short message service (SMS) reminder at 3 months increases the percentage of patients retested for chlamydia at 1-4 months, compared to SMS alone. In this unblinded randomized controlled trial, participants were randomized 1:1 to intervention (home arm) or control (clinic arm) status. Participants included 200 each of women, heterosexual men, and men who have sex with men diagnosed and treated for chlamydia at sexual health services. Three months after chlamydia diagnosis, home arm participants received an SMS reminder and postal home collection kit (women, vaginal swab; heterosexual men, Copan UriSwab; men who have sex with men, UriSwab and rectal swab). The main outcome measures were the percentage of participants retested at 1-4 months after chlamydia diagnosis and the percentage in each arm with repeat positive tests, by risk group and overall, analyzed by intention to treat. Data were collected from 2011 to 2013 and analyzed in 2014. The percentage retested within 1-4 months of chlamydia diagnosis was significantly higher in home versus clinic arm participants among women (64% [66/103] vs 39% [38/97], p<0.001); heterosexual men (56% [57/101] vs 34% [34/99], p=0.002); men who have sex with men (62% [61/98] vs 44% [45/102], p=0.010); and overall (61% [184/302] vs 39% [117/298], p<0.001). The percentage in the home versus clinic arm with repeat positive tests was significantly higher among men who have sex with men (16% [16/98] vs 5% [5/102], p=0.021) and overall (10% [31/302] vs 4% [12/298], p=0.006). The addition of a postal home collection kit to routine SMS reminders resulted in substantial improvements in chlamydia retesting rates in all three risk groups and detection of more repeat positive tests, compared with SMS alone. Extending the intervention to other primary care settings with low retesting rates should be considered. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008-2010.

PubMed

Dimech, Wayne; Lim, Megan S C; Van Gemert, Caroline; Guy, Rebecca; Boyle, Douglas; Donovan, Basil; Hellard, Margaret

2014-06-12

Chlamydial infection is the most common notifiable disease in Australia, Europe and the US. Australian notifications of chlamydia rose four-fold from 20,274 cases in 2002 to 80,846 cases in 2011; the majority of cases were among young people aged less than 29 years. Along with test positivity rates, an understanding of the number of tests performed and the demographics of individuals being tested are key epidemiological indicators. The ACCESS Laboratory Network was established in 2008 to address this issue. The ACCESS Laboratory Network collected chlamydia testing data from 15 laboratories around Australia over a three-year period using data extraction software. All chlamydia testing data from participating laboratories were extracted from the laboratory information system; patient identifiers converted to a unique, non-reversible code and de-identified data sent to a single database. Analysis of data by anatomical site included all specimens, but in age and sex specific analysis, only one testing episode was counted. From 2008 to 2010 a total of 628,295 chlamydia tests were referred to the 15 laboratories. Of the 592,626 individual episodes presenting for testing, 70% were from female and 30% from male patients. In female patients, chlamydia positivity rate was 6.4% overall; the highest rate in 14 year olds (14.3%). In male patients, the chlamydia positivity rate was 9.4% overall; the highest in 19 year olds (16.5%). The most common sample type was urine (57%). In 3.2% of testing episodes, multiple anatomical sites were sampled. Urethral swabs gave the highest positivity rate for all anatomical sites in both female (7.7%) and male patients (14%), followed by urine (7.6% and 9.4%, respectively) and eye (6.3% and 7.9%, respectively). The ACCESS Laboratory Network data are unique in both number and scope and are representative of chlamydia testing in both general practice and high-risk clinics. The findings from these data highlight much lower levels of testing in young people aged 20 years or less; in particular female patients aged less than 16 years, despite being the group with the highest positivity rate. Strategies are needed to increase the uptake of testing in this high-risk group.

Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008–2010

PubMed Central

2014-01-01

Background Chlamydial infection is the most common notifiable disease in Australia, Europe and the US. Australian notifications of chlamydia rose four-fold from 20,274 cases in 2002 to 80,846 cases in 2011; the majority of cases were among young people aged less than 29 years. Along with test positivity rates, an understanding of the number of tests performed and the demographics of individuals being tested are key epidemiological indicators. The ACCESS Laboratory Network was established in 2008 to address this issue. Methods The ACCESS Laboratory Network collected chlamydia testing data from 15 laboratories around Australia over a three-year period using data extraction software. All chlamydia testing data from participating laboratories were extracted from the laboratory information system; patient identifiers converted to a unique, non-reversible code and de-identified data sent to a single database. Analysis of data by anatomical site included all specimens, but in age and sex specific analysis, only one testing episode was counted. Results From 2008 to 2010 a total of 628,295 chlamydia tests were referred to the 15 laboratories. Of the 592,626 individual episodes presenting for testing, 70% were from female and 30% from male patients. In female patients, chlamydia positivity rate was 6.4% overall; the highest rate in 14 year olds (14.3%). In male patients, the chlamydia positivity rate was 9.4% overall; the highest in 19 year olds (16.5%). The most common sample type was urine (57%). In 3.2% of testing episodes, multiple anatomical sites were sampled. Urethral swabs gave the highest positivity rate for all anatomical sites in both female (7.7%) and male patients (14%), followed by urine (7.6% and 9.4%, respectively) and eye (6.3% and 7.9%, respectively). Conclusions The ACCESS Laboratory Network data are unique in both number and scope and are representative of chlamydia testing in both general practice and high-risk clinics. The findings from these data highlight much lower levels of testing in young people aged 20 years or less; in particular female patients aged less than 16 years, despite being the group with the highest positivity rate. Strategies are needed to increase the uptake of testing in this high-risk group. PMID:24920016

Enzyme immunoassay of Chlamydia in birds.

PubMed

Ruppanner, R; Behymer, D E; DeLong, W J; Franti, C E; Schulz, T

1984-01-01

Serum samples from 192 free-living birds (27 species) were tested for antibodies against Chlamydia using the enzyme-linked immunosorbent assay (ELISA); 97 (51%) were seropositive. The highest antibody prevalence was among pheasants (96%), ducks (88%), and blackbirds (86%). None of 41 starlings tested were seropositive. The serotesting of 42 confined pheasants indicated 100% exposure to the organism. The ELISA is a sensitive, rapid serologic method that can be of epidemiologic and diagnostic value for detecting exposure to Chlamydia. The ELISA could also be used for mass-screening of pet birds where chlamydiosis may be considered a potential public health hazard.

High-resolution typing of Chlamydia trachomatis: epidemiological and clinical uses.

PubMed

de Vries, Henry J C; Schim van der Loeff, Maarten F; Bruisten, Sylvia M

2015-02-01

A state-of-the-art overview of molecular Chlamydia trachomatis typing methods that are used for routine diagnostics and scientific studies. Molecular epidemiology uses high-resolution typing techniques such as multilocus sequence typing, multilocus variable number of tandem repeats analysis, and whole-genome sequencing to identify strains based on their DNA sequence. These data can be used for cluster, network and phylogenetic analyses, and are used to unveil transmission networks, risk groups, and evolutionary pathways. High-resolution typing of C. trachomatis strains is applied to monitor treatment efficacy and re-infections, and to study the recent emergence of lymphogranuloma venereum (LGV) amongst men who have sex with men in high-income countries. Chlamydia strain typing has clinical relevance in disease management, as LGV needs longer treatment than non-LGV C. trachomatis. It has also led to the discovery of a new variant Chlamydia strain in Sweden, which was not detected by some commercial C. trachomatis diagnostic platforms. After a brief history and comparison of the various Chlamydia typing methods, the applications of the current techniques are described and future endeavors to extend scientific understanding are formulated. High-resolution typing will likely help to further unravel the pathophysiological mechanisms behind the wide clinical spectrum of chlamydial disease.

Polarized Cell Division of Chlamydia trachomatis

PubMed Central

Abdelrahman, Yasser; Ouellette, Scot P.; Belland, Robert J.; Cox, John V.

2016-01-01

Bacterial cell division predominantly occurs by a highly conserved process, termed binary fission, that requires the bacterial homologue of tubulin, FtsZ. Other mechanisms of bacterial cell division that are independent of FtsZ are rare. Although the obligate intracellular human pathogen Chlamydia trachomatis, the leading bacterial cause of sexually transmitted infections and trachoma, lacks FtsZ, it has been assumed to divide by binary fission. We show here that Chlamydia divides by a polarized cell division process similar to the budding process of a subset of the Planctomycetes that also lack FtsZ. Prior to cell division, the major outer-membrane protein of Chlamydia is restricted to one pole of the cell, and the nascent daughter cell emerges from this pole by an asymmetric expansion of the membrane. Components of the chlamydial cell division machinery accumulate at the site of polar growth prior to the initiation of asymmetric membrane expansion and inhibitors that disrupt the polarity of C. trachomatis prevent cell division. The polarized cell division of C. trachomatis is the result of the unipolar growth and FtsZ-independent fission of this coccoid organism. This mechanism of cell division has not been documented in other human bacterial pathogens suggesting the potential for developing Chlamydia-specific therapeutic treatments. PMID:27505160

The 'real-world' impact of improved diagnostic techniques for Chlamydia trachomatis infection in Glasgow.

PubMed

Scoular, A; McCartney, R; Kinn, S; Carr, S; Walker, A

2001-09-01

In April 1997, the main chlamydia laboratory in Glasgow introduced ligase chain reaction (LCR) as its standard diagnostic test. The diagnostic effectiveness and health economic impact of introduction of LCR testing was assessed. Between April 1996 to March 2000, results of all chlamydia detection tests on genital specimens sent from general practitioners and the two main sexual healthcare providers (Genitourinary Medicine and Family Planning services) were reviewed. A preliminary economic assessment, inclusive of staff, reagents, consumables and laboratory overheads was conducted. Overall, testing activity increased four and a half times between 1996-97 and 1999-2000; the proportionate rise was greatest in general practice. Although chlamydia testing in both genders increased over the review period, testing activity rose disproportionately in women (59%, compared with a 31% increase in men). The overall Chlamydia trachomatis detection rate rose from 4.8% in 1996-97 to 7.8% in 1999-2000. Following introduction of LCR testing, an estimated additional 331 men and 844 women were diagnosed during the study period. The cost per additional diagnosis made was estimated at 162 Pounds for men and 263 Pounds for women. Substantial health gains are likely to be achieved, at both an individual and public health level, as a result of introduction of LCR testing for genital chlamydial infection.

Perceptions of Self-Testing for Chlamydia: Understanding and Predicting Self-Test Use.

PubMed

Powell, Rachael; Pattison, Helen M; Marriott, John F

2016-05-10

Self-testing technology allows people to test themselves for chlamydia without professional support. This may result in reassurance and wider access to chlamydia testing, but anxiety could occur on receipt of positive results. This study aimed to identify factors important in understanding self-testing for chlamydia outside formal screening contexts, to explore the potential impacts of self-testing on individuals, and to identify theoretical constructs to form a Framework for future research and intervention development. Eighteen university students participated in semi-structured interviews; eleven had self-tested for chlamydia. Data were analysed thematically usingaFrameworkapproach. Perceivedbenefitsofself-testingincludeditsbeingconvenient, anonymousandnotrequiringphysicalexamination. Therewasconcernabouttestaccuracyandsome participants lacked confidence in using vulvo-vaginal swabs. While some participants expressed concern about the absence of professional support, all said they would seek help on receiving a positive result. Factors identified in Protection Motivation Theory and the Theory of Planned Behaviour, such as response efficacy and self-efficacy, were found to be highly salient to participants in thinking about self-testing. These exploratory findings suggest that self-testing independentlyofformalhealthcaresystemsmaynomorenegativelyimpactpeoplethanbeingtested by health care professionals. Participants' perceptions about self-testing behaviour were consistent with psychological theories. Findings suggest that interventions which increase confidence in using self-tests and that provide reassurance of test accuracy may increase self-test intentions.

Chlamydia gallinacea, not C. psittaci, is the endemic chlamydial species in chicken (Gallus gallus).

PubMed

Guo, Weina; Li, Jing; Kaltenboeck, Bernhard; Gong, Jiansen; Fan, Weixing; Wang, Chengming

2016-01-18

To investigate the prevalence and diversity of Chlamydia spp. in domestic birds in China, oral and cloacal swabs of healthy chickens, ducks, geese and pigeons were collected nationwide from live-animal markets and examined by Chlamydia spp. 23 S rRNA gene FRET-PCR followed by high-resolution melting curve analysis and confirmatory sequencing. Overall, 26.2% of the birds (602/2,300) were positive for Chlamydia spp. and five Chlamydia spp. were identified. While occasional detection of C. suis and C. muridarum in poultry is reported here for the first time, the predominant chlamydial agent was C. gallinacea representing 63.8% of all positives (384/602) and 81.2% of positive chickens (359/442). Analysis of the C. gallinacea ompA phylogeny revealed at least 13 well segregated variants (serovars). Seven-month monitoring of C. gallinacea-infected chickens indicated that the infection was persistent. C. gallinacea-infected chickens remained without overt clinical disease, but showed body weight gains significantly reduced by 6.5-11.4% beginning in week 3 post-infection. This study indicates that C. gallinacea is the endemic chlamydial species in chickens, whereas C. psittaci dominates only in pigeons. Further studies are required to address the specific conditions under which C. gallinacea could act as an avian pathogen and possibly also a zoonotic agent.

A comparative study of RNA and DNA as internal gene expression controls early in the developmental cycle of Chlamydia pneumoniae.

PubMed

Engström, Patrik; Bailey, Leslie; Onskog, Thomas; Bergström, Sven; Johansson, Jörgen

2010-03-01

Many microbial pathogens invade and proliferate within host cells and the molecular mechanism underlying this behavior is currently being revealed for several bacterial species. Testing clinically relevant antibacterial compounds and elucidating their effects on gene expression requires adequate controls, especially when studying genetically intractable organisms such as Chlamydia spp., for which various gene fusions cannot be constructed. Until now, relative mRNA levels in Chlamydia have been measured using different internal gene expression controls, including 16S rRNA, mRNAs, and DNA. Here, we compared the advantages and disadvantages of various internal expression controls during the early phase of Chlamydia pneumoniae development. The relative abundance of target mRNAs varied using the different internal control RNAs. This was partly due to variation in the transcript stability of the RNA species. Also, seven out of nine of the analyzed RNAs increased fivefold or more between 2 and 14 h postinfection, while the amount of DNA and number of cells remained essentially unaltered. Our results suggest that RNA should not be used as a gene expression control during the early phase of Chlamydia development, and that intrinsic bacterial DNA is preferable for that purpose because it is stable, abundant, and its relative amount is generally correlated with bacterial numbers.

A mouse model for Chlamydia suis genital infection.

PubMed

Donati, Manuela; Di Paolo, Maria; Favaroni, Alison; Aldini, Rita; Di Francesco, Antonietta; Ostanello, Fabio; Biondi, Roberta; Cremonini, Eleonora; Ginocchietti, Laura; Cevenini, Roberto

2015-02-01

A mouse model for Chlamydia suis genital infection was developed. Ninety-nine mice were randomly divided into three groups and intravaginally inoculated with chlamydia: 45 mice (group 1) received C. suis purified elementary bodies (EBs), 27 (group 2) were inoculated with C. trachomatis genotype E EBs and 27 mice (group 3) with C. trachomatis genotype F EBs. Additionally, 10 mice were used as a negative control. At seven days post-infection (dpi) secretory anti-C. suis IgA were recovered from vaginal swabs of all C. suis inoculated mice. Chlamydia suis was isolated from 93, 84, 71 and 33% vaginal swabs at 3, 5, 7 and 12 dpi. Chlamydia trachomatis genotype E and F were isolated from 100% vaginal swabs up to 7 dpi and from 61 and 72%, respectively, at 12 dpi. Viable C. suis and C. trachomatis organisms were isolated from uterus and tubes up to 16 and 28 dpi, respectively. The results of the present study show the susceptibility of mice to intravaginal inoculation with C. suis. A more rapid course and resolution of C. suis infection, in comparison to C. trachomatis, was highlighted. The mouse model could be useful for comparative investigations involving C. suis and C. trachomatis species. © FEMS 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effect of Chlamydia diagnosis on heterosexual relationships.

PubMed

O'Farrell, Nigel; Weiss, Helen A

2013-09-01

This study investigated whether a Chlamydia diagnosis was associated with relationship breakup or physical violence from partners when compared to other attenders at a sexually transmitted infections (STIs) clinic. Patients diagnosed with Chlamydia and who had a regular partner at the time of diagnosis, were contacted 3-12 months later and completed a questionnaire on relationship history. A comparison group of gender-matched non-STI patients were also interviewed. About half of Chlamydia cases (exposed) and non-cases (unexposed) had broken up with their partner since diagnosis (52% vs. 47%; p=0.42), but cases were more likely to have split up within one week of diagnosis (48% vs. 24%; p=0.003), and somewhat more likely to resume the relationship (24% vs. 15%; p=0.24). The prevalence of reported physical violence in the past year was slightly higher in cases than the unexposed group (9% vs. 4%; p=0.09). Cases that saw a health adviser were less likely to report experiencing physical violence than those who had not seen a health adviser (7% vs. 12%: p=0.31). Patients with Chlamydia are more likely to suffer relationship breakup soon after diagnosis than STI clinic attenders without an STI. Health advice should include reassurance about sexual relationships as well as safer sex.

The natural history of untreated Chlamydia trachomatis infection in the interval between screening and returning for treatment.

PubMed

Geisler, William M; Wang, Chengbin; Morrison, Sandra G; Black, Carolyn M; Bandea, Claudiu I; Hook, Edward W

2008-02-01

Studies of the natural history of genital chlamydial infections in humans are sparse and have had study design limitations. An improved understanding of chlamydial natural history may influence recommendations for elements of control efforts such as chlamydia screening frequency or time parameters for partner notification. Addressing limitations of prior studies in part, we are prospectively studying chlamydial natural history in sexually transmitted diseases clinic patients in the interval between screening and returning for treatment of positive chlamydial tests. Results of repeat chlamydial testing and clinical outcomes and their associated predictors are being evaluated. In the initial 129 subjects, 89% were female, 88% were black, median age was 21 years, and the median interval between screening and treatment was 13 days. Based on nucleic acid amplification testing at treatment, spontaneous resolution of chlamydia occurred in 18%. Resolution was somewhat more common in subjects with longer intervals between screening and treatment. Persisting infections more often progressed to develop clinical signs at the time of treatment (e.g., urethritis or cervicitis). Two women and one man developed chlamydial complications between screening and treatment. Our findings demonstrate that although spontaneous resolution of chlamydia is common, many persons with persisting chlamydia progress to develop signs of infection and some develop complications.

Medical Surveillance Monthly Report. Volume 16, Number 7, July 2009

DTIC Science & Technology

2009-07-01

Reporting locations Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2008 2009...borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2008 2009 2008 2009 2008 2009 2008

Asymptomatic natural Chlamydia pecorum infection reduces growth rates in calves by up to 48 percent

USDA-ARS?s Scientific Manuscript database

Intracellular Chlamydia (C.) bacteria cause in cattle some acute but rare diseases such as abortion, sporadic bovine encephalomyelitis, kerato-conjunctivitis, pneumonia, enteritis and polyarthritis. Much more frequent, essentially ubiquitous worldwide, are low-level, asymptomatic chlamydial infecti...

Ectopic Pregnancy, Active Component, U.S. Armed Forces, 2002-2011

DTIC Science & Technology

2012-07-01

had prior diagnoses of Chlamydia trachomatis or Neisseria gonor- rhoeae infections of the reproductive tract (data not shown). The proportions...diagnoses of genital infections with chlamydia or gonococci or pelvic inflammatory disease. PID is the one of the strongest independent risk

Transmission Behaviors and Prevalence of Chlamydia and Gonorrhea Among Adult Film Performers.

PubMed

Javanbakht, Marjan; Dillavou, M Claire; Rigg, Robert W; Kerndt, Peter R; Gorbach, Pamina M

2017-03-01

Adult film work involves multiple sex partners, unprotected intercourse and frequent oral/rectal contact. Data on sexual networks and sexual behaviors of adult film performers (AFP) are limited. From August 2012 to May 2013, AFPs in Los Angeles, CA, seeking care at 2 clinics that provide sexually transmitted infections (STIs) testing to performers were offered urogenital, pharyngeal, and rectal chlamydia/gonorrhea testing. Participants were 18 years or older and performed in at least 1 adult film scene within the past year. A Web-based survey was used to collect sexual behavior information. A total of 360 AFPs were enrolled; 75% (n = 271) were women, and the median age was 25 years (interquartile range, 22-31 years). Most reported a main partner (73%), 23% reported non-film transactional partners, and only 6% reported always using condoms on-set. Overall, 24% (n = 86) tested positive for chlamydia or gonorrhea; 15% for chlamydia (n = 54) and 11% for gonorrhea (n = 41). Prevalence of chlamydia/gonorrhea varied by time as a performer (median, year 2 vs year 3; P = 0.06), and days of adult film-work in the past 30 days (median, 6 days vs 4 days; P = 0.02). In multivariable analyses, age (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) and type of scene (adjusted odds ratio for double vaginal = 2.89; 95% confidence interval, 1.29-6.48) were associated with chlamydia/gonorrhea positivity. Adult film performers had a high prevalence of STIs and reported low levels of condom use in the context of most sexual partnerships. Targeted intervention strategies-both in and outside the workplace-are needed to limit the spread of STIs.

Chlamydia and gonorrhoea infections and the risk of adverse obstetric outcomes: a retrospective cohort study.

PubMed

Liu, Bette; Roberts, Christine L; Clarke, Marilyn; Jorm, Louisa; Hunt, Jennifer; Ward, James

2013-12-01

To examine the association between prior chlamydia and gonorrhoea infections and adverse obstetric outcomes. Records of women resident in New South Wales, Australia with a singleton first birth during 1999-2008 were linked to chlamydia and gonorrhoea notifications using probabilistic linkage. Obstetric outcomes and potential confounders were ascertained from the birth record. Logistic regression, adjusted for potential confounders was used to estimate the association between a disease notification prior to the birth and adverse birth outcomes: spontaneous preterm birth (SPTB), small for gestational age (SGA) and stillbirth. Among 354 217 women, 1.0% (n=3658) had a prior chlamydia notification; 0.06% (n=196) had a prior gonorrhoea notification. The majority of notifications (>80%) occurred before the estimated conception date. 4.1% of women had a SPTB, 12.1% had a SGA baby and 0.6% of women had a stillbirth. Among women with a prior chlamydia notification, the risk of SPTB and stillbirth was increased, aOR 1.17 (95% CI 1.01 to 1.37) and aOR 1.40 (95% CI 1.00 to 1.96) respectively but there was no association with SGA, aOR 0.99 (95% CI 0.89 to 1.09). For women with gonorrhoea the risks for SPTB, stillbirth and SGA were respectively aOR 2.50 (95%CI 1.39 to 4.50), 2.35 (95% CI 0.58 to 9.56) and 0.98 (95% CI 0.58 to 1.68). Among women with a prior chlamydia diagnosis, the risk of SPTB did not differ between women diagnosed >1 year prior to conception, within the year prior to conception or during the pregnancy, (p=0.9). Sexually transmissible infections in pregnancy and the preconception period may be important in predicting pregnancy outcomes.

Modest rise in chlamydia and gonorrhoea testing did not increase case detection in a clinical HIV cohort in Ontario, Canada

PubMed Central

Burchell, Ann N; Grewal, Ramandip; Allen, Vanessa G; Gardner, Sandra L; Moravan, Veronika; Bayoumi, Ahmed M; Kaul, Rupert; McGee, Frank; Millson, Margaret (Peggy) E; Remis, Robert S; Raboud, Janet; Mazzulli, Tony; Rourke, Sean B

2014-01-01

Objectives We described patterns of testing for chlamydia and gonorrhoea infection among persons in specialty HIV care in Ontario, Canada, from 2008 to 2011. Methods We analysed data from 3165 participants in the OHTN Cohort Study attending one of seven specialty HIV care clinics. We obtained chlamydia and gonorrhoea test results via record linkage with the provincial public health laboratory. We estimated the proportion of participants who underwent testing annually, the positivity rate among those tested and the proportion diagnosed with chlamydia or gonorrhoea among all under observation. We explored risk factors for testing and diagnosis using multiple logistic regression analysis. Results The proportion tested annually rose from 15.2% (95% CI 13.6% to 16.7%) in 2008 to 27.0% (95% CI 25.3% to 28.6%) in 2011 (p<0.0001). Virtually all were urine-based nucleic acid amplification tests. Testing was more common among men who have sex with men (MSM), younger adults, Toronto residents, persons attending primary care clinics and persons who had tested in the previous year or who had more clinic visits in the current year. We observed a decrease in test positivity rates over time. However, the annual proportion diagnosed remained stable and in 2011 this was 0.97% (95% CI 0.61% to 1.3%) and 0.79% (95% CI 0.46% to 1.1%) for chlamydia and gonorrhoea, respectively. Virtually all cases were among MSM. Conclusions Chlamydia and gonorrhoea testing increased over time while test positivity rates declined and the overall proportion diagnosed remained stable, suggesting that the modest increase in testing did not improve case detection. PMID:25178285

Mapping patient pathways and estimating resource use for point of care versus standard testing and treatment of chlamydia and gonorrhoea in genitourinary medicine clinics in the UK.

PubMed

Adams, Elisabeth J; Ehrlich, Alice; Turner, Katherine M E; Shah, Kunj; Macleod, John; Goldenberg, Simon; Meray, Robin K; Pearce, Vikki; Horner, Patrick

2014-07-23

We aimed to explore patient pathways using a chlamydia/gonorrhoea point-of-care (POC) nucleic acid amplification test (NAAT), and estimate and compare the costs of the proposed POC pathways with the current pathways using standard laboratory-based NAAT testing. Workshops were conducted with healthcare professionals at four sexual health clinics representing diverse models of care in the UK. They mapped out current pathways that used chlamydia/gonorrhoea tests, and constructed new pathways using a POC NAAT. Healthcare professionals' time was assessed in each pathway. The proposed POC pathways were then priced using a model built in Microsoft Excel, and compared to previously published costs for pathways using standard NAAT-based testing in an off-site laboratory. Pathways using a POC NAAT for asymptomatic and symptomatic patients and chlamydia/gonorrhoea-only tests were shorter and less expensive than most of the current pathways. Notably, we estimate that POC testing as part of a sexual health screen for symptomatic patients, or as stand-alone chlamydia/gonorrhoea testing, could reduce costs per patient by as much as £16 or £6, respectively. In both cases, healthcare professionals' time would be reduced by approximately 10 min per patient. POC testing for chlamydia/gonorrhoea in a clinical setting may reduce costs and clinician time, and may lead to more appropriate and quicker care for patients. Further study is warranted on how to best implement POC testing in clinics, and on the broader clinical and cost implications of this technology. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cost-benefit analysis of Chlamydia trachomatis screening in pregnant women in a high burden setting in the United States.

PubMed

Ditkowsky, Jared; Shah, Khushal H; Hammerschlag, Margaret R; Kohlhoff, Stephan; Smith-Norowitz, Tamar A

2017-02-18

Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) in the United States (U.S.) [1] and remains a major public health problem. We determined the cost- benefit of screening all pregnant women aged 15-24 for Chlamydia trachomatis infection compared with no screening. We developed a decision analysis model to estimate costs and health-related effects of screening pregnant women for C. trachomatis in a high burden setting (Brooklyn, NY). Outcome data was from literature for pregnant women in the 2015 US population. A virtual cohort of 6,444,686 pregnant women, followed for 1 year was utilized. Using outcomes data from the literature, we predicted the number of C. trachomatis cases, associated morbidity, and related costs. Two comparison arms were developed: pregnant women who received chlamydia screening, and those who did not. Costs and morbidity of a pregnant woman-infant pair with C. trachomatis were calculated and compared. Cost and benefit of screening relied on the prevalence of C. trachomatis; when rates are above 16.9%, screening was proven to offer net cost savings. At a pre-screening era prevalence of 8%, a screening program has an increased expense of $124.65 million ($19.34/individual), with 328 thousand more cases of chlamydia treated, and significant reduction in morbidity. At a current estimate of prevalence, 6.7%, net expenditure for screening is $249.08 million ($38.65/individual), with 204.63 thousand cases of treated chlamydia and reduced morbidity. Considering a high prevalence region, prenatal screening for C. trachomatis resulted in increased expenditure, with a significant reduction in morbidity to woman-infant pairs. Screening programs are appropriate if the cost per individual is deemed acceptable to prevent the morbidity associated with C. trachomatis.

[Chlamydia pneumoniae--etiology of ophthalmia neonatorum].

PubMed

Krásný, J; Borovanská, J; Hrubá, D

2003-07-01

The authors observed mucous discharge in palpebral aperture, accompanied by a different degree of effusion of eyelids and chemosis of conjunctivae, particularly the tarsal ones, in 12 physiological newborns. Chlamydia pneumoniae proved to be the etiological agent in the newborn ophthalmia. The eye infection was not detected in the same period of time and in the same maternity hospital in the period of observation from September 1999 to March 2001. The detection of Chlamydia pneumoniae was performed in conjunctiva smears. The impression films on slides were examined by the method of indirect immunofluorescence with the use of specific monoclonal antibodies (medac, Germany). In the early stages the secretion included a sanguineous component, which was then changing into a mucoid or mucopurulent form. The character of conjunctival symptoms was changing in the course of inflammation. Effusion of the lower transitory fold (plica) was gradually accompanied by a picture of pseudofollicular changes on the tarsal conjunctiva. Clarithromycin in the form of syrup at daily doses of 15 mg/kg/day for the period of two weeks offered an efficient therapy of the affection. Control smears after 14 days were always negative and, at the same time, the pathological finding on the conjunctivae disappeared. The nasolacrimal obstruction was the only complication of this chlamydia infection, taking place in seven sucklings, i.e. in 58%. The passage through lacrimal drainage system reappeared in all the affected infants until they reached one year of age. The remaining question to be answered is the way the newborns encountered the infection. A nosocomial infection may be the case, but Chlamydia pneumoniae could also be present in the urogenital tract of mothers and transferred to the newborn via the birth canal similarly as is the case of Chlamydia trachomatis infection. The mode of infection deserves further investigation.

Community-Based Assessment to Inform a Chlamydia Screening Program for Women in a Rural American Indian Community

PubMed Central

Smartlowit-Briggs, Lucy; Pearson, Cynthia; Whitefoot, Patricia; Altamirano, Bianca N.; Womack, Michelle; Bastin, Marie; Dombrowski, Julia C.

2017-01-01

Background Rates of chlamydial infection in American Indian/Alaska Native women in the United States are approximately 4-fold those in non-Hispanic white women. We conducted a community-based survey of self-identified American Indian/Alaska Native women 14 to 25 years of age on a reservation in the Northwestern United States to inform a chlamydia screening strategy. Methods The anonymous survey assessed respondents’ knowledge, perceptions, and preferences related to chlamydia screening, results receipt, and partner notification. We recruited women using respondent-driven sampling, school-based sampling, and direct recruitment through social media and fliers. Participants in schools completed the survey as a paper-based, self-administered survey. Other participants could complete the survey in person, by phone as an interviewer-administered survey, or online. Results We recruited 162 participants, most in schools (n = 83; 51%) or by peer referral (n = 55; 34%). Only 1 woman completed the survey online. Thirty-one respondents (19%) reported a history of an unplanned first pregnancy, and 19 (12%) reported a history of a diagnosed sexually transmitted disease. Most women (n = 98; 63%) recognized the potential impact of Chlamydia trachomatis on fertility. The preferred site for chlamydia screening was the Indian Health Service Clinic (n = 114; 70%), but 79 women (41%) would accept a C. trachomatis test at a nonclinical testing site. Of the 56 women (35%) who would accept home testing, most preferred to get the test kit from a clinic. Conclusions Our results suggest that Indian Health Service efforts to increase chlamydia screening in the clinic and through outreach may be more successful than promotion of home testing in this population. PMID:27196261

Community-Based Assessment to Inform a Chlamydia Screening Program for Women in a Rural American Indian Community.

PubMed

Smartlowit-Briggs, Lucy; Pearson, Cynthia; Whitefoot, Patricia; Altamirano, Bianca N; Womack, Michelle; Bastin, Marie; Dombrowski, Julia C

2016-06-01

Rates of chlamydial infection in American Indian/Alaska Native women in the United States are approximately 4-fold those in non-Hispanic white women. We conducted a community-based survey of self-identified American Indian/Alaska Native women 14 to 25 years of age on a reservation in the Northwestern United States to inform a chlamydia screening strategy. The anonymous survey assessed respondents' knowledge, perceptions, and preferences related to chlamydia screening, results receipt, and partner notification. We recruited women using respondent-driven sampling, school-based sampling, and direct recruitment through social media and fliers. Participants in schools completed the survey as a paper-based, self-administered survey. Other participants could complete the survey in person, by phone as an interviewer-administered survey, or online. We recruited 162 participants, most in schools (n = 83; 51%) or by peer referral (n = 55; 34%). Only 1 woman completed the survey online. Thirty-one respondents (19%) reported a history of an unplanned first pregnancy, and 19 (12%) reported a history of a diagnosed sexually transmitted disease. Most women (n = 98; 63%) recognized the potential impact of Chlamydia trachomatis on fertility. The preferred site for chlamydia screening was the Indian Health Service Clinic (n = 114; 70%), but 79 women (41%) would accept a C. trachomatis test at a nonclinical testing site. Of the 56 women (35%) who would accept home testing, most preferred to get the test kit from a clinic. Our results suggest that Indian Health Service efforts to increase chlamydia screening in the clinic and through outreach may be more successful than promotion of home testing in this population.

Retesting young STI clinic visitors with urogenital Chlamydia trachomatis infection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls.

PubMed

Kampman, Cjg; Koedijk, Fdh; Driessen-Hulshof, Hcm; Hautvast, Jla; van den Broek, Ivf

2016-03-01

The objective of this study is to assess the effect of reminder text messages 6 months after the initial treatment on retest and chlamydia reinfection rates in young heterosexuals compared with a historical control group and to assess factors associated with both outcomes. Heterosexual people (aged 16-23 years), testing positive for urogenital chlamydia, were offered a retest after 6 months. Participants received a text message reminder at 6 months after the initial chlamydia diagnosis. Rates of retest uptake and the result of the retest were analysed using Cox regression. Prevalence ratios (PRs) were calculated to identify factors associated with these outcomes. Furthermore, the retest rate was compared with the retest rate of a historical control group. 30.6% (253/838) of the study group returned within 5-8 months compared with 9.2% (140/1530) in the historical control group. Women and persons who were not notified for a sexually transmitted infection (STI) at inclusion were more likely to return for a retest. 20.4% (56/275) of participants had a chlamydia reinfection upon retesting. Reinfection was higher in participants reporting STI-related symptoms (PR 3.2, 95% CI 1.8 to 5.6) and in participants who were notified for an STI at retest (PR 5.3, 95% CI 2.4 to 11.5). A text message reminder appeared to have a clear, positive impact on the resulting retest rate. These results also indicate that retesting is necessary to identify chlamydia reinfections. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Readiness of pharmacists and consumers for pharmacy-based chlamydia screening in Australia and Switzerland.

PubMed

Arnet, Isabelle; Gudka, Sajni; Salter, Sandra; Hersberger, Kurt E; Clifford, Rhonda

2018-06-01

To assess chlamydia knowledge, willingness to undertake pharmacy-based chlamydia testing, and facilitators and barriers to such testing in consumers and community pharmacists, in Australia (AUS) and Switzerland (CH). Statements of interest were retrieved from literature and assembled into a 12-item online survey (English and German versions). Survey was disseminated through Facebook, pharmacies' publicly available emails and professional websites (March 2015). Consumers and pharmacists (AUS: n cons  = 198, n pharm  = 162; CH: n cons  = 209, n pharm  = 223) were predominantly female (>65%). Mean chlamydia knowledge scores (maximum of 8) were higher in Australia in consumers (AUS: 6.8 ± 1.5 vs CH: 4.2 ± 2.4; p < 0.001) and in pharmacists (AUS: 7.1 ± 1.1 vs CH: 6.1 ± 1.4; p < 0.001). High willingness of consumers to seek testing (AUS: 79.3% vs CH: 83.3%, p = 0.3) and of pharmacists to provide testing (AUS: 95.7% vs CH: 80.3%, p < 0.001) was observed. Greatest barrier for consumers was "Embarrassed about asking for a test" (AUS: 47.8% vs CH: 51.2%, p = 0.7) and "No remuneration" for pharmacists (AUS: 40.7% vs CH: 31.8%, p = 0.07). The majority of consumers and pharmacists support pharmacy-based chlamydia testing. There is now emerging evidence that the policy makers in Australia and Switzerland need to develop pharmacy-based chlamydia testing as core business. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Sexually Transmitted Infection Prevalence in Women with HIV: Is There a Role for Targeted Screening?

PubMed

Dionne-Odom, Jodie; Westfall, Andrew O; Van Der Pol, Barbara; Fry, Karen; Marrazzo, Jeanne

2018-04-10

Rates of sexually transmitted infections (STI) and HIV are highest in the southern U.S., but vary widely by gender, age and risk behavior. Current guidelines recommend annual screening for chlamydia, gonorrhea, syphilis and trichomoniasis in all sexually active women with HIV. Screening rates and test positivity for chlamydia, gonorrhea, syphilis and trichomoniasis were determined per calendar year in this retrospective cohort study of women in care at an urban HIV clinic in Birmingham, Alabama, 2013-2015. Chlamydia, gonorrhea, and trichomonas infection were detected by molecular diagnostics and syphilis by serology. A combined endpoint for CT/GC/syphilis (STI-3) was created based on similar test positivity and predictors. Predictors of STI-3 were identified using logistic regression and generalized estimating equations. Among 745 women with HIV, median age was 46.8 years, 78.8% were Black and 61% were sexually active. In 2015, 83.7% of women were tested for STI. Test positivity was 1.0% for chlamydia, 0.5% for gonorrhea, 1.6% for syphilis, and 13.3% for trichomoniasis. Independent predictors of STI-3 were recent chlamydia or gonorrhea (OR 3.7, 95% CI 1-13.4, p=0.047), public insurance compared to private (OR 3.5, CI 1-11.8, p=0.048) and sex after drugs/alcohol (OR 3.0, CI 1.2-8.0, p=0.025). Women age ≥50 were less likely to have STI (OR 0.3, CI 0.1-1, p=0.040). In a cohort of women engaged in HIV care in the southern United States, detection of chlamydia, gonorrhea and syphilis was infrequent but trichomoniasis was common. Many women screened for STI were low-risk and universal testing strategies warrant evaluation.

Chlamydia pecorum is the endemic intestinal species in cattle while C. gallinacea, C. psittaci and C. pneumoniae associate with sporadic systemic infection.

PubMed

Li, Jing; Guo, Weina; Kaltenboeck, Bernhard; Sachse, Konrad; Yang, Yi; Lu, Guangwu; Zhang, Jilei; Luan, Lu; You, Jinfeng; Huang, Ke; Qiu, Haixiang; Wang, Yaoyao; Li, Min; Yang, Zhangping; Wang, Chengming

2016-09-25

To investigate the prevalence and diversity of bovine Chlamydia spp. in cattle, whole blood from dairy and beef cattle in 11 provinces of China (n=2003) and vaginal swabs, whole blood samples, feces, milk samples from cows in a Yangzhou dairy farm (n=108) were examined using genus- and species-specific PCRs. In cattle from 11 provinces, 2.4% (48/2003) of whole-blood samples were positive for Chlamydia spp., and four Chlamydia species (C. pneumoniae, 41.7%, 20/48; C. psittaci, 22.9%, 11/48; C. gallinacea, 20.8%, 10/48; C. pecorum, 6.3%, 3/48) were identified. In a further study on a Yangzhou dairy farm, 64.8% (70/108) of the cows were positive for Chlamydia spp. C. pecorum was the intestinal endemic species (51/51, 100%), and C. gallinacea was the most frequent species in vaginal swabs (24/27, 88.9%), whole blood buffy coats (5/8, 62.5%) and milk (4/6, 66.7%). C. psittaci and C. pneumoniae were infrequently detected. DNA sequencing of the ompA gene demonstrated the presence of multiple in-herd C. pecorum serovars and single C. gallinacea and C. psittaci serovars which were identical with those of poultry from Yangzhou. This is the first report of C. gallinacea and C. pneumoniae in cattle. Further study is required to address the transmission of Chlamydia spp., in particular of C. gallinacea and C. pneumoniae from their natural hosts, and their potential pathogenic effect on health and production of cattle. Copyright © 2016 Elsevier B.V. All rights reserved.

Self-Reported Impact of Chlamydia Testing on Subsequent Behavior: Results of an Online Survey of Young Adults in England.

PubMed

Hartney, Thomas; Baraitser, Paula; Nardone, Anthony

2015-09-01

The National Chlamydia Screening Programme performs 1.7 million tests annually among young adults in England. The effect of chlamydia screening on subsequent behavior is unknown. This study examined the self-reported impact of testing on young adults' subsequent health care-seeking and sexual behavior. We conducted a cross-sectional Web-based anonymous survey using an online panel to recruit 1521 young adults aged 16 to 24 years and resident in England. Survey questions were developed using the theory of planned behavior. Multivariate log-binomial regression was used to identify the variables associated with an impact on subsequent behavior after testing. Most respondents reported that being tested for chlamydia had a positive effect on their subsequent sexual behavior (68.6%; 422/615) or health care-seeking behavior (80.0%; 492/615). In multivariate analysis, being female and having a high level of engagement at last test were both associated with positive impacts on sexual behavior (72.7% [adjusted prevalence ratio {aPR}, 1.19; 95% confidence interval {CI}, 1.07-1.33] and 82.7% [aPR, 1.55; 95% CI, 1.27-1.89], respectively), and health care-seeking behavior (84.4% [aPR, 1.13; 95% Cl, 1.04-1.24] and 86.3% [aPR, 1.23; 95% CI, 1.07-1.41], respectively). Among respondents with minimum level of engagement, 72.4% (76/105) reported an increase in subsequent health care-seeking behavior. Chlamydia testing had a positive impact on young adults' self-reported health care-seeking and sexual behavior. This suggests that chlamydia screening has a wider effect on young adults' sexual health beyond that of treatment alone.

A new approach to estimating trends in chlamydia incidence.

PubMed

Ali, Hammad; Cameron, Ewan; Drovandi, Christopher C; McCaw, James M; Guy, Rebecca J; Middleton, Melanie; El-Hayek, Carol; Hocking, Jane S; Kaldor, John M; Donovan, Basil; Wilson, David P

2015-11-01

Directly measuring disease incidence in a population is difficult and not feasible to do routinely. We describe the development and application of a new method for estimating at a population level the number of incident genital chlamydia infections, and the corresponding incidence rates, by age and sex using routine surveillance data. A Bayesian statistical approach was developed to calibrate the parameters of a decision-pathway tree against national data on numbers of notifications and tests conducted (2001-2013). Independent beta probability density functions were adopted for priors on the time-independent parameters; the shapes of these beta parameters were chosen to match prior estimates sourced from peer-reviewed literature or expert opinion. To best facilitate the calibration, multivariate Gaussian priors on (the logistic transforms of) the time-dependent parameters were adopted, using the Matérn covariance function to favour small changes over consecutive years and across adjacent age cohorts. The model outcomes were validated by comparing them with other independent empirical epidemiological measures, that is, prevalence and incidence as reported by other studies. Model-based estimates suggest that the total number of people acquiring chlamydia per year in Australia has increased by ∼120% over 12 years. Nationally, an estimated 356 000 people acquired chlamydia in 2013, which is 4.3 times the number of reported diagnoses. This corresponded to a chlamydia annual incidence estimate of 1.54% in 2013, increased from 0.81% in 2001 (∼90% increase). We developed a statistical method which uses routine surveillance (notifications and testing) data to produce estimates of the extent and trends in chlamydia incidence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Immunization against chlamydial genital infection in guinea pigs with UV-inactivated and viable chlamydiae administered by different routes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rank, R.G.; Batteiger, B.E.; Soderberg, L.S.

1990-08-01

Female guinea pigs were immunized with viable or UV light-inactivated chlamydiae, belonging to the species Chlamydia psittaci, by intravenous, subcutaneous, oral, or ocular routes. All animals were then inoculated vaginally with viable chlamydiae to determine the extent of protection against challenge infection induced by the various regimens. The course of genital infection was significantly reduced in intensity in all groups of animals except the unimmunized controls and those animals immunized orally with inactivated antigen. Guinea pigs immunized with viable antigen were more likely to develop resistance to challenge infection and, in general, had a significantly greater degree of protection thanmore » animals immunized with inactivated antigen. No one route seemed superior in producing a protective response. Animals in all groups demonstrating protection developed serum and secretion immunoglobulin G antibody responses to chlamydiae. Lymphocyte proliferative reactions to chlamydial antigen were variable among groups. Immunoblot analysis of serum and secretions indicated a wide range of antibody specificities, but most protected animals produced antibodies to the major outer membrane protein, lipopolysaccharide, and the 61-kilodalton protein. No definitive associations could be made between the increased ability of immunization with viable organisms to produce resistance to challenge infection and a particular immune parameter. These data indicate that viable chlamydiae given by various routes are able to induce a strong immune response which can provide resistance against reinfection in some cases or at least reduce the degree of infection to a greater degree than inactivated antigen. However, complete resistance to genital tract infection may be difficult to obtain and alternate immunizations strategies may have to be developed.« less

The association of metabolic syndrome and Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, and herpes simplex virus type 1: The Persian Gulf Healthy Heart Study

PubMed Central

Nabipour, Iraj; Vahdat, Katayon; Jafari, Seyed Mojtaba; Pazoki, Raha; Sanjdideh, Zahra

2006-01-01

Background The metabolic syndrome together with insulin resistance and their consequences are basic factors in pathogenesis of atherosclerosis. Chronic infections with herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), and Chlamydia pneumoniae are associated with the development of atherosclerosis and coronary heart disease. The infectious aspects of metabolic syndrome have not been investigated. Methods In a cross-sectional, population-based study, we used National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP)-III criteria in 1791 subjects, aged 25 years and over, selected by cluster random sampling in three Iranian ports in the northern Persian Gulf. Sera were analyzed for IgG antibodies to Chlamydia pneumoniae, HSV-1, Helicobacter pylori (H. pylori) and CMV using ELISA. Results In multiple logistic regression analysis, of the infectious agents, CMV [OR = 1.81 (1.05–3.10); p = 0.03], H. pylori [OR = 1.50 (1.12–2.00); p = 0.007] and Chlamydia pneumoniae [OR = 1.69 (1.27–2.25); p < 0.0001] showed a significant association with the metabolic syndrome in men and HSV-1 [OR = 1.95 (1.22–3.11); p = 0.005], H. pylori [OR = 1.45 (1.09–1.94); 0.01] and Chlamydia pneumoniae [OR = 1.65 (1.23–2.21); p = 0.001] in women. Conclusion The metabolic syndrome, which occurs very frequently in the general population, has a significant association with prior infection with Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus and herpes simplex virus type 1. Hypothesis about participation of infection in pathogenesis of metabolic syndrome should be investigated. PMID:17140429

Chlamydial infections in wildlife-conservation threats and/or reservoirs of 'spill-over' infections?

PubMed

Burnard, Delaney; Polkinghorne, Adam

2016-11-30

Members of the order Chlamydiales are biphasic intracellular pathogens known to cause disease in both humans and animals. As we learn more about the genetic diversity of this group of pathogens, evidence is growing that these bacteria infect a broader range of animal hosts than previously thought. Over 400 host species are now documented globally with the majority of these being wild animals. Given the impact of chlamydial infections on humans and domesticated animals, the identification of members of the order Chlamydiales in wildlife raises significant questions over a) their impact on animal health and b) the relationships to those strains also found in humans and domestic animals. In some species such as the iconic marsupial, the koala, the conservation impact is known with chlamydial infections associated with debilitating disease, however, in general, little is known about the pathogenic potential of Chlamydiae infecting most wildlife hosts. Accumulating evidence suggests contact with wild animals is a risk factor for infections in domestic animals and/or humans. Beyond the well-recognised zoonotic pathogen, Chlamydia psittaci, a range of studies have now reported traditional pathogens in the family Chlamydiaceae such as Chlamydia pecorum, Chlamydia suis, Chlamydia pneumoniae and Chlamydia abortus in wild animals. The spectre of cross-host transmission 'spill-over' and 'spill-back' in the epidemiology of infections is of potential concern, however, comprehensive epidemiological studies are lacking for most of these. Accurate evaluation of the significance of chlamydial infections in wildlife is otherwise hampered by i) the cross-sectional nature of most impact studies, ii) a lack of standardised diagnostic approaches, iii) limited study sizes, and iv) biases associated with opportunistic sampling. Copyright © 2016 Elsevier B.V. All rights reserved.

Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

PubMed

Graham, Simon; Smith, Lucy Watchirs; Fairley, Christopher K; Hocking, Jane

2016-04-01

Higher notification rates of sexually transmissible infections (STIs) are reported among Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal people in Australia. The aim of this study is to estimate the pooled prevalence of chlamydia, gonorrhoea, syphilis and trichomonas among Aboriginal people in Australia by sex, age-group, setting (clinic vs population/community-based) and population group [adults, pregnant females, young people (12-29 years) and prisoners]. The databases Medline, PubMed and Web of Science were searched in May 2015. A meta-analysis was conducted to estimate the pooled prevalence of the four STIs in Aboriginal people and if possible, by gender, age-group, setting and population group. A total of 46 studies were included. The pooled prevalence was 11.2% (95%CI: 9.4-13.0%) for chlamydia (36 studies), 12.5% (95%CI: 10.5-14.6%) for gonorrhoea (28 studies), 16.8% (95%CI: 11.0-22.6%) for syphilis (13 studies) and 22.6% (95%CI: 18.5-26.7%) for trichomonas (11 studies); however, there was significant heterogeneity between studies (I(2) <97.5%, P<0.01). In the subgroup analysis, a higher pooled prevalence occurred in females than males for chlamydia (12.7% vs 7.7%) and gonorrhoea (10.7% vs 8.1%). The prevalence of chlamydia was 12.4% in clinic-based compared with 4.3% in population-based studies. The highest pooled prevalence by population group was among pregnant females (16.8%) and young people (16.2%) for chlamydia, pregnant females (25.2%) for trichomonas; and young people for gonorrhoea (11.9%). This review highlights the need to decrease the prevalence of STIs among Aboriginal people through community-based programs that target asymptomatic young people.

Geographic epidemiology of gonorrhoea and chlamydia on a large military installation: application of a GIS system

PubMed Central

Zenilman, J; Glass, G; Shields, T; Jenkins, P; Gaydos, J; McKee, K

2002-01-01

Objectives: The geographic epidemiology of infectious diseases can help in identifying point source outbreaks, elucidating dispersion patterns, and giving direction to control strategies. We sought to establish a geographic information system (GIS) infectious disease surveillance system at a large US military post (Fort Bragg, North Carolina) using STDs as the initial outcome for the model. Methods: Addresses of incident cases were plotted onto digitised base maps of Fort Bragg (for on-post addresses) and surrounding Cumberland County, NC (for off-post addresses) using MAPINFO Version 5. We defined 26 geographic sectors on the installation. Active duty soldiers attending the post preventive medicine clinic were enrolled between July 1998 and June 1999. Results: Gonorrhoea (GC) was diagnosed in 210/2854 (7.4%) and chlamydia (CT) in 445/2860 (15.6%). African-American male soldiers were at higher risk for GC (OR = 4.6 (95% CL 3.0 to 7.2)) and chlamydia (OR = 2.0 (1.4 to 2.7)). For women, there were no ethnic differences in gonorrhoea prevalence, but chlamydia was higher in African-Americans (OR = 2.0 (1.4–2.7)). Rank and housing type were associated with gonorrhoea and chlamydia in men, but were not significant factors in women. For gonorrhoea, two geographic sectors had prevalences between 14.0%–16.5%, three between 10.3%–13.9%, three between 7.1%–10.2%, and five between 3.0%–7.1%.. The geographic distribution demonstrated a core-like pattern where the highest sectors were contiguous and were sectors containing barracks housing lower enlisted grade personnel. In contrast, chlamydia prevalence was narrowly distributed. Conclusion: GIS based disease surveillance was easily and rapidly implemented in this setting and should be useful in developing preventive interventions. PMID:11872858

The contribution of Chlamydia-specific CD8⁺ T cells to upper genital tract pathology.

PubMed

Vlcek, Kelly R; Li, Weidang; Manam, Srikanth; Zanotti, Brian; Nicholson, Bruce J; Ramsey, Kyle H; Murthy, Ashlesh K

2016-02-01

Genital chlamydial infections lead to severe upper reproductive tract pathology in a subset of untreated women. We demonstrated previously that tumor necrosis factor (TNF)-α-producing CD8(+) T cells contribute significantly to chlamydial upper genital tract pathology in female mice. In addition, we observed that minimal chlamydial oviduct pathology develops in OT-1 transgenic (OT-1) mice, wherein the CD8(+) T-cell repertoire is restricted to recognition of the ovalbumin peptide Ova(257-264), suggesting that non-Chlamydia-specific CD8(+) T cells may not be responsible for chlamydial pathogenesis. In the current study, we evaluated whether antigen-specific CD8(+) T cells mediate chlamydial pathology. Groups of wild-type (WT) C57BL/6J, OT-1 mice, and OT-1 mice replete with WT CD8(+) T cells (1 × 10(6) cells per mouse intravenously) were infected intravaginally with C. muridarum (5 × 10(4) IFU/mouse). Serum total anti-Chlamydia antibody and total splenic anti-Chlamydia interferon (IFN)-γ and TNF-α responses were comparable among the three groups of animals. However, Chlamydia-specific IFN-γ and TNF-α production from purified splenic CD8(+) T cells of OT-1 mice was minimal, whereas responses in OT-1 mice replete with WT CD8(+) T cells were comparable to those in WT animals. Vaginal chlamydial clearance was comparable between the three groups of mice. Importantly, the incidence and severity of oviduct and uterine horn pathology was significantly reduced in OT-1 mice but reverted to WT levels in OT-1 mice replete with WT CD8(+) T cells. Collectively, these results demonstrate that Chlamydia-specific CD8(+) T cells contribute significantly to upper genital tract pathology.

Characterization and Evolution of Cell Division and Cell Wall Synthesis Genes in the Bacterial Phyla Verrucomicrobia, Lentisphaerae, Chlamydiae, and Planctomycetes and Phylogenetic Comparison with rRNA Genes▿ †

PubMed Central

Pilhofer, Martin; Rappl, Kristina; Eckl, Christina; Bauer, Andreas Peter; Ludwig, Wolfgang; Schleifer, Karl-Heinz; Petroni, Giulio

2008-01-01

In the past, studies on the relationships of the bacterial phyla Planctomycetes, Chlamydiae, Lentisphaerae, and Verrucomicrobia using different phylogenetic markers have been controversial. Investigations based on 16S rRNA sequence analyses suggested a relationship of the four phyla, showing the branching order Planctomycetes, Chlamydiae, Verrucomicrobia/Lentisphaerae. Phylogenetic analyses of 23S rRNA genes in this study also support a monophyletic grouping and their branching order—this grouping is significant for understanding cell division, since the major bacterial cell division protein FtsZ is absent from members of two of the phyla Chlamydiae and Planctomycetes. In Verrucomicrobia, knowledge about cell division is mainly restricted to the recent report of ftsZ in the closely related genera Prosthecobacter and Verrucomicrobium. In this study, genes of the conserved division and cell wall (dcw) cluster (ddl, ftsQ, ftsA, and ftsZ) were characterized in all verrucomicrobial subdivisions (1 to 4) with cultivable representatives (1 to 4). Sequence analyses and transcriptional analyses in Verrucomicrobia and genome data analyses in Lentisphaerae suggested that cell division is based on FtsZ in all verrucomicrobial subdivisions and possibly also in the sister phylum Lentisphaerae. Comprehensive sequence analyses of available genome data for representatives of Verrucomicrobia, Lentisphaerae, Chlamydiae, and Planctomycetes strongly indicate that their last common ancestor possessed a conserved, ancestral type of dcw gene cluster and an FtsZ-based cell division mechanism. This implies that Planctomycetes and Chlamydiae may have shifted independently to a non-FtsZ-based cell division mechanism after their separate branchings from their last common ancestor with Verrucomicrobia. PMID:18310338

Chlamydia trachomatis related knowledge and practices in medical practioners--a survey.

PubMed

Hashmi, Shahkamal; Ali, Syed Imtiaz; Tanwir, Farzeen; Shamsi, Taiba Yousuf; Ahmed, Farrukh Rafiq; Rai, Kelash

2014-01-01

Chlamydia trachomatis is a frequently encountered condition by general physicians, urologists and infectious diseases specialists. It can affect both genders and causes significant morbidity if not treated properly and promptly. In addition, it can cause ophthalmia neonatorum, which manifests as neonatal conjunctivitis in the newborns. The data was collected from fourteen tertiary care hospitals in two provinces of Pakistan during the time period of four months (September-December 2013). Inclusion criteria included all medical practitioners working at those hospitals and there were no limitations of age and gender to participate. The participants were approached through email which included a self administered questionnaire. Written consent was obtained from the participants and the study was approved by the ethical committee of all selected hospital. Overall 130 participants participated with a response rate of 65%. Females were 52.3% and males were 47.7%. In the study 17.7% of male and 29.4% of female participants proclaimed that they referred a patient to an infectious disease specialist in case the diagnosis of Chlamydia was dubious. 72.5% of the male and 55.8% of the female medical practitioners indicated that they yield detailed sexual history from the patients with Chlamydia. Regarding inquiring about the drugs history from the patient at risk of STDs, 22.6% male and 35.3% of female participants informed that they took a detailed drug history. Only 1.5% of the female medical practitioners notified Chlamydia to the partner of diseased patient themselves (provider referral). 24% male and 17.6% female participants had an understanding regarding the definite test of diagnosis for sexually transmitted Chlamydia. More sexual health skills development is required in medical practitioners working in Pakistan. The major deficient areas are sexual and drug history taking, management of sexually transmitted diseases and partner notification.

Sample size considerations using mathematical models: an example with Chlamydia trachomatis infection and its sequelae pelvic inflammatory disease.

PubMed

Herzog, Sereina A; Low, Nicola; Berghold, Andrea

2015-06-19

The success of an intervention to prevent the complications of an infection is influenced by the natural history of the infection. Assumptions about the temporal relationship between infection and the development of sequelae can affect the predicted effect size of an intervention and the sample size calculation. This study investigates how a mathematical model can be used to inform sample size calculations for a randomised controlled trial (RCT) using the example of Chlamydia trachomatis infection and pelvic inflammatory disease (PID). We used a compartmental model to imitate the structure of a published RCT. We considered three different processes for the timing of PID development, in relation to the initial C. trachomatis infection: immediate, constant throughout, or at the end of the infectious period. For each process we assumed that, of all women infected, the same fraction would develop PID in the absence of an intervention. We examined two sets of assumptions used to calculate the sample size in a published RCT that investigated the effect of chlamydia screening on PID incidence. We also investigated the influence of the natural history parameters of chlamydia on the required sample size. The assumed event rates and effect sizes used for the sample size calculation implicitly determined the temporal relationship between chlamydia infection and PID in the model. Even small changes in the assumed PID incidence and relative risk (RR) led to considerable differences in the hypothesised mechanism of PID development. The RR and the sample size needed per group also depend on the natural history parameters of chlamydia. Mathematical modelling helps to understand the temporal relationship between an infection and its sequelae and can show how uncertainties about natural history parameters affect sample size calculations when planning a RCT.

Chlamydia screening is not cost-effective at low participation rates: evidence from a repeated register-based implementation study in The Netherlands.

PubMed

de Wit, G Ardine; Over, Eelco A B; Schmid, Boris V; van Bergen, Jan E A M; van den Broek, Ingrid V F; van der Sande, Marianne A B; Welte, Robert; Op de Coul, Eline L M; Kretzschmar, Mirjam E

2015-09-01

In three pilot regions of The Netherlands, all 16-29 year olds were invited to participate in three annual rounds of Chlamydia screening. The aim of the present study is to evaluate the cost-effectiveness of repeated Chlamydia screening, based on empirical data. A mathematical model was employed to estimate the influence of repeated screening on prevalence and incidence of Chlamydial infection. A model simulating the natural history of Chlamydia was combined with cost and utility data to estimate the number of major outcomes and quality-adjusted life-years (QALYs) associated with Chlamydia. Six screening scenarios (16-29 years annually; 16-24 years annually; women only; biennial screening; biennial screening women only; screening every five years) were compared with no screening in two sexual networks, representing both lower ('national network') and higher ('urban network') baseline prevalence. Incremental cost-effectiveness ratios (ICERs) for the different screening scenarios were estimated. Uncertainty and sensitivity analyses were performed. In all scenarios and networks, cost per major outcome averted are above €5000. Cost per QALY are at least €50,000. The default scenario as piloted in the Netherlands was least cost-effective, with ICERs of €232,000 in the national and €145,000 in the urban sexual network. Results were robust in sensitivity analyses. It is unlikely that repeated rounds of Chlamydia screening will be cost-effective. Only at high levels of willingness to pay for a QALY (>€50,000) screening may be more cost-effective than no screening. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Inclusion keratoconjunctivitis ('pink eye') in sheep. A proposal for a new name for chlamydial keratoconjunctivitis in sheep and comment on recent clinical trials.

PubMed

Bogaard, A E

1984-09-01

The cytoplasmatic inclusion bodies, which, in 1931, Coles discovered in the corneal cells of sheep suffering from contagious keratoconjunctivitis are now considered to be the reticulate bodies of a chlamydia, Colesiota conjunctivae (synonym: Chlamydia psittaci ovis). According to the postulates of Koch Colesiota conjunctivae is a primary cause of contagious keratoconjunctivitis in sheep, but the clinical picture is complex and is a result of the interaction between the infecting chlamydiae, host resistance factors, and secondary infections caused by opportunistic bacterial ocular pathogens. The clinical syndrome might also be caused by other micro-organisms, such as Mycoplasma conjunctivae or environmental factors, such as dust. However, in these cases, cytoplasmatic inclusion bodies cannot be found in the corneal cells of diseased eyes. To differentiate chlamydial keratoconjunctivitis from keratoconjunctivitis due to other causes, it is proposed to include in the name the laboratory findings typical for this disease: Sheep Inclusion Keratoconjunctivitis. Chlamydia are Gram-negative bacteria, which are obligate intracellular parasites. Prolonged treatment seems to be required to eradicate chlamydiae from a host and antibiotics must reach intracellular levels that are higher than their minimum inhibitory concentration for chlamydiae. Tetracyclines are the drugs of choice. This means that for a microbiological cure, diseased sheep must be injected several times a day for a week or more. Because the disease is usually self-limiting and economic losses are considered low, this seems unnecessary and control of the disease by local treatment of secondary infections seems sufficient. However, this will not prevent spreading of the disease in a herd and relapses may occur.

In Contrast to Chlamydia trachomatis, Waddlia chondrophila Grows in Human Cells without Inhibiting Apoptosis, Fragmenting the Golgi Apparatus, or Diverting Post-Golgi Sphingomyelin Transport

PubMed Central

Dille, Stephanie; Kleinschnitz, Eva-Maria; Kontchou, Collins Waguia; Nölke, Thilo

2015-01-01

The Chlamydiales are an order of obligate intracellular bacteria sharing a developmental cycle inside a cytosolic vacuole, with very diverse natural hosts, from amoebae to mammals. The clinically most important species is Chlamydia trachomatis. Many uncertainties remain as to how Chlamydia organizes its intracellular development and replication. The discovery of new Chlamydiales species from other families permits the comparative analysis of cell-biological events and may indicate events that are common to all or peculiar to some species and more or less tightly linked to “chlamydial” development. We used this approach in the infection of human cells with Waddlia chondrophila, a species from the family Waddliaceae whose natural host is uncertain. Compared to C. trachomatis, W. chondrophila had slightly different growth characteristics, including faster cytotoxicity. The embedding in cytoskeletal structures was not as pronounced as for the C. trachomatis inclusion. C. trachomatis infection generates proteolytic activity by the protease Chlamydia protease-like activity factor (CPAF), which degrades host substrates upon extraction; these substrates were not cleaved in the case of W. chondrophila. Unlike Chlamydia, W. chondrophila did not protect against staurosporine-induced apoptosis. C. trachomatis infection causes Golgi apparatus fragmentation and redirects post-Golgi sphingomyelin transport to the inclusion; both were absent from W. chondrophila-infected cells. When host cells were infected with both species, growth of both species was reduced. This study highlights differences between bacterial species that both depend on obligate intracellular replication inside an inclusion. Some features seem principally dispensable for intracellular development of Chlamydiales in vitro but may be linked to host adaptation of Chlamydia and the higher virulence of C. trachomatis. PMID:26056386

Medical Surveillance Monthly Report (MSMR). Volume 16, Number 5, May 2009

DTIC Science & Technology

2009-05-01

location Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis ‡ Urethritis§ Cold Heat 2008 2009 2008...borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis ‡ Urethritis§ Cold Heat 2008 2009 2008 2009 2008 2009 2008

Medical Surveillance Monthly Report. Volume 16, Number 8, August 2009

DTIC Science & Technology

2009-08-01

through 31 July 2008 and 31 July 2009 Reporting location Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea ...53 39 19 5 13 4 56 20 22 18 Reporting location Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis

The Proteome of the Isolated Chlamydia trachomatis Containing Vacuole Reveals a Complex Trafficking Platform Enriched for Retromer Components

PubMed Central

Fischer, Martina; Jehmlich, Nico; Rose, Laura; Koch, Sophia; Laue, Michael; Renard, Bernhard Y.; Schmidt, Frank; Heuer, Dagmar

2015-01-01

Chlamydia trachomatis is an important human pathogen that replicates inside the infected host cell in a unique vacuole, the inclusion. The formation of this intracellular bacterial niche is essential for productive Chlamydia infections. Despite its importance for Chlamydia biology, a holistic view on the protein composition of the inclusion, including its membrane, is currently missing. Here we describe the host cell-derived proteome of isolated C. trachomatis inclusions by quantitative proteomics. Computational analysis indicated that the inclusion is a complex intracellular trafficking platform that interacts with host cells’ antero- and retrograde trafficking pathways. Furthermore, the inclusion is highly enriched for sorting nexins of the SNX-BAR retromer, a complex essential for retrograde trafficking. Functional studies showed that in particular, SNX5 controls the C. trachomatis infection and that retrograde trafficking is essential for infectious progeny formation. In summary, these findings suggest that C. trachomatis hijacks retrograde pathways for effective infection. PMID:26042774

Primary health care providers surveyed commonly misinterpret 'first void urine' for chlamydia screening.

PubMed

Lusk, M Josephine; Uddin, Ruby; Ferson, Mark; Rawlinson, William; Konecny, Pam

2009-03-01

An open question survey of general practitioners (GP) and hospital emergency department (ED) doctors revealed that the term 'FVU' (first void urine) used for urine chlamydia testing, is ambiguous, potentially leading to incorrect urine sample collection and barriers to effective screening. The results of this survey indicate that only 4.3% (95% confidence interval [CI] 0.5-14.5%) of GP and 6.9% (95% CI 0.9-22.8%) of ED doctors respectively, correctly interpreted the meaning of FVU. The majority of clinicians surveyed misunderstood 'FVU' to require the first urine void of the day, accounting for 68.1% (95% CI 52.9-80.9%) of GP responses and 37.9% (95% CI 20.7-57.7%) of ED doctors responses. This highlights the need for clarification and standardisation of terminology used in urine chlamydia screening for health care providers, in order to optimise strategies for diagnosis and control of the ongoing chlamydia epidemic.

Diagnosis and treatment of chlamydia and gonorrhoea in general practice in England 2000–2011: a population-based study using data from the UK Clinical Practice Research Datalink

PubMed Central

Wetten, Sally; Mohammed, Hamish; Yung, Mandy; Mercer, Catherine H; Cassell, Jackie A; Hughes, Gwenda

2015-01-01

Objectives To determine the relative contribution of general practices (GPs) to the diagnosis of chlamydia and gonorrhoea in England and whether treatment complied with national guidelines. Design Analysis of longitudinal electronic health records in the Clinical Practice Research Datalink (CPRD) and national sexually transmitted infection (STI) surveillance databases, England, 2000–2011. Setting GPs, and community and specialist STI services. Participants Patients diagnosed with chlamydia (n=1 386 169) and gonorrhoea (n=232 720) at CPRD GPs, and community and specialist STI Services from 2000–2011. Main outcome measures Numbers and rates of chlamydia and gonorrhoea diagnoses; percentages of patients diagnosed by GPs relative to other services; percentage of GP patients treated and antimicrobials used; percentage of GP patients referred. Results The diagnosis rate (95% CI) per 100 000 population of chlamydia in GP increased from 22.8 (22.4–23.2) in 2000 to 29.3 (28.8–29.7) in 2011 (p<0.001), while the proportion treated increased from 59.5% to 78.4% (p=0.001). Over 90% were prescribed a recommended antimicrobial. Over the same period, the diagnosis rate (95% CI) per 100 000 population of gonorrhoea in GP ranged between 3.2 (3–3.3) and 2.4 (2.2–2.5; p=0.607), and the proportion treated ranged between 32.7% and 53.6% (p=0.262). Despite being discontinued as a recommended therapy for gonorrhoea in 2005, ciprofloxacin accounted for 42% of prescriptions in 2007 and 20% in 2011. Over the study period, GPs diagnosed between 9% and 16% of chlamydia cases and between 6% and 9% of gonorrhoea cases in England. Conclusions GP makes an important contribution to the diagnosis and treatment of bacterial STIs in England. While most patients diagnosed with chlamydia were managed appropriately, many of those treated for gonorrhoea received antimicrobials no longer recommended for use. Given the global threat of antimicrobial resistance, GPs should remain abreast of national treatment guidelines and alert to treatment failure in their patients. PMID:26022269

Chlamydia trachomatis-host cell interactions: role of the chlamydial major outer membrane protein as an adhesin.

PubMed Central

Su, H; Watkins, N G; Zhang, Y X; Caldwell, H D

1990-01-01

The major outer membrane protein (MOMP) of Chlamydia trachomatis is characterized by four symmetrically spaced variable domains (VDs I to IV) whose sequences vary among serotypes. The surface-exposed portions of these VDs contain contiguous sequences that are both serotyping determinants and in vivo target sites for neutralizing antibodies. Previous studies using surface proteolysis of C. trachomatis B implicated VDs II and IV of the MOMP of this serotype in the attachment of chlamydiae to host cells. In this study, we used monoclonal antibodies (MAbs) specific to antigenic determinants located in VDs II and IV of the MOMP of serotype B to further investigate the role of the MOMP in the attachment of chlamydiae to host cells. MABs specific to serotype- and subspecies-specific epitopes located in exposed VDs II and IV, respectively, neutralized chlamydial infectivity for hamster kidney cells by blocking chlamydial attachment. We radioiodinated these MAbs and used them to determine the number and topology of the surface-exposed VDs II and IV epitopes on chlamydial elementary bodies. VDs II and IV each comprised approximately 2.86 x 10(4) negatively charged sites and were in proximity on the chlamydial cell surface. These studies suggest that the MAbs blocked chlamydial attachment by inhibiting electrostatic interactions with host cells. We examined the effects of thermal inactivation on both chlamydial attachment and conformation of the MOMP. Heat-inactivated chlamydiae failed to attach to host cells and exhibited a conformational change in an inaccessible invariant hydrophobic nonapeptide sequence located within VD IV of the MOMPs of C. trachomatis serotypes. These findings suggest that in addition to electrostatic interactions, a common hydrophobic component of the MOMP also contributes to the binding of chlamydiae to host cells. Thus, we propose that the MOMP functions as a chlamydial adhesin by promoting nonspecific (electrostatic and hydrophobic) interactions with host cells. Surface-accessible negatively charged VDs appear to be important in electrostatic binding, while the invariant region of VD IV may provide a subsurface hydrophobic depression which further promotes binding of chlamydiae to host cells through hydrophobic interactions. Images PMID:2318528

The prevalence of Chlamydia trachomatis infection in Australia: a systematic review and meta-analysis

PubMed Central

2012-01-01

Background Chlamydia trachomatis is a common sexually transmitted infection in Australia. This report aims to measure the burden of chlamydia infection by systematically reviewing reports on prevalence in Australian populations. Methods Electronic databases and conference websites were searched from 1997–2011 using the terms ‘Chlamydia trachomatis’ OR ‘chlamydia’ AND ‘prevalence’ OR ‘epidemiology’ AND ‘Australia’. Reference lists were checked and researchers contacted for additional literature. Studies were categorised by setting and participants, and meta-analysis conducted to determine pooled prevalence estimates for each category. Results Seventy-six studies met the inclusion criteria for the review. There was a high level of heterogeneity between studies; however, there was a trend towards higher chlamydia prevalence in younger populations, Indigenous Australians, and those attending sexual health centres. In community or general practice settings, pooled prevalence for women <25 years in studies conducted post-2005 was 5.0% (95% CI: 3.1, 6.9; five studies), and for men <30 years over the entire review period was 3.9% (95% CI: 2.7, 5.1; six studies). For young Australians aged <25 years attending sexual health, family planning or youth clinics, estimated prevalence was 6.2% (95% CI: 5.1, 7.4; 10 studies) for women and 10.2% (95% CI: 9.5, 10.9; five studies) for men. Other key findings include pooled prevalence estimates of 22.1% (95% CI: 19.0, 25.3; three studies) for Indigenous women <25 years, 14.6% (95% CI: 11.5, 17.8; three studies) for Indigenous men <25 years, and 5.6% (95% CI: 4.8, 6.3; 11 studies) for rectal infection in men who have sex with men. Several studies failed to report basic demographic details such as sex and age, and were therefore excluded from the analysis. Conclusions Chlamydia trachomatis infections are a significant health burden in Australia; however, accurate estimation of chlamydia prevalence in Australian sub-populations is limited by heterogeneity within surveyed populations, and variations in sampling methodologies and data reporting. There is a need for more large, population-based studies and prospective cohort studies to compliment mandatory notification data. PMID:22583480

Relative resistance to erythromycin in Chlamydia trachomatis.

PubMed Central

Mourad, A; Sweet, R L; Sugg, N; Schachter, J

1980-01-01

Recent Chlamydia trachomatis isolates were tested in a tissue culture system for susceptibility to tetracycline, erythromycin, rosaramicin, rifampin, and clindamycin. Rifampin was the most active drug (minimal inhibitory concentration, less than or equal to 0.02 microgram/ml). Tetracycline and rasaramicin were highly active, with a concentration of less than or equal to 0.25 microgram/ml being chlamydicidal. Clindamycin was least active on a weight basis, requiring up to 16 microgram/ml to prevent the passage of chlamydiae into a drug-free tissue culture system. Relative resistance to erythromycin was detected; two isolates were capable of limited replication in 1 microgram/ml. PMID:7447426

Outbreak of Pneumonia in the Setting of Fatal Pneumococcal Meningitis among US Army Trainees: Potential Role of Chlamydia pneumoniae Infection

DTIC Science & Technology

2011-06-02

Chlamydia pneumoniae, Mycoplasma pneumoniae, Streptococcus pneumoniae, Bordetella pertussis, and Legionella pneumophila[10] in addition to undergoing...and Metzgar D. A multiplex PCR for detection of Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, and Bordetella pertussis in

In Vitro Osteoblast Model for Bone Wound Infections and Antimicrobial Therapy (Addendum)

DTIC Science & Technology

2012-01-01

recent study indicated that infection of Chlamydia pneumonia induced that maximum expression of proinflammatory IL8 (among other cytokines) at 72 hours...2011. Induction of proinflammatory cytokines in human osteoblastic cells by Chlamydia pneumoniae. Cytokine. Nov;56(2):450-7. APPENDIXES: None

Factors associated with Chlamydia trachomatis testing in a high school based screening and previously in clinical practice: a cross-sectional study in Norway

PubMed Central

2013-01-01

Background High school based chlamydia screening has been shown to increase uptake and detect hidden infections among sexually active adolescents. Our study aimed to: i) examine the proportions of 15–20 year-olds tested in a high school based screening and previously in clinical practice, ii) determine chlamydia prevalence according to testing pattern, and iii) examine factors associated with testing in the two settings. Methods A population based cross-sectional study was conducted in 5 high schools in Norway in 2009, using web-questionnaires and Chlamydia trachomatis PCR in first-void urine (800 girls/818 boys, mean age 17.2 years). Only sexually active participants at risk for chlamydia infections were included in the analyses. Crude and multivariable logistic regression models were applied with ‘clinic based testing’ and ‘school based screening’ as outcome variables. Results 56% of girls and 21% of boys reported previous clinic based testing. In the school based screening, 93% were tested with no gender difference. 42% of girls and 74% of boys were tested for the first time at school (‘school-only test’). Both girls with clinic based testing and girls with school-only test had high chlamydia prevalence (7.3% vs 7.2%). Boys with clinic based testing had twice the prevalence of those with school-only test (6.2% vs 3.0%, p = 0.01). Half of infections were detected in participants with school-only test. One-fifth were repeat infections. In multivariable analysis of girls and boys combined, female gender, older age, early sexual debut, no condom use at first and last intercourse, steady relationship, and higher number of lifetime partners increased the odds of clinic based testing. The odds of school based screening increased with male gender, academic affiliation, later sexual debut, condom use at first intercourse, and current urogenital symptoms in multivariable analysis. Conclusions More than half the girls had been tested prior to the school based screening and had high prevalence independent of previous clinic based testing. School screening was mostly associated with factors unknown to increase chlamydia infection risk, while clinic based testing was associated with traditional risk factors. The unusually high and equal participation between genders and the detection of a large chlamydia reservoir confirms the value of school based screening suggesting this approach to be further explored in Norway. PMID:23915415

High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria.

PubMed

Keshinro, Babajide; Crowell, Trevor A; Nowak, Rebecca G; Adebajo, Sylvia; Peel, Sheila; Gaydos, Charlotte A; Rodriguez-Hart, Cristina; Baral, Stefan D; Walsh, Melissa J; Njoku, Ogbonnaya S; Odeyemi, Sunday; Ngo-Ndomb, Teclaire; Blattner, William A; Robb, Merlin L; Charurat, Manhattan E; Ake, Julie

2016-01-01

Sexually transmitted infection (STI) and HIV prevalence have been reported to be higher amongst men who have sex with men (MSM) in Nigeria than in the general population. The objective of this study was to characterize the prevalence of HIV, chlamydia and gonorrhoea in this population using laboratory-based universal testing. TRUST/RV368 represents a cohort of MSM and transgender women (TGW) recruited at trusted community centres in Abuja and Lagos, Nigeria, using respondent-driven sampling (RDS). Participants undergo a structured comprehensive assessment of HIV-related risks and screening for anorectal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae , and HIV. Crude and RDS-weighted prevalence estimates with 95% confidence intervals (CIs) were calculated. Log-binomial regression was used to explore factors associated with prevalent HIV infection and STIs. From March 2013 to January 2016, 862 MSM and TGW (316 in Lagos and 546 in Abuja) underwent screening for HIV, chlamydia and gonorrhoea at study enrolment. Participants' median age was 24 years [interquartile range (IQR) 21-27]. One-third (34.2%) were identified as gay/homosexual and 65.2% as bisexual. The overall prevalence of HIV was 54.9%. After adjusting for the RDS recruitment method, HIV prevalence in Abuja was 43.5% (95% CI 37.3-49.6%) and in Lagos was 65.6% (95% CI 54.7-76.5%). The RDS-weighted prevalence of chlamydia was 17.0% (95% CI 11.8-22.3%) in Abuja and 18.3% (95% CI 11.1-25.4%) in Lagos. Chlamydia infection was detected only at the anorectal site in 70.2% of cases. The RDS-weighted prevalence of gonorrhoea was 19.1% (95% CI 14.6-23.5%) in Abuja and 25.8% (95% CI 17.1-34.6%) in Lagos. Overall, 84.2% of gonorrhoea cases presented with anorectal infection only. Over 95% of STI cases were asymptomatic. In a multivariable model, increased risk for chlamydia/gonorrhoea was associated with younger age, gay/homosexual sexual orientation and higher number of partners for receptive anal sex. HIV infection was associated with older age, female gender identity and number of partners for receptive anal sex. There is a high burden of infection with HIV and asymptomatic chlamydia and gonorrhoea among MSM and TGW in Nigeria. Most cases would have been missed without anorectal screening. Interventions are needed to target this population for appropriate STI screening and management beginning at a young age.

Uptake and Population-Level Impact of Expedited Partner Therapy (EPT) on Chlamydia trachomatis and Neisseria gonorrhoeae: The Washington State Community-Level Randomized Trial of EPT

PubMed Central

Golden, Matthew R.; Kerani, Roxanne P.; Stenger, Mark; Hughes, James P.; Aubin, Mark; Malinski, Cheryl; Holmes, King K.

2015-01-01

Background Expedited partner therapy (EPT), the practice of treating the sex partners of persons with sexually transmitted infections without their medical evaluation, increases partner treatment and decreases gonorrhea and chlamydia reinfection rates. We conducted a stepped-wedge, community-level randomized trial to determine whether a public health intervention promoting EPT could increase its use and decrease chlamydia test positivity and gonorrhea incidence in women. Methods and Findings The trial randomly assigned local health jurisdictions (LHJs) in Washington State, US, into four study waves. Waves instituted the intervention in randomly assigned order at intervals of 6–8 mo. Of the state’s 25 LHJs, 24 were eligible and 23 participated. Heterosexual individuals with gonorrhea or chlamydial infection were eligible for the intervention. The study made free patient-delivered partner therapy (PDPT) available to clinicians, and provided public health partner services based on clinician referral. The main study outcomes were chlamydia test positivity among women ages 14–25 y in 219 sentinel clinics, and incidence of reported gonorrhea in women, both measured at the community level. Receipt of PDPT from clinicians was evaluated among randomly selected patients. 23 and 22 LHJs provided data on gonorrhea and chlamydia outcomes, respectively. The intervention increased the percentage of persons receiving PDPT from clinicians (from 18% to 34%, p < 0.001) and the percentage receiving partner services (from 25% to 45%, p < 0.001). Chlamydia test positivity and gonorrhea incidence in women decreased over the study period, from 8.2% to 6.5% and from 59.6 to 26.4 per 100,000, respectively. After adjusting for temporal trends, the intervention was associated with an approximately 10% reduction in both chlamydia positivity and gonorrhea incidence, though the confidence bounds on these outcomes both crossed one (chlamydia positivity prevalence ratio = 0.89, 95% CI 0.77–1.04, p = 0.15; gonorrhea incidence rate ratio = 0.91, 95% CI .71–1.16, p = 0.45). Study findings were potentially limited by inadequate statistical power, by the institution of some aspects of the study intervention outside of the research randomization sequence, and by the fact that LHJs did not constitute truly isolated sexual networks. Conclusions A public health intervention promoting the use of free PDPT substantially increased its use and may have resulted in decreased chlamydial and gonococcal infections at the population level. Trial Registration ClinicalTrials.gov NCT01665690 PMID:25590331

[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].

PubMed

Hatori, Toru; Nakamura, Tamiko; Tsukui, Satoshi

2013-01-01

Serum levels of antibody against Chlamydia trachomatis are used routinely to diagnose chlamydial infection among patients undergoing counseling and testing for sexually transmitted disease at public health centers in Japan, whereas tests for pathogen detection are conducted at most clinics. The objective of the present study was to evaluate the usefulness of a test for detecting C. trachomatis and to compare it with that of screening for serum chlamydia antibodies at a public health center. Serum chlamydia antibody titers were estimated using an ELISA, while C. trachomatis was detected in the urine using the nucleic acid amplification assay that included strand displacement amplification (SDA). We compared the results of 120 patients (64 men and 56 women), because the sensitivity of the method using urine samples from women has been reported to be as high as that using cervical samples. The serum antibody test results were considered to be positive when either one or both of the IgA and IgG antibodies were positive. The overall prevalence of positive results for the antibody test was 24.2% (14.1% for men and 35.7% for women), and that for the SDA method was 7.5% (3.1% for men and 12.5% for women). The concordance rate of the 2 tests was 81.7%, with a kappa statistic of 0.35 (95% CI, 0.10-0.59). Of the 9 subjects who were positive for C. trachomatis using the SDA assay, 1 had serum chlamydia IgA antibodies, 6 had IgG antibodies, 1 had both the antibodies, and 1 had no antibodies. On the other hand, of the 111 subjects who were negative for C. trachomatis, only 8 had chlamydia IgA antibodies, 5 had IgG antibodies, and 8 had both the antibodies. These results indicated there was no association between serum IgA antibodies and the presence of C. trachomatis. The presence of serum chlamydia antibodies was significantly higher in subjects with a past history of genital chlamydial infection than in those without a past history of infection (P<0.01). However, there was no difference in the results of the SDA assay between subjects with or without a previous infection. Thus, although serum chlamydia antibodies are generally measured at public health centers, tests for detecting C. trachomatis should also be used.

The aetiology of vaginal symptoms in rural Haiti.

PubMed

Bristow, Claire C; Desgrottes, Tania; Cutler, Lauren; Cutler, David; Devarajan, Karthika; Ocheretina, Oksana; Pape, Jean William; Klausner, Jeffrey D

2014-08-01

Vaginal symptoms are a common chief complaint amongst women visiting outpatient clinics in rural Haiti. A systematic sample of 206 consecutive women over age 18 with gynaecological symptoms underwent gynaecologic examination and laboratory testing for chlamydia, gonorrhoea, syphilis, HIV infection, trichomoniasis, candidiasis, and bacterial vaginosis. Among 206 women, 174 (84%) presented with vaginal discharge, 165 (80%) with vaginal itching, 123 (60%) with vaginal pain or dysuria, and 18 (9%) with non-traumatic vaginal sores or boils. Laboratory results were positive forChlamydia trachomatisin 5.4% (11/203), syphilis in 3.5% (7/202), HIV in 1.0% (2/200), andNeisseria gonorrhoeaein 1.0% (2/203). Among those that had microscopy, hyphae suggestive of candidiasis were visualized in 2.2% (1/45) and no cases of trichomoniasis were diagnosed 0% (0/45). Bacterial vaginosis was diagnosed in 28.3% (13/46). The prevalence of chlamydia was 4.9 (95% CI: 1.3-17.7) times greater among those 25 years of age and under (10.8%) than those older (2.3%). Chlamydia and bacterial vaginosis were the most common sexually transmitted infection and vaginal condition, respectively, in this study of rural Haitian adult women. The higher risk of chlamydia in younger women suggests education and screening programmes in young women should be considered. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The Significant Impact of Different Insurance Enrollment Criteria on the HEDIS Chlamydia Screening Measure for Young Women Enrolled in Medicaid and Commercial Insurance Plans.

PubMed

Patel, Chirag G; Tao, Guoyu

2015-10-01

The impact of length of enrollment in a health plan on eligibility of women under the Healthcare Effectiveness Data and Information Set (HEDIS) chlamydia screening measure is not fully understood. We assessed the representativeness of the measure among the proportion of women aged 15 to 24 years with a gap in coverage for Medicaid and commercial health insurance. Truven Health Marketscan Medicaid and commercial health insurance data from 2006 to 2012 were used to make comparisons between proportions of women with a gap in coverage to those enrolled in insurance plans for different numbers of months. Approximately 48% of Medicaid-insured women and 31% of commercially insured women had an at least 2-month gap that disqualified them from eligibility for inclusion in the HEDIS chlamydia screening measure. Extending eligibility to women with at least 6 months of coverage, regardless of gap, would increase the proportion of insured women included in the HEDIS measure to 76% (from 52%) for Medicaid and 83% (from 69%) for commercial insurance, without much effect on chlamydia testing rate. This would make the measure more representative of all insured women. The large proportion of young women who had a 2-month or greater gap in coverage in Medicaid had a significant impact on the overall representativeness of the current HEDIS chlamydia screening measure.

Tetracycline Selective Pressure and Homologous Recombination Shape the Evolution of Chlamydia suis: A Recently Identified Zoonotic Pathogen.

PubMed

Joseph, Sandeep J; Marti, Hanna; Didelot, Xavier; Read, Timothy D; Dean, Deborah

2016-09-02

Species closely related to the human pathogen Chlamydia trachomatis (Ct) have recently been found to cause zoonotic infections, posing a public health threat especially in the case of tetracycline resistant Chlamydia suis (Cs) strains. These strains acquired a tet(C)-containing cassette via horizontal gene transfer (HGT). Genomes of 11 Cs strains from various tissues were sequenced to reconstruct evolutionary pathway(s) for tet(C) HGT. Cs had the highest recombination rate of Chlamydia species studied to date. Admixture occurred among Cs strains and with Chlamydia muridarum but not with Ct Although in vitro tet(C) cassette exchange with Ct has been documented, in vivo evidence may require examining human samples from Ct and Cs co-infected sites. Molecular-clock dating indicated that ancestral clades of resistant Cs strains predated the 1947 discovery of tetracycline, which was subsequently used in animal feed. The cassette likely spread throughout Cs strains by homologous recombination after acquisition from an external source, and our analysis suggests Betaproteobacteria as the origin. Selective pressure from tetracycline may be responsible for recent bottlenecks in Cs populations. Since tetracycline is an important antibiotic for treating Ct, zoonotic infections at mutual sites of infection indicate the possibility for cassette transfer and major public health repercussions. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Chlamydia gallinacea, not C. psittaci, is the endemic chlamydial species in chicken (Gallus gallus)

PubMed Central

Guo, Weina; Li, Jing; Kaltenboeck, Bernhard; Gong, Jiansen; Fan, Weixing; Wang, Chengming

2016-01-01

To investigate the prevalence and diversity of Chlamydia spp. in domestic birds in China, oral and cloacal swabs of healthy chickens, ducks, geese and pigeons were collected nationwide from live-animal markets and examined by Chlamydia spp. 23 S rRNA gene FRET-PCR followed by high-resolution melting curve analysis and confirmatory sequencing. Overall, 26.2% of the birds (602/2,300) were positive for Chlamydia spp. and five Chlamydia spp. were identified. While occasional detection of C. suis and C. muridarum in poultry is reported here for the first time, the predominant chlamydial agent was C. gallinacea representing 63.8% of all positives (384/602) and 81.2% of positive chickens (359/442). Analysis of the C. gallinacea ompA phylogeny revealed at least 13 well segregated variants (serovars). Seven-month monitoring of C. gallinacea-infected chickens indicated that the infection was persistent. C. gallinacea-infected chickens remained without overt clinical disease, but showed body weight gains significantly reduced by 6.5–11.4% beginning in week 3 post-infection. This study indicates that C. gallinacea is the endemic chlamydial species in chickens, whereas C. psittaci dominates only in pigeons. Further studies are required to address the specific conditions under which C. gallinacea could act as an avian pathogen and possibly also a zoonotic agent. PMID:26778053

Productive and Penicillin-Stressed Chlamydia pecorum Infection Induces Nuclear Factor Kappa B Activation and Interleukin-6 Secretion In Vitro.

PubMed

Leonard, Cory A; Schoborg, Robert V; Borel, Nicole

2017-01-01

Nuclear factor kappa B (NFκB) is an inflammatory transcription factor that plays an important role in the host immune response to infection. The potential for chlamydiae to activate NFκB has been an area of interest, however most work has focused on chlamydiae impacting human health. Given that inflammation characteristic of chlamydial infection may be associated with severe disease outcomes or contribute to poor overall fitness in farmed animals, we evaluated the ability of porcine chlamydiae to induce NFκB activation in vitro . C. pecorum infection induced both NFκB nuclear translocation and activation at 2 hours post infection (hpi), an effect strongly enhanced by suppression of host de novo protein synthesis. C. suis and C. trachomatis showed less capacity for NFκB activation compared to C. pecorum , suggesting a species-specific variation in NFκB activation. At 24 hpi, C. pecorum induced significant NFκB activation, an effect not abolished by penicillin (beta lactam)-induced chlamydial stress. C. pecorum -dependent secretion of interleukin 6 was also detected in the culture supernatant of infected cells at 24 hpi, and this effect, too, was unchanged by penicillin-induced chlamydial stress. Taken together, these results suggest that NFκB participates in the early inflammatory response to C. pecorum and that stressed chlamydiae can promote inflammation.

Enhanced Direct Major Histocompatibility Complex Class I Self-Antigen Presentation Induced by Chlamydia Infection

PubMed Central

Cram, Erik D.; Simmons, Ryan S.; Palmer, Amy L.; Hildebrand, William H.; Rockey, Daniel D.

2015-01-01

The direct major histocompatibility complex (MHC) class I antigen presentation pathway ensures intracellular peptides are displayed at the cellular surface for recognition of infected or transformed cells by CD8+ cytotoxic T lymphocytes. Chlamydia spp. are obligate intracellular bacteria and, as such, should be targeted by CD8+ T cells. It is likely that Chlamydia spp. have evolved mechanisms to avoid the CD8+ killer T cell responses by interfering with MHC class I antigen presentation. Using a model system of self-peptide presentation which allows for posttranslational control of the model protein's stability, we tested the ability of various Chlamydia species to alter direct MHC class I antigen presentation. Infection of the JY lymphoblastoid cell line limited the accumulation of a model host protein and increased presentation of the model-protein-derived peptides. Enhanced self-peptide presentation was detected only when presentation was restricted to defective ribosomal products, or DRiPs, and total MHC class I levels remained unaltered. Skewed antigen presentation was dependent on a bacterial synthesized component, as evidenced by reversal of the observed phenotype upon preventing bacterial transcription, translation, and the inhibition of bacterial lipooligosaccharide synthesis. These data suggest that Chlamydia spp. have evolved to alter the host antigen presentation machinery to favor presentation of defective and rapidly degraded forms of self-antigen, possibly as a mechanism to diminish the presentation of peptides derived from bacterial proteins. PMID:26597986

Do Archaea and bacteria co-infection have a role in the pathogenesis of chronic chagasic cardiopathy?

PubMed

Higuchi, Maria de Lourdes; Kawakami, Joyce; Ikegami, Renata; Clementino, Maysa Beatriz Mandetta; Kawamoto, Flavio M; Reis, Marcia M; Bocchi, Edimar

2009-07-01

Chronic cardiopathy (CC) in Chagas disease is a fibrotic myocarditis with C5b-9 complement deposition. Mycoplasma and Chlamydia may interfere with the complement response. Proteolytic enzymes and archaeal genes that have been described in Trypanosoma cruzi may increase its virulence. Here we tested the hypothesis that different ratios of Mycoplasma, Chlamydia and archaeal organisms, which are frequent symbionts, may be associated with chagasic clinical forms. eight indeterminate form (IF) and 20 CC chagasic endomyocardial biopsies were submitted to in situ hybridization, electron and immunoelectron microscopy and PCR techniques for detection of Mycoplasma pneumoniae (MP), Chlamydia pneumoniae(CP), C5b-9 and archaeal-like bodies. MP and CP-DNA were always present at lower levels in CC than in IF (p < 0.001) and were correlated with each other only in CC. Electron microscopy revealed Mycoplasma, Chlamydia and two types of archaeal-like bodies. One had electron dense lipid content (EDL) and was mainly present in IF. The other had electron lucent content (ELC) and was mainly present in CC. In this group, ELC correlated negatively with the other microbes and EDL and positively with C5b-9. The CC group was positive for Archaea and T. cruzi DNA. In conclusion, different amounts of Mycoplasma, Chlamydia and archaeal organisms may be implicated in complement activation and may have a role in Chagas disease outcome.

Application of DNA Chip Scanning Technology for Automatic Detection of Chlamydia trachomatis and Chlamydia pneumoniae Inclusions

PubMed Central

Bogdanov, Anita; Endrész, Valeria; Urbán, Szabolcs; Lantos, Ildikó; Deák, Judit; Burián, Katalin; Önder, Kamil; Ayaydin, Ferhan; Balázs, Péter

2014-01-01

Chlamydiae are obligate intracellular bacteria that propagate in the inclusion, a specific niche inside the host cell. The standard method for counting chlamydiae is immunofluorescent staining and manual counting of chlamydial inclusions. High- or medium-throughput estimation of the reduction in chlamydial inclusions should be the basis of testing antichlamydial compounds and other drugs that positively or negatively influence chlamydial growth, yet low-throughput manual counting is the common approach. To overcome the time-consuming and subjective manual counting, we developed an automatic inclusion-counting system based on a commercially available DNA chip scanner. Fluorescently labeled inclusions are detected by the scanner, and the image is processed by ChlamyCount, a custom plug-in of the ImageJ software environment. ChlamyCount was able to measure the inclusion counts over a 1-log-unit dynamic range with a high correlation to the theoretical counts. ChlamyCount was capable of accurately determining the MICs of the novel antimicrobial compound PCC00213 and the already known antichlamydial antibiotics moxifloxacin and tetracycline. ChlamyCount was also able to measure the chlamydial growth-altering effect of drugs that influence host-bacterium interaction, such as gamma interferon, DEAE-dextran, and cycloheximide. ChlamyCount is an easily adaptable system for testing antichlamydial antimicrobials and other compounds that influence Chlamydia-host interactions. PMID:24189259

Demographic and behavioural profile of adults infected with chlamydia: a case-control study

PubMed Central

Radcliffe, K; Ahmad, S; Gilleran, G; Ross, J

2001-01-01

Objectives: To determine which demographic and behavioural parameters are independently associated with chlamydial infection in adults. Methods: Subjects were recruited prospectively from male and female attendees at a large clinic for sexually transmitted infections (STI). All subjects were tested for chlamydia and gonorrhoea and asked to complete a questionnaire addressing demography, sexual and non-sexual (including drug taking) behaviour, and history of STI. Cases were those attending with a new clinical episode and found to be infected with chlamydia, but who did not have gonorrhoea. A control group was selected randomly from those found to be negative on screening for both infections. Results: 986 cases and 1212 controls were recruited over one calendar year. The following were found to be independent risk factors for chlamydial infection on multivariate analysis (odds ratios with 95% confidence intervals in parentheses): being unmarried (1.8; 1.1–3.1); black Caribbean ethnicity (2; 1.5–2.7). Increasing age, fewer partners, and higher reported use of condoms were associated with a lower risk of infection. Conclusion: Black Caribbeans are at increased risk from chlamydia after controlling for sexual behaviour and socioeconomic status. Future research should seek an explanation elsewhere—for example, in terms of differences in sexual mixing or effectiveness of healthcare interventions. Key Words: chlamydia; epidemiology; sexual behaviour PMID:11463926

Productive and Penicillin-Stressed Chlamydia pecorum Infection Induces Nuclear Factor Kappa B Activation and Interleukin-6 Secretion In Vitro

PubMed Central

Leonard, Cory A.; Schoborg, Robert V.; Borel, Nicole

2017-01-01

Nuclear factor kappa B (NFκB) is an inflammatory transcription factor that plays an important role in the host immune response to infection. The potential for chlamydiae to activate NFκB has been an area of interest, however most work has focused on chlamydiae impacting human health. Given that inflammation characteristic of chlamydial infection may be associated with severe disease outcomes or contribute to poor overall fitness in farmed animals, we evaluated the ability of porcine chlamydiae to induce NFκB activation in vitro. C. pecorum infection induced both NFκB nuclear translocation and activation at 2 hours post infection (hpi), an effect strongly enhanced by suppression of host de novo protein synthesis. C. suis and C. trachomatis showed less capacity for NFκB activation compared to C. pecorum, suggesting a species-specific variation in NFκB activation. At 24 hpi, C. pecorum induced significant NFκB activation, an effect not abolished by penicillin (beta lactam)-induced chlamydial stress. C. pecorum-dependent secretion of interleukin 6 was also detected in the culture supernatant of infected cells at 24 hpi, and this effect, too, was unchanged by penicillin-induced chlamydial stress. Taken together, these results suggest that NFκB participates in the early inflammatory response to C. pecorum and that stressed chlamydiae can promote inflammation. PMID:28553623

Association of anti-Chlamydia antibodies with ectopic pregnancy in Benin city, Nigeria: a case-control study.

PubMed

Agholor, K; Omo-Aghoja, L; Okonofua, F

2013-06-01

Ectopic pregnancy remains a major public health problem especially in many developing countries where it is a significant contributor to pregnancy related morbidity and mortality. To determine the association between prior Chlamydia trachomatis infection and the risk of ectopic pregnancy. A case-control study from two tertiary health care facilities in Benin City, Nigeria. Ninety eight women with ectopic pregnancy (cases) and another 98 women with uncomplicated intrauterine pregnancy (controls) matched for age, were interviewed using a semi-structured questionnaire and evaluated for serological evidence of prior Chlamydia trachomatis infection. The antibody titres in cases (48%) were significantly higher than in controls (16.3%) (p<0.001). However, the association between Chlamydia antibodies and ectopic pregnancy was attenuated when the effects of indicators of previous pelvic infections, socio-demographic characteristics, contraceptive and sexual history were controlled for. Primary level of education (OR = 6.32; CI, 2.31 - 17.3), three or more lifetime sexual partners (OR = 5.71; CI, 2.39 - 13.65) and prior history of vaginal discharge (OR = 5.00; CI, 2.03 - 12.3) were more likely to be associated with ectopic pregnancy than with the presence of antibodies to Chlamydia trachomatis (OR = 2.82; 95% CI, 1.33 - 5.95). The Population Attributable Risk was 30.9%. Chlamydial infections play only a limited role in the pathogenesis of ectopic pregnancy.

Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011

PubMed Central

2012-01-01

Background The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including Chlamydia trachomatis. Modelling studies suggest that reductions in the prevalence of chlamydia infection will require a high level of population screening coverage and positivity among those screened. General practice has a potentially important role to play in delivering these levels of coverage since large numbers (up to 60%) of young people visit their general practice every year but previous work suggests that there are barriers to delivering screening in this setting. The aim of this study was to evaluate an intervention to increase chlamydia screening in general practice within Primary Care Trusts (PCTs) of Lambeth and Southwark, a strategy combining financial incentives and supportive practice visits to raise awareness and solve problems. Methods Data on age, gender, venue and chlamydia result for tests on under 25 s in Lambeth from 2003–11 was obtained from the National Chlamydia Screening Programme. We analysed the number and percentage of tests generated in general practice, and looked at the number of practices screening more than 10% of their practice cohort of 15–24 year olds, male/female ratio and positivity rates across other screening venues. We also looked at practices screening less than 10% and studied change over time. We compared data from Lambeth and Southwark with London and England. We also studied features of the level and type of educational and financial incentive interventions employed. Results Chlamydia tests performed in general practice increased from 23 tests in 2003–4 to 4813 tests in 2010–11 in Lambeth. In Southwark they increased from 5 tests in 2003/04 to 4321 in 2010/11. In 2011, 44.6% of tests came from GPs in Lambeth and 46% from GP’s in Southwark. In Lambeth 62.7% of practices tested more than 10% of their cohort and in Southwark this was 55.8%. In Lambeth, postivity rate in 2010/11 was 5.8% in men and 6.0% in women. In Southwark positivity rate was 3.9% in men and 5.3% in women. In 2003/04 13% tests in general practice (Lambeth) were from men, this increased to 25% in 2010/11. In Southwark this increased from 20% in 2003/04 to 27.6% in 2010/11. We compared the results with London and national data and showed significant differences between GP testing in Lambeth and Southwark, and GP testing in London and the rest of England. Conclusions General practices can be important potential providers of chlamydia tests. With a combination of sustained support, financial incentives and feedback on performance, general practice may be able to test a large percentage of 15–24 year olds. General practice is also a potentially important provider of chlamydia tests to young men. PMID:22984897

Medical Surveillance Monthly Report (MSMR). Volume 16, Number 9, September 2009

DTIC Science & Technology

2009-09-01

disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008...Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008

Medical Surveillance Monthly Report. Volume 16, Number 6, June 2009

DTIC Science & Technology

2009-06-01

Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 NORTH ATLANTIC...Arthropod-borne Sexually transmitted Environmental Lyme disease Malaria Chlamydia Gonorrhea Syphilis‡ Urethritis§ Cold Heat 2008 2009 2008 2009 2008 2009

Lymphogranuloma venereum proctitis

PubMed Central

Harrison, Tucker; Stroup, Jeff

2016-01-01

We describe a 60-year-old man who presented with rectal pain and bleeding of a month's duration. His presentation was highly suggestive of lymphogranuloma venereum (LGV) proctitis. Nucleic acid amplification for chlamydia and gonorrhea via rectal swab revealed evidence supportive of anorectal chlamydia. Treatment with doxycycline resulted in complete resolution of his symptoms. PMID:27695183

76 FR 27331 - Draft Guidance for Industry and Food and Drug Administration Staff; Establishing the Performance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-11

... Characteristics of In Vitro Diagnostic Devices for Chlamydia Trachomatis and/or Neisseria Gonorrhoeae: Screening... entitled ``Establishing the Performance Characteristics of In Vitro Diagnostic Devices for Chlamydia... clinical performance of in vitro diagnostic devices (IVDs) intended for C. trachomatis and/or N...

Where do young Irish women want Chlamydia-screening services to be set up? A qualitative study employing Goffman's impression management framework.

PubMed

Balfe, Myles; Brugha, Ruairi; O' Connell, Emer; McGee, Hannah; O' Donovan, Diarmuid

2010-01-01

We conducted interviews with 35 young women recruited from eight community healthcare rural and urban settings across two regions of Ireland. The aim of the study was to explore where these women thought Chlamydia-screening services should be located. Respondents wanted screening services to be located in settings where they would not be witnessed either asking for, or being asked to take, Chlamydia tests. Respondents were worried that their identities would become stigmatized if others were to find out that they had accepted screening. Findings are interpreted through Goffman's stigma and impression management framework. We conclude with public health recommendations.

Typing of Lymphogranuloma Venereum Chlamydia trachomatis Strains

PubMed Central

Christerson, Linus; de Vries, Henry J.C.; de Barbeyrac, Bertille; Gaydos, Charlotte A.; Henrich, Birgit; Hoffmann, Steen; Schachter, Julius; Thorvaldsen, Johannes; Vall-Mayans, Martí; Klint, Markus; Morré, Servaas A.

2010-01-01

We analyzed by multilocus sequence typing 77 lymphogranuloma venereum Chlamydia trachomatis strains from men who have sex with men in Europe and the United States. Specimens from an outbreak in 2003 in Europe were monoclonal. In contrast, several strains were in the United States in the 1980s, including a variant from Europe. PMID:21029543

Chlamydia trachomatis in Cervical Lymph Node of Man with Lymphogranuloma Venereum, Croatia, 20141.

PubMed

Gjurašin, Branimir; Lepej, Snježana Židovec; Cole, Michelle J; Pitt, Rachel; Begovac, Josip

2018-04-01

We report an HIV-infected person who was treated for lymphogranuloma venereum cervical lymphadenopathy and proctitis in Croatia in 2014. Infection with a variant L2b genovar of Chlamydia trachomatis was detected in a cervical lymph node aspirate. A prolonged course of doxycycline was required to cure the infection.

Chlamydia Pneumoniae Infections and Sudden Unexpected Deaths in Denmark.

ERIC Educational Resources Information Center

Johannsen, Finn

1993-01-01

Blood samples from 38 runners on the Danish national orienteering team revealed no ongoing chlamydia pneumoniae, although 42% had an earlier infection, similar to the incidence in the general population. However, over 2% had an ongoing lyme borreliosis infection, and 18% had an earlier infection, which is a higher incidence than in the general…

Risk Factors for "Chlamydia Trachomatis" Infection in a California Collegiate Population

ERIC Educational Resources Information Center

Sipkin, Diane L.; Gillam, Alix; Grady, Laurie Bisset

2003-01-01

"Chlamydia trachomatis" infection in college students has not undergone a detailed large-scale evaluation. The authors undertook a cross-sectional study of 4,086 students enrolled on the campuses of California State University, Sacramento, and 3 local community colleges from fall 2000 through spring 2002. They used an outreach screening…

C. trachomatis in female reproductive tract infections and RFLP-based genotyping: a 16-year study from a tertiary care hospital.

PubMed

Gita, Satpathy; Suneeta, Mittal; Anjana, Sharma; Niranjan, Nayak; Sujata, Mohanty; Pandey, R M

2011-01-01

Presence of Chlamydia trachomatis in endocervix was determined in 2466 women attending a tertiary care hospital in New Delhi, India over a period of 16 years, using a monoclonal-based direct immunofluorescence assay, tissue culture isolation, and a conventional PCR assay. Chlamydia antigen could be detected in 391 out of 2466 (15.85%) of patients studied; in 27.27% women with PID, 16.74% women with cervicitis, 16.03% women with infertility, and 12.06% women with adverse pregnancy outcomes, respectively. There was a statistically significant decreasing trend in Chlamydia antigen positivity between the years 1994-1999 and 2000-2004; the apparent decline in antigen positivity between the years 2000-2004 and 2005-2010 was not statistically significant. Antigen detection assay detected equal number of positives as the PCR assay; tissue culture isolation demonstrated lower positivity. In a few representative specimens from cervicitis patients, genotyping was done using RFLP pattern analysis of C. trachomatis MOMP gene amplified by PCR assay, all of these belonged to Chlamydia trachomatis serovar E.

C. trachomatis in Female Reproductive Tract Infections and RFLP-Based Genotyping: A 16-Year Study from a Tertiary Care Hospital

PubMed Central

Gita, Satpathy; Suneeta, Mittal; Anjana, Sharma; Niranjan, Nayak; Sujata, Mohanty; Pandey, R. M.

2011-01-01

Presence of Chlamydia trachomatis in endocervix was determined in 2466 women attending a tertiary care hospital in New Delhi, India over a period of 16 years, using a monoclonal-based direct immunofluorescence assay, tissue culture isolation, and a conventional PCR assay. Chlamydia antigen could be detected in 391 out of 2466 (15.85%) of patients studied; in 27.27% women with PID, 16.74% women with cervicitis, 16.03% women with infertility, and 12.06% women with adverse pregnancy outcomes, respectively. There was a statistically significant decreasing trend in Chlamydia antigen positivity between the years 1994–1999 and 2000–2004; the apparent decline in antigen positivity between the years 2000–2004 and 2005–2010 was not statistically significant. Antigen detection assay detected equal number of positives as the PCR assay; tissue culture isolation demonstrated lower positivity. In a few representative specimens from cervicitis patients, genotyping was done using RFLP pattern analysis of C. trachomatis MOMP gene amplified by PCR assay, all of these belonged to Chlamydia trachomatis serovar E. PMID:21747643

Cost-effectiveness of Chlamydia Vaccination Programs for Young Women

PubMed Central

Chesson, Harrell W.; Gift, Thomas L.; Brunham, Robert C.; Bolan, Gail

2015-01-01

We explored potential cost-effectiveness of a chlamydia vaccine for young women in the United States by using a compartmental heterosexual transmission model. We tracked health outcomes (acute infections and sequelae measured in quality-adjusted life-years [QALYs]) and determined incremental cost-effectiveness ratios (ICERs) over a 50-year analytic horizon. We assessed vaccination of 14-year-old girls and catch-up vaccination for 15–24-year-old women in the context of an existing chlamydia screening program and assumed 2 prevaccination prevalences of 3.2% by main analysis and 3.7% by additional analysis. Estimated ICERs of vaccinating 14-year-old girls were $35,300/QALY by main analysis and $16,200/QALY by additional analysis compared with only screening. Catch-up vaccination for 15–24-year-old women resulted in estimated ICERs of $53,200/QALY by main analysis and $26,300/QALY by additional analysis. The ICER was most sensitive to prevaccination prevalence for women, followed by cost of vaccination, duration of vaccine-conferred immunity, and vaccine efficacy. Our results suggest that a successful chlamydia vaccine could be cost-effective. PMID:25989525

An observational study to evaluate three pilot programmes of retesting chlamydia-positive individuals within 6 months in the South West of England

PubMed Central

Angel, Georgina; Horner, Paddy J; O'Brien, Norah; Sharp, Matt; Pye, Karl; Priestley, Cecilia; Macleod, John; Looker, Katharine J; Turner, Katherine M E

2015-01-01

Objectives To evaluate 3 pilot chlamydia retesting programmes in South West England which were initiated prior to the release of new National Chlamydia Screening Programme (NCSP) guidelines recommending retesting in 2014. Methods Individuals testing positive between August 2012 and July 2013 in Bristol (n=346), Cornwall (n=252) and Dorset (n=180) programmes were eligible for inclusion in the retesting pilots. The primary outcomes were retest within 6 months (yes/no) and repeat diagnosis at retest (yes/no), adjusted for area, age and gender. Results Overall 303/778 (39.0%) of participants were retested within 6 months and 31/299 (10.4%) were positive at retest. Females were more likely to retest than males and Dorset had higher retesting rates than the other areas. Conclusions More than a third of those eligible were retested within the time frame of the study. Chlamydia retesting programmes appear feasible within the context of current programmes to identify individuals at continued risk of infection with relatively low resource and time input. PMID:26510723

Chlamydia trachomatis OmpA genotyping as a tool for studying the natural history of genital chlamydial infection.

PubMed

Geisler, W M; Black, C M; Bandea, C I; Morrison, S G

2008-12-01

To investigate the relationship of Chlamydia trachomatis (CT) outer membrane protein A (OmpA) type to the clearance of CT infection before treatment. CT OmpA genotyping, with amplification and sequencing of ompA, was utilised to study the natural history of CT infection (spontaneous resolution vs persistence) in 102 individuals with chlamydia-positive screening tests returning for treatment. CT OmpA distribution was associated with spontaneous resolution of CT, most notably with CT OmpA genotype J/Ja detected more often from the initial screening CT test than other genotypes in those who then had spontaneous resolution of CT noted at the time of treatment. Five individuals with presumed persisting CT infection had discordant CT OmpA genotypes at the screening and treatment visits, suggesting possible new interval CT infection. Clearance of chlamydia by the host before treatment may be influenced by the CT OmpA genotype infecting the host. CT OmpA genotyping may be a valuable tool in understanding the natural history of chlamydial infections.

Rac interacts with Abi-1 and WAVE2 to promote an Arp2/3-dependent actin recruitment during chlamydial invasion.

PubMed

Carabeo, Rey A; Dooley, Cheryl A; Grieshaber, Scott S; Hackstadt, Ted

2007-09-01

Chlamydiae are Gram-negative obligate intracellular pathogens to which access to an intracellular environment is fundamental to their development. Chlamydial attachment to host cells induces the activation of the Rac GTPase, which is required for the localization of WAVE2 at the sites of chlamydial entry. Co-immunoprecipitation experiments demonstrated that Chlamydia trachomatis infection promoted the interaction of Rac with WAVE2 and Abi-1, but not with IRSp53. siRNA depletion of WAVE2 and Abi-1 abrogated chlamydia-induced actin recruitment and significantly reduced the uptake of the pathogen by the depleted cells. Chlamydia invasion also requires the Arp2/3 complex as demonstrated by its localization to the sites of chlamydial attachment and the reduced efficiency of chlamydial invasion in cells overexpressing the VCA domain of the neural Wiskott-Aldrich syndrome protein. Thus, C. trachomatis activates Rac and promotes its interaction with WAVE2 and Abi-1 to activate the Arp2/3 complex resulting in the induction of actin cytoskeletal rearrangements that are required for invasion.

Does infection with Chlamydia pneumoniae and/or Helicobacter pylori increase the expression of endothelial cell adhesion molecules in humans?

PubMed

Schumacher, A; Seljeflot, I; Lerkerød, A B; Sommervoll, L; Otterstad, J E; Arnesen, H

2002-10-01

To investigate if Chlamydia pneumoniae and/or Helicobacter pylori seropositivity is associated with elevated levels of soluble endothelial cell adhesion molecules (sCAMs) as markers of atherosclerotic activity. Immunoglobulin A (IgA) and IgG antibodies to the two bacteria, soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin were measured in coronary heart disease (CHD) patients (n = 193) and age- and sex-matched controls (n = 193). Two different serological methods were used for the detection of Chlamydia antibodies: Labsystems microimmunofluorescence to detect species-specific C. pneumoniae antibodies and Medac's recombinant enzyme-linked immunosorbent assay to detect genus-specific lipopolysaccharide antibodies. The concentrations of sICAM-1 and E-selectin were higher in CHD patients with positive vs. negative Chlamydia lipopolysaccharide IgA (P = 0.044 for both). H. pylori antibodies alone did not predict raised levels of sCAMs, but in CHD patients sICAM-1 was increased with IgA seropositivity to both bacteria compared to double seronegativity (P = 0.034). Concentrations of sVCAM-1 were elevated in CHD patients with double IgA seropositivity compared to those with Chlamydia lipopolysaccharide IgA seropositivity alone (P = 0.018). Our results may indicate that C. pneumoniae contributes to increased inflammation in CHD, and that this contribution is even more pronounced when present in combination with H. pylori IgA antibodies.

Evidence for the existence of two new members of the family Chlamydiaceae and proposal of Chlamydia avium sp. nov. and Chlamydia gallinacea sp. nov.

PubMed

Sachse, Konrad; Laroucau, Karine; Riege, Konstantin; Wehner, Stefanie; Dilcher, Meik; Creasy, Heather Huot; Weidmann, Manfred; Myers, Garry; Vorimore, Fabien; Vicari, Nadia; Magnino, Simone; Liebler-Tenorio, Elisabeth; Ruettger, Anke; Bavoil, Patrik M; Hufert, Frank T; Rosselló-Móra, Ramon; Marz, Manja

2014-03-01

The family Chlamydiaceae with the recombined single genus Chlamydia currently comprises nine species, all of which are obligate intracellular organisms distinguished by a unique biphasic developmental cycle. Anecdotal evidence from epidemiological surveys in flocks of poultry, pigeons and psittacine birds have indicated the presence of non-classified chlamydial strains, some of which may act as pathogens. In the present study, phylogenetic analysis of ribosomal RNA and ompA genes, as well as multi-locus sequence analysis of 11 field isolates were conducted. All independent analyses assigned the strains into two different clades of monophyletic origin corresponding to pigeon and psittacine strains or poultry isolates, respectively. Comparative genome analysis involving the type strains of currently accepted Chlamydiaceae species and the designated type strains representing the two new clades confirmed that the latter could be classified into two different species as their average nucleotide identity (ANI) values were always below 94%, both with the closest relative species and between themselves. In view of the evidence obtained from the analyses, we propose the addition of two new species to the current classification: Chlamydia avium sp. nov. comprising strains from pigeons and psittacine birds (type strain 10DC88(T); DSMZ: DSM27005(T), CSUR: P3508(T)) and Chlamydia gallinacea sp. nov. comprising strains from poultry (type strain 08-1274/3(T); DSMZ: DSM27451(T), CSUR: P3509(T)). Copyright © 2014 Elsevier GmbH. All rights reserved.

A Macaque Model for Rectal Lymphogranuloma Venereum and Non-Lymphogranuloma Venereum Chlamydia trachomatis: Impact on Rectal Simian/Human Immunodeficiency Virus Acquisition.

PubMed

Vishwanathan, Sundaram Ajay; Aubert, Rachael D; Morris, Monica R; Zhao, Chunxia; Philips, Christi; Khalil, George M; Deyounks, Frank; Kelley, Kristen; Ritter, Jana M; Chen, C Y; Kersh, Ellen N; McNicholl, Janet M

2017-09-01

Sustained genital tract inflammation caused by sexually transmitted infections (STIs) is known to increase risk of vaginal human immunodeficiency virus (HIV) infections but, to our knowledge, there are no nonhuman primate studies that have evaluated its link to rectal HIV acquisition. Rhesus macaques inoculated with Chlamydia trachomatis (CT) (serovars LGV-L2 and CT-E; n = 7) or saline (n = 7) received up to 20 rectal challenges twice a week of simian/HIV immunodeficiency virus (SHIVSF162p3). SHIV viremia was determined by real-time PCR and Chlamydia infection by APTIMA Combo 2 testing. The rectal cytokine-chemokine levels were evaluated by multiplex bead assays. Rectal Chlamydia infection was maintained throughout the study. We did not observe significant differences (P = 1.0) in frequency of SHIV acquisition between the STI and control arms. It took fewer SHIV challenges to infect the STI animals although the difference was not significant (P = 0.59). There were no significant differences in peak plasma viremia between STI and control arms (P = 0.63). The association of plasma viremia with rectal shedding was significantly different by arm (P = 0.038). In the first such study in a macaque model, we did not observe an increased risk of SHIV acquisition due to rectal Chlamydia coinfection. This macaque model can be further developed and expanded to better investigate the impact of different rectal STIs on HIV acquisition.

Community pharmacy and cash reward: a winning combination for chlamydia screening?

PubMed

Currie, Marian J; Deeks, Louise S; Cooper, Gabrielle M; Martin, Sarah J; Parker, Rhian M; Del Rosario, Rendry; Hocking, Jane S; Bowden, Francis J

2013-05-01

To date, the uptake of chlamydia screening in community pharmacies has been limited. The objective of this cross-sectional study was to determine if a cash reward, offered to both the provider and the consumer of chlamydia screening, increased the uptake of screening in community pharmacies. During 4 weeks in 2011, chlamydia screening and education were offered in four city and two suburban pharmacies to people aged 16-30 years. Those who provided a urine sample for testing, contact details, and completed a brief questionnaire were rewarded with $A10. Positive participants, and their nominated contacts, were offered treatment. Over a period of 751.5 h, 979 testing kits were requested, and 900 (93%) urine samples returned. Using probabilistic linkage methods, we determined that 671/900 (75%) urine samples were from unique individuals. 0.9 unique samples were obtained/hour of screening, 63% of which were provided by men. 19/671 (2.8%; 95% CI 1.7% to 4.4%) people tested positive, 5.2% (95% CI 2.8% to 8.8%) of women, and 1.4% (1.4 0.5 to 3.1) of men. 11/19 (58%) people were contacted and treated-two for suspected pelvic inflammatory disease. Providing a cash reward to encourage chlamydia screening in community pharmacies resulted in greater participation rates than previously reported pharmacy-based studies, particularly among men. Easily implemented mechanisms to reduce inappropriate repeat screening, incorrect contact details and effects on pharmacy work flow may enhance the efficiency of this approach.

The Rsb Phosphoregulatory Network Controls Availability of the Primary Sigma Factor in Chlamydia trachomatis and Influences the Kinetics of Growth and Development

PubMed Central

Thompson, Christopher C.; Griffiths, Cherry; Nicod, Sophie S.; Lowden, Nicole M.; Wigneshweraraj, Sivaramesh; Fisher, Derek J.; McClure, Myra O.

2015-01-01

Chlamydia trachomatis is an obligate intracellular human pathogen that exhibits stage-specific gene transcription throughout a biphasic developmental cycle. The mechanisms that control modulation in transcription and associated phenotypic changes are poorly understood. This study provides evidence that a switch-protein kinase regulatory network controls availability of σ66 , the main sigma subunit for transcription in Chlamydia. In vitro analysis revealed that a putative switch-protein kinase regulator, RsbW, is capable of interacting directly with σ66, as well as phosphorylating its own antagonist, RsbV1, rendering it inactive. Conversely, the putative PP2C-like phosphatase domain of chlamydial RsbU was capable of reverting RsbV1 into its active state. Recent advances in genetic manipulation of Chlamydia were employed to inactivate rsbV1, as well as to increase the expression levels of rsbW or rsbV1, in vivo. Representative σ66-dependent gene transcription was repressed in the absence of rsbV1 or upon increased expression of RsbW, and increased upon elevated expression of RsbV1. These effects on housekeeping transcription were also correlated to several measures of growth and development. A model is proposed where the relative levels of active antagonist (RsbV1) and switch-protein anti-sigma factor (RsbW) control the availability of σ66 and subsequently act as a molecular 'throttle' for Chlamydia growth and development. PMID:26313645

Genital Chlamydia trachomatis Infections Clear More Slowly in Men Than Women, but Are Less Likely to Become Established.

PubMed

Lewis, Joanna; Price, Malcolm J; Horner, Paddy J; White, Peter J

2017-07-15

Rigorous estimates for clearance rates of untreated chlamydia infections are important for understanding chlamydia epidemiology and designing control interventions, but were previously only available for women. We used data from published studies of chlamydia-infected men who were retested at a later date without having received treatment. Our analysis allowed new infections to take one of 1, 2, or 3 courses, each clearing at a different rate. We determined which of these 3 models had the most empirical support. The best-fitting model had 2 courses of infection in men, as was previously found for women: "slow-clearing" and "fast-clearing." Only 68% (57%-78%) (posterior median and 95% credible interval [CrI]) of incident infections in men were slow-clearing, vs 77% (69%-84%) in women. The slow clearance rate in men (based on 6 months' follow-up) was 0.35 (.05-1.15) year-1 (posterior median and 95% CrI), corresponding to mean infection duration 2.84 (.87-18.79) years. This compares to 1.35 (1.13-1.63) years in women. Our estimated clearance rate is slower than previously assumed. Fewer infections become established in men than women but once established, they clear more slowly. This study provides an improved description of chlamydia's natural history to inform public health decision making. We describe how further data collection could reduce uncertainty in estimates. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Modest rise in chlamydia and gonorrhoea testing did not increase case detection in a clinical HIV cohort in Ontario, Canada.

PubMed

Burchell, Ann N; Grewal, Ramandip; Allen, Vanessa G; Gardner, Sandra L; Moravan, Veronika; Bayoumi, Ahmed M; Kaul, Rupert; McGee, Frank; Millson, Margaret Peggy E; Remis, Robert S; Raboud, Janet; Mazzulli, Tony; Rourke, Sean B

2014-12-01

We described patterns of testing for chlamydia and gonorrhoea infection among persons in specialty HIV care in Ontario, Canada, from 2008 to 2011. We analysed data from 3165 participants in the OHTN Cohort Study attending one of seven specialty HIV care clinics. We obtained chlamydia and gonorrhoea test results via record linkage with the provincial public health laboratory. We estimated the proportion of participants who underwent testing annually, the positivity rate among those tested and the proportion diagnosed with chlamydia or gonorrhoea among all under observation. We explored risk factors for testing and diagnosis using multiple logistic regression analysis. The proportion tested annually rose from 15.2% (95% CI 13.6% to 16.7%) in 2008 to 27.0% (95% CI 25.3% to 28.6%) in 2011 (p<0.0001). Virtually all were urine-based nucleic acid amplification tests. Testing was more common among men who have sex with men (MSM), younger adults, Toronto residents, persons attending primary care clinics and persons who had tested in the previous year or who had more clinic visits in the current year. We observed a decrease in test positivity rates over time. However, the annual proportion diagnosed remained stable and in 2011 this was 0.97% (95% CI 0.61% to 1.3%) and 0.79% (95% CI 0.46% to 1.1%) for chlamydia and gonorrhoea, respectively. Virtually all cases were among MSM. Chlamydia and gonorrhoea testing increased over time while test positivity rates declined and the overall proportion diagnosed remained stable, suggesting that the modest increase in testing did not improve case detection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A Prototype Recombinant-Protein Based Chlamydia pecorum Vaccine Results in Reduced Chlamydial Burden and Less Clinical Disease in Free-Ranging Koalas (Phascolarctos cinereus).

PubMed

Waugh, Courtney; Khan, Shahneaz Ali; Carver, Scott; Hanger, Jonathan; Loader, Joanne; Polkinghorne, Adam; Beagley, Kenneth; Timms, Peter

2016-01-01

Diseases associated with Chlamydia pecorum infection are a major cause of decline in koala populations in Australia. While koalas in care can generally be treated, a vaccine is considered the only option to effectively reduce the threat of infection and disease at the population level. In the current study, we vaccinated 30 free-ranging koalas with a prototype Chlamydia pecorum vaccine consisting of a recombinant chlamydial MOMP adjuvanted with an immune stimulating complex. An additional cohort of 30 animals did not receive any vaccine and acted as comparison controls. Animals accepted into this study were either uninfected (Chlamydia PCR negative) at time of initial vaccination, or infected (C. pecorum positive) at either urogenital (UGT) and/or ocular sites (Oc), but with no clinical signs of chlamydial disease. All koalas were vaccinated/sampled and then re-released into their natural habitat before re-capturing and re-sampling at 6 and 12 months. All vaccinated koalas produced a strong immune response to the vaccine, as indicated by high titres of specific plasma antibodies. The incidence of new infections in vaccinated koalas over the 12-month period post-vaccination was slightly less than koalas in the control group, however, this was not statistically significant. Importantly though, the vaccine was able to significantly reduce the infectious load in animals that were Chlamydia positive at the time of vaccination. This effect was evident at both the Oc and UGT sites and was stronger at 6 months than at 12 months post-vaccination. Finally, the vaccine was also able to reduce the number of animals that progressed to disease during the 12-month period. While the sample sizes were small (statistically speaking), results were nonetheless striking. This study highlights the potential for successful development of a Chlamydia vaccine for koalas in a wild setting.

Population based study of genital Chlamydia trachomatis prevalence and associated factors in Norway: a cross sectional study.

PubMed

Kløvstad, Hilde; Grjibovski, Andrej; Aavitsland, Preben

2012-07-02

The number of diagnosed cases of Chlamydia trachomatis infection has been increasing in the past years in Norway although the testing rate has been relatively stable. The aim of this study was to measure the prevalence of genital Chlamydia trachomatis in young men and women in one county in Norway and determine associated factors in order to better target preventive measures. We mailed to a random sample of 10,000 persons aged 18-25 in Rogaland county a mail-back urine sample kit and a self-administered questionnaire with questions on socio-demographic details, health seeking behaviour and symptoms of and history of sexually transmitted diseases. Associations between current Clamydia trachomatis infection and the above mentioned factors were studied by multiple logistic regression. The response rate among women was 18.9% (930/4923) and 11.9% (605/5077) among men. The prevalence of Chlamydia trachomatis infection was 5.8% (95% CI 4.5-6.8) among women and 5.1% (95% CI 3.8-6.8) among men. For men a greater number of partners during the last year (p for trend < 0.001), and living in a municipality without a local youth clinic increased the odds of infection (OR 8.6, 95% CI 2.2-33.9). For women a greater number of partners during the last year (p < 0.001) and not having consulted a family doctor for STIs (OR 2.1 95% CI 1.1-4.2) were positively associated with infection while not having a previous Chlamydia trachomatis diagnosis decreased the odds of having this infection (OR 0.3, 95% CI 0.2-0.7). Our results indicate the importance of having a visible youth clinic in each municipality. It also suggests targeting women who have had a previous Chlamydia trachomatis infection diagnosed before.

Meeting sexual partners online: associated sexual behaviour and prevalent chlamydia infection among adolescents in Norway: a cross-sectional study.

PubMed

Gravningen, Kirsten; Aicken, Catherine Rh; Schirmer, Henrik; Mercer, Catherine H

2016-03-01

Evidence is mixed as to whether meeting sexual partners online ('internet-partners') is associated with risky sexual behaviour and/or sexually transmitted infection transmission. Accordingly, we sought to estimate the prevalence of reporting various online romantic and sexual activities among Norwegian adolescents, including internet-partners, and the reason for meeting them and to examine differences in sexual behaviour, partnership characteristics and chlamydia infection prevalence among those reporting internet-partners versus those reporting only offline partners. Population-based cross-sectional survey among sexually experienced girls and boys, 15-20 years, using electronic questionnaires and collecting urine samples for Chlamydia trachomatis PCR testing (79% provided both, n=1023). We used logistic regression to examine associations, adjusting for potentially confounding variables. Overall, 30% of both genders reported internet-partners (ever). Boys (but not girls) with internet-partners had higher chlamydia prevalence than those reporting meeting sexual partners only offline (8.1%, 95% CI 4.3% to 13.7% vs 1.6%, 0.5% to 3.7%). Two-thirds of girls and 37% of boys reported meeting their most recent internet-partner to start a romantic relationship, while the remainder did so with the specific intention of having sex. Among both genders, reporting sexual (vs romantic) reasons for meeting their most recent internet-partners was associated with reporting several risky sexual behaviours, including multiple recent sex partners (adjusted OR girls: 3.27, boys: 2.48) and three-fold higher chlamydia prevalence. This population-based study suggests that internet-partners are common among adolescents in Norway, and the reason for meeting them was more strongly associated with additionally reporting sexual risk behaviours and prevalent chlamydia infection than the internet itself as a meeting venue. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Can we use postal surveys with anonymous testing to monitor chlamydia prevalence in young women in England? Pilot study incorporating randomised controlled trial of recruitment methods.

PubMed

Woodhall, Sarah C; Nichols, Tom; Alexander, Sarah; da Silva, Filomeno Coelho; Mercer, Catherine H; Ison, Catherine; Gill, O Noel; Soldan, Kate

2015-09-01

Chlamydia prevalence in the general population is a potential outcome measure for the evaluation of chlamydia control programmes. We carried out a pilot study to determine the feasibility of using a postal survey for population-based chlamydia prevalence monitoring. Postal invitations were sent to a random sample of 2000 17-year-old to 18-year-old women registered with a general practitioner in two pilot areas in England. Recipients were randomised to receive either a self-sampling kit (n=1000), a self-sampling kit and offer of £5 voucher on return of sample (n=500) or a self-sampling kit on request (n=500). Participants returned a questionnaire and self-taken vulvovaginal swab sample for unlinked anonymous Chlamydia trachomatis testing. Non-responders were sent a reminder letter 3 weeks after initial invitation. We calculated the participation rate (number of samples returned/number of invitations sent) and cost per sample returned (including cost of consumables and postage) in each group. A total of 155/2000 (7.8%) samples were returned with consent for testing. Participation rates varied by invitation group: 7.8% in the group who were provided with a self-sampling kit, 14% in the group who were also offered a voucher and 1.0% in the group who were not sent a kit. The cost per sample received was lowest (£36) in the group who were offered both a kit and a voucher. The piloted survey methodology achieved low participation rates. This approach is not suitable for population-based monitoring of chlamydia prevalence among young women in England. (UKCRN ID 10913). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Diagnosis and treatment of chlamydia and gonorrhoea in general practice in England 2000-2011: a population-based study using data from the UK Clinical Practice Research Datalink.

PubMed

Wetten, Sally; Mohammed, Hamish; Yung, Mandy; Mercer, Catherine H; Cassell, Jackie A; Hughes, Gwenda

2015-04-22

To determine the relative contribution of general practices (GPs) to the diagnosis of chlamydia and gonorrhoea in England and whether treatment complied with national guidelines. Analysis of longitudinal electronic health records in the Clinical Practice Research Datalink (CPRD) and national sexually transmitted infection (STI) surveillance databases, England, 2000-2011. GPs, and community and specialist STI services. Patients diagnosed with chlamydia (n=1,386,169) and gonorrhoea (n=232,720) at CPRD GPs, and community and specialist STI Services from 2000-2011. Numbers and rates of chlamydia and gonorrhoea diagnoses; percentages of patients diagnosed by GPs relative to other services; percentage of GP patients treated and antimicrobials used; percentage of GP patients referred. The diagnosis rate (95% CI) per 100,000 population of chlamydia in GP increased from 22.8 (22.4-23.2) in 2000 to 29.3 (28.8-29.7) in 2011 (p<0.001), while the proportion treated increased from 59.5% to 78.4% (p=0.001). Over 90% were prescribed a recommended antimicrobial. Over the same period, the diagnosis rate (95% CI) per 100,000 population of gonorrhoea in GP ranged between 3.2 (3-3.3) and 2.4 (2.2-2.5; p=0.607), and the proportion treated ranged between 32.7% and 53.6% (p=0.262). Despite being discontinued as a recommended therapy for gonorrhoea in 2005, ciprofloxacin accounted for 42% of prescriptions in 2007 and 20% in 2011. Over the study period, GPs diagnosed between 9% and 16% of chlamydia cases and between 6% and 9% of gonorrhoea cases in England. GP makes an important contribution to the diagnosis and treatment of bacterial STIs in England. While most patients diagnosed with chlamydia were managed appropriately, many of those treated for gonorrhoea received antimicrobials no longer recommended for use. Given the global threat of antimicrobial resistance, GPs should remain abreast of national treatment guidelines and alert to treatment failure in their patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Is rectal douching and sharing douching equipment associated with anorectal chlamydia and gonorrhoea? A cross-sectional study among men who have sex with men.

PubMed

Achterbergh, Rca; van der Helm, J J; van den Boom, W; Heijman, T; Stolte, I G; van Rooijen, M S; de Vries, Hjc

2017-09-01

Men who have sex with men (MSM) are at high risk for anorectal chlamydia and gonorrhoea infections. Many MSM use rectal douches in preparation for sex, which might break down the mucosal barrier function and facilitate the acquisition of STI. We determined whether rectal douching or sharing douching equipment was associated with anorectal chlamydia and gonorrhoea. In a cross-sectional study among 994 MSM attending the STI outpatient clinic of Amsterdam between February and April 2011, data were collected on rectal douching, sexual behaviour and STI. We used multivariable logistic regression analysis to determine the association between rectal douching, including sharing of douching equipment, and anorectal chlamydia and gonorrhoea for those reporting receptive anal sex. We adjusted for other risk behaviour, that is, condom use, number of partners and HIV status. Of 994 MSM, 46% (n=460) practised rectal douching, of whom 25% (n=117) shared douching equipment. Median age was 39 years (IQR 30-47), median number of sex partners in the 6 months prior to consult was five (IQR 3-10) and 289 (29.0%) participants were HIV positive. The prevalence of anorectal chlamydia and/or gonorrhoea for those reporting receptive anal sex was 9.6% (n=96). In multivariable analysis, HIV positivity (aOR=2.2, 95% CI 1.3 to 3.6), younger age (aOR=2.5, CI 1.4 to 4.5 for those aged <35 years compared with those aged ≥45 years), and more sexual partners (aOR=1.2, 95% CI 1.0 to 1.5 for 1 log increase) were significantly associated with anorectal STI. However, rectal douching or sharing douching equipment were not significantly associated with anorectal chlamydia and/or gonorrhoea (p=0.647). Almost half of MSM used rectal douching and a quarter of these shared douching equipment. Though using douching equipment does not appear to contribute to anorectal chlamydia and gonorrhoea in this study, STI prevalence remains high and prevention strategies like early testing and treatment remain of utmost importance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Tools to overcome potential barriers to chlamydia screening in general practice: Qualitative evaluation of the implementation of a complex intervention.

PubMed

Ricketts, Ellie J; Francischetto, Elaine O'Connell; Wallace, Louise M; Hogan, Angela; McNulty, Cliodna A M

2016-03-22

Chlamydia trachomatis remains a significant public health problem. We used a complex intervention, with general practice staff, consisting of practice based workshops, posters, computer prompts and testing feedback and feedback to increase routine chlamydia screening tests in under 25 year olds in South West England. We aimed to evaluate how intervention components were received by staff and to understand what determined their implementation into ongoing practice. We used face-to-face and telephone individual interviews with 29 general practice staff analysed thematically within a Normalisation Process Theory Framework which explores: 1. Coherence (if participants understand the purpose of the intervention); 2. Cognitive participation (engagement with and implementation of the intervention); 3. Collective action (work actually undertaken that drives the intervention forwards); 4. Reflexive monitoring (assessment of the impact of the intervention). Our results showed coherence as all staff including receptionists understood the purpose of the training was to make them aware of the value of chlamydia screening tests and how to increase this in their general practice. The training was described by nearly all staff as being of high quality and responsible for creating a shared understanding between staff of how to undertake routine chlamydia screening. Cognitive participation in many general practice staff teams was demonstrated through their engagement by meeting after the training to discuss implementation, which confirmed the role of each staff member and the use of materials. However several participants still felt unable to discuss chlamydia in many consultations or described sexual health as low priority among colleagues. National targets were considered so high for some general practice staff that they didn't engage with the screening intervention. Collective action work undertaken to drive the intervention included use of computer prompts which helped staff remember to make the offer, testing rate feedback and having a designated lead. Ensuring patients collected samples when still in the general practice was not attained in most general practices. Reflexive monitoring showed positive feedback from patients and other staff about the value of screening, and feedback about the general practices testing rates helped sustain activity. A complex intervention including interactive workshops, materials to help implementation and feedback can help chlamydia screening testing increase in general practices.

High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria

PubMed Central

Keshinro, Babajide; Crowell, Trevor A; Nowak, Rebecca G; Adebajo, Sylvia; Peel, Sheila; Gaydos, Charlotte A; Rodriguez-Hart, Cristina; Baral, Stefan D; Walsh, Melissa J; Njoku, Ogbonnaya S; Odeyemi, Sunday; Ngo-Ndomb, Teclaire; Blattner, William A; Robb, Merlin L; Charurat, Manhattan E; Ake, Julie

2016-01-01

Introduction Sexually transmitted infection (STI) and HIV prevalence have been reported to be higher amongst men who have sex with men (MSM) in Nigeria than in the general population. The objective of this study was to characterize the prevalence of HIV, chlamydia and gonorrhoea in this population using laboratory-based universal testing. Methods TRUST/RV368 represents a cohort of MSM and transgender women (TGW) recruited at trusted community centres in Abuja and Lagos, Nigeria, using respondent-driven sampling (RDS). Participants undergo a structured comprehensive assessment of HIV-related risks and screening for anorectal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae, and HIV. Crude and RDS-weighted prevalence estimates with 95% confidence intervals (CIs) were calculated. Log-binomial regression was used to explore factors associated with prevalent HIV infection and STIs. Results From March 2013 to January 2016, 862 MSM and TGW (316 in Lagos and 546 in Abuja) underwent screening for HIV, chlamydia and gonorrhoea at study enrolment. Participants’ median age was 24 years [interquartile range (IQR) 21–27]. One-third (34.2%) were identified as gay/homosexual and 65.2% as bisexual. The overall prevalence of HIV was 54.9%. After adjusting for the RDS recruitment method, HIV prevalence in Abuja was 43.5% (95% CI 37.3–49.6%) and in Lagos was 65.6% (95% CI 54.7–76.5%). The RDS-weighted prevalence of chlamydia was 17.0% (95% CI 11.8–22.3%) in Abuja and 18.3% (95% CI 11.1–25.4%) in Lagos. Chlamydia infection was detected only at the anorectal site in 70.2% of cases. The RDS-weighted prevalence of gonorrhoea was 19.1% (95% CI 14.6–23.5%) in Abuja and 25.8% (95% CI 17.1–34.6%) in Lagos. Overall, 84.2% of gonorrhoea cases presented with anorectal infection only. Over 95% of STI cases were asymptomatic. In a multivariable model, increased risk for chlamydia/gonorrhoea was associated with younger age, gay/homosexual sexual orientation and higher number of partners for receptive anal sex. HIV infection was associated with older age, female gender identity and number of partners for receptive anal sex. Conclusions There is a high burden of infection with HIV and asymptomatic chlamydia and gonorrhoea among MSM and TGW in Nigeria. Most cases would have been missed without anorectal screening. Interventions are needed to target this population for appropriate STI screening and management beginning at a young age. PMID:27931519

A prospective assessment of pelvic infection risk following same-day sexually transmitted infection testing and levonorgestrel intrauterine system placement.

PubMed

Turok, David K; Eisenberg, David L; Teal, Stephanie B; Keder, Lisa M; Creinin, Mitchell D

2016-11-01

Misperceptions persist that intrauterine device placement is related to pelvic infections and Chlamydia and gonorrhea testing results are needed prior to placement. We sought to evaluate the relationship of Chlamydia and gonorrhea screening to pelvic infection for up to 2 years following placement of the levonorgestrel 52-mg intrauterine system. A total of 1751 nulliparous and multiparous females 16 to 45 years old enrolled in a multicenter trial designed to evaluate the efficacy and safety of a new levonorgestrel intrauterine system for up to 7 years. Participants had Chlamydia screening at study entry and yearly if they were age ≤25 years. Women also had baseline gonorrhea screening if testing had not been performed since starting their current sexual relationship. Those who changed sexual partners during the trial had repeated Chlamydia and gonorrhea testing. Intrauterine system insertion could occur on the same day as screening. Participants did not receive prophylactic antibiotics for intrauterine system placement. Investigators performed pelvic examinations after 12 and 24 months and when clinically indicated during visits at 3, 6, and 18 months after placement and unscheduled visits. Pelvic infection included any clinical diagnosis of pelvic inflammatory disease or endometritis. Most participants (n = 1364, 79.6%) did not have sexually transmitted infection test results available prior to intrauterine system placement. In all, 29 (1.7%) participants had positive baseline testing for a sexually transmitted infection (Chlamydia, n = 25; gonorrhea, n = 3; both, n = 1); 6 of these participants had known results (all with Chlamydia infection) prior to intrauterine system placement and received treatment before enrollment. The 23 participants whose results were not known at the time of intrauterine system placement received treatment without intrauterine system removal and none developed pelvic infection. The incidence of positive Chlamydia testing was similar among those with and without known test results at the time of intrauterine system placement (1.9% vs 1.5%, respectively, P = .6). Nine (0.5%) participants had a diagnosis of pelvic infection over 2 years after placement, all of whom had negative Chlamydia screening on the day of or within 1 month after intrauterine system placement. Infections were diagnosed in 3 participants within 7 days, 1 at 39 days, and 5 at ≥6 months. Seven participants received outpatient antibiotic treatment and 2 (diagnoses between 6-12 months after placement) received inpatient treatment. Two (0.1%) participants had intrauterine system removal related to infection (at 6 days and at 7 months after placement), both of whom only required outpatient treatment. Conducting Chlamydia and gonorrhea testing on the same day as intrauterine system placement is associated with a low risk of pelvic infection (0.2%). Over the first 2 years of intrauterine system use, infections are infrequent and not temporally related to intrauterine system placement. Pelvic infection can be successfully treated in most women with outpatient antibiotics and typically does not require intrauterine system removal. Women without clinical evidence of active infection can have intrauterine system placement and sexually transmitted infection screening, if indicated, on the same day. Copyright © 2016 Elsevier Inc. All rights reserved.

Human Immunodeficiency Virus and Chlamydia/Gonorrhea Testing among Heterosexual College Students: Who Is Getting Tested and Why Do Some Not?

ERIC Educational Resources Information Center

Moore, Erin W.

2013-01-01

Objective: This study explored college students' reported history of human immunodeficiency virus (HIV) and chlamydia/gonorrhea and characteristics of students reporting testing. Additionally, it assessed their motivation regarding future testing and reasons for lack of motivation. Participants: The sample consisted of 292 sexually experienced…

Nucleotide and phylogenetic analyses of the Chlamydia trachomatis ompA gene indicates it is a hotspot for mutation

USDA-ARS?s Scientific Manuscript database

Background: Serovars of the human pathogen Chlamydia trachomatis occupy one of three specific tissue niches. Genomic analyses indicate that the serovars have a phylogeny congruent with their pathobiology and have an average substitution rate of less than one nucleotide per kilobase. The ompA gene, h...

Asymptomatic Lymphogranuloma Venereum in Men who Have Sex with Men, United Kingdom.

PubMed

Saxon, Cara; Hughes, Gwenda; Ison, Catherine

2016-01-01

We investigated prevalence of lymphogranuloma venereum (LGV) among men who have sex with men who were tested for chlamydia at 12 clinics in the United Kingdom during 10 weeks in 2012. Of 713 men positive for Chlamydia trachomatis, 66 (9%) had LGV serovars; 15 (27%) of 55 for whom data were available were asymptomatic.

Chlamydia trachomatis in Cervical Lymph Node of Man with Lymphogranuloma Venereum, Croatia, 20141

PubMed Central

Lepej, Snježana Židovec; Cole, Michelle J.; Pitt, Rachel; Begovac, Josip

2018-01-01

We report an HIV-infected person who was treated for lymphogranuloma venereum cervical lymphadenopathy and proctitis in Croatia in 2014. Infection with a variant L2b genovar of Chlamydia trachomatis was detected in a cervical lymph node aspirate. A prolonged course of doxycycline was required to cure the infection. PMID:29553338

Effects of Oxygen on Biodegradation of Fuels in a Corroding Environment

DTIC Science & Technology

2013-06-12

Planctomycetes o Lentisphaerae • Firmicutes • Chloroflexi oChlamydiae • Bacteroidetes • Actinobacteria 100% 90% Q) (,) 80% r:::: ca 70% "C r... Actinobacteria 1.4%~ 2.1 % Chlamydiae 1.4% Lentisphaerae 22.4% 35.0% V errucomicrobia 2.1 % Planctomycetes 6.8% 10.2% 12.5% Bacteroidetes 30.1 % 17.0% 14.0

Detection of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis in infertile Bulgarian men with multiplex real-time polymerase chain reaction.

PubMed

Ouzounova-Raykova, Vessela; Rangelov, Simeon; Ouzounova, Iordanka; Mitov, Ivan

2015-07-01

The effect of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis over the sperm quality is still unclear. The aim of this study was to determine their prevalence in infertile Bulgarian men. A total of 281 men were examined by applying mRT-PCR. The registered prevalence was as follows: C. trachomatis - 13.9%, U. urealyticum - 19.2%, M. hominis - 9.9%. Co-infection was established in eight swabs. This first in Bulgaria to study for detection of chlamydia and mycoplasmas in infertile men by mRT-PCR demonstrates higher prevalence of the tested microorganisms in the infertile group toward the control one. © 2015 APMIS. Published by John Wiley & Sons Ltd.

Genital Chlamydia trachomatis: Understanding the Roles of Innate and Adaptive Immunity in Vaccine Research

PubMed Central

Vasilevsky, Sam; Greub, Gilbert; Nardelli-Haefliger, Denise

2014-01-01

SUMMARY Chlamydia trachomatis is the leading cause of bacterial sexually transmitted disease worldwide, and despite significant advances in chlamydial research, a prophylactic vaccine has yet to be developed. This Gram-negative obligate intracellular bacterium, which often causes asymptomatic infection, may cause pelvic inflammatory disease (PID), ectopic pregnancies, scarring of the fallopian tubes, miscarriage, and infertility when left untreated. In the genital tract, Chlamydia trachomatis infects primarily epithelial cells and requires Th1 immunity for optimal clearance. This review first focuses on the immune cells important in a chlamydial infection. Second, we summarize the research and challenges associated with developing a chlamydial vaccine that elicits a protective Th1-mediated immune response without inducing adverse immunopathologies. PMID:24696438

Treatment of Chlamydia-associated ocular disease via a recombinant protein based vaccine in the koala (Phascolarctos cinereus).

PubMed

Waugh, Courtney; Austin, Ray; Polkinghorne, Adam; Timms, Peter

2016-11-01

Koalas (Phascolarctos cinereus) are affected by debilitating chlamydial disease that can lead to blindness, infertility, and death. The causative agent is the intracellular bacterium Chlamydia pecorum. While antibiotics can be used to treat koala chlamydial infection, they are often ineffective or cause severe dysbiosis to the animal's unique gut flora. Recent work has progressed on the development of a protective vaccine for Chlamydia in the koala. This study demonstrates that the use of a vaccine can have a positive effect in koalas already with clinical signs of ocular disease, suggesting a possible therapeutic effect and an alternative to antibiotic therapy. Copyright © 2016 International Alliance for Biological Standardization. All rights reserved.

Detection of the presence of Chlamydia trachomatis bacteria using diffusing wave spectroscopy with a small number of scatterers

NASA Astrophysics Data System (ADS)

Ulyanov, Sergey; Ulianova, Onega; Filonova, Nadezhda; Moiseeva, Yulia; Zaitsev, Sergey; Saltykov, Yury; Polyanina, Tatiana; Lyapina, Anna; Kalduzova, Irina; Larionova, Olga; Utz, Sergey; Feodorova, Valentina

2018-04-01

Theory of diffusing wave spectroscopy has been firstly adapted to the problem of rapid detection of Chlamydia trachomatis bacteria in blood samples of Chlamydia patients. Formula for correlation function of temporal fluctuations of speckle intensity is derived for the case of small number of scattering events. Dependence of bandwidth of spectrum on average number of scatterers is analyzed. Set-up for detection of the presence of C. trachomatis cells in aqueous suspension is designed. Good agreement between theoretical results and experimental data is shown. Possibility of detection of the presence of C. trachomatis cells in probing volume using diffusing wave spectroscopy with a small number of scatterers is successfully demonstrated for the first time.

Chlamydia muridarum evades growth restriction by the IFN-gamma-inducible host resistance factor Irgb10.

PubMed

Coers, Jörn; Bernstein-Hanley, Isaac; Grotsky, David; Parvanova, Iana; Howard, Jonathan C; Taylor, Gregory A; Dietrich, William F; Starnbach, Michael N

2008-05-01

Chlamydiae are obligate intracellular bacterial pathogens that exhibit a broad range of host tropism. Differences in host tropism between Chlamydia species have been linked to host variations in IFN-gamma-mediated immune responses. In mouse cells, IFN-gamma can effectively restrict growth of the human pathogen Chlamydia trachomatis but fails to control growth of the closely related mouse pathogen Chlamydia muridarum. The ability of mouse cells to resist C. trachomatis replication is largely dependent on the induction of a family of IFN-gamma-inducible GTPases called immunity-related GTPases or IRGs. In this study we demonstrate that C. muridarum can specifically evade IRG-mediated host resistance. It has previously been suggested that C. muridarum inactivates the IRG protein Irga6 (Iigp1) to dampen the murine immune response. However, we show that Irga6 is dispensable for the control of C. trachomatis replication. Instead, an effective IFN-gamma response to C. trachomatis requires the IRG proteins Irgm1 (Lrg47), Irgm3 (Igtp), and Irgb10. Ectopic expression of Irgb10 in the absence of IFN-gamma is sufficient to reduce intracellular growth of C. trachomatis but fails to restrict growth of C. muridarum, indicating that C. muridarum can specifically evade Irgb10-driven host responses. Importantly, we find that Irgb10 protein intimately associates with inclusions harboring C. trachomatis but is absent from inclusions formed by C. muridarum. These data suggest that C. muridarum has evolved a mechanism to escape the murine IFN-gamma response by restricting access of Irgb10 and possibly other IRG proteins to the inclusion.

Cleavage of the NF-κB Family Protein p65/RelA by the Chlamydial Protease-like Activity Factor (CPAF) Impairs Proinflammatory Signaling in Cells Infected with Chlamydiae*

PubMed Central

Christian, Jan; Vier, Juliane; Paschen, Stefan A.; Häcker, Georg

2010-01-01

Chlamydiae are obligate intracellular bacteria that frequently cause human disease. Chlamydiae replicate in a membranous vacuole in the cytoplasm termed inclusion but have the ability to transport proteins into the host cell cytosol. Chlamydial replication is associated with numerous changes of host cell functions, and these changes are often linked to proteolytic events. It has been shown earlier that the member of the NF-κB family of inflammation-associated transcription factors, p65/RelA, is cleaved during chlamydial infection, and a chlamydial protease has been implicated. We here provide evidence that the chlamydial protease chlamydial protease-like activity factor (CPAF) is responsible for degradation of p65/RelA during infection. This degradation was seen in human and in mouse cells infected with either Chlamydia trachomatis or Chlamydia pneumoniae where it correlated with the expression of CPAF and CPAF activity. Isolated expression of active C. trachomatis or C. pneumoniae CPAF in human or mouse cells yielded a p65 fragment of indistinguishable size from the one generated during infection. Expression of active CPAF in human cells caused a mild reduction in IκBα phosphorylation but a strong reduction in NF-κB reporter activity in response to interleukin-1β. Infection with C. trachomatis likewise reduced this responsiveness. IL-1β-dependent secretion of IL-8 was further reduced by CPAF expression. Secretion of CPAF is, thus, a mechanism that reduces host cell sensitivity to a proinflammatory stimulus, which may facilitate bacterial growth in vivo. PMID:21041296

An early evaluation of clinical and economic costs and benefits of implementing point of care NAAT tests for Chlamydia trachomatis and Neisseria gonorrhoea in genitourinary medicine clinics in England.

PubMed

Turner, Katherine M E; Round, Jeff; Horner, Patrick; Macleod, John; Goldenberg, Simon; Deol, Arminder; Adams, Elisabeth J

2014-03-01

To estimate the costs and benefits of clinical pathways incorporating a point of care (POC) nucleic acid amplification test (NAAT) for chlamydia and gonorrhoea in genitourinary medicine (GUM) clinics compared with standard off-site laboratory testing. We simulated 1.2 million GUM clinic attendees in England. A simulation in Microsoft Excel was developed to compare existing standard pathways of management for chlamydia and gonorrhoea with a POC NAAT. We conducted scenario analyses to evaluate the robustness of the model findings. The primary outcome was the incremental cost-effectiveness ratio. Secondary outcomes included the number of inappropriate treatments, complications and transmissions averted. The baseline cost of using the point of POC NAAT was £103.9 million compared with £115.6 million for standard care. The POC NAAT was also associated with a small increase of 46 quality adjusted life years, making the new test both more effective and cheaper. Over 95 000 inappropriate treatments might be avoided by using a POC NAAT. Patients receive diagnosis and treatment on the same day as testing, which may also prevent 189 cases of pelvic inflammatory disease and 17 561 onward transmissions annually. Replacing standard laboratory tests for chlamydia and gonorrhoea with a POC test could be cost saving and patients would benefit from more accurate diagnosis and less unnecessary treatment. Overtreatment currently accounts for about a tenth of the reported treatments for chlamydia and gonorrhoea and POC NAATs would effectively eliminate the need for presumptive treatment.

Identifying a need for more focused treatment of chlamydia and gonorrhoea in the emergency department.

PubMed

Wilson, Sean P; Knych, McKenna; Iordanova, Rossitza; Mahan, Meredith; Vohra, Taher

2016-10-01

The indolent nature of chlamydia and gonorrhoea, along with the time delay associated with current diagnostic testing, makes definitive diagnosis while in the emergency department impossible. We therefore sought to determine the proportion of patients who receive accurate, presumptive antimicrobial treatment for these infections. A retrospective chart review was performed on all patient encounters that underwent chlamydia and gonorrhoea testing at an urban emergency department during a single month in 2012. Each encounter was reviewed for nucleic acid amplification test results and whether presumptive antibiotics were given during the initial visit. A total of 639 patient encounters were reviewed; 87.2% were female and the mean age was 26.7 years. Chlamydia was present in 11.1%, with women and men having similar infection rates: 10.6% vs. 14.6% (p = 0.277). Gonorrhoea was present in 5.0%, with a lower prevalence among women than men: 3.2% vs. 17.1% (p < 0.001). Women received presumptive treatment less often than men: 37.7% vs. 82.9% (p < 0.001). Presumptive treatment was less accurate in women than men: 7.9% vs. 25.6% (p < 0.001). After combining genders, 10.2% received accurate presumptive treatment; 33.3% were overtreated and 4.4% missed treatment. Presumptive treatment for chlamydia and gonorrhoea was more frequent and more accurate in men than in women. Overall, one-third of patients received unnecessary antibiotics, yet nearly 5% missed treatment. Better methods are needed for identifying patients who need treatment. © The Author(s) 2016.

Baseline factors associated with incident HIV and STI in four microbicide trials.

PubMed

Feldblum, Paul J; Lie, Che-Chin; Weaver, Mark A; Van Damme, Lut; Halpern, Vera; Adeiga, Adesina; Bakare, Rashidi; Schwartz, Jill; Becker, Marissa; Solomon, Suniti

2010-10-01

Analyzing pooled data from 4 recent microbicide trials, we aimed to determine characteristics of participants at higher risk of HIV and sexually transmitted infections (STIs), to inform targeted recruitment, preserved study power, and potentially smaller study sizes in future trials. We evaluated the relationships between participants' characteristics and the incidence of HIV, STIs, and reproductive tract infections (RTIs). We calculated incidence rates as the number of infection events divided by the person-years of observation. We applied Cox regression models to assess the relationships between baseline demographic, reproductive and behavioral factors and incident HIV, STIs and RTIs. The pooled incidence rates for HIV, chlamydia, and gonorrhea were 2.1, 6.4 and 9.9 per 100 person-years, respectively. Proportions of participants with trichomoniasis, bacterial vaginosis (BV), and candidiasis were 0.06, 0.40, and 0.40, respectively. In final multivariable models, age and education were significantly (and inversely) associated with incident HIV; baseline chlamydia, baseline trichomoniasis, and younger age were associated with incident Chlamydia; and baseline gonorrhea infection, younger age, less education, nulliparous status, baseline chlamydia, and condom use for contraception were associated with incident gonorrhea. Three factors were associated with trichomoniasis: baseline trichomoniasis infection, baseline chlamydia, and baseline BV. Only younger age was robustly associated with multiple STI outcomes in our multivariable analyses. Although there was little evidence of associations between baseline STIs and incident HIV, they were strongly associated with incident STIs. We found no evidence that measured baseline sexual behavior factors were associated with incident HIV or STIs.

Get Tested Why Not? A novel approach to internet-based chlamydia and gonorrhea testing in Canada.

PubMed

Mann, Tara A; Uddin, Zhaida; Hendriks, Andrew M; Bouchard, Christiane J; Etches, Vera G

2013-03-07

The objective of the Get Tested Why Not campaign is to increase access to chlamydia and gonorrhea testing and sexual health information, with specific focus on youth. Individuals between the ages of 15-29 are most affected by chlamydia and gonorrhea infections in Ottawa and were identified as the target population. Youth from the target population were engaged in the development and launch of the campaign. Development of the campaign began in 2009 and led to a launch on March 21, 2011. Social media promotion as well as traditional advertising approaches developed awareness of the campaign within the target population. The campaign consists of a bilingual, youth-friendly website and texting service. After assessing appropriateness of testing, clients can download a requisition form for urine-based chlamydia and gonorrhea testing and submit a sample at one of 26 laboratories across Ottawa. During year 1 of the campaign, there were 13,385 website hits and 104 specimens submitted for chlamydia and gonorrhea testing. The majority (57.6%, n=60) of requisitions were submitted by members of the target population (age 15-29). Of the requisitions submitted, 95 (91.3%) were negative, 4 (3.9%) were positive and 5 (4.8%) were cancelled due to lab errors. The campaign is reaching the target population and has demonstrated a positive impact on knowledge and intended behaviours of users. The use of technology has expanded testing options, thereby potentially broadening Ottawa Public Health's reach to clients who may be less likely to test through traditional testing approaches.

Chlamydia pecorum: fetal and placental lesions in sporadic caprine abortion.

PubMed

Giannitti, Federico; Anderson, Mark; Miller, Myrna; Rowe, Joan; Sverlow, Karen; Vasquez, Marce; Cantón, Germán

2016-03-01

Chlamydial abortion in small ruminants is usually associated with Chlamydia abortus infection. Although Chlamydia pecorum has been detected in aborted ruminants and epidemiological data suggests that C. pecorum is abortigenic in these species, published descriptions of lesions in fetuses are lacking. This work describes fetoplacental lesions in a caprine abortion with C. pecorum infection, and further supports the abortigenic role of C. pecorum in ruminants. A 16-month-old Boer goat aborted twin fetuses at ~130 days of gestation. Both fetuses (A and B) and the placenta of fetus A were submitted for postmortem examination and diagnostic workup. At autopsy, the fetuses had moderate anasarca, intermuscular edema in the hindquarters (A), and brachygnathia and palatoschisis (B). In the placenta, the cotyledons were covered by yellow fibrinosuppurative exudate that extended into the adjacent intercotyledonary areas. Histologically, there was severe suppurative and necrotizing placentitis with vasculitis (arteriolitis) and thrombosis, multifocal lymphohistiocytic and neutrophilic hepatitis (A), and fibrinosuppurative enteritis in both fetuses. Chlamydia antigen was detected in the placenta by the direct fluorescent antibody test and in fetal intestines by immunohistochemistry. Nested polymerase chain reaction of DNA extracted from formalin-fixed, paraffin-embedded sections of placenta and intestine amplified 400 bp of the Chlamydia 16S rRNA gene that was sequenced and found to be 99% identical to C. pecorum by BLAST analysis. Other known abortigenic infectious agents were ruled out by specific testing. It is concluded that C. pecorum infection is associated with fetoplacental lesions and sporadic abortion in goats. © 2015 The Author(s).

The Predominant CD4+ Th1 Cytokine Elicited to Chlamydia trachomatis Infection in Women Is Tumor Necrosis Factor Alpha and Not Interferon Gamma

PubMed Central

Gupta, Kanupriya; Ogendi, Brian M. O.; Bakshi, Rakesh K.; Kapil, Richa; Press, Christen G.; Sabbaj, Steffanie; Lee, Jeannette Y.

2017-01-01

ABSTRACT Chlamydia trachomatis infection is the most prevalent bacterial sexually transmitted infection and can cause significant reproductive morbidity in women. There is insufficient knowledge of C. trachomatis-specific immune responses in humans, which could be important in guiding vaccine development efforts. In contrast, murine models have clearly demonstrated the essential role of T helper type 1 (Th1) cells, especially interferon gamma (IFN-γ)-producing CD4+ T cells, in protective immunity to chlamydia. To determine the frequency and magnitude of Th1 cytokine responses elicited to C. trachomatis infection in humans, we stimulated peripheral blood mononuclear cells from 90 chlamydia-infected women with C. trachomatis elementary bodies, Pgp3, and major outer membrane protein and measured IFN-γ-, tumor necrosis factor alpha (TNF-α)-, and interleukin-2 (IL-2)-producing CD4+ and CD8+ T-cell responses using intracellular cytokine staining. The majority of chlamydia-infected women elicited CD4+ TNF-α responses, with frequency and magnitude varying significantly depending on the C. trachomatis antigen used. CD4+ IFN-γ and IL-2 responses occurred infrequently, as did production of any of the three cytokines by CD8+ T cells. About one-third of TNF-α-producing CD4+ T cells coproduced IFN-γ or IL-2. In summary, the predominant Th1 cytokine response elicited to C. trachomatis infection in women was a CD4+ TNF-α response, not CD4+ IFN-γ, and a subset of the CD4+ TNF-α-positive cells produced a second Th1 cytokine. PMID:28100498

Chlamydia screening in England: a qualitative study of the narrative behind the policy

PubMed Central

2012-01-01

Background The rationale for the English National Chlamydia Screening Programme (NCSP) has been questioned. There has been little analysis, however, of what drove the NCSP’s establishment and how it was implemented. Such analysis will help inform the future development of the NCSP. This study used a qualitative, theory-driven approach to evaluate the rationale for the NCSP’s establishment and implementation. Methods Semi-structured interviews with 14 experts in chlamydia screening were undertaken. The interview data were analysed with policy documents and commentaries from peer-reviewed journals (published 1996–2010) using the Framework approach. Results Two themes drove the NCSP’s establishment and implementation. The first, chlamydia control, was prominently referenced in documents and interviews. The second theme concerned the potential for chlamydia screening to advance wider improvements in sexual health. In particular, screening was expected to promote sexual health services in primary care and encourage discussion of sexual health with young people. While this theme was only indirectly referenced in policy documents, it was cited by interviewees as a strong influence on implementation in the early years. However, by full rollout of the Programme, a focus on screening volume may have limited the NCSP’s capacity to improve broader aspects of sexual health. Conclusions A combination of explicit and implicit drivers underpinned the Programme’s establishment. This combination may explain why there was widespread support for its introduction and why implementation of the NCSP was inconsistent. The potential to improve young people’s sexual health more comprehensively should be made explicit in future planning of the NCSP. PMID:22545922

Sexual risk behaviours, HIV and other sexually transmitted infections among female sex workers in Indonesia.

PubMed

Magnani, Robert; Riono, Pandu; Nurhayati; Saputro, Eko; Mustikawati, Dyah; Anartati, Atiek; Prabawanti, Ciptasari; Majid, Nurholis; Morineau, Guy

2010-10-01

To assess the HIV/AIDS epidemic situation among female sex workers (FSW) in Indonesia using data from the 2007 Integrated Biological-Behavioural Surveillance (IBBS). Behavioural data were collected from time-location samples of 5947 FSW in 10 cities in late 2007. HIV, syphilis, gonorrhoea and chlamydia test results were obtained for 4396, 4324, 3291 and 3316 FSW, respectively. Trends in HIV prevalence were assessed via linkage with sentinel surveillance data. Factors associated with HIV, gonorrhoea and chlamydia infection were assessed using multivariable logistic regression. HIV prevalence averaged 10.5% among direct and 4.9% among indirect FSW, and had increased steadily among direct FSW from 2002 to 2007. Prevalence of chlamydia, gonorrhoea and active syphilis averaged 35.6%, 31.8% and 7.3%, respectively, among direct FSW, and 28.7%, 14.3% and 3.5% among indirect FSW. Being a direct FSW, younger age and having current infection with syphilis and gonorrhoea and/or chlamydia were associated with a higher likelihood of HIV infection. Number of clients in the past week and consumption of alcohol before having sex were associated with a higher likelihood of gonorrhoea and/or chlamydia infection, while having received a STI clinic check-up in the previous 3 months and/or periodic presumptive treatment for sexually transmitted infections (STIs) in the past 6 months were associated with reduced likelihood of infection. The HIV/AIDS epidemic among FSW in Indonesia appears to be expanding, albeit unevenly across provinces and types of FSW. High STI prevalence is conducive to further expansion, but recent efforts to strengthen STI control appear promising.

Chlamydia muridarum Genital and Gastrointestinal Infection Tropism Is Mediated by Distinct Chromosomal Factors.

PubMed

Morrison, Sandra G; Giebel, Amanda M; Toh, Evelyn C; Spencer, Horace J; Nelson, David E; Morrison, Richard P

2018-07-01

Some members of the genus Chlamydia , including the human pathogen Chlamydia trachomatis , infect multiple tissues, including the genital and gastrointestinal (GI) tracts. However, it is unknown if bacterial targeting to these sites is mediated by multifunctional or distinct chlamydial factors. We previously showed that disruption of individual large clostridial toxin homologs encoded within the Chlamydia muridarum plasticity zone were not critical for murine genital tract infection. Here, we assessed whether cytotoxin genes contribute to C. muridarum GI tropism. Infectivity and shedding of wild-type (WT) C. muridarum and three mutants containing nonsense mutations in different cytotoxin genes, tc0437 , tc0438 , and tc0439 , were compared in mouse genital and GI infection models. One mutant, which had a nonsense mutation in tc0439 , was highly attenuated for GI infection and had a GI 50% infectious dose (ID 50 ) that was 1,000 times greater than that of the WT. GI inoculation with this mutant failed to elicit anti-chlamydial antibodies or to protect against subsequent genital tract infection. Genome sequencing of the tc0439 mutant revealed additional chromosomal mutations, and phenotyping of additional mutants suggested that the GI attenuation might be linked to a nonsense mutation in tc0600 The molecular mechanism underlying this dramatic difference in tissue-tropic virulence is not fully understood. However, isolation of these mutants demonstrates that distinct chlamydial chromosomal factors mediate chlamydial tissue tropism and provides a basis for vaccine initiatives to isolate chlamydia strains that are attenuated for genital infection but retain the ability to colonize the GI tract and elicit protective immune responses. Copyright © 2018 Morrison et al.

Seroprevalence of Chlamydia trachomatis in Enugu, Nigeria.

PubMed

Ikeme, A C; Ezegwui, H U; Ikeako, L C; Agbata, I; Agbata, E

2011-01-01

Chlamydia infections in women cause pelvic inflammatory disease, which often results in devastating consequences of infertility, ectopic pregnancy, or chronic pelvic pain. The infection is largely asymptomatic. To determine the seroprevalence of Chlamydia trachomatis in Enugu, South Eastern Nigeria. A population-based prospective study comprising female residents of Enugu, South Eastern Nigeria. Indirect solid phase enzyme immunoassay of Chlamydia antibodies was done using ImmunoComb C0. Trachomatis IgG Kit (Orgenics). The population comprised 136 female undergraduate students and 150 non-student women. The overall prevalence of C. trachomatis in the population studied was 29.4%. The percentage of subjects who admitted to be having multiple sexual partners was higher among the student population (71.2%) compared to those from the non-student population (28.8%). The highest percentage of seroprevalence was 28 (33.3%) in the age group of 20-24 years for the student population and 18 (21.4%) in the age group of 25-29 years for the non-student population. The highest seroprevalence of C. trachomatis antibodies (69.0%) in both populations was observed in females without any history of infection. Females that had pelvic inflammatory disease, sexually transmitted infection, and secondary infertility assayed for C. trachomatis had seroprevalence levels of 19%, 9.5%, and 2.4%, respectively. There was a positive correlation between positive Chlamydia assay and the type of subject population (student or non-student) with r2 value of 1.55 at P < 0.01. C. trachomatis infection is largely underdiagnosed and remains a silent disease in the apparently healthy population of Enugu, South eastern Nigeria.

Rates of Asymptomatic Nonurethral Gonorrhea and Chlamydia in a Population of University Men Who Have Sex with Men

ERIC Educational Resources Information Center

Pinsky, Laura; Chiarilli, Daniel B.; Klausner, Jeffrey D.; Kull, Ryan M.; O'Keefe, Richard; Heffer, Calley; Seward, Samuel L., Jr.

2012-01-01

Objectives: The study determined prevalence of asymptomatic nonurethral gonorrhea and chlamydia in men who have sex with men (MSM) seen at the Columbia University Health Service for routine care. Participants: The study enrolled 200 participants from March 2007 to May 2010. Results: Specimens were tested using culture and nucleic acid…

HPV vaccine catch up schedule - an opportunity for chlamydia screening.

PubMed

Grotowski, Miriam; May, Jenny

2008-07-01

The human papillomavirus (HPV) vaccine (Gardasil) catch up schedule in general practice is available until June 2009 to females not in school and under the age of 27 years. A course of three injections is given over 6 months. This provides a unique opportunity for sexual health screening in an age group where chlamydia screening is a priority.

Asymptomatic Lymphogranuloma Venereum in Men who Have Sex with Men, United Kingdom

PubMed Central

Saxon, Cara; Ison, Catherine

2016-01-01

We investigated prevalence of lymphogranuloma venereum (LGV) among men who have sex with men who were tested for chlamydia at 12 clinics in the United Kingdom during 10 weeks in 2012. Of 713 men positive for Chlamydia trachomatis, 66 (9%) had LGV serovars; 15 (27%) of 55 for whom data were available were asymptomatic. PMID:26691688

Rapid Determination of Lymphogranuloma Venereum Serovars of Chlamydia trachomatis by Quantitative High-Resolution Melt Analysis (HRMA)

PubMed Central

Stevens, Matthew P.; Garland, Suzanne M.; Zaia, Angelo M.; Tabrizi, Sepehr N.

2012-01-01

A quantitative high-resolution melt analysis assay was developed to differentiate lymphogranuloma venereum-causing serovars of Chlamydia trachomatis (L1 to L3) from other C. trachomatis serovars (D to K). The detection limit of this assay is approximately 10 copies per reaction, comparable to the limits of other quantitative-PCR-based methods. PMID:22933594

A simple and rapid DNA extraction method for Chlamydia trachomatis detection from urogenital swabs.

PubMed

Butzler, Matthew A; Reed, Jennifer L; McFall, Sally M

2017-11-01

A highly sensitive and specific Chlamydia trachomatis (CT) diagnostic test was developed by combining filtration isolation of nucleic acid (FINA) extraction with quantitative polymerase chain reaction including an internal control to identify test inhibition. A pilot study of 40 clinical specimens yielded 100% sensitivity and specificity. Copyright © 2017 Elsevier Inc. All rights reserved.

Targeting of a chlamydial protease impedes intracellular bacterial growth.

PubMed

Christian, Jan G; Heymann, Julia; Paschen, Stefan A; Vier, Juliane; Schauenburg, Linda; Rupp, Jan; Meyer, Thomas F; Häcker, Georg; Heuer, Dagmar

2011-09-01

Chlamydiae are obligate intracellular bacteria that propagate in a cytosolic vacuole. Recent work has shown that growth of Chlamydia induces the fragmentation of the Golgi apparatus (GA) into ministacks, which facilitates the acquisition of host lipids into the growing inclusion. GA fragmentation results from infection-associated cleavage of the integral GA protein, golgin-84. Golgin-84-cleavage, GA fragmentation and growth of Chlamydia trachomatis can be blocked by the peptide inhibitor WEHD-fmk. Here we identify the bacterial protease chlamydial protease-like activity factor (CPAF) as the factor mediating cleavage of golgin-84 and as the target of WEHD-fmk-inhibition. WEHD-fmk blocked cleavage of golgin-84 as well as cleavage of known CPAF targets during infection with C. trachomatis and C. pneumoniae. The same effect was seen when active CPAF was expressed in non-infected cells and in a cell-free system. Ectopic expression of active CPAF in non-infected cells was sufficient for GA fragmentation. GA fragmentation required the small GTPases Rab6 and Rab11 downstream of CPAF-activity. These results define CPAF as the first protein that is essential for replication of Chlamydia. We suggest that this role makes CPAF a potential anti-infective therapeutic target.

Sero-epidemiological assessment of Chlamydia trachomatis infection and sub-fertility in Samoan women.

PubMed

Menon, S; Stansfield, S H; Walsh, M; Hope, E; Isaia, L; Righarts, A A; Niupulusu, T; Temese, S V A; Iosefa-Siitia, L; Auvaa, L; Tapelu, S A; Motu, M F; Suaalii-Sauni, T; Timms, P; Hill, P C; Huston, W M

2016-04-21

In our recent village-based cross-sectional study, the prevalence of nucleic acid amplification technique (NAAT) diagnosed Chlamydia trachomatis (CT) in sexually active Samoan women was very high (36 %), and test positivity was associated with sub-fertility. We conducted a serological and epidemiological analysis in these participants to identify if serological data can provide further insight into the potential contribution of CT to sub-fertility in this population. Serological prediction of CT associated sub-fertility was conducted using a series of commercial tests. The correlation between fertility or sub-fertility, behavioral factors, and serologically predicted CT associated sub-fertility was determined. A positive antibody reaction against the Chlamydia Major Outer Membrane Protein (MOMP) was significantly associated with sub-fertility, with 50 % of infertile women being positive. Serum IgG and IgA antibodies against MOMP correlated with current infection measured by urine NAAT, suggesting longer term infections are common in this population. Chlamydia pneumoniae antibodies were frequently detected in this population (84 %), and unexpectedly, were significantly associated with sub-fertility. The high prevalence of chlamydial infection and of positive chlamydial sub-fertility results suggests that CT is an important and frequent contributory factor to sub-fertility in this population.

Clinical evaluation of a new single-tube multiplex reverse transcription PCR assay for simultaneous detection of 11 respiratory viruses, Mycoplasma pneumoniae and Chlamydia in hospitalized children with acute respiratory infections.

PubMed

Zhao, Meng-Chuan; Li, Gui-Xia; Zhang, Dan; Zhou, Hang-Yu; Wang, Hao; Yang, Shuo; Wang, Le; Feng, Zhi-Shan; Ma, Xue-Jun

2017-06-01

Respiratory Pathogen 13 Detection Kit (13× kit) is able to simultaneously detect 11 respiratory viruses, Mycoplasma pneumoniae (MP) and Chlamydia in a single reaction. Using 572 Nasopharyngeal aspirates collected from hospitalized children, the clinical performance of 13× kit for detecting 11 respiratory viruses was evaluated in comparison with a routinely used 2-tube multiplex reverse transcription PCR assay (2-tube assay) at provincial Centers for Disease Control and Prevention in China. The clinical performance of 13× kit for detecting MP and Chlamydia was evaluated by commercial real-time quantitative PCR (qPCR) kits or sequencing. For tested viruses, the assay concordance was 95.98% and the kappa coefficient was 0.89. All the MP and Chlamydia positive samples detected by 13× kit were confirmed as true positives. The utilization of the 13× kit in clinical settings will be helpful for doctors to assess clinical outcome according to virus type or multiple infections, and to limit the use of antibiotics. Copyright © 2017 Elsevier Inc. All rights reserved.

The immune response against Chlamydia suis genital tract infection partially protects against re-infection.

PubMed

De Clercq, Evelien; Devriendt, Bert; Yin, Lizi; Chiers, Koen; Cox, Eric; Vanrompay, Daisy

2014-09-25

The aim of the present study was to reveal the characteristic features of genital Chlamydia suis infection and re-infection in female pigs by studying the immune response, pathological changes, replication of chlamydial bacteria in the genital tract and excretion of viable bacteria. Pigs were intravaginally infected and re-infected with C. suis strain S45, the type strain of this species. We demonstrated that S45 is pathogenic for the female urogenital tract. Chlamydia replication occurred throughout the urogenital tract, causing inflammation and pathology. Furthermore, genital infection elicited both cellular and humoral immune responses. Compared to the primo-infection of pigs with C. suis, re-infection was characterized by less severe macroscopic lesions and less chlamydial elementary bodies and inclusions in the urogenital tract. This indicates the development of a certain level of protection following the initial infection. Protective immunity against re-infection coincided with higher Chlamydia-specific IgG and IgA antibody titers in sera and vaginal secretions, higher proliferative responses of peripheral blood mononuclear cells (PBMC), higher percentages of blood B lymphocytes, monocytes and CD8⁺ T cells and upregulated production of IFN-γ and IL-10 by PBMC.

Effect of cold water-induced stress on immune response, pathology and fertility in mice during Chlamydia muridarum genital infection

PubMed Central

Belay, Tesfaye; Woart, Anthony; Graffeo, Vincent

2017-01-01

Abstract Genital infection by Chlamydia trachomatis is the most common bacterial sexually transmitted disease worldwide. It causes serious reproductive health complications, including pelvic inflammatory disease and infertility. Stress is implicated as a risk factor for various infections; however, its effect on chlamydia genital infection is unknown. We previously showed that repeated exposure of mice to cold water results in increased severity of chlamydia genital infection. In this study, cold water-induced stress resulted in (i) elevated levels of norepinephrine (NE) and epinephrine in the spleen and genital tract of stressed mice; (ii) elevated IL-1β, TNF-α, IL-6 and nitric oxide production in macrophage-rich peritoneal cells of mice; (iii) supplement of NE in vitro exerts an immunosuppressive effect on splenic T-cell production of cytokines; (iv) decreased C. muridarum shedding in the genital tract of β1Adr/β2Adr receptor KO mice; and (v) a higher rate of infertility in infected mice. These results suggest that cold water stress induces the production of catecholamines, which may play a critical role in the modulation of the immune system leading to increased intensity of C. muridarum genital infection. PMID:28431099

Immunohistochemical detection of chlamydiae in formalin-fixed tissue sections: comparison of a monoclonal antibody with yolk derived antibodies (IgY).

PubMed

Kunz, U S; Pospischil, A; Paccaud, M F

1991-06-01

Immunohistological detection of chlamydiae in formalin-fixed and paraffin-embedded sections of various organs from several species is described. In a retrospective study, two antisera, a commercially available monoclonal murine antibody (IgMur) and vitelline immunoglobulins (IgY), extracted from the egg yolk of immunized hens, were compared and tested for their applicability under routine condition. Both antisera were applied to tissues from which chlamydiae had been isolated or in which the presence of chlamydiae had been suspected in specially stained sections. Antigen labelling was optimal with the monoclonal antibody. Vitelline immunoglobulins produced some unspecific reactions, especially in lung tissue sections. Because of the antigenic relationship between the vitelline antibodies and tissues of birds, IgY are not suitable for the detection of psittacosis on avian substrates, when using an indirect immunological method. Staining in other tissues e.g. intestine or placenta was of equal quality as that attained with monoclonal antibodies. Depending on the advantages and disadvantages in every individual case, one of the two antibodies may be chosen for further studies. Vitelline antibodies should be preferred with respect to animal welfare.

Prevalence of Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae Based on Data Collected by a Network of Clinical Microbiology Laboratories, in Italy.

PubMed

Salfa, Maria Cristina; Suligoi, Barbara

Bacterial and protozoal sexually transmitted infections (STIs), such as Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae, may cause acute symptoms, chronic infections and severe long-term complications. The complications of these infections in women include pelvic inflammatory disease, chronic pelvic pain, tubal infertility, ectopic pregnancy, and infertility. Moreover, infection during pregnancy is associated with premature rupture of the membranes, low birth weight and miscarriage.In Italy, Chlamydia trachomatis and Trichomonas vaginalis infections are not subject to mandatory reporting; while gonorrhoea is subject to mandatory reporting.To extend surveillance to STIs that are widespread yet often asymptomatic and to improve the knowledge on the epidemiology of these infections in Italy, in 2009 the "Centro Operativo AIDS of the Istituto Superiore di SanitÁ", in collaboration with the Association of Italian Clinical Microbiologists (AMCLI, Associazione Microbiologi Clinici Italiani), launched the sentinel STIs surveillance system based on a network of 13 clinical microbiology laboratories.The main objective of the surveillance was to assess the prevalence and risk factors associated with Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoea infections among individuals attending microbiology laboratories in Italy.

Infection of Hysterectomized Mice with Chlamydia muridarum and Chlamydia trachomatis

PubMed Central

Yang, Chunfu; Whitmire, William M.; Sturdevant, Gail L.; Bock, Kevin; Moore, Ian

2017-01-01

ABSTRACT We studied infection and immunity of hysterectomized mice infected with Chlamydia muridarum and Chlamydia trachomatis to determine if there were differences between these species in their ability to infect vaginal squamous epithelial cells in vivo independently of proximal upper genital tract tissues. We found that C. muridarum readily colonized and infected vaginal squamous epithelial cells, whereas C. trachomatis did not. Primary infection of the vaginal epithelium with C. muridarum produced infections of a duration longer than that reported for normal mice. Infection resulted in an inflammatory response in the vagina characterized by neutrophils and infiltrating submucosal plasma cells consisting primarily of T cells. Despite the delayed clearance, rechallenged C. muridarum-infected mice were highly immune. Mice vaginally infected with C. muridarum produced serum and vaginal wash antibodies and an antigen-specific gamma interferon-dominated Th1-biased T cell response. By comparison, mice vaginally infected with C. trachomatis exhibited transient low-burden infections, produced no detectable tissue inflammatory response, and failed to seroconvert. We discuss how these marked differences in the biology of vaginal infection between these otherwise genetically similar species are possibly linked to pathogen-specific virulence genes and how they may influence pathology and immunity in the upper genital tract. PMID:28461392

Attachment defect in mouse fibroblasts (L cells) persistently infected with Chlamydia psittaci.

PubMed Central

Moulder, J W; Levy, N J; Zeichner, S L; Lee, C K

1981-01-01

Almost all the cells in populations of mouse fibroblasts (L cells) persistently infected with the 6BC strain of Chlamydia psittaci were immune to superinfection with high multiplicities of C. psittaci, whether or not the L cells contained visible chlamydial inclusions. As ascertained by experiments with 14C-labeled C. psittaci, immunity to superinfection resulted from the failure of added chlamydiae to attach to persistently infected host cells. However, when exogenous C. psittaci was introduced into persistently infected L cells by centrifuging the inoculum onto host cell monolayers or by pretreating the monolayers with diethylaminoethyl-dextran, these chlamydiae produced expected numbers of infectious progeny. Persistently infected L cells were associated in an unknown way with a C. psittaci population that entered the host cells only with the aid of centrifugation or pretreatment with diethylaminoethyl-dextran. Inclusion-free, persistently infected L cells appeared to present at least two separate hindrances to chlamydial activity: blockage of the attachment of exogenous elementary bodies to persistently infected host cells and prevention of the initiation of chlamydial multiplication by means of a normal developmental cycle in the absence of added C. psittaci. Images PMID:7298188

Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia

PubMed Central

Adachi, Kristina; Nielsen-Saines, Karin

2016-01-01

Screening and treatment of sexually transmitted infections (STIs) in pregnancy represents an overlooked opportunity to improve the health outcomes of women and infants worldwide. Although Chlamydia trachomatis is the most common treatable bacterial STI, few countries have routine pregnancy screening and treatment programs. We reviewed the current literature surrounding Chlamydia trachomatis in pregnancy, particularly focusing on countries in sub-Saharan Africa and Asia. We discuss possible chlamydial adverse pregnancy and infant health outcomes (miscarriage, stillbirth, ectopic pregnancy, preterm birth, neonatal conjunctivitis, neonatal pneumonia, and other potential effects including HIV perinatal transmission) and review studies of chlamydial screening and treatment in pregnancy, while simultaneously highlighting research from resource-limited countries in sub-Saharan Africa and Asia. PMID:27144177

Patterns of chlamydia testing in different settings and implications for wider STI diagnosis and care: a probability sample survey of the British population.

PubMed

Clifton, Soazig; Mercer, Catherine H; Woodhall, Sarah C; Sonnenberg, Pam; Field, Nigel; Lu, Le; Johnson, Anne M; Cassell, Jackie A

2017-06-01

Following widespread rollout of chlamydia testing to non-specialist and community settings in the UK, many individuals receive a chlamydia test without being offered comprehensive STI and HIV testing. We assess sexual behaviour among testers in different settings with a view to understanding their need for other STI diagnostic services. A probability sample survey of the British population undertaken 2010-2012 (the third National Survey of Sexual Attitudes and Lifestyles). We analysed weighted data on chlamydia testing (past year), including location of most recent test, and diagnoses (past 5 years) from individuals aged 16-44 years reporting at least one sexual partner in the past year (4992 women, 3406 men). Of the 26.8% (95% CI 25.4% to 28.2%) of women and 16.7% (15.5% to 18.1%) of men reporting a chlamydia test in the past year, 28.4% of women and 41.2% of men had tested in genitourinary medicine (GUM), 41.1% and 20.7% of women and men respectively tested in general practice (GP) and the remainder tested in other non-GUM settings. Women tested outside GUM were more likely to be older, in a relationship and to live in rural areas. Individuals tested outside GUM reported fewer risk behaviours; nevertheless, 11.0% (8.6% to 14.1%) of women and 6.8% (3.9% to 11.6%) of men tested in GP and 13.2% (10.2% to 16.8%) and 9.6% (6.5% to 13.8%) of women and men tested in other non-GUM settings reported 'unsafe sex', defined as two or more partners and no condom use with any partner in the past year. Individuals treated for chlamydia outside GUM in the past 5 years were less likely to report an HIV test in that time frame (women: 54.5% (42.7% to 65.7%) vs 74.1% (65.9% to 80.9%) in GUM; men: 23.9% (12.7% to 40.5%) vs 65.8% (56.2% to 74.3%)). Most chlamydia testing occurred in non-GUM settings, among populations reporting fewer risk behaviours. However, there is a need to provide pathways to comprehensive STI care to the sizeable minority at higher risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Changing Pattern of Chlamydia trachomatis Strains in Lymphogranuloma Venereum Outbreak, France, 2010-2015.

PubMed

Peuchant, Olivia; Touati, Arabella; Sperandio, Clément; Hénin, Nadège; Laurier-Nadalié, Cécile; Bébéar, Cécile; de Barbeyrac, Bertille

2016-11-01

We describe a change in the molecular epidemiology of Chlamydia trachomatis strains involved in an outbreak of rectal lymphogranuloma venereum in France during January 2010-April 2015. Until 2012, the C. trachomatis L2b strain predominated; however, starting in 2013, most cases involved the L2 strain. We also identified 4 genetic L2b ompA variants.

Man up Monday: An Integrated Public Health Approach to Increase Sexually Transmitted Infection Awareness and Testing among Male Students at a Midwest University

ERIC Educational Resources Information Center

Anderson, Elizabeth A.; Eastman-Mueller, Heather P.; Henderson, Scott; Even, Susan

2016-01-01

Objective: This campaign sought to (a) increase awareness of sexual health and chlamydia testing; (b) motivate students, particularly sexually active men who do not pursue regular sexually transmitted infection (STI) testing, to get tested; and (c) improve the capacity of the student health center to provide free chlamydia testing and treatment…

"Pee-in-a-Pot": acceptability and uptake of on-site chlamydia screening in a student population in the Republic of Ireland

PubMed Central

2010-01-01

Background The aim of the study was to explore the acceptability and uptake of on-campus screening using a youth friendly approach in two Third Level higher education institutions (HEIs). This study is part of wider research exploring the optimal setting for chlamydia screening in Ireland. Methods Male and female students were given the opportunity to take a free anonymous test for chlamydia during a one week programme of "pee-in-a-pot" days at two HEI campuses in the West of Ireland. The study was set up after extensive consultation with the two HEIs and advertised on the two campuses using a variety of media in the two weeks preceding the screening days. Screening involved the provision and distribution of testing packs at communal areas and in toilet facilities. In Ireland, chlamydia notifications are highest amongst 20-29 year olds and hence the screening criterion was aimed at 18-29 year olds. Urine samples were tested using a nucleic acid amplification test (NAAT). Following the screening days, qualitative in-depth interviews were conducted with participants about their experiences of the event. Results Out of 1,249 test kits distributed in two HEIs, 592 specimens were collected giving a return rate of 47.5%. Tests excluded (54) were due to labelling errors or ineligibility of participants' age. Two thirds of those tested were females and the mean age was 21 years. Overall,3.9% (21/538) of participants tested positive, 5% (17/336) among females and 2% (4/191) among males. Participant interviews identified factors which enhanced student participation such as anonymity, convenience, accessibility of testing, and the informal and non-medical approach to testing. Conclusions Screening for chlamydia using on-campus "pee-in-a-pot" days is an acceptable strategy in this population. This model can detect and treat asymptomatic cases of chlamydia and avoid many of the barriers associated with testing for sexually transmitted infections (STIs) in clinical settings. PMID:21070646

Understanding sexual activity and Chlamydia testing rate based on linked national survey and Medicaid claims data.

PubMed

Tao, Guoyu; Hua, Jennifer; Chen, Jessica L

2015-01-01

Monitoring adherence to national recommendations for annual chlamydia screening of female adolescents and young adult women is important for targeting quality improvement interventions to improve low screening rates. However, accurate measurement of rates may vary depending on the data source used to determine eligible sexually-active women. The 2001-2004 NHANES data linked with Medicaid administrative data by respondent's unique identifier, the 2011-2012 NHANES data, and the 2004 and 2010 Medicaid data were used in this cross-sectional analysis. We defined self-reported sexual activity by self-reported sexual behaviors, claim-identified sexual activity by reproductive-related claims among women who had ≥ one healthcare claim, HEDIS-defined sexual activity by reproductive-related claims among women who were enrolled in Medicaid for ≥330 days and had ≥ one healthcare claim, and chlamydia tests by claims submitted in the 12 months prior to the survey interview. Of Medicaid women aged 18-25 years, 91.5% self-reported to be sexually-active. Of self-reported sexually-active women aged 18-25 years, 92.0% had ≥ one healthcare claim in the 12 months prior to the survey interview; of this subpopulation, only 58.8% were enrolled in Medicaid for ≥ 330 days in the 12 months prior to the survey interview; of this further subpopulation, 74.1% had healthcare claims identifying them as sexually-active in the 12 months prior to the survey interview. Of HEDIS-defined sexually-active women, 42.4% had chlamydia testing. Our study suggests that the number of sexually-active women aged 18-25 years used as the denominator in the chlamydia testing measure could be significantly different, depending upon the definition applied and the data used. Our data highlight the limited representativeness of Medicaid population in the current HEDIS measure on chlamydia testing when a high proportion of women who were enrolled in Medicaid for <330 days had been excluded from the measure. The interventions that can improve the proportion of women who were enrolled in Medicaid for ≥ 330 days among all young Medicaid women are needed not only for improving health care services, but also for measuring quality of healthcare.

Clinical, diagnostic and pathologic features of presumptive cases of Chlamydia pecorum-associated arthritis in Australian sheep flocks.

PubMed

Walker, Evelyn; Moore, Cecily; Shearer, Patrick; Jelocnik, Martina; Bommana, Sankhya; Timms, Peter; Polkinghorne, Adam

2016-09-08

Arthritis is an economically significant disease in lambs and is usually the result of a bacterial infection. One of the known agents of this disease is Chlamydia pecorum, a globally recognised livestock pathogen associated with several diseases in sheep, cattle and other hosts. Relatively little published information is available on the clinical, diagnostic and pathologic features of C. pecorum arthritis in sheep, hindering efforts to enhance our understanding of this economically significant disease. In this case series, a combination of standard diagnostic testing used routinely by veterinarians, such as the Chlamydia complement fixation text (CFT), veterinary clinical examinations, and additional screening via C. pecorum specific qPCR was used to describe putative chlamydial infections in five sheep flocks with suspected ovine arthritis. Five separate cases involving multiple lambs (aged six to ten months) of different breeds with suspected C. pecorum arthritis are presented. In two of the five cases, arthritic lambs exhibited marked depression and lethargy. Arthritis with concurrent conjunctivitis was present in four out of five lamb flocks examined. Chlamydia CFT demonstrated medium to high positive antibody titres in all flocks examined. C. pecorum shedding was evident at multiple sites including the conjunctiva, rectum and vagina, as determined via qPCR. Two of the five flocks received antimicrobials and all flocks recovered uneventfully regardless of treatment. This case series highlights the features a field veterinarian may encounter in cases of suspected ovine chlamydial arthritis. Our analysis suggests a presumptive diagnosis of chlamydial arthritis in lambs can be made when there is evidence of joint stiffness with or without synovial effusion and elevated chlamydia antibody titres. C. pecorum-specific qPCR was found to be a useful ancillary diagnostic tool, detecting Chlamydia positivity in low or negative CFT titre animals. Variables such as symptom duration relative to sampling, sheep breed and farm management practices were all factors recorded that paint a complex epidemiological and diagnostic picture for this disease. These case studies serve to provide a platform for further research to improve diagnostic testing and new treatment and control strategies for C. pecorum infections in sheep.

The influence of two different invitation letters on Chlamydia testing participation: randomized controlled trial.

PubMed

Ten Hoor, Gill; Hoebe, Christian Jpa; van Bergen, Jan Eam; Brouwers, Elfi Ehg; Ruiter, Robert Ac; Kok, Gerjo

2014-01-30

In The Netherlands, screening for chlamydia (the most prevalent sexually transmitted infection worldwide) is a relatively simple and free procedure. Via an invitation letter sent by the public health services (PHS), people are asked to visit a website to request a test kit. They can then do a chlamydia test at home, send it anonymously to a laboratory, and, within two weeks, they can review their test results online and be treated by their general practitioner or the PHS. Unfortunately, the participation rates are low and the process is believed to be not (cost-) effective. The objective of this study was to assess whether the low participation rate of screening for chlamydia at home, via an invitation letter asking to visit a website and request a test kit, could be improved by optimizing the invitation letter through systematically applied behavior change theories and evidence. The original letter and a revised letter were randomly sent out to 13,551 citizens, 16 to 29 years old, in a Dutch municipality. Using behavior change theories, the revised letter sought to increase motivation to conduct chlamydia screening tests. The revised letter was tailored to beliefs that were found in earlier studies: risk perception, advantages and disadvantages (attitude), moral norm, social influence, and response- and self-efficacy. Revisions to the new letter also sought to avoid possible unwanted resistance caused when people feel pressured, and included prompts to trigger the desired behavior. No significant differences in test package requests were found between the two letters. There were also no differences between the original and revised letters in the rates of returned tests (11.80%, 581/4922 vs. 11.07%, 549/4961) or positive test results (4.8%, 23/484 vs. 4.1%, 19/460). It is evident that the new letter did not improve participation compared to the original letter. It is clear that the approach of inviting the target population through a letter does not lead to higher participation rates for chlamydia screening. Other approaches have to be developed and pilot tested.

Approche à la lymphogranulomatose vénérienne

PubMed Central

O’Byrne, Patrick; MacPherson, Paul; DeLaplante, Stephane; Metz, Gila; Bourgault, Andree

2016-01-01

Résumé Objectif Revoir la littérature sur la lymphogranulomatose vénérienne (LGV) donner un aperçu des lignes directrices de pratique clinique et en discuter. Sources d’information Les mots-clés Chlamydia trachomatis et lymphogranuloma venereum (en anglais) ont séparément fait l’objet d’une recherche dans PubMed. Des études empiriques, revues pratiques et lignes directrices de pratique clinique ont été incluses. Toutes les listes de références ont été examinées pour relever d’autres articles. Message principal Depuis 2003, la LGV refait surface dans de nombreux pays occidentaux, y compris au Canada parmi les hommes ayant des relations sexuelles avec des hommes. Bien que la LGV soit un sérotype de Chlamydia trachomatis (sérotype L), elle peut envahir les ganglions lymphatiques régionaux, et donc se manifester par des symptômes qui diffèrent de ceux des autres sous-types de chlamydia (sérotypes A à K). En particulier, la LGV consiste en 3 phases : papule ou ulcère non douloureux au point d’inoculation; envahissement des ganglions lymphatiques régionaux, pouvant se manifester par un syndrome inguinal or rectal; et destruction irréversible du tissu lymphatique. Les sérotypes A à K de chlamydia, quant à eux, produisent exclusivement des infections superficielles de la muqueuse. La lymphogranulomatose vénérienne nécessite aussi un schéma thérapeutique différent de celui pour les autres sérotypes de chlamydia. Conclusion À la lumière de la résurgence actuelle de la LGV, de ses symptômes et de son évolution clinique uniques, et de la nécessité d’un traitement qui diffère de celui des autres sérotypes de chlamydia, il importe que les fournisseurs de soins de première ligne reconnaissent quand il faut inclure la LGV dans le diagnostic différentiel.

Dendrimer-conjugated peptide vaccine enhances clearance of Chlamydia trachomatis genital infection.

PubMed

Ganda, Ingrid S; Zhong, Qian; Hali, Mirabela; Albuquerque, Ricardo L C; Padilha, Francine F; da Rocha, Sandro R P; Whittum-Hudson, Judith A

2017-07-15

Peptide-based vaccines have emerged in recent years as promising candidates in the prevention of infectious diseases. However, there are many challenges to maintaining in vivo peptide stability and enhancement of peptide immunogenicity to generate protective immunity which enhances clearance of infections. Here, a dendrimer-based carrier system is proposed for peptide-based vaccine delivery, and shows its anti-microbial feasibility in a mouse model of Chlamydia trachomatis. Chlamydiae are the most prevalent sexually transmitted bacteria worldwide, and also the causal agent of trachoma, the leading cause of preventable infectious blindness. In spite of the prevalence of this infectious agent and the many previous vaccine-related studies, there is no vaccine commercially available. The carrier system proposed consists of generation 4, hydroxyl-terminated, polyamidoamine (PAMAM) dendrimers (G4OH), to which a peptide mimic of a chlamydial glycolipid antigen-Peptide 4 (Pep4, AFPQFRSATLLL) was conjugated through an ester bond. The ester bond between G4OH and Pep4 is expected to break down mainly in the intracellular environment for antigen presentation. Pep4 conjugated to dendrimer induced Chlamydia-specific serum antibodies after subcutaneous immunizations. Further, this new vaccine formulation significantly protected immunized animals from vaginal challenge with infectious Chlamydia trachomatis, and it reduced infectious loads and tissue (genital tract) damage. Pep4 conjugated to G4OH or only mixed with peptide provided enhanced protection compared to Pep4 and adjuvant (i.e. alum), suggesting a potential adjuvant effect of the PAMAM dendrimer. Combined, these results demonstrate that hydroxyl-terminated PAMAM dendrimer is a promising polymeric nanocarrier platform for the delivery of peptide vaccines and this approach has potential to be expanded to other infectious intracellular bacteria and viruses of public health significance. Copyright © 2017 Elsevier B.V. All rights reserved.

Behavioral and community correlates of adolescent pregnancy and Chlamydia rates in rural counties in Minnesota.

PubMed

Kozhimannil, Katy B; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

2015-06-01

Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Pregnancy and chlamydia infection rates among 15-19 year-old females were compared across Minnesota's 87 counties, stratified by rural/urban designations. Regression models for rural counties (n = 66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study.

Missed opportunities for concurrent HIV-STD testing in an academic emergency department.

PubMed

Klein, Pamela W; Martin, Ian B K; Quinlivan, Evelyn B; Gay, Cynthia L; Leone, Peter A

2014-01-01

We evaluated emergency department (ED) provider adherence to guidelines for concurrent HIV-sexually transmitted disease (STD) testing within an expanded HIV testing program and assessed demographic and clinical factors associated with concurrent HIV-STD testing. We examined concurrent HIV-STD testing in a suburban academic ED with a targeted, expanded HIV testing program. Patients aged 18-64 years who were tested for syphilis, gonorrhea, or chlamydia in 2009 were evaluated for concurrent HIV testing. We analyzed demographic and clinical factors associated with concurrent HIV-STD testing using multivariate logistic regression with a robust variance estimator or, where applicable, exact logistic regression. Only 28.3% of patients tested for syphilis, 3.8% tested for gonorrhea, and 3.8% tested for chlamydia were concurrently tested for HIV during an ED visit. Concurrent HIV-syphilis testing was more likely among younger patients aged 25-34 years (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.78, 2.10) and patients with STD-related chief complaints at triage (AOR=11.47, 95% CI 5.49, 25.06). Concurrent HIV-gonorrhea/chlamydia testing was more likely among men (gonorrhea: AOR=3.98, 95% CI 2.25, 7.02; chlamydia: AOR=3.25, 95% CI 1.80, 5.86) and less likely among patients with STD-related chief complaints at triage (gonorrhea: AOR=0.31, 95% CI 0.13, 0.82; chlamydia: AOR=0.21, 95% CI 0.09, 0.50). Concurrent HIV-STD testing in an academic ED remains low. Systematic interventions that remove the decision-making burden of ordering an HIV test from providers may increase HIV testing in this high-risk population of suspected STD patients.

Lipopolysaccharide-binding alkylpolyamine DS-96 inhibits Chlamydia trachomatis infection by blocking attachment and entry.

PubMed

Osaka, Ichie; Hefty, P Scott

2014-06-01

Vaginally delivered microbicides are being developed to offer women self-initiated protection against transmission of sexually transmitted infections such as Chlamydia trachomatis. A small molecule, DS-96, rationally designed for high affinity to Escherichia coli lipid A, was previously demonstrated to bind and neutralize lipopolysaccharide (LPS) from a wide variety of Gram-negative bacteria (D. Sil et al., Antimicrob. Agents Chemother. 51: 2811-2819, 2007, doi:10.1128/AAC.00200-07). Aside from the lack of the repeating O antigen, chlamydial lipooligosaccharide (LOS) shares general molecular architecture features with E. coli LPS. Importantly, the portion of lipid A where the interaction with DS-96 is expected to take place is well conserved between the two organisms, leading to the hypothesis that DS-96 inhibits Chlamydia infection by binding to LOS and compromising the function. In this study, antichlamydial activity of DS-96 was examined in cell culture. DS-96 inhibited the intercellular growth of Chlamydia in a dose-dependent manner and offered a high level of inhibition at a relatively low concentration (8 μM). The data also revealed that infectious elementary bodies (EBs) were predominantly blocked at the attachment step, as indicated by the reduced number of EBs associated with the host cell surface following pretreatment. Of those EBs that were capable of attachment, the vast majority was unable to gain entry into the host cell. Inhibition of EB attachment and entry by DS-96 suggests that Chlamydia LOS is critical to these processes during the developmental cycle. Importantly, given the low association of host toxicity previously reported by Sil et al., DS-96 is expected to perform well in animal studies as an active antichlamydial compound in a vaginal microbicide. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Lactobacilli Inactivate Chlamydia trachomatis through Lactic Acid but Not H2O2

PubMed Central

Gong, Zheng; Luna, Yesmin; Yu, Ping; Fan, Huizhou

2014-01-01

Lactobacillus species dominate the microbiome in the lower genital tract of most reproductive-age women. Producing lactic acid and H2O2, lactobacilli are believed to play an important role in prevention of colonization by and growth of pathogens. However, to date, there have been no reported studies characterizing how lactobacilli interact with Chlamydia trachomatis, a leading sexually transmitted bacterium. In this report, we demonstrate inactivation of C. trachomatis infectivity by culture media conditioned by Lactobacillus crispatus, L. gasseri and L. jensenii, known to be dominating organisms in the human vaginal microbiome. Lactobacillus still cultures produced lactic acid, leading to time- and concentration-dependent killing of C. trachomatis. Neutralization of the acidic media completely reversed chlamydia killing. Addition of lactic acid into Lactobacillus-unconditioned growth medium recapitulated the chlamydiacidal activity of conditioned media. The H2O2 concentrations in the still cultures were found to be comparable to those reported for the cervicovaginal fluid, but insufficient to inactivate chlamydiae. Aeration of Lactobacillus cultures by shaking markedly induced H2O2 production, but strongly inhibited Lactobacillus growth and lactic acid production, and thus severely affected acidification, leading to significantly reduced chlamydiacidal efficiency. These observations indicate lactobacilli inactivate chlamydiae primarily through maintaining acidity in a relatively hypoxic environment in the vaginal lumen with limited H2O2, which is consistent with the notion that women with higher vaginal pH are more prone to sexually transmitted C. trachomatis infection. In addition to lactic acid, formic acid and acetic acid also exhibited potent chlamydiacidal activities. Taken together, our findings imply that lowering the vaginal pH through engineering of the vaginal microbiome and other means will make women less susceptible to C. trachomatis infection. PMID:25215504

The efficacy of azithromycin and doxycycline for the treatment of rectal chlamydia infection: a systematic review and meta-analysis.

PubMed

Kong, Fabian Yuh Shiong; Tabrizi, Sepehr N; Fairley, Christopher Kincaid; Vodstrcil, Lenka A; Huston, Wilhelmina M; Chen, Marcus; Bradshaw, Catriona; Hocking, Jane S

2015-05-01

There are increasing concerns about treatment failure following treatment for rectal chlamydia with 1 g of azithromycin. A systematic review and meta-analysis was conducted to investigate the efficacy of 1 g of azithromycin as a single dose or 100 mg of doxycycline twice daily for 7 days for the treatment of rectal chlamydia. Medline, Embase, PubMed, Cochrane Controlled Trials Register, Australia New Zealand Clinical Trial Register and ClinicalTrials.gov were searched to the end of April 2014. Studies using 1 g of azithromycin or 7 days of doxycycline for the treatment of rectal chlamydia were eligible. Gender, diagnostic test, serovar, symptomatic status, other sexually transmitted infections, follow-up time, attrition and microbial cure were extracted. Meta-analysis was used to calculate pooled (i) azithromycin and doxycycline efficacy and (ii) efficacy difference. All eight included studies were observational. The random-effects pooled efficacy for azithromycin (based on eight studies) was 82.9% (95% CI 76.0%-89.8%; I(2) = 71.0%; P < 0.01) and for doxycycline (based on five studies) was 99.6% (95% CI 98.6%-100%; I(2) = 0%; P = 0.571), resulting in a random-effects pooled efficacy difference (based on five studies) of 19.9% (95% CI 11.4%-28.3%; I(2) = 48.5%; P = 0.101) in favour of doxycycline. The efficacy of single-dose azithromycin may be considerably lower than 1 week of doxycycline for treating rectal chlamydia. However, the available evidence is very poor. Robust randomized controlled trials are urgently required. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Chlamydia suis and Chlamydia trachomatis induce multifunctional CD4 T cells in pigs.

PubMed

Käser, T; Pasternak, J A; Delgado-Ortega, M; Hamonic, G; Lai, K; Erickson, J; Walker, S; Dillon, J R; Gerdts, V; Meurens, F

2017-01-03

Chlamydia trachomatis infections are the most prominent bacterial sexually-transmitted disease world-wide and a lot of effort is put into the development of an effective vaccine. Pigs have been shown to be a valuable animal model for C. trachomatis vaccine development. The aim of this study was to decipher the T-cell-mediated immune response to chlamydial infections including C. trachomatis and C. suis, the chlamydia species naturally infecting pigs with a demonstrated zoonotic potential. Vaginal infection of pigs with C. suis and C. trachomatis lasted from 3 to 21days and intra-uterine infection was still present after 21days in 3 out of 5 C. suis- and 4 out of 5 C. trachomatis-inoculated animals and caused severe pathological changes. Humoral immune responses including neutralizing antibodies were found predominantly in response to C. suis starting at 14days post inoculation. The T-cell-mediated immune responses to C. trachomatis and C. suis-infections started at 7days post inoculation and consisted mainly of CD4 + T cells which were either IFN-γ single cytokine-producing or IFN-γ/TNF-α double cytokine-producing T-helper 1 cells. IL-17-producing CD4 + T cells were rare or completely absent. The T-cell-mediated immune responses were triggered by both homologous or heterologous re-stimulation indicating that cross-protection between the two chlamydia species is possible. Thus, having access to a working genital C. suis and C. trachomatis infection model, efficient monitoring of the host-pathogen interactions, and being able to accurately assess the responses to infection makes the pig an excellent animal model for vaccine development which also could bridge the gap to the clinical phase for C. trachomatis vaccine research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ecological analysis examining the association between census tract-level incarceration and reported chlamydia incidence among female adolescents and young adults in San Francisco.

PubMed

Stoltey, Juliet E; Li, Ye; Bernstein, Kyle T; Philip, Susan S

2015-08-01

Incarceration has been linked to increased risk of sexually transmitted infections (STIs). We conducted a census tract-level ecological analysis to explore the relationship between neighbourhood incarceration rates and chlamydia incidence among adolescent girls and young women under age 25 in San Francisco in 2010 to focus public health efforts in neighbourhoods at risk. Female chlamydial cases under age 25 that were reported to the San Francisco Department of Public Health in 2010 were geocoded to census tract, and chlamydia incidence was calculated. Addresses of incarcerated individuals were geocoded, and census tract-specific incarceration was estimated. American Community Survey data from 2005 to 2009 provided tract-specific survey estimates of demographic and socioeconomic characteristics of communities to allow for evaluation of potential census tract-level confounders. A Poisson mixed model was used to assess the relationship of census tract-level incarceration rate with chlamydial case rate. Accounting for spatial dependence in neighbouring regions, there was a positive association between incarceration rates and chlamydia incidence in young women under age 25 in San Francisco, and this association decreased as poverty increased, after controlling for other risk factors in the model. This ecological analysis supports the neighbourhood role of incarceration in the risk of chlamydia among young women. These results have important implications for directing limited public health resources to local areas at risk in order to geographically focus prevention interventions and provide improved access to STI services in specific neighbourhoods with high incarceration rates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chlamydia trachomatis dapF Encodes a Bifunctional Enzyme Capable of Both d-Glutamate Racemase and Diaminopimelate Epimerase Activities

PubMed Central

2018-01-01

ABSTRACT Peptidoglycan is a sugar/amino acid polymer unique to bacteria and essential for division and cell shape maintenance. The d-amino acids that make up its cross-linked stem peptides are not abundant in nature and must be synthesized by bacteria de novo. d-Glutamate is present at the second position of the pentapeptide stem and is strictly conserved in all bacterial species. In Gram-negative bacteria, d-glutamate is generated via the racemization of l-glutamate by glutamate racemase (MurI). Chlamydia trachomatis is the leading cause of infectious blindness and sexually transmitted bacterial infections worldwide. While its genome encodes a majority of the enzymes involved in peptidoglycan synthesis, no murI homologue has ever been annotated. Recent studies have revealed the presence of peptidoglycan in C. trachomatis and confirmed that its pentapeptide includes d-glutamate. In this study, we show that C. trachomatis synthesizes d-glutamate by utilizing a novel, bifunctional homologue of diaminopimelate epimerase (DapF). DapF catalyzes the final step in the synthesis of meso-diaminopimelate, another amino acid unique to peptidoglycan. Genetic complementation of an Escherichia coli murI mutant demonstrated that Chlamydia DapF can generate d-glutamate. Biochemical analysis showed robust activity, but unlike canonical glutamate racemases, activity was dependent on the cofactor pyridoxal phosphate. Genetic complementation, enzymatic characterization, and bioinformatic analyses indicate that chlamydial DapF shares characteristics with other promiscuous/primordial enzymes, presenting a potential mechanism for d-glutamate synthesis not only in Chlamydia but also numerous other genera within the Planctomycetes-Verrucomicrobiae-Chlamydiae superphylum that lack recognized glutamate racemases. PMID:29615498

Behavioral and Community Correlates of Adolescent Pregnancy and Chlamydia Rates in Rural Counties in Minnesota1

PubMed Central

Kozhimannil, Katy B.; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

2014-01-01

Purpose Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Methods Pregnancy and chlamydia infection rates among 15–19 year-old females were compared across Minnesota’s 87 counties, stratified by rural/urban designations. Regression models for rural counties (n=66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Findings Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. Conclusions This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study. PMID:25344773

Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: a longitudinal analysis of possible causal links.

PubMed

Gallo, Maria F; Macaluso, Maurizio; Warner, Lee; Fleenor, Michael E; Hook, Edward W; Brill, Ilene; Weaver, Mark A

2012-03-01

Interactions between bacterial vaginosis (BV) and inflammatory sexually transmitted infections, such as gonorrhea and chlamydial infection, are not well understood. Furthermore, evidence regarding the sexual transmission of BV is equivocal. We assessed associations between incident BV and incidences of gonorrhea and/or chlamydial infection ("gonorrhea/chlamydia"), as well as similarities in associations for the two processes, among 645 female patients at a sexually transmitted disease clinic in Alabama followed prospectively for 6 months from 1995 to 1998. We identified predictors of both incident BV and gonorrhea/chlamydia and used bivariate logistic regression to determine whether these predictors differed. Participants completed 3188 monthly, follow-up visits. Several factors associated with incident BV involved sexual intercourse: young age (<16 years) at first intercourse (adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1-1.9), recent drug use during sex (aOR, 1.7; 95% CI, 1.2-2.5), prevalent trichomoniasis (aOR, 2.8; 95% CI, 1.7-4.6) and incident syphilis (aOR, 9.7; 95% CI, 1.9-48.4). Few statistical differences between potential factors for BV and gonorrhea/chlamydia emerged. BV appeared to precede the acquisition of gonorrhea/chlamydia (pairwise odds ratio, 1.6; 95% CI, 1.1-2.3), and vice versa (pairwise odds ratio, 2.4; 95% CI, 1.7-3.5). Findings are consistent with a causal role of sexual behavior in the acquisition of BV and confirm that BV facilitates acquisition of gonorrhea/chlamydia and vice versa independently from other risk factors. Published by Elsevier Inc.

[Trends and determinants factors of Chlamydia trachomatis genital infection in young people under 25 years. Catalonia 2007-2014].

PubMed

López-Corbeto, Evelin; González, Victoria; Bascunyana, Elisabeth; Humet, Victoria; Casabona, Jordi

2016-10-01

Chlamydia trachomatis (chlamydia) infection is the most common bacterial sexually transmitted diseases (STD). However, the prevalence among young people is unknown in our country. In 2007, the monitoring of the prevalence and behaviours related to acquiring it began in Catalonia in young people ≤25years. To determine and monitor the prevalence and determining factors of chlamydia among a young sexually active population ≤25years, treated in sexual and reproductive health care centras (CT/NG-ASSIR) and in prisons (CT/NG-Prisons). An analysis was performed on 6 cross-sectional data studies in two sentinel populations of young people from the period 2007-2014. Behavioural indicators were recorded and urine specimens were collected for analysis by PCR. The prevalence and trends are described, and the variables associated with infection were evaluated using multivariate logistic regression analysis. The mean prevalence for CT/NG-ASSIR was 7.4%, with an upward trend (P=.174), and an increase of 46.5%. CT/NG-Prisons had a mean 8.0%, with an upward trend (P=.282), and an increase of 31.6%. Age and foreign origin are presented as risk factors in both populations. The concurrent sexual partners added to CT/NG-ASSIR and the time spent in prison to CT/NG-Prisons. The results underscore the need for a more efficient approach to control activities related to chlamydia infection in Catalonia. Policies need to be strengthened to promote safer sexual behaviours and active case finding by opportunistic screening in less than 25year-old. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Caveolin-mediated endocytosis of the Chlamydia M278 outer membrane peptide encapsulated in poly(lactic acid)-Poly(ethylene glycol) nanoparticles by mouse primary dendritic cells enhances specific immune effectors mediated by MHC class II and CD4+ T cells.

PubMed

Dixit, Saurabh; Sahu, Rajnish; Verma, Richa; Duncan, Skyla; Giambartolomei, Guillermo H; Singh, Shree R; Dennis, Vida A

2018-03-01

We previously developed a Chlamydia trachomatis nanovaccine (PPM) by encapsulating a chlamydial M278 peptide within poly(lactic acid)-poly(ethylene glycol) biodegradable nanoparticles that immunopotentiated Chlamydia-specific immune effector responses in mice. Herein, we investigated the mechanistic interactions of PPM with mouse bone marrow-derived dendritic cells (DCs) for its uptake, trafficking, and T cell activation. Our results reveal that PPM triggered enhanced expression of effector cytokines and chemokines, surface activation markers (Cd1d2, Fcgr1), pathogen-sensing receptors (TLR2, Nod1), co-stimulatory (CD40, CD80, CD86) and MHC class I and II molecules. Co-culturing of PPM-primed DCs with T cells from C. muridarum vaccinated mice yielded an increase in Chlamydia-specific immune effector responses including CD3 + lymphoproliferation, CD3 + CD4 + IFN-γ-secreting cells along with CD3 + CD4 + memory (CD44 high and CD62L high ) and effector (CD44 high and CD62L low ) phenotypes. Intracellular trafficking analyses revealed an intense expression and colocalization of PPM predominantly in endosomes. PPM also upregulated the transcriptional and protein expression of the endocytic mediator, caveolin-1 in DCs. More importantly, the specific inhibition of caveolin-1 led to decreased expression of PPM-induced cytokines and co-stimulatory molecules. Our investigation shows that PPM provided enhancement of uptake, probably by exploiting the caveolin-mediated endocytosis pathway, endosomal processing, and MHC II presentation to immunopotentiate Chlamydia-specific immune effector responses mediated by CD4 + T cells. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Impact of a Social Marketing Campaign on HIV and Sexually Transmissible Infection Testing Among Men Who Have Sex With Men in Australia.

PubMed

Wilkinson, Anna L; Pedrana, Alisa E; El-Hayek, Carol; Vella, Alyce M; Asselin, Jason; Batrouney, Colin; Fairley, Christopher K; Read, Tim R H; Hellard, Margaret; Stoové, Mark

2016-01-01

In response to increasing HIV and other sexually transmissible infection (HIV/STI) notifications in Australia, a social marketing campaign Drama Downunder (DDU) was launched in 2008 to promote HIV/STI testing among men who have sex with men (MSM). We analyzed prospective data from (1) an online cohort of MSM and (2) clinic-level HIV/STI testing to evaluate the impact of DDU on HIV, syphilis, gonorrhea, and chlamydia testing. (1) Cohort participants who completed 3 surveys (2010-2014) contributed to a Poisson regression model examining predictors of recent HIV testing.(2) HIV, syphilis, gonorrhea, and chlamydia tests among MSM attending high caseload primary care clinics (2007-2013) were included in an interrupted time series analysis. (1) Although campaign awareness was high among 242 MSM completing 726 prospective surveys, campaign recall was not associated with self-reported HIV testing. Reporting previous regular HIV testing (adjusted incidence rate ratio, 2.4; 95% confidence interval, 1.3-4.4) and more than 10 partners in the previous 6 months (adjusted incidence rate ratio, 1.2; 95% confidence interval, 1.1-1.4) was associated with recent HIV testing. (2) Analysis of 257,023 tests showed increasing monthly HIV, syphilis, gonorrhea, and chlamydia tests pre-DDU. Post-DDU, gonorrhea test rates increased significantly among HIV-negative MSM, with modest and nonsignificant increasing rates of HIV, syphilis, and chlamydia testing. Among HIV-positive MSM, no change in gonorrhea or chlamydia testing occurred and syphilis testing declined significantly. Increasing HIV/STI testing trends among MSM occurred pre- and post-DDU, coinciding with other plausible drivers of testing. Modest changes in HIV testing post-DDU suggest that structural changes to improve testing access may need to occur alongside health promotion to increase testing frequency.

Postal urine specimens: are they a feasible method for genital chlamydial infection screening?

PubMed Central

Macleod, J; Rowsell, R; Horner, P; Crowley, T; Caul, E O; Low, N; Smith, G D

1999-01-01

BACKGROUND: A United Kingdom (UK) screening programme for Chlamydia trachomatis has recently been announced. Pilot projects involving the opportunistic testing of women attending health facilities are due to commence in several sites. There is a danger that this approach will fail to obtain adequate population coverage. The alternative--true systematic population screening--is generally assumed to be unfeasible. Studies in Denmark using postal urine specimens have challenged this assumption. No such studies have been reported from the UK. AIM: To assess the potential of urine specimens sent by post as the basis for a UK population screening strategy for genital chlamydial infection. METHOD: Two hundred patients (100 men, 100 women) aged 18 to 45 years were randomly sampled from the list of one urban group practice. Subjects were mailed an explanatory letter, a urine sample container, a sexual lifestyle questionnaire, and a prepaid return envelope. Non-responders were contacted by telephone; persistent non-responders were visited at home. Samples were tested for Chlamydia by DNA amplification and enzyme immunoassay. RESULTS: Sixty-four (32%) subjects were no longer living at their GP registered address. Of the remaining 136, 126 (93%) responded to the survey and 113 (83%) accepted the request for a urine sample and completed a questionnaire. Acceptance rates were similar for men and women and across age groups. Four samples (3%) were Chlamydia positive. CONCLUSION: Home mailed urine specimen collection in conjunction with a self-completed postal questionnaire is feasible. This could provide a viable basis both for determining population Chlamydia prevalence and for a UK Chlamydia population screening strategy. Overall cost effectiveness of such a strategy will depend on the cost of the test used. Comparative performance characteristics of the different currently available tests in this setting have yet to be fully determined. PMID:10562745

An online study combining the constructs from the theory of planned behaviour and protection motivation theory in predicting intention to test for chlamydia in two testing contexts.

PubMed

Powell, Rachael; Pattison, Helen M; Francis, Jill J

2016-01-01

Chlamydia is a common sexually transmitted infection that has potentially serious consequences unless detected and treated early. The health service in the UK offers clinic-based testing for chlamydia but uptake is low. Identifying the predictors of testing behaviours may inform interventions to increase uptake. Self-tests for chlamydia may facilitate testing and treatment in people who avoid clinic-based testing. Self-testing and being tested by a health care professional (HCP) involve two contrasting contexts that may influence testing behaviour. However, little is known about how predictors of behaviour differ as a function of context. In this study, theoretical models of behaviour were used to assess factors that may predict intention to test in two different contexts: self-testing and being tested by a HCP. Individuals searching for or reading about chlamydia testing online were recruited using Google Adwords. Participants completed an online questionnaire that addressed previous testing behaviour and measured constructs of the Theory of Planned Behaviour and Protection Motivation Theory, which propose a total of eight possible predictors of intention. The questionnaire was completed by 310 participants. Sufficient data for multiple regression were provided by 102 and 118 respondents for self-testing and testing by a HCP respectively. Intention to self-test was predicted by vulnerability and self-efficacy, with a trend-level effect for response efficacy. Intention to be tested by a HCP was predicted by vulnerability, attitude and subjective norm. Thus, intentions to carry out two testing behaviours with very similar goals can have different predictors depending on test context. We conclude that interventions to increase self-testing should be based on evidence specifically related to test context.

Population attributable risk for chlamydia infection in a cohort of young international travellers (backpackers) and residents in Australia

PubMed Central

Guy, Rebecca; Donovan, Basil; McNulty, Anna

2011-01-01

Aim To estimate the population attributable risk (PAR) for Chlamydia trachomatis infection in young men and women in Sydney, Australia. Method Multivariate logistic regression was used to examine the association between demographic, sexual behaviour and other potential risk factors and chlamydia positivity in young (≤30 years) heterosexual international travellers (backpackers) and Australian residents attending a sexual health clinic. Point and interval estimates of PAR were calculated to quantify the proportion of chlamydia infections that can theoretically be prevented if a combination of risk factors is eliminated from a target population. Results In males, the PAR associated with inconsistent condom use in the past 3 months was 65% (95% CI 56% to 71%) in backpackers compared to 50% (95% CI 41% to 56%) in non-backpackers and the PAR associated with reporting three or more female sexual partners in the past 3 months was similar between male backpackers and non-backpackers (33% (95% CI 28% to 40%) and 36% (95% CI 32% to 41%), respectively). In females, the PAR associated with inconsistent condom use in the past 3 months was 51% (95% CI 42% to 59%) in backpackers compared to 41% (95% CI 31% to 51%) in non-backpackers, and the PAR associated with reporting three or more male sexual partners in the past 3 months was 14% (95% CI 11% to 18%) in backpackers compared to 30% (95% CI 25% to 37%) in non-backpackers. Conclusion These findings suggest that the largest number of chlamydia infections could be avoided by increasing condom use, particularly in backpackers. Reporting multiple partners was also associated with a large proportion of infections and the risk associated with this behaviour should be considered in health promotion strategies. PMID:22021720

Population attributable risk for chlamydia infection in a cohort of young international travellers (backpackers) and residents in Australia.

PubMed

Wand, Handan; Guy, Rebecca; Donovan, Basil; McNulty, Anna

2011-02-23

To estimate the population attributable risk (PAR) for Chlamydia trachomatis infection in young men and women in Sydney, Australia. Multivariate logistic regression was used to examine the association between demographic, sexual behaviour and other potential risk factors and chlamydia positivity in young (≤ 30 years) heterosexual international travellers (backpackers) and Australian residents attending a sexual health clinic. Point and interval estimates of PAR were calculated to quantify the proportion of chlamydia infections that can theoretically be prevented if a combination of risk factors is eliminated from a target population. In males, the PAR associated with inconsistent condom use in the past 3 months was 65% (95% CI 56% to 71%) in backpackers compared to 50% (95% CI 41% to 56%) in non-backpackers and the PAR associated with reporting three or more female sexual partners in the past 3 months was similar between male backpackers and non-backpackers (33% (95% CI 28% to 40%) and 36% (95% CI 32% to 41%), respectively). In females, the PAR associated with inconsistent condom use in the past 3 months was 51% (95% CI 42% to 59%) in backpackers compared to 41% (95% CI 31% to 51%) in non-backpackers, and the PAR associated with reporting three or more male sexual partners in the past 3 months was 14% (95% CI 11% to 18%) in backpackers compared to 30% (95% CI 25% to 37%) in non-backpackers. These findings suggest that the largest number of chlamydia infections could be avoided by increasing condom use, particularly in backpackers. Reporting multiple partners was also associated with a large proportion of infections and the risk associated with this behaviour should be considered in health promotion strategies.

Screening of oropharynx and anorectum increases prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection in female STD clinic visitors.

PubMed

Peters, Remco P H; Nijsten, Noëmi; Mutsaers, Johan; Jansen, Casper L; Morré, Servaas A; van Leeuwen, A Petra

2011-09-01

The relevance of screening of oropharynx and anorectum in addition to endocervical tests for detection of Chlamydia trachomatis and Neisseria gonorrhoeae infection is unclear in women, while there is a documented benefit of this approach in men who have sex with men. Female visitors to the sexually transmitted disease (STD) clinic were asked about their sexual practice as a part of the routine electronic patient file. In addition to tests for endocervical infection, swabs were taken from the oropharynx and anorectum to test for C. trachomatis and N. gonorrhoeae based on the history of sexual contact. Routinely, all electronic patient files are anonymously included in a database for surveillance purposes. In this observational study, we analyzed all consultations in the database over an 18 months period. A total of 4299 consultations were registered; 10% of women had endocervical chlamydia and 1.1% had gonorrhea. The detection rates for C. trachomatis and N. gonorrhoeae from oropharyngeal samples were 1.9% and 0.8%, and from anorectal samples 8.7% and 1.7%, respectively. Except for 2 cases of pharyngeal gonorrhea, all oropharyngeal and anorectal infections were asymptomatic. Inclusion of oropharyngeal and anorectal tests in the screening protocol was associated with a percentage increase in prevalence of chlamydia by 9.5% and gonorrhea by 31%, relative to tests for endocervical tests alone. The percentage increase in prevalence was higher than that for the symptom-based approach (3.7% and 10.4%, respectively). Inclusion of oropharyngeal and anorectal tests in the STD screening protocol increases the prevalence of chlamydia and gonorrhea in women. Screening of anatomical sites based on sexual history is preferred over a symptom-based protocol.

Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection.

PubMed

Geisler, William M; Uniyal, Apurva; Lee, Jeannette Y; Lensing, Shelly Y; Johnson, Shacondra; Perry, Raymond C W; Kadrnka, Carmel M; Kerndt, Peter R

2015-12-24

Urogenital Chlamydia trachomatis infection remains prevalent and causes substantial reproductive morbidity. Recent studies have raised concern about the efficacy of azithromycin for the treatment of chlamydia infection. We conducted a randomized trial comparing oral azithromycin with doxycycline for the treatment of urogenital chlamydia infection among adolescents in youth correctional facilities, to evaluate the noninferiority of azithromycin (1 g in one dose) to doxycycline (100 mg twice daily for 7 days). The treatment was directly observed. The primary end point was treatment failure at 28 days after treatment initiation, with treatment failure determined on the basis of nucleic acid amplification testing, sexual history, and outer membrane protein A (OmpA) genotyping of C. trachomatis strains. Among the 567 participants enrolled, 284 were randomly assigned to receive azithromycin, and 283 were randomly assigned to receive doxycycline. A total of 155 participants in each treatment group (65% male) made up the per-protocol population. There were no treatment failures in the doxycycline group. In the azithromycin group, treatment failure occurred in 5 participants (3.2%; 95% confidence interval, 0.4 to 7.4%). The observed difference in failure rates between the treatment groups was 3.2 percentage points, with an upper boundary of the 90% confidence interval of 5.9 percentage points, which exceeded the prespecified absolute 5-percentage-point cutoff for establishing the noninferiority of azithromycin. In the context of a closed population receiving directly observed treatment for urogenital chlamydia infection, the efficacy of azithromycin was 97%, and the efficacy of doxycycline was 100%. The noninferiority of azithromycin was not established in this setting. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT00980148.).

Chlamydia trachomatis can protect host cells against apoptosis in the absence of cellular Inhibitor of Apoptosis Proteins and Mcl-1.

PubMed

Ying, Songmin; Christian, Jan G; Paschen, Stefan A; Häcker, Georg

2008-01-01

Infection with Chlamydia protects mammalian host cells against apoptosis. Hypotheses have been proposed to explain this molecularly, including the up-regulation of host anti-apoptotic proteins such as cellular Inhibitor of Apoptosis Protein (IAP) 2 and the Bcl-2 protein Mcl-1. To test for the importance of these proteins, we used mouse embryonic fibroblasts from gene-targeted mice that were deficient in cIAP1, cIAP2, cIAP1/cIAP2, XIAP, or Mcl-1. Infection with Chlamydia trachomatis protected all cells equally well against apoptosis, which was induced either with tumour necrosis factor/cycloheximide (IAP-knock-out cells) or staurosporine (Mcl-1-knock-out). Therefore, these cellular anti-apoptotic proteins are not essential for apoptosis-protection by C. trachomatis.

Chlamydia gallinacea: a widespread emerging Chlamydia agent with zoonotic potential in backyard poultry.

PubMed

Li, L; Luther, M; Macklin, K; Pugh, D; Li, J; Zhang, J; Roberts, J; Kaltenboeck, B; Wang, C

2017-10-01

Chlamydia gallinacea, a new chlamydial agent, has been reported in four European countries as well as Argentina and China. Experimentally infected chickens with C. gallinacea in previous study showed no clinical signs but had significantly reduced gains in body weight (6·5-11·4%). Slaughterhouse workers exposed to infected chickens have developed atypical pneumonia, indicating C. gallinacea is likely a zoonotic agent. In this study, FRET-PCR confirmed that C. gallinacea was present in 12·4% (66/531) of oral-pharyngeal samples from Alabama backyard poultry. Phylogenetic comparisons based on ompA variable domain showed that 16 sequenced samples represented 14 biotypes. We report for the first time the presence of C. gallinacea in North America, and this warrants further research on the organism's pathogenicity, hosts, transmission, and zoonotic potential.

Considerations for the rational design of a Chlamydia vaccine.

PubMed

Liang, Steven; Bulir, David; Kaushic, Charu; Mahony, James

2017-04-03

Chlamydia trachomatis is the leading cause of preventable blindness and the most common bacterial sexually transmitted infection. Remarkable progress in vaccine research over the past six decades has led to the advancement of novel C. trachomatis vaccine candidates into clinical trials. However, many questions regarding the role of specific cellular populations and molecular mechanisms in protective immunity against human C. trachomatis genital tract infections remain unanswered. Biomarkers of vaccine induced protective immunity are elusive in humans, while a cautionary message on the translatability of data obtained from current animal models has emanated from vaccine research and development efforts against other important human pathogens. In this commentary, we highlight recent advances in Chlamydia vaccine development and discuss their implications in the context of a rational approach to the design of a human C. trachomatis vaccine.

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 01, January 2010

DTIC Science & Technology

2010-01-01

transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009... Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 2008 2009 NATIONAL...transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2008 2009 2008 2009

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 03, March 2010

DTIC Science & Technology

2010-03-01

transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009... Gonorrhea Syphilis Cold c Heatc Q Fever Tuberculosis 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 2009 2010 NATIONAL...Arthropod-borne Sexually transmitted Environmental Travel associated Lyme disease Malaria Chlamydia Gonorrhea Syphilis Cold c Heatc Q Fever

A case of lymphogranuloma venereum of 20 years' duration. Isolation of Chlamydia trachomatis from perianal lesions.

PubMed Central

Dan, M; Rotmensch, H H; Eylan, E; Rubinstein, A; Ginsberg, R; Liron, M

1980-01-01

Chlamydia trachomatis was isolated from perianal lesions in a patient in whom lymphogranuloma venereum had been diagnosed 20 years previously. Treatment with tetracycline resulted in a pronounced improvement. Although C trachomatis is known to persist for a long time in the host, isolation of the micro-organism from infected tissues after such a prolonged period has not previously been reported. Images PMID:7427708

Changing Pattern of Chlamydia trachomatis Strains in Lymphogranuloma Venereum Outbreak, France, 2010–2015

PubMed Central

Touati, Arabella; Sperandio, Clément; Hénin, Nadège; Laurier-Nadalié, Cécile; Bébéar, Cécile; de Barbeyrac, Bertille

2016-01-01

We describe a change in the molecular epidemiology of Chlamydia trachomatis strains involved in an outbreak of rectal lymphogranuloma venereum in France during January 2010–April 2015. Until 2012, the C. trachomatis L2b strain predominated; however, starting in 2013, most cases involved the L2 strain. We also identified 4 genetic L2b ompA variants. PMID:27767927

Comparative in vitro susceptibility studies of FCE 22250 and rifampicin on Legionella and Chlamydia trachomatis strains.

PubMed

Zanetti, S; Ungheri, D; Castellani Pastoris, M; Fadda, G

1987-01-01

The in vitro activities of rifampicin and the new rifamycin FCE 22250 were evaluated against the intracellular pathogens Legionella and Chlamydia trachomatis. The data reported in this study give evidence that FCE 22250 shows excellent in vitro results, even better than those obtained with rifampicin, leading to the possibility of clinical applications of this new drug on Legionnaire's disease and chlamydial infections.

Cytological and histopathological abnormalities of the cervix in genital Chlamydia trachomatis infections.

PubMed

Cevenini, R; Costa, S; Rumpianesi, F; Donati, M; Guerra, B; Diana, R; Antonini, M P

1981-10-01

Since genital infection with Chlamydia trachomatis may be associated with cervical abnormalities 160 patients with grandular ectopia attending a gynaecological outpatient clinic were examined for antibodies against C trachomatis, the presence of C trachomatis infection, and cytological and histopathological abnormalities of the cervix.A significantly higher incidence of histological dysplasia was found in women with glandular ectopia who had antichlamydial antibodies than in those without.

Cytological and histopathological abnormalities of the cervix in genital Chlamydia trachomatis infections

PubMed Central

Cevenini, R; Costa, S; Rumpianesi, F; Donati, M; Guerra, B; Diana, R; Antonini, M P

1981-01-01

Since genital infection with Chlamydia trachomatis may be associated with cervical abnormalities 160 patients with grandular ectopia attending a gynaecological outpatient clinic were examined for antibodies against C trachomatis, the presence of C trachomatis infection, and cytological and histopathological abnormalities of the cervix. A significantly higher incidence of histological dysplasia was found in women with glandular ectopia who had antichlamydial antibodies than in those without. PMID:7296254

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 08, August 2010

DTIC Science & Technology

2010-08-01

notifi able medical event reports that included diagnostic codes (ICD-9-CM) indicative of chlamydia, gonorrhea, syphilis, herpes simplex virus (HSV...infections of interest for this report Results: Condition Diagnostic codes Chlamydia 099.41, 099.5 Gonorrhea 098 Herpes simplex (HSV) 054 Human...housing arrangements may also play roles and off er opportunities for targeted prevention.6 Human papillomavirus (HPV), the cause of genital warts

Induction of partial immunity in both males and females is sufficient to protect females against sexual transmission of Chlamydia.

PubMed

O'Meara, C P; Armitage, C W; Kollipara, A; Andrew, D W; Trim, L; Plenderleith, M B; Beagley, K W

2016-07-01

Sexually transmitted Chlamydia trachomatis causes infertility, and because almost 90% of infections are asymptomatic, a vaccine is required for its eradication. Mathematical modeling studies have indicated that a vaccine eliciting partial protection (non-sterilizing) may prevent Chlamydia infection transmission, if administered to both sexes before an infection. However, reducing chlamydial inoculum transmitted by males and increasing infection resistance in females through vaccination to elicit sterilizing immunity has yet to be investigated experimentally. Here we show that a partially protective vaccine (chlamydial major outer membrane protein (MOMP) and ISCOMATRIX (IMX) provided sterilizing immunity against sexual transmission between immunized mice. Immunizing male or female mice before an infection reduced chlamydial burden and disease development, but did not prevent infection. However, infection and inflammatory disease responsible for infertility were absent in 100% of immunized female mice challenged intravaginally with ejaculate collected from infected immunized males. In contrast to the sterilizing immunity generated following recovery from a previous chlamydial infection, protective immunity conferred by MOMP/IMX occurred independent of resident memory T cells. Our results demonstrate that vaccination of males or females can further protect the opposing sex, whereas vaccination of both sexes can synergize to elicit sterilizing immunity against Chlamydia sexual transmission.

Laser therapy in women genital Chlamydia trachomatis infection complicated with PID and infertility

NASA Astrophysics Data System (ADS)

Brinzan, Daniela; Paiusan, Lucian; Smeu, Claudia-Ramona

2018-04-01

Genital Chlamydia Trachomatis infection is one of the most common sexually transmitted infections with more than 50 million new cases occurred globally every year. Underdiagnosed and untreated, it can generate long term severe complications including PID, infertility, ectopic pregnancy and chronic pelvic pain. Among 20 patients diagnosed with PID and infertility in our medical office during one year, we selected a study group of 10 patients with genital Chlamydia Trachomatis infection. The diagnostic methods used were anamnesis, clinical examination, Pap smear, bacteriological and serological tests, ultra sound examination. The group of patients selected was monitored for one year. The treatment took into account general measures for both partners and specific measures (antibiotic treatment and focused laser therapy). The initial group was split in two, group A treated only with antibiotics and group B treated with both antibiotics and laser therapy. All the 5 patients of group B presented an improvement of the clinical manifestations and 3 of them ended up with pregnancy. On the other hand, in group B, only one patient manifested total disappearance of pains and the infertility persisted for all. It is noteworthy that the association of laser therapy in the treatment of Chlamydia Trachomatis infection has brought significant improvement in the inflammatory processes of internal genitalia (PID) and in the fertility of the couple.

An observational study to evaluate three pilot programmes of retesting chlamydia-positive individuals within 6 months in the South West of England.

PubMed

Angel, Georgina; Horner, Paddy J; O'Brien, Norah; Sharp, Matt; Pye, Karl; Priestley, Cecilia; Macleod, John; Looker, Katharine J; Turner, Katherine M E

2015-10-28

To evaluate 3 pilot chlamydia retesting programmes in South West England which were initiated prior to the release of new National Chlamydia Screening Programme (NCSP) guidelines recommending retesting in 2014. Individuals testing positive between August 2012 and July 2013 in Bristol (n=346), Cornwall (n=252) and Dorset (n=180) programmes were eligible for inclusion in the retesting pilots. The primary outcomes were retest within 6 months (yes/no) and repeat diagnosis at retest (yes/no), adjusted for area, age and gender. Overall 303/778 (39.0%) of participants were retested within 6 months and 31/299 (10.4%) were positive at retest. Females were more likely to retest than males and Dorset had higher retesting rates than the other areas. More than a third of those eligible were retested within the time frame of the study. Chlamydia retesting programmes appear feasible within the context of current programmes to identify individuals at continued risk of infection with relatively low resource and time input. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effect of cold water-induced stress on immune response, pathology and fertility in mice during Chlamydia muridarum genital infection.

PubMed

Belay, Tesfaye; Woart, Anthony; Graffeo, Vincent

2017-07-31

Genital infection by Chlamydia trachomatis is the most common bacterial sexually transmitted disease worldwide. It causes serious reproductive health complications, including pelvic inflammatory disease and infertility. Stress is implicated as a risk factor for various infections; however, its effect on chlamydia genital infection is unknown. We previously showed that repeated exposure of mice to cold water results in increased severity of chlamydia genital infection. In this study, cold water-induced stress resulted in (i) elevated levels of norepinephrine (NE) and epinephrine in the spleen and genital tract of stressed mice; (ii) elevated IL-1β, TNF-α, IL-6 and nitric oxide production in macrophage-rich peritoneal cells of mice; (iii) supplement of NE in vitro exerts an immunosuppressive effect on splenic T-cell production of cytokines; (iv) decreased C. muridarum shedding in the genital tract of β1Adr/β2Adr receptor KO mice; and (v) a higher rate of infertility in infected mice. These results suggest that cold water stress induces the production of catecholamines, which may play a critical role in the modulation of the immune system leading to increased intensity of C. muridarum genital infection. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Analysis of laboratory testing results for Chlamydia trachomatis infection in an STI clinic in India: Need for extragenital screening.

PubMed

Arif, Nazneen; Juyal, Deepak; Sebastian, Sujeesh; Khanna, Neena; Dhawan, Benu

2017-04-01

Extragenital sites are believed to serve as hidden reservoirs for ongoing transmission of infection. In addition, treatment for rectal Chlamydia infection is different from that of genital Chlamydia infection. Many cases may be missed if only genital testing is performed. Between September 2015 and August 2016, all male and female attendees at an STI clinic of a tertiary care hospital with genital and or extragenital discharge were screened for CT infection. Samples included endocervical swabs in women, urethral swabs and urine samples in men. Rectal and pharyngeal samples were collected wherever indicated. Of total of 439 samples collected from 417 patients (245 women and 172 men), samples from women had a high positivity rate than men. (13.6% and 11%). High rates of rectal CT was detected nearly 30.43%. All rectal positive cases except one had no concomitant genital infection. Prevalence of extragenital Chlamydia is increasing in men as well as women. What needs to be stressed on is the sexual behaviour of an individual and not the sexual identity. Further studies are needed to help formulate guidelines and recommendations for extragenital screening in a population. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Sexually Transmitted Infections Among Incarcerated Women: Findings From a Decade of Screening in a Los Angeles County Jail, 2002–2012

PubMed Central

Boudov, Melina; Anderson, Laura J.; Malek, Mark; Smith, Lisa V.; Chien, Michael; Guerry, Sarah

2014-01-01

Objectives. We describe and report findings from a screening program to identify sexually transmitted infections (STIs) and HIV among female inmates in Los Angeles County Jail. Methods. Chlamydia and gonorrhea screening was offered to entering female inmates. Women were eligible if they were (1) aged 30 years or younger, or (2) pregnant or possibly pregnant, or (3) booked on prostitution or sex-related charges. Voluntary syphilis and HIV testing was offered to all women between 2006 and 2009. This analysis reports on data collected from 2002 through 2012. Results. A total of 76 207 women participated in the program. Chlamydia prevalence was 11.4% and gonorrhea was 3.1%. Early syphilis was identified in 1.4% (141 of 9733) and the overall prevalence of HIV was 1.1% (83 of 7448). Treatment levels for early syphilis and HIV were high (99% and 100%, respectively), but only 56% of chlamydia and 58% of gonorrhea cases were treated. Conclusions. Screening incarcerated women in Los Angeles County revealed a high prevalence of STIs and HIV. These inmates represent a unique opportunity for the identification of STIs and HIV, although strategies to improve chlamydia and gonorrhea treatment rates are needed. PMID:25211762

Self-Collected versus Clinician-Collected Sampling for Chlamydia and Gonorrhea Screening: A Systemic Review and Meta-Analysis

PubMed Central

Lunny, Carole; Taylor, Darlene; Hoang, Linda; Wong, Tom; Gilbert, Mark; Lester, Richard; Krajden, Mel; Ogilvie, Gina

2015-01-01

Background The increases in STI rates since the late 1990s in Canada have occurred despite widespread primary care and targeted public health programs and in the setting of universal health care. More innovative interventions are required that would eliminate barriers to STI testing such as internet-based or mail-in home and community service testing for patients that are hard to reach, who refuse to go for clinician-based testing, or who decline an examination. Jurisdictions such as New Zealand and some American states currently use self-collected sampling, but without the required evidence to determine whether self-collected specimens are as accurate as clinician-collected specimens in terms of chlamydia and gonorrhea diagnostic accuracy. The objective of the review is to compare self-collected vaginal, urine, pharyngeal and rectal samples to our reference standard - clinician-collected cervical, urethral, pharyngeal and rectal sampling techniques to identify a positive specimen using nucleic acid amplification test assays. Methods The hierarchical summary receiver operating characteristic and the fixed effect models were used to assess the accuracy of comparable specimens that were collected by patients compared to clinicians. Sensitivity and specificity estimates with 95% confidence intervals (CI) were reported as our main outcome measures. Findings We included 21 studies based on over 6100 paired samples. Fourteen included studies examined chlamydia only, 6 compared both gonorrhea and chlamydia separately in the same study, and one examined gonorrhea. The six chlamydia studies comparing self-collection by vaginal swab to a clinician-collected cervical swab had the highest sensitivity (92%, 95% CI 87-95) and specificity (98%, 95% CI 97-99), compared to other specimen-types (urine/urethra or urine/cervix). Six studies compared urine self-samples to urethra clinician-collected samples in males and produced a sensitivity of 88% (95% CI 83-93) and a specificity of 99% (95% CI 0.94-0.99). Taking into account that urine samples may be less sensitive than cervical samples, eight chlamydia studies that compared urine self-collected verses clinician-collected cervical samples had a sensitivity of 87% (95% CI 81-91) and high specificity of 99% (95% CI 0.98-1.00). For gonorrhea testing, self-collected urine samples compared to clinician-collected urethra samples in males produced a sensitivity of 92% (95% CI 83-97) and specificity of 99% (95% CI 0.98-1.00). Conclusion The sensitivity and specificity of vaginal self-collected swabs compared to swabs collected by clinicians supports the use of vaginal swab as the recommended specimen of choice in home-based screening for chlamydia and gonorrhea. Urine samples for gonorrhea collected by men had comparably high sensitivity and specificity, so could be recommended as they can be left at room temperature for several days, allowing for the possibility of mail-in home-based testing. In populations that may not go for testing at all, do not have the option of clinical testing, or who refuse a clinical examination, self-collected screening would be a good alternative. We recommend that guidelines on how to self-collect gonorrhea and chlamydia urine, vaginal, rectal and pharyngeal specimens be published. PMID:26168051

Host-Cell Survival and Death During Chlamydia Infection

PubMed Central

Ying, Songmin; Pettengill, Matthew; Ojcius, David M.; Häcker, Georg

2008-01-01

Different Chlamydia trachomatis strains are responsible for prevalent bacterial sexually-transmitted disease and represent the leading cause of preventable blindness worldwide. Factors that predispose individuals to disease and mechanisms by which chlamydiae cause inflammation and tissue damage remain unclear. Results from recent studies indicate that prolonged survival and subsequent death of infected cells and their effect on immune effector cells during chlamydial infection may be important in determining the outcome. Survival of infected cells is favored at early times of infection through inhibition of the mitochondrial pathway of apoptosis. Death at later times displays features of both apoptosis and necrosis, but pro-apoptotic caspases are not involved. Most studies on chlamydial modulation of host-cell death until now have been performed in cell lines. The consequences for pathogenesis and the immune response will require animal models of chlamydial infection, preferably mice with targeted deletions of genes that play a role in cell survival and death. PMID:18843378

Detection of Chlamydia pneumoniae in a collection of captive snakes and response to treatment with marbofloxacin.

PubMed

Rüegg, S R; Regenscheit, N; Origgi, F C; Kaiser, C; Borel, N

2015-09-01

In a collection of 58 snakes comprising predominantly Eurasian vipers in Switzerland, five snakes died unexpectedly during hibernation from 2009 to 2012. In one snake, organisms resembling chlamydiae were detected by immunohistochemistry in multiple histiocytic granulomas. Real-time quantitative PCR and microarray analysis were used to determine the presence of Chlamydia pneumoniae in tissue samples and cloacal/choanal swabs from snakes in the collection; 8/53 (15.1%) of the remaining snakes were positive. Although one infected snake had suppurative periglossitis, infection with C. pneumoniae did not appear to be associated with specific clinical signs in snakes. Of seven snakes treated with 5 mg/kg marbofloxacin IM once daily, five became PCR negative for C. pneumoniae following treatment, whereas one animal remained positive and one snake was lost to follow-up. Copyright © 2015 Elsevier Ltd. All rights reserved.

Chlamydia felis: Lack of association between clinical signs and the presence of the cryptic plasmid.

PubMed

Gonsales, F F; Brandão, P E; Melville, P A; Zuniga, E; Benites, N R

2016-08-01

Chlamydia felis is an obligate intracellular bacterial pathogen that infects cats, causing severe conjunctivitis associated with upper respiratory tract disease (URTD). In the present study, 186 cats from three non-commercial catteries in São Paulo, SP, Brazil were evaluated. The detection of Chlamydia felis was performed by PCR. The clinical severity was scored from 1 to 4, with a score of 4 as the most severe manifestation. The total occurrence of C. felis was of 18.82% (35/186) of cats overall, but notably, 58.06% (18/31) of infected cats originated from a single cattery. All animals harboring C. felis had URTD clinical signs and higher scores (3 and 4). In addition, C. felis occurrence was associated with the presence of cryptic plasmid. However, the virulence and clinical severity were not correlated. Copyright © 2016 Elsevier Ltd. All rights reserved.

The L2b real-time PCR targeting the pmpH gene of Chlamydia trachomatis used for the diagnosis of lymphogranuloma venereum is not specific to L2b strains.

PubMed

Touati, A; Peuchant, O; Hénin, N; Bébéar, C; de Barbeyrac, B

2016-06-01

The French Reference Centre for chlamydiae uses two real-time PCRs targeting the pmpH gene of Chlamydia trachomatis to differentiate between L strains and variant L2b, responsible for a lymphogranuloma venereum outbreak in Europe. We compared the results obtained for 122 L2b C. trachomatis-positive specimens, using the two real-time PCRs, with the sequencing of the ompA gene. Only 91 specimens were confirmed as L2b. Our results demonstrate that the lymphogranuloma venereum outbreak is no longer dominated by the variant L2b, and that many L-positive specimens were misidentified as L2b with the method used, which raises the question of its specificity. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Lymphogranuloma venereum proctosigmoiditis is a mimicker of inflammatory bowel disease.

PubMed

Gallegos, Marlene; Bradly, Dawn; Jakate, Shriram; Keshavarzian, Ali

2012-07-07

There has been an increasing prevalence of lymphogranuloma venereum (LGV) or Chlamydia trachomatis (C. trachomatis) cases among the men who have sex with men (MSM) population, particularly in Europe and North America. These cases may present with an incomplete or undisclosed history and proctosigmoiditis without characteristic adenopathy syndrome. During the initial evaluation and colonoscopy, there is a strong clinical and endoscopic suspicion of inflammatory bowel disease (IBD) by virtue of presentation and endoscopic and histological findings. The diagnosis of IBD is subsequently modified to LGV proctosigmoiditis when one or more of the following transpire: (1) there is failure of response to IBD therapy; (2) additional components of history (MSM/travel) may be identified; (3) return of initially performed Chlamydia antibody test is positive; and (4) response to antibiotics effective against Chlamydia. We describe three such cases initially suspected to be an inflammatory bowel disease and subsequently identified as C. trachomatis proctosigmoiditis.

Lymphogranuloma venereum proctosigmoiditis is a mimicker of inflammatory bowel disease

PubMed Central

Gallegos, Marlene; Bradly, Dawn; Jakate, Shriram; Keshavarzian, Ali

2012-01-01

There has been an increasing prevalence of lymphogranuloma venereum (LGV) or Chlamydia trachomatis (C. trachomatis) cases among the men who have sex with men (MSM) population, particularly in Europe and North America. These cases may present with an incomplete or undisclosed history and proctosigmoiditis without characteristic adenopathy syndrome. During the initial evaluation and colonoscopy, there is a strong clinical and endoscopic suspicion of inflammatory bowel disease (IBD) by virtue of presentation and endoscopic and histological findings. The diagnosis of IBD is subsequently modified to LGV proctosigmoiditis when one or more of the following transpire: (1) there is failure of response to IBD therapy; (2) additional components of history (MSM/travel) may be identified; (3) return of initially performed Chlamydia antibody test is positive; and (4) response to antibiotics effective against Chlamydia. We describe three such cases initially suspected to be an inflammatory bowel disease and subsequently identified as C. trachomatis proctosigmoiditis. PMID:22783058

Impact of Active Metabolism on Chlamydia trachomatis Elementary Body Transcript Profile and Infectivity.

PubMed

Grieshaber, Scott; Grieshaber, Nicole; Yang, Hong; Baxter, Briana; Hackstadt, Ted; Omsland, Anders

2018-07-15

Bacteria of the genus Chlamydia include the significant human pathogens Chlamydia trachomatis and C. pneumoniae All chlamydiae are obligate intracellular parasites that depend on infection of a host cell and transition through a biphasic developmental cycle. Following host cell invasion by the infectious elementary body (EB), the pathogen transitions to the replicative but noninfectious reticulate body (RB). Differentiation of the RB back to the EB is essential to generate infectious progeny. While the EB form has historically been regarded as metabolically inert, maintenance of infectivity during incubation with specific nutrients has revealed active maintenance of the infectious phenotype. Using transcriptome sequencing, we show that the transcriptome of extracellular EBs incubated under metabolically stimulating conditions does not cluster with germinating EBs but rather with the transcriptome of EBs isolated directly from infected cells. In addition, the transcriptional profile of the extracellular metabolizing EBs more closely resembled that of EB production than germination. Maintenance of infectivity of extracellular EBs was achieved by metabolizing chemically diverse compounds, including glucose 6-phosphate, ATP, and amino acids, all of which can be found in extracellular environments, including mucosal secretions. We further show that the EB cell type actively maintains infectivity in the inclusion after terminal differentiation. Overall, these findings contribute to the emerging understanding that the EB cell form is actively maintained through metabolic processes after terminal differentiation to facilitate prolonged infectivity within the inclusion and under host cell free conditions, for example, following deposition at mucosal surfaces. IMPORTANCE Chlamydiae are obligate intracellular Gram-negative bacteria that are responsible for a wide range of diseases in both animal and human hosts. According to the Centers for Disease Control and Prevention, C. trachomatis is the most frequently reported sexually transmitted infection in the United States, costing the American health care system nearly $2.4 billion annually. Every year, there are over 4 million new cases of Chlamydia infections in the United States and an estimated 100 million cases worldwide. To cause disease, Chlamydia must successfully complete its complex biphasic developmental cycle, alternating between an infectious cell form (EB) specialized for initiating entry into target cells and a replicative form (RB) specialized for creating and maintaining the intracellular replication niche. The EB cell form has historically been considered metabolically quiescent, a passive entity simply waiting for contact with a host cell to initiate the next round of infection. Recent studies and data presented here demonstrate that the EB maintains its infectious phenotype by actively metabolizing a variety of nutrients. Therefore, the EB appears to have an active role in chlamydial biology, possibly within multiple environments, such as mucosal surfaces, fomites, and inside the host cell after formation. Copyright © 2018 American Society for Microbiology.

Identification, characterisation and expression analysis of natural killer receptor genes in Chlamydia pecorum infected koalas (Phascolarctos cinereus).

PubMed

Morris, Katrina M; Mathew, Marina; Waugh, Courtney; Ujvari, Beata; Timms, Peter; Polkinghorne, Adam; Belov, Katherine

2015-10-15

Koalas (Phascolarctos cinereus), an iconic Australian marsupial, are being heavily impacted by the spread of Chlamydia pecorum, an obligate intracellular bacterial pathogen. Koalas vary in their response to this pathogen, with some showing no symptoms, while others suffer severe symptoms leading to infertility, blindness or death. Little is known about the pathology of this disease and the immune response against it in this host. Studies have demonstrated that natural killer (NK) cells, key components of the innate immune system, are involved in the immune response to chlamydial infections in humans. These cells can directly lyse cells infected by intracellular pathogens and their ability to recognise these infected cells is mediated through NK receptors on their surface. These are encoded in two regions of the genome, the leukocyte receptor complex (LRC) and the natural killer complex (NKC). These two families evolve rapidly and different repertoires of genes, which have evolved by gene duplication, are seen in different species. In this study we aimed to characterise genes belonging to the NK receptor clusters in the koala by searching available koala transcriptomes using a combination of search methods. We developed a qPCR assay to quantify relative expression of four genes, two encoded within the NK receptor cluster (CLEC1B, CLEC4E) and two known to play a role in NK response to Chalmydia in humans (NCR3, PRF1). We found that the NK receptor repertoire of the koala closely resembles that of the Tasmanian devil, with minimal genes in the NKC, but with lineage specific expansions in the LRC. Additional genes important for NK cell activity, NCR3 and PRF1, were also identified and characterised. In a preliminary study to investigate whether these genes are involved in the koala immune response to infection by its chlamydial pathogen, C. pecorum, we investigated the expression of four genes in koalas with active chlamydia infection, those with past infection and those without infection using qPCR. This analysis revealed that one of these four, CLEC4E, may be upregulated in response to chlamydia infection. We have characterised genes of the NKC and LRC in koalas and have discovered evidence that one of these genes may be upregulated in koalas with chlamydia, suggesting that these receptors may play a role in the immune response of koalas to chlamydia infection.

Assessment of best single sample for finding chlamydia in women with and without symptoms: a diagnostic test study.

PubMed

Schoeman, Sarah A; Stewart, Catherine M W; Booth, Russell A; Smith, Susan D; Wilcox, Mark H; Wilson, Janet D

2012-12-12

To compare vulvovaginal swabs with endocervical swabs as optimal diagnostic sample for detection of Chlamydia trachomatis infection. A diagnostic test study. An urban sexual health centre. 3973 women aged ≥ 16 years requesting testing for sexually transmitted infections. Participants took a vulvovaginal swab before routine examination, and clinicians took an endocervical swab during examination. Diagnosis of chlamydia infection with samples analysed using the Aptima Combo-2 assay; positive results confirmed with the Aptima CT assay. Of the 3973 participants, 410 (10.3%) were infected with C trachomatis. Infected women were significantly younger (22 v 25 years, P<0.0001) and more likely to have symptoms suggestive of a bacterial sexually transmitted infection (53% v 41%, odds ratio 1.63 (95% CI 1.30 to 2.04)), be a contact of someone with a sexually transmitted infection (25% v 5%, odds ratio 6.18 (4.61 to 8.30)), clinically diagnosed with cervicitis (17% v 4%, odds ratio 4.92 (3.50 to 6.91)), and have pelvic inflammatory disease (9% v 3%, odds ratio 2.85 (1.87 to 4.33)). When women co-infected with gonorrhoea were included in the analysis, there was an association with mixed ethnicity (10% v 7%, odds ratio 1.53 (1.07 to 2.17)); but when those with gonorrhoea were removed, women of white ethnicity were significantly more likely to have chlamydia (85% v 80%, odds ratio 1.40 (1.03 to 1.91)). On analysis of complete paired results, vulvovaginal swabs were significantly more sensitive than endocervical swabs (97% (95% CI 95% to 98%) v 88% (85% to 91%), P<0.00001); corresponding specificities were 99.9% and 100%. In women with symptoms suggestive of a bacterial sexually transmitted infection, vulvovaginal swabs were significantly more sensitive than endocervical swabs (97% (93% to 98%) v 88% (83% to 92%), P=0.0008), as they were in women without symptoms (97% (94% to 99%) v 89% (84% to 93%), P=0.002). Vulvovaginal swabs are significantly better than endocervical swabs at detecting chlamydia in women with and without symptoms suggestive of sexually transmitted infections. In those with symptoms, using endocervical samples rather than vulvovaginal swabs would have missed 9% of infections, or 1 in every 11 cases of chlamydia. ISRCTN42867448.

Did L Strains Responsible for Lymphogranuloma Venereum Proctitis Spread Among People With Genital Chlamydia trachomatis Infection in France in 2013?

PubMed

Touati, Arabella; Vernay-Vaisse, Chantal; Janier, Michel; Le Hen, Isabelle; Charlois, Cécile; Dhotte, Philippe; Decré, Dominique; Bébéar, Cécile; de Barbeyrac, Bertille

2016-06-01

We retrospectively analyzed 1802 nonrectal Chlamydia trachomatis-positive specimens to determine if the L strains responsible for rectal Lymphogranuloma venereum in men who have sex with men could spread to the heterosexual population. No evidence for Lymphogranuloma venereum transmission among heterosexuals in France was observed in 2013. L2b strains seem to be restricted to the men who have sex with men population.

Rural counties chlamydia and gonorrhea rates in Pennsylvania among adolescents and young adults.

PubMed

Pinto, Casey N; Dorn, Lorah D; Chinchilli, Vernon M; Du, Ping; Chi, Guangqing

2017-09-01

American adolescents and young adults between the ages of 15 and 24 account for 50% of all sexually transmitted diseases (STDs) annually. Rural populations in this age group are often understudied, despite having factors that place them at higher risk for STDs. The purpose of this study was to evaluate the utility of time series analysis in the assessment of rural Pennsylvania county-level chlamydia and gonorrhea rates overtime (2004-2014) for 15- to 19- and 20- to 24-year-old age groups by gender. An exploratory analysis was completed using Pennsylvania STD surveillance case report and census data, to develop a linear mixed-effects model of the STD rate for each Pennsylvania county for the years 2004 through 2014 using 3-month increments. A cubic polynomial spline regression model was assumed over the 44 time points for each county to account for possible oscillations in the STD rate during the 11-year period. Eight out of 12 rural counties had a significant increase in chlamydia or gonorrhea rates, and five rural counties had significant decreases in chlamydia or gonorrhea rates from 2004 to 2014. Results from this study provide the first analysis of change in rates of STDs in rural settings and demonstrate the utility of time series analysis for populations with small sample sizes. Copyright © 2017 Elsevier Inc. All rights reserved.

A retrospective study of recurrent chlamydia infection in men and women: is there a role for targeted screening for those at risk?

PubMed

Evans, C; Das, C; Kinghorn, G

2009-03-01

Chalmydia trachomatis remains the commonest sexually transmitted infection (STI) in the UK. This study identifies those at risk of recurrent infection (RI) attending a central genitourinary clinic, time to subsequent reinfection and duration of at-risk behaviour for the consideration of targeted chlamydia screening. From 1995 to 2005, a total of 14,011 patients' were diagnosed with chlamydia and 1743 (12.4%) had RI, classified as a repeat infection greater than three months after initial diagnosis. Individual risk factors for both sexes include young age <25, two or more partners and failure to attend for test of cure (TOC) and previous STI. Men of non-White ethnicity, symptoms and those self-referred were also at risk. Combined risk factors for both sexes were non-White ethnicity, symptoms, young age, previous STI and two or more partners. Attendance for TOC considerably reduced RI rates in men (odds ratio [OR] = 0.549; 95% confidence interval [CI] 0.359-0.840). Mean time to first and last reinfection in men was 1.91 and 2.49 years, in women 1.76 and 1.92 years. One in eight individuals with chlamydia infection are at risk of RI, the majority of which will occur within two years of initial presentation. These individuals have identifiable risk factors facilitating targeted re-screening, enhanced follow-up and support for behavioural change.

The cryptic plasmid is more important for Chlamydia muridarum to colonize the mouse gastrointestinal tract than to infect the genital tract.

PubMed

Shao, Lili; Melero, Jose; Zhang, Nu; Arulanandam, Bernard; Baseman, Joel; Liu, Quanzhong; Zhong, Guangming

2017-01-01

Chlamydia has been detected in the gastrointestinal tracts of both animals and humans. However, the mechanism by which Chlamydia colonizes the gut remains unclear. Chlamydia muridarum is known to spread from the genital to the gastrointestinal tracts hematogenously. The C. muridarum plasmid is a key pathogenic determinant in the mouse upper genital tract although plasmid-deficient C. muridarum is still able to colonize the upper genital tract. We now report that plasmid-deficient C. muridarum exhibits significantly delayed/reduced spreading from the mouse genital to the gastrointestinal tracts. C. muridarum with or without plasmid maintained similar levels in the mouse circulatory system following intravenous inoculation but the hematogenous plasmid-deficient C. muridarum was significantly less efficient in colonizing the gastrointestinal tract. Consistently, plasmid-deficient C. muridarum failed to restore normal colonization in the gastrointestinal tract even after intragastric inoculation at a high dose. Thus, we have demonstrated a plasmid-dependent colonization of C. muridarum in the gastrointestinal tract, supporting the concept that C. muridarum may have acquired the plasmid for adaptation to the mouse gastrointestinal tract during oral-fecal transmission. Since the plasmid is more important for C. muridarum to colonize the gastrointestinal tract than to infect the genital tract, the current study has laid a foundation for further defining the host pathways targeted by the plasmid-encoded or -regulated chlamydial effectors.