==================================CMR44================================== 44. Chlamydia Trachomatis and Fitz-Hugh-Curtis Syndrome. Chlamydia Trachomatis and immunologic responses. Treatment. 1 UI - 87074603 AU - Gatt D ; Heafield T ; Jantet G TI - Curtis-Fitz-Hugh syndrome: the new mimicking disease? AB - Seven cases of the Curtis-Fitz-Hugh syndrome diagnosed over a six month period are reviewed with particular reference to the widely ranging modes of presentation. All presented as acute surgical emergencies but unlike other series, right upper quadrant pain was the presenting symptom in only one case. Right upper quadrant pain nonetheless, featured to a variable extent in all cases, being relatively shortlived in three. Conditions mimicked included left renal colic, acute appendicitis, pulmonary embolism, acute cholecystitis, chronic cholecystitis and urinary tract infection. In five cases symptoms dated back to a difficult or complicated termination of pregnancy and in one case a hysterectomy had been performed twelve years previously at which time the patient had documented evidence of pelvic inflammation. Diagnosis was made laparoscopically and all symptoms responded satisfactorily to a four week course of tetracycline. MH - Acute Disease ; Adnexitis/*DIAGNOSIS/ETIOLOGY ; Adolescence ; Adult ; Chlamydia Infections/DIAGNOSIS ; Diagnosis, Differential ; Female ; Hepatitis/*DIAGNOSIS/ETIOLOGY ; Human ; Peritoneoscopy ; Syndrome SO - Ann R Coll Surg Engl 1986 Sep;68(5):271-4 2 UI - 86270873 AU - Marbet UA ; Stalder GA ; V:ogtlin J ; Loosli J ; Frei A ; Althaus B ; Gyr K TI - Diffuse peritonitis and chronic ascites due to infection with Chlamydia trachomatis in patients without liver disease: new presentation of the Fitz-Hugh-Curtis syndrome. AB - Two women were admitted for increasing abdominal pain, vaginal discharge, and severe or moderate chronic ascites. Diffuse peritonitis without evidence of liver disease was found in both cases, and in one the ascites and vaginal discharge contained Chlamydia trachomatis. Both patients responded to doxycycline, and this and the laboratory findings pointed strongly to C trachomatis as the aetiological agent. C trachomatis may cause severe peritoneal infections with chronic ascites formation in the absence of liver disease in women with the Fitz-Hugh-Curtis syndrome. Prompt diagnosis and antibiotics lead to rapid cure. MH - Adult ; Ascites/DRUG THERAPY/*ETIOLOGY ; Ascitic Fluid/ MICROBIOLOGY ; Case Report ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/*COMPLICATIONS ; Doxycycline/ THERAPEUTIC USE ; Female ; Human ; Peritonitis/DRUG THERAPY/ *ETIOLOGY ; Syndrome ; Vagina/MICROBIOLOGY SO - Br Med J [Clin Res] 1986 Jul 5;293(6538):5-6 1 UI - 87111432 AU - Ward ME ; Treharne JD ; Murray A TI - Antigenic specificity of human antibody to chlamydia in trachoma and lymphogranuloma venereum. AB - An understanding of the molecular basis of the humoral immune response to chlamydial infections in man requires the identification of target antigens to which antibodies are directed. The antigenic specificity of antibody from patients with lymphogranuloma venereum (LGV) or trachoma was therefore assessed by Western blotting. Surface polypeptides were first identified using purified chlamydial outer membrane complex as antigen. Antibodies in sera from patients with LGV but not from control negative sera reacted with a wide range of chlamydial surface polypeptides with molecular masses of 19, 29, 41, 58, 63 and 65 kDa. The major component of the antibody response detected by both immunoblotting and immunoprecipitation assay was directed against the major outer membrane protein (MOMP). Antibody to MOMP was species-specific on Western blotting, whereas antibody to several other polypeptides recognized common immunodeterminants on polypeptides of C. psittaci Cal-10 of equivalent molecular mass. Immunologically C. psittaci Cal-10 was more closely related to LGV strains of C. trachomatis than a guinea pig inclusion conjunctivitis strain of C. psittaci. Trachoma sera collected from a village in southern Iran showed predominantly type-specific antibody on micro-immunofluorescence to serotype A or B trachoma agents. These sera showed a weak immune response to MOMP, a pronounced response to a polypeptide of 36 kDa and much less widespread reactivity with other chlamydial polypeptides. The lack of an immune response to SDS-stable immunodeterminants on MOMP might contribute to the susceptibility of trachoma patients to repeated cycles of ocular infection with chlamydiae. MH - Antibodies/*IMMUNOLOGY ; Antigenic Determinants ; Antigens, Bacterial/IMMUNOLOGY ; Antigens, Surface/IMMUNOLOGY ; Chlamydia psittaci/IMMUNOLOGY ; Chlamydia trachomatis/IMMUNOLOGY ; Cross Reactions ; Human ; Lymphogranuloma Venereum/*IMMUNOLOGY ; Ornithosis/IMMUNOLOGY ; Support, Non-U.S. Gov't ; Trachoma/ *IMMUNOLOGY SO - J Gen Microbiol 1986 Jun;132 ( Pt 6):1599-610 2 UI - 87109866 AU - Cevenini R ; Rumpianesi F ; Donati M ; Moroni A ; Sambri V ; La Placa M TI - Class specific immunoglobulin response to individual polypeptides of Chlamydia trachomatis, elementary bodies, and reticulate bodies in patients with chlamydial infection. AB - Sera from 10 women with Chlamydia trachomatis culture positive cervicitis and sera from six men with C trachomatis positive non-gonococcal urethritis were studied for the presence of IgG, IgM, and IgA antibodies to polypeptides of C trachomatis elementary bodies and reticulate bodies using immunoblotting techniques. All the sera with IgG, IgM, or IgA immunoglobulins specific to C trachomatis recognised the major outer membrane protein (MOMP) of elementary bodies. IgG antibodies also detected several other proteins, whereas IgM immunoglobulins recognised only MOMP and proteins of 60 kD, 62 kD, and 66 kD. The IgA reacted with MOMP and the 60 kD and 62 kD proteins in elementary bodies. Class specific antibody response against the proteins of reticulate bodies was similar to that observed for elementary body antigens--with one substantial difference: no reaction was observed in the 60 kD and 62 kD positions. This suggests that 60 kD and 62 kD proteins are deficient in reticulate bodies. MH - Antibodies, Bacterial/*ANALYSIS ; Bacterial Outer Membrane Proteins/*IMMUNOLOGY ; Chlamydia trachomatis/*IMMUNOLOGY ; Chlamydia Infections/*IMMUNOLOGY ; Female ; Human ; IgA/ANALYSIS ; IgG/ANALYSIS ; IgM/ANALYSIS ; Immunoglobulins/*ANALYSIS ; Male ; Peptides/*IMMUNOLOGY SO - J Clin Pathol 1986 Dec;39(12):1313-6 3 UI - 87108883 AU - Oriel JD TI - Ciprofloxacin in the treatment of gonorrhoea and non-gonococcal urethritis. AB - The treatment of gonococcal infections by quinolones is reviewed. Acrosoxacin is effective, but side effects are relatively common. Ciprofloxacin is effective in single dosage against urogenital gonococcal infections, and probably also against rectal and pharyngeal infections. It is effective against infections by penicillinase-producing Neisseria gonorrhoeae. In vitro, ciprofloxacin is active against Chlamydia trachomatis, and preliminary results indicate that this drug may be of value in the treatment of non-gonococcal urethritis and chlamydial infection. No major side effects of ciprofloxacin therapy in patients with these infections have been reported. MH - Anti-Infective Agents, Urinary/THERAPEUTIC USE ; Chlamydia trachomatis ; Chlamydia Infections/DRUG THERAPY ; Ciprofloxacin/ *THERAPEUTIC USE ; Gonorrhea/*DRUG THERAPY ; Human ; Norfloxacin/ THERAPEUTIC USE ; Quinolines/THERAPEUTIC USE ; Review ; Urethritis/*DRUG THERAPY SO - J Antimicrob Chemother 1986 Nov;18 Suppl D:129-32 4 UI - 87105501 AU - van der Willigen AH ; Tjiam KH ; Wagenvoort JH ; Polak-Vogelzang AA ; Michel MF ; Stolz E TI - Evaluation of roxithromycin in the treatment of non-gonococcal urethritis in males. AB - One-hundred and fifty-two male patients suffering from non-gonococcal urethritis were treated with an oral dosage of 300 mg roxithromycin daily for seven days. Chlamydia trachomatis was isolated from the urethra in 53 patients (35%), and Ureaplasma urealyticum in 42 patients (28%). After treatment, 49 (92%) of the 53 patients with positive Chlamydia trachomatis cultures and 34 (81%) of the 42 patients with positive Ureaplasma urealyticum cultures had negative cultures at follow-up. A clinical cure was observed in 137 patients (90%). Ten patients (7%) showed side effects consisting of nausea, sensation of distended abdomen, headache and fatigue. Seventy-eight male patients suffering from nongonococcal urethritis were treated with an oral dosage of 2 X 150mg roxithromycin daily for seven days. Chlamydia trachomatis was isolated from the urethra in 22 patients (28%), and Ureaplasma urealyticum in 30 patients (38%). After treatment, all of the 22 patients with formerly positive Chlamydia trachomatis cultures and 23 (77%) of the 30 patients with formerly positive Ureaplasma urealyticum cultures were negative at follow-up. A clinical cure was observed in 70 patients (90%). Three patients (4%) showed side-effects consisting of nausea and headache. It is concluded that roxithromycin is a good alternative to tetracycline and erythromycin in the treatment of non-gonococcal urethritis in males. MH - Antibiotics/*THERAPEUTIC USE ; Chlamydia trachomatis/DRUG EFFECTS ; Chlamydia Infections/*DRUG THERAPY ; Drug Evaluation ; Human ; Male ; Mycoplasmatales Infections/*DRUG THERAPY ; Ureaplasma/DRUG EFFECTS ; Urethritis/*DRUG THERAPY SO - Eur J Clin Microbiol 1986 Dec;5(6):612-4 5 UI - 87104346 AU - Whittum-Hudson JA ; Prendergast RA ; Taylor HR TI - Changes in conjunctival lymphocyte populations induced by oral immunization with Chlamydia trachomatis. AB - The populations of lymphocyte subsets in the conjunctiva were assessed in monkeys enterically immunized with different preparations of Chlamydia trachomatis prior to ocular challenge. Subsets were identified in immunohistochemical studies employing cross-reactive anti-human monoclonal and polyclonal reagents. Ocular challenge of orally immunized animals resulted in more equal numbers of T-helper and T suppressor/cytotoxic cells, compared to the higher proportion of TS seen in naive monkeys. TH:TS/CTL ratios of 1.0-2.0 and 0.1-0.5 respectively were observed. Orally immunized monkeys also showed proportionately more IgA- and IgG-bearing cells and less IgM-bearing cells. B cells of each class were commonly seen immediately under the epithelial basement membrane. Although oral immunization induced a number of changes in the proportions and distribution of lymphocyte subsets which subsequently appeared in the conjunctiva, these changes were not correlated with disease outcome, except for the appearance of increased proportions of follicular IgA-bearing cells in partially protected monkeys. MH - Administration, Oral ; Animal ; B Lymphocytes/CYTOLOGY ; Bacterial Vaccines/ADMINISTRATION & DOSAGE ; Chlamydia trachomatis/*IMMUNOLOGY ; Conjunctiva/*CYTOLOGY ; *Immunization ; Lymphocytes/*CLASSIFICATION/MICROBIOLOGY ; Macaca fascicularis ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; T Lymphocytes/CYTOLOGY SO - Curr Eye Res 1986 Dec;5(12):973-9 6 UI - 87089140 AU - Toyofuku H ; Takashima I ; Arikawa J ; Hashimoto N TI - Monoclonal antibodies against Chlamydia psittaci. AB - Five monoclonal antibodies were prepared against Chlamydia (C.) psittaci strain Pigeon-1041 isolated from a feral pigeon in Sapporo. Reactions of these antibodies to chlamydiae were examined using five strains of C. psittaci and two strains of C. trachomatis in an enzyme-linked immunosorbent assay, microimmunofluorescent test and complement fixation test. The antibodies were divided into two groups: three genus-specific (A2, D2, and I21) and two strain-specific (F2 and H9) antibodies. The antigenic determinant site of A2 was KIO4 sensitive, but those of D2, F2, and H9 were not affected greatly by KIO4 treatment. Nine C. psittaci strains from feral pigeons and 16 strains from budgerigars were classified into three groups and four groups, respectively, by reaction patterns against the monoclonal antibodies. MH - Animal ; Antibodies, Bacterial/*IMMUNOLOGY ; Antibodies, Monoclonal/*IMMUNOLOGY ; Antigens, Bacterial/IMMUNOLOGY ; Birds/ MICROBIOLOGY ; Chlamydia psittaci/CLASSIFICATION/*IMMUNOLOGY ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia/*IMMUNOLOGY ; Periodic Acids/PHARMACODYNAMICS ; Pigeons/MICROBIOLOGY ; Species Specificity SO - Microbiol Immunol 1986;30(10):945-55 7 UI - 87074791 AU - Hook EW 3d ; Judson FN ; Verdon MS ; Ehret JM ; Handsfield HH TI - Comparative study of cefoperazone and spectinomycin for treatment of uncomplicated gonorrhea in men. AB - Beta-lactamase-negative Neisseria gonorrhoeae infections were treated with single-dose cefoperazone (0.5 or 1.0 g) or spectinomycin (2.0 g). Anogenital infections were cured in 36 (83%) of 43 volunteers given 0.5 g of cefoperazone, 61 of 61 volunteers given 1.0 g of cefoperazone, and 99 of 100 volunteers given spectinomycin. The cefoperazone geometric mean MIC for 242 isolates was 0.028 microgram/ml. Cefoperazone (1.0 g) and spectinomycin (2.0 g) are comparable for the therapy of anogenital gonorrhea in men. MH - Actinospectacin/*THERAPEUTIC USE ; Adolescence ; Adult ; Cefoperazone/*THERAPEUTIC USE ; Chlamydia trachomatis ; Chlamydia Infections/COMPLICATIONS/THERAPY ; Comparative Study ; Gonorrhea/ COMPLICATIONS/*DRUG THERAPY ; Human ; Male ; Microbial Sensitivity Tests ; Random Allocation ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Antimicrob Agents Chemother 1986 Oct;30(4):619-21 8 UI - 87074784 AU - Bowie WR ; Willetts V ; Sibau L TI - Failure of norfloxacin to eradicate Chlamydia trachomatis in nongonococcal urethritis. AB - Norfloxacin has some activity in vitro against Chlamydia trachomatis and Ureaplasma urealyticum, although not at levels attainable in serum. In this study, norfloxacin was administered (400 mg orally twice daily for 10 days) to men with acute nongonococcal urethritis. Of 25 men from whom C. trachomatis was initially isolated, 21 had the organism reisolated at the first follow-up visit posttreatment, and there were minimal changes in the number of inclusion-forming units in culture. Ultimately, all but 1 of the 22 men from whom C. trachomatis was initially isolated and who were monitored became clinical failures within 42 +/- 7 days posttreatment. The clinical outcome was significantly better for men from whom U. urealyticum was initially isolated but from whom C. trachomatis was not isolated. Of 27 men, 17 became and stayed culture negative for U. urealyticum at follow-ups, and clinically, 15 no longer had nongonococcal urethritis. Of these 15, all 12 monitored until at least 42 +/- 7 days posttreatment remained improved. Of 26 men from whom neither C. trachomatis nor U. urealyticum was initially isolated, 18 improved and all 15 who were monitored until at least 42 +/- 7 days posttreatment remained improved. Thus, although norfloxacin attains high levels in urine and has good tissue penetration, it had essentially no activity against chlamydial urethritis in men. It had better, but incomplete, activity against U. urealyticum. For quinolones to show promise in vivo against C. trachomatis, either the MICs will need to be much lower or the levels attained in serum will have to be much higher. MH - Adolescence ; Adult ; Chlamydia trachomatis ; Chlamydia Infections/*DRUG THERAPY ; Human ; Male ; Middle Age ; Mycoplasmatales Infections/DRUG THERAPY ; Norfloxacin/ *THERAPEUTIC USE ; Support, Non-U.S. Gov't ; Ureaplasma ; Urethritis/*DRUG THERAPY/MICROBIOLOGY SO - Antimicrob Agents Chemother 1986 Oct;30(4):594-7 9 UI - 87056958 AU - Kaul R ; Wenman WM TI - Cyclic AMP inhibits developmental regulation of Chlamydia trachomatis. AB - The effect of cyclic AMP (cAMP) on the chlamydial growth cycle was studied with Chlamydia trachomatis-infected HeLa cells. At concentrations of 1 mM, cAMP had a profound effect on the chlamydial developmental cycle, resulting in small, immature inclusions. Immunoblot analysis revealed the absence of elementary body (EB)-specific antigens in the cAMP-treated cells. This effect was observed only if cAMP was added within the first 12 h of incubation and continued thereafter. Its withdrawal at any time from the medium led to the reappearance of fully mature, infectious organisms. Analogs or breakdown products of cAMP exerted no inhibitory effect on chlamydial development. Intracellular inclusions from the cAMP-treated cells were unable to infect fresh HeLa monolayers, in contrast to the completely infectious nontreated inclusions. Protein profiles of the cAMP-treated organisms (at any time point) resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis very closely resembled reticulate bodies (RB) and did not possess characteristic EB-binding proteins. Collectively, these observations suggest an inhibitory role for cAMP at the RB stage of intracellular development. We also identified a cAMP receptor protein which is associated with RB and not with EB, further supporting a role for this system in the developmental regulation of chlamydiae. MH - Adenine Nucleotides/PHARMACODYNAMICS ; Adenine/PHARMACODYNAMICS ; Adenosine Cyclic Monophosphate/*PHARMACODYNAMICS ; Adenosine/ PHARMACODYNAMICS ; Antigens, Bacterial/ANALYSIS ; Chlamydia trachomatis/ANALYSIS/DRUG EFFECTS/*GROWTH & DEVELOPMENT/ IMMUNOLOGY ; Dibutyryl Cyclic AMP/PHARMACODYNAMICS ; Hela Cells ; Human ; Receptors, Cyclic AMP/ANALYSIS ; RO 20-1724/ PHARMACODYNAMICS ; Support, Non-U.S. Gov't SO - J Bacteriol 1986 Nov;168(2):722-7 10 UI - 87053958 AU - Hobson D ; Arya OP ; Rao PM ; Lee N ; Tait IA ; Bradley MG ; Mallinson H TI - Evaluation of a seven day course of oxytetracycline in women with chlamydial cervicitis. AB - In an urban clinic for sexually-transmitted diseases, 270 women with cervical swabs culture positive for Chlamydia trachomatis were treated with 250 mg oxytetracycline orally four times daily for 7 days. Chlamydial infection was found again in 17 of 220 (7.3%) women examined one month after treatment, and in 12 of 113 (9.7%) women reexamined three months after treatment. Even in cases where reinfection seemed unlikely, only 177 of 198 (89%) were cured. Most post-treatment infections were not clinically apparent, and laboratory follow-up was essential for evaluation of chemotherapy. MH - Cervicitis/*DRUG THERAPY ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/*DRUG THERAPY ; Drug Administration Schedule ; Female ; Human ; Oxytetracycline/ *ADMINISTRATION & DOSAGE ; Recurrence SO - Eur J Clin Microbiol 1986 Oct;5(5):591-5 11 UI - 87053957 AU - Kosseim M ; Brunham RC TI - Fallopian tube obstruction as a sequela to Chlamydia trachomatis infection. AB - The association of tubal infertility and ectopic pregnancy with Chlamydia trachomatis infection was investigated using a case-control study design. Although culture methods failed to document active chlamydial infection in the majority of cases, serology revealed a significant association of Chlamydia trachomatis antibody with tubal infertility and ectopic pregnancy. Thirteen of 18 (72%) women with tubal factor infertility and 18 of 32 (56%) women with ectopic pregnancy had antibodies to Chlamydia trachomatis as compared to 11 of 49 (22%) normal pregnant controls. Interestingly, only 7 of 18 (39%) infertile women and 5 of 36 (14%) women with ectopic pregnancy recalled a history of pelvic inflammatory disease. These results suggest that chlamydia-associated salpingitis, whether clinically evident or subclinical, is a major contributor to diseases of tubal dysfunction. MH - Antibodies, Bacterial/ANALYSIS ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*COMPLICATIONS ; Female ; Human ; Infertility, Female/*ETIOLOGY ; Pregnancy ; Pregnancy, Ectopic/ *ETIOLOGY ; Salpingitis/*COMPLICATIONS ; Support, Non-U.S. Gov't SO - Eur J Clin Microbiol 1986 Oct;5(5):584-90 12 UI - 87053956 AU - Persson K ; Br:oms M TI - Chlamydial respiratory infection in childhood and spurious immunoglobulin M. AB - The role of Chlamydia trachomatis was investigated in lower respiratory tract infections in 254 children. The organism was not isolated in any child but Bordetella pertussis was isolated from 65. Two of the latter and one of the remaining 189 children with negative isolation, however, had immunoglobulin M (IgM) antibodies to Chlamydia trachomatis (titers of 1:64, 1:64 and 1:128). Exhaustive absorption of the sera with bordetella antigen left the chlamydial titers unchanged, thus excluding the possibility of cross-reactivity with bordetella antigen. To determine whether nonspecific stimulation of B lymphocytes played a role, sera from 72 children with infectious mononucleosis were examined. Chlamydial IgM antibodies (greater than or equal to 1:64) were detected in 14 of these sera, significantly more often than in other acute childhood infections (p = 0.002). Serotyping showed that these antibodies had a heterogeneous specificity in different sera and a reactivity pattern suggesting they were monoclonal. The association found between chlamydial IgM antibodies and Epstein-Barr virus infection implies that there is nonspecific production of these antibodies in infectious mononucleosis, suggesting that similar nonspecific antibody production could occur in other infections. This might explain the chlamydial IgM found in children with lower respiratory tract infections in whom chlamydial infection could not be confirmed by isolation. MH - Antibodies, Bacterial/*BIOSYNTHESIS ; Bordetella Pertussis/ IMMUNOLOGY/ISOLATION & PURIFICATION ; Child ; Child, Preschool ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/ *IMMUNOLOGY ; Epstein-Barr Virus/IMMUNOLOGY ; Human ; IgM/ *BIOSYNTHESIS ; Infant ; Infectious Mononucleosis/IMMUNOLOGY ; Pneumonia/*IMMUNOLOGY ; Whooping Cough/IMMUNOLOGY SO - Eur J Clin Microbiol 1986 Oct;5(5):581-3 13 UI - 87053955 AU - Gray J ; Hovelius B ; M~ardh PA TI - Chlamydial infections in children: a seroepidemiological study. AB - A seroepidemiological study was conducted in 329 Swedish children aged 3-12 years, some of whom had upper respiratory tract infections, in order to determine the prevalence of serum IgG and IgM antibodies to Chlamydia trachomatis in this age group. Serum antibodies were detected by microimmunofluorescence assay. IgG antibodies were found in 28 (8.5%) of the children; titers were greater than or equal to 1:16 in 15 children (4.6%). Their prevalence in boys (9.4%) and girls (7.6%) was not significantly different. IgM antibodies were found in only six children. Their peak prevalence occurred in boys at the age of 8, and in girls at the age of 12. The serological findings are discussed in the light of current knowledge about chlamydial infections in children and the specificity of chlamydial antibody tests. MH - Age Factors ; Antibodies, Bacterial/*ANALYSIS ; Child ; Child, Preschool ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*IMMUNOLOGY/OCCURRENCE ; Female ; Fluorescent Antibody Technic ; Human ; IgG/*ANALYSIS ; IgM/*ANALYSIS ; Male ; Retrospective Studies ; Sex Factors ; Sweden SO - Eur J Clin Microbiol 1986 Oct;5(5):576-80 14 UI - 87053954 AU - Numazaki K ; Chiba S ; Kogawa K ; Umetsu M ; Motoya H ; Nakao T TI - Relationship between Chlamydia trachomatis infection and elevated serum immunoglobulin M levels in premature infants. AB - Serum immunoglobulin M (IgM) antibodies to Chlamydia trachomatis and to human cytomegalovirus (CMV) were detected by enzyme-linked fluorescence assay and enzyme-linked immunosorbent assay, respectively in 19 premature infants with chronic lung diseases, in 43 extremely low birth weight premature infants and in 123 neonates with elevated serum IgM levels. Ten of the 19 premature infants with chronic lung diseases had elevated serum IgM levels, and five had IgM antibodies to Chlamydia trachomatis. Three of the 43 extremely low birth weight premature infants had elevated serum IgM levels, and two had IgM antibodies to Chlamydia trachomatis. Three of the 123 neonates with elevated serum IgM levels (excluding those with chronic lung diseases and extremely low birth weight) had IgM antibodies to CMV. These results suggest that chronic lung diseases in low birth weight infants might be caused by intrauterine Chlamydia trachomatis infection. MH - Antibodies, Bacterial/*BIOSYNTHESIS ; Antibodies, Viral/ BIOSYNTHESIS ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*IMMUNOLOGY ; Chronic Disease ; Comparative Study ; Cytomegaloviruses/IMMUNOLOGY ; Female ; Human ; IgM/*BIOSYNTHESIS ; Infant, Low Birth Weight/IMMUNOLOGY ; Infant, Newborn ; Infant, Premature, Diseases/*IMMUNOLOGY ; Lung Diseases/IMMUNOLOGY ; Male SO - Eur J Clin Microbiol 1986 Oct;5(5):573-5 15 UI - 87053952 AU - Moi H ; Danielsson D TI - Diagnosis of genital Chlamydia trachomatis infection in males by cell culture and antigen detection test. AB - Urethral Chlamydia trachomatis infection was diagnosed in 204 of 1,011 (20.2%) male patients by cell culture, in 219 (21.7%) by an antigen detection test consisting of a solid phase immunoassay, and in 247 (24.4%) patients by both methods combined. The positive results of the two methods agreed for 176 patients, and both positive and negative results of the tests agreed for 940 patients (93%). With cell culture as the reference method, the antigen detection test had a sensitivity of 86.3%, a specificity of 94.7%, a positive predictive value of 80.4% and a negative predictive value of 96.5%. It gave false negative results in 28 patients. In 43 patients the antigen detection test gave a positive result, whereas culture was negative. Thirty-nine of these males were treated with antibiotics (tetracycline or erythromycin), 19 because their consorts had a proven Chlamydia trachomatis infection, and 20 for obvious clinical and/or microscopic findings of urethritis requiring treatment. According to this analysis there were 19 probable misses by cell culture test and four true false-positives by the antigen detection test, i.e. less than 0.4% of all patients examined. Since one-third of males with a final diagnosis of Chlamydia trachomatis infection were clinically asymptomatic efforts to control genital chlamydial infections must identify this reservoir. The antigen detection test provides an alternative diagnostic method to the more laborious and time-consuming cell culture procedure. MH - Antigens, Bacterial/*ANALYSIS ; Chlamydia trachomatis/IMMUNOLOGY/ ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS ; Comparative Study ; False Negative Reactions ; False Positive Reactions ; Human ; Immunoenzyme Technics ; Male ; Predictive Value of Tests ; Urethritis/*DIAGNOSIS SO - Eur J Clin Microbiol 1986 Oct;5(5):563-8 16 UI - 87053950 AU - Larsen JH ; Wulf HC ; Friis-M:ller A TI - Comparison of a fluorescent monoclonal antibody assay and a tissue culture assay for routine detection of infections caused by Chlamydia trachomatis. AB - The applicability of a commercial direct immunofluorescent monoclonal antibody assay for detection of Chlamydia trachomatis elementary bodies was studied on endocervical smears from 506 women attending a venereal disease clinic. The aim of this prospective examination was to simulate a daily routine. The results were compared to those of a well-functioning tissue culture assay. The overall positivity was 22.7%. Based on a positivity criterion of greater than or equal to 1 elementary body in the fluorescent antibody assay, the two assays agreed in 84.8% of the cases. In 50 specimens the antibody assay was positive and the culture assay negative, whereas in 23 the culture assay was positive and the antibody assay negative. The positive predictive value was 63.8%. Most of the discrepancies were found in specimens containing few elementary bodies or inclusions. Based on a criterion of greater than or equal to 10 elementary bodies, the positive predictive value was 70.9%, but the sensitivity fell to 67.5%. MH - Antibodies, Monoclonal/*DIAGNOSTIC USE ; Chlamydia trachomatis/ IMMUNOLOGY/ISOLATION & PURIFICATION ; Chlamydia Infections/ *DIAGNOSIS ; Comparative Study ; Female ; Fluorescent Antibody Technic ; Human ; Predictive Value of Tests ; Prospective Studies ; Species Specificity SO - Eur J Clin Microbiol 1986 Oct;5(5):554-8 17 UI - 87052580 AU - Godfrey E ; Winn W Jr ; Keathley JD TI - Performance of microtrak direct test for Chlamydia trachomatis in a prevalence study. AB - Three hundred thirty-two women, aged 18-30 yr. attending two clinics in Burlington Vermont were screened for infection with Chlamydia trachomatis by two methods. Microtrak Direct Test (SYVA) and cell culture. The overall sensitivity for Microtrak compared with culture was 75% (18 of 24), the specificity was 99.7% (307 of 308), the positive predictive value was 94.7% (18 of 19), and the negative predictive value was 98.1% (307 of 313). Prevalence of Chlamydia trachomatis in this population was estimated to be 7.2% (95% confidence intervals 4.4-10.0). The results from this study suggest that Microtrak is less sensitive when used in unselected patient groups from populations of lower prevalence, in contrast to higher sensitivities previously reported. MH - Adolescence ; Adult ; Antigens, Bacterial/ANALYSIS ; Chlamydia trachomatis/IMMUNOLOGY/*ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS/OCCURRENCE ; Comparative Study ; Female ; *Fluorescent Antibody Technic ; Genital Diseases, Female/ *DIAGNOSIS/OCCURRENCE ; Human ; Predictive Value of Tests ; Reagent Kits, Diagnostic ; Sexually Transmitted Diseases/ OCCURRENCE ; Support, Non-U.S. Gov't ; Vermont SO - Diagn Microbiol Infect Dis 1986 Nov;5(4):313-6 18 UI - 87038895 AU - Hawes LA ; Gilbert GL TI - Seroepidemiology of Chlamydia trachomatis infection in infertile women in Melbourne. AB - A serological study was undertaken to determine the prevalence of antibody to Chlamydia trachomatis in women and to investigate any possible role of the organism in infertility and pelvic inflammatory disease. Thirty-seven per cent of pregnant women were found to have antibodies to Chl. trachomatis, as were 69% of women with pelvic inflammatory disease. Eighty-five per cent of women who were infertile due to inflammatory tubal damage and 78% who were infertile secondary to ectopic pregnancy had antibody as compared with 56% of women who were infertile for other reasons. Sperm bank donors and children showed low prevalences (16% and 3%, respectively). Exposure to Chl. trachomatis is widespread in sexually active women and appears to have a role in pelvic inflammatory disease and infertility that is due to inflammatory tubal disease. MH - Adnexitis/COMPLICATIONS/ETIOLOGY/*IMMUNOLOGY ; Adolescence ; Adult ; Antibodies, Bacterial/*ANALYSIS ; Child ; Child, Preschool ; Chlamydia trachomatis/*IMMUNOLOGY ; Chlamydia Infections/*IMMUNOLOGY/OCCURRENCE ; Comparative Study ; Female ; Human ; Infertility, Female/ETIOLOGY/*IMMUNOLOGY ; Male ; Pregnancy Complications, Infectious/IMMUNOLOGY ; Pregnancy SO - Med J Aust 1986 Nov 17;145(10):497-9 19 UI - 87034233 AU - Mahony JB ; Chernesky MA ; Bromberg K ; Schachter J TI - Accuracy of immunoglobulin M immunoassay for diagnosis of chlamydial infections in infants and adults. AB - An improved solid-phase enzyme immunoassay (EIA) with Chlamydia trachomatis L2 434/Bu elementary bodies was developed for the measurement of immunoglobulin M (IgM) antibody to C. trachomatis in serum. Comparison of EIA and microimmunofluorescence IgM antibody titers of 156 serum samples revealed an EIA sensitivity and specificity of 100% for infants, but reduced sensitivity (85%) and specificity (76%) for sera from adults. Sera containing IgM class rheumatoid factor produced false-positive IgM results which could easily be eliminated by pretreatment of the sera with anti-human IgG. Analysis of sera from infants with chlamydial infections revealed that 17 of 17 infants with C. trachomatis pneumonia had high IgM antibody titers (geometric mean titer, 1:64,812), whereas two infants with conjunctivitis only lacked detectable IgM antibody. EIA detected IgM antibody to several serovar groups in serum, including serovars B, BDE, FG, and J. IgM antibody to C. trachomatis in serum was detected as early as 5 days after the infection that was acquired at delivery and persisted for 3 months. The availability of an EIA possessing good sensitivity and specificity for the detection of IgM antibody to C. trachomatis may permit more laboratories to diagnose perinatal chlamydial infections. MH - Adult ; Antibodies, Bacterial/ANALYSIS ; Chlamydia trachomatis/ *IMMUNOLOGY/ISOLATION & PURIFICATION ; Chlamydia Infections/ *DIAGNOSIS ; Conjunctivitis, Inclusion/DIAGNOSIS ; False Positive Reactions ; Fluorescent Antibody Technic ; Human ; IgM/*ANALYSIS ; Immunoenzyme Technics ; Infant ; Pneumonia/DIAGNOSIS ; Rheumatoid Factor/IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - J Clin Microbiol 1986 Nov;24(5):731-5 20 UI - 87032434 AU - Brade L ; Schramek S ; Schade U ; Brade H TI - Chemical, biological, and immunochemical properties of the Chlamydia psittaci lipopolysaccharide. AB - The lipopolysaccharide (LPS) of Chlamydia psittaci was extracted from yolk sac-grown elementary bodies, purified, and characterized chemically, immunochemically, and biologically. The LPS contained D-galactosamine, D-glucosamine, phosphorus, long-chain fatty acids, and 3-deoxy-D-manno-2-octulosonic acid in the molar ratio of approximately 1:2:2:6:5. The antigenic properties of the isolated LPS were compared with those of the LPS from Chlamydia trachomatis and Salmonella minnesota Re by the passive hemolysis and passive hemolysis inhibition tests, absorption, hydrolysis kinetics, and Western blot analysis with rabbit polyclonal antisera against chlamydiae and with a mouse monoclonal antibody recognizing a genus-specific epitope of chlamydial LPS. Two antigenic determinants were identified, one of which was chlamydia specific and the other of which was cross-reactive with Re LPS. Both determinants were destroyed during acid hydrolysis, whereby a third antigen specificity was exposed which was indistinguishable from the lipid A antigenicity. In rabbit polyclonal antisera prepared against Formalin-killed elementary bodies or detergent-solubilized membranes, two antibody specificities were differentiated. One of these was chlamydia specific, and the other was cross-reactive with Re LPS. The LPS of C. psittaci was inactive within typical endotoxin parameters (lethal toxicity, pyrogenicity, local Shwartzman reactivity); it was, however, active in some in vitro assays, such as those testing for mouse B-cell mitogenicity and the induction of prostaglandin E2 in mouse peritoneal macrophages. MH - Abortion, Veterinary/MICROBIOLOGY ; Animal ; Carbohydrates/ ANALYSIS ; Chlamydia psittaci/*IMMUNOLOGY ; Chlamydia Infections/ VETERINARY ; Chlamydia/IMMUNOLOGY ; Fatty Acids/ANALYSIS ; Female ; Hemolysis ; Immune Sera ; Lipopolysaccharides/*ISOLATION & PURIFICATION ; Pregnancy ; Sheep Diseases/MICROBIOLOGY ; Sheep ; Species Specificity ; Support, Non-U.S. Gov't SO - Infect Immun 1986 Nov;54(2):568-74 21 UI - 87030819 AU - Forsey T ; Stainsby K ; Hoger PH ; Ridgway GL ; Darougar S ; Fischer-Brugge U TI - Comparison of two immunofluorescence tests for detecting antibodies to C. trachomatis. AB - Two immunofluorescence tests were compared for detecting antibodies to chlamydiae. The inclusion antigen test was more sensitive, detecting antibodies in more sera and at higher titres. The micro-IF test was more specific, differentiating between antibodies to C. trachomatis and those to C.IOL 207. Antibodies to this non-genital chlamydial type accounted for half the positive results. These antibodies can cause the prevalence of C. trachomatis infections to be over estimated when genus-specific serology tests are used. MH - Antibodies, Bacterial/*ANALYSIS ; Antibody Specificity ; Chlamydia trachomatis/*IMMUNOLOGY ; Chlamydia Infections/ IMMUNOLOGY/*OCCURRENCE ; Comparative Study ; *Fluorescent Antibody Technic ; Human SO - Eur J Epidemiol 1986 Jun;2(2):163-4 22 UI - 87024516 AU - Roddy RE ; Handsfield HH ; Hook EW 3d TI - Comparative trial of single-dose ciprofloxacin and ampicillin plus probenecid for treatment of gonococcal urethritis in men. AB - In a double-blind comparative trial, 100 men with uncomplicated gonorrhea caused by beta-lactamase-negative Neisseria gonorrhoeae were treated with a single 0.25-g dose of ciprofloxacin administered orally or with 3.5 g of ampicillin plus 1.0 g of probenecid administered orally. Urethral infection was eradicated in all 49 men treated with ciprofloxacin and in 47 (92%) of 51 men treated with ampicillin-probenecid (P = 0.12). The geometric mean MICs for pretreatment isolates were 0.008 microgram of ciprofloxacin per ml, 0.09 microgram of penicillin G per ml, 0.52 microgram of tetracycline per ml, and 23.5 micrograms of spectinomycin per ml. Chlamydia trachomatis infection persisted in 10 of 11 men treated with ciprofloxacin and in 11 of 14 men treated with ampicillin-probenecid. A single 0.25-g dose of ciprofloxacin was effective for treatment of uncomplicated urethral gonorrhea in men, but it did not eradicate coinfection with C. trachomatis. MH - Adolescence ; Adult ; Ampicillin/*THERAPEUTIC USE ; Chlamydia trachomatis/DRUG EFFECTS ; Chlamydia Infections/COMPLICATIONS/ DRUG THERAPY ; Ciprofloxacin/*THERAPEUTIC USE ; Clinical Trials ; Comparative Study ; Double-Blind Method ; Drug Therapy, Combination ; Gonorrhea/COMPLICATIONS/*DRUG THERAPY ; Human ; Male ; Microbial Sensitivity Tests ; Neisseria Gonorrhoeae/DRUG EFFECTS ; Probenecid/*THERAPEUTIC USE ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Urethritis/*DRUG THERAPY SO - Antimicrob Agents Chemother 1986 Aug;30(2):267-9 23 UI - 87019271 AU - Stamm WE ; Cole B TI - Asymptomatic Chlamydia trachomatis urethritis in men. AB - Ten men with asymptomatic urethritis due to Chlamydia trachomatis were identified through culture screening and were treated with ceftriaxone (1 g given intramuscularly). Seven of the eight men who were followed for at least 21 days before and after therapy remained asymptomatic but culture-positive. One originally asymptomatic man had onset of symptomatic non-gonococcal urethritis 18 days after his first positive culture. Among asymptomatic men with positive cultures, pyuria was present in urine specimens obtained at 17 of 18 visits, while the leukocyte count on the urethral gram stain was above normal at ten of 29 visits (P less than .01). Therefore, one may conclude that ceftriaxone (1 g given intramuscularly) was ineffective therapy for chlamydial urethritis; male urethral infection with C. trachomatis can remain asymptomatic for 21-45 days; and in this population pyuria detected by urinalysis correlates better with infection than does a urethral gram stain. MH - Ceftriaxone/*THERAPEUTIC USE ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/DIAGNOSIS/*DRUG THERAPY ; Human ; Male ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Time Factors ; Urethritis/*DRUG THERAPY/MICROBIOLOGY SO - Sex Transm Dis 1986 Jul-Sep;13(3):163-5 24 UI - 87016972 AU - Watkins NG ; Hadlow WJ ; Moos AB ; Caldwell HD TI - Ocular delayed hypersensitivity: a pathogenetic mechanism of chlamydial-conjunctivitis in guinea pigs. AB - We used a naturally occurring, Chlamydia psittaci-caused eye disease in guinea pigs, guinea pig inclusion conjunctivitis, as an animal model to understand both the immune response and the pathogenesis of chlamydial eye infections. When instilled into the conjunctival sac of guinea pigs that had been previously infected and were immune, viable chlamydiae or a Triton X-100-soluble extract of them produced a short-lived (12-48 hr) eye disease indistinguishable clinically and histologically from that observed during primary chlamydial eye infection. The clinical and histologic findings were consistent with those of ocular delayed hypersensitivity. Ocular delayed hypersensitivity was induced by primary chlamydial infection at mucosal sites other than conjunctival, such as vaginal and intestinal. Preliminary characterization of the hypersensitivity allergen shows that it is heat sensitive and common to the genus Chlamydia. The allergen is apparently not surface-exposed on chlamydiae and requires viable but not replicating organisms for activity. Our observation should be useful in understanding pathogenetic mechanisms of Chlamydia trachomatis-caused infections in humans, in particular those that produce chronic inflammatory diseases, such as blinding trachoma and urogenital diseases. MH - Animal ; Antigens, Bacterial/IMMUNOLOGY ; Chlamydia trachomatis ; Chlamydia Infections/*IMMUNOLOGY ; Conjunctiva/IMMUNOLOGY ; Conjunctivitis, Bacterial/*IMMUNOLOGY ; Conjunctivitis, Inclusion/ *IMMUNOLOGY ; Female ; Guinea Pigs ; Heat ; Hypersensitivity, Delayed/IMMUNOLOGY ; Immunity, Cellular SO - Proc Natl Acad Sci USA 1986 Oct;83(19):7480-4 25 UI - 87007285 AU - Sarov I ; Kleinman D ; Holcberg G ; Potashnik G ; Insler V ; Cevenini R ; Sarov B TI - Specific IgG and IgA antibodies to Chlamydia trachomatis in infertile women. AB - IgG, IgA, and IgM antibody titers to Chlamydia trachomatis were determined in sera of 80 infertile women and 100 controls by a single antigen (L-2) immunoperoxidase assay. The infertile women included 50 with unexplained infertility and normal hysterosalpingogram (HSG) and 30 with abnormal HSG. The control sera included 50 from primiparous and 50 from multiparous women. The prevalence of C. trachomatis IgG antibody was significantly higher in infertile women with abnormal HSG as compared with infertile patients with normal HSG and controls (87% v. 20% and 10%, respectively). The geometric mean titer (GMT) of C. trachomatis IgG antibodies of infertile women with abnormal HSG was significantly higher than those of controls (20.7 v. 5.6). A significantly higher prevalence of C. trachomatis IgA antibodies was found in infertile women with both abnormal and normal HSG than in controls (77% and 14% v. 3% respectively). No C. trachomatis IgM antibodies (less than 2) were found in any of the infertile or control groups. The possibility that serum C. trachomatis IgA antibodies may serve as a marker for early recognition of persistent C. trachomatis is discussed. MH - Adult ; Animal ; Antibodies, Bacterial/*ANALYSIS ; *Antibody Specificity ; Chlamydia trachomatis/*IMMUNOLOGY ; Comparative Study ; Female ; Human ; IgA/*IMMUNOLOGY ; IgG/*IMMUNOLOGY ; IgM/ ANALYSIS ; Immunoenzyme Technics ; Infertility, Female/ *IMMUNOLOGY ; Pregnancy ; Pregnancy, Multiple ; Support, Non-U.S. Gov't SO - Int J Fertil 1986 Jul-Aug;31(3):193-7 26 UI - 87007123 AU - Manor E ; Sarov I TI - Fate of Chlamydia trachomatis in human monocytes and monocyte-derived macrophages. AB - The fate of Chlamydia trachomatis (L2/434/Bu) in human peripheral blood monocytes and human monocyte-derived macrophages was studied by transmission electron microscopy (TEM) and by measuring the yield of infectious C. trachomatis in one-step growth experiments. Two main types of phagosome were seen by TEM in the cytoplasm of C. trachomatis-infected human monocytes (1 h postinfection [p.i.]): one in which the elementary body (EB) was tightly surrounded by the membrane of the phagosome and another in which the EB appeared in an enlarged phagosome. Later, 24 to 48 h p.i., each phagosome contained a single EB-like particle, an atypical reticulate body, or a damaged particle. One-step growth experiments showed that infection of human monocytes with C. trachomatis results in a decrease of infectious particles between 24 and 96 h p.i., whereas infection of the monocytes by C. psittaci (6BC strain) results in productive infection with, however, a 3.5-log lower yield than in control MA-104 cells. In contrast to the abortive replication of C. trachomatis in monocytes, monocyte-derived macrophages permitted replication as indicated by one-step growth experiments and TEM. in C. trachomatis-infected, monocyte-derived macrophages 72 h p.i., inclusions of two kinds were observed by TEM. One was very similar to the typical inclusions appearing in infected MA-104 (control) cells; the other was atypical, pleomorphic, often contained "channels,: and held relatively few EB and reticulate bodies, some of which appeared damaged or abnormal. The significance of the responses to infection with C. trachomatis in monocytes compared with monocyte-derived macrophages and the role of these cells in sustaining chronic or latent infection and in dissemination of the infection to various parts of the body is discussed. MH - Chlamydia psittaci/GROWTH & DEVELOPMENT/IMMUNOLOGY ; Chlamydia trachomatis/GROWTH & DEVELOPMENT/*IMMUNOLOGY ; Human ; Macrophages/IMMUNOLOGY/*MICROBIOLOGY ; Microscopy, Electron ; Monocytes/IMMUNOLOGY/*MICROBIOLOGY ; Support, Non-U.S. Gov't SO - Infect Immun 1986 Oct;54(1):90-5 27 UI - 87007122 AU - Colley DG ; Goodman TG ; Barsoum IS TI - Ocular sensitization of mice by live (but not irradiated) Chlamydia trachomatis serovar A. AB - Ocular exposure of mice to live elementary bodies of Chlamydia trachomatis serovar A results in immunological sensitization of the mice. This reactivity is manifested by the development of early (5 h) and delayed-type (24 h) dermal reactivity and serovar-specific antibody formation against either live or irradiated (100 kilorads) elementary bodies. Parallel ocular exposure of mice to irradiated elementary bodies does not result in this sensitization. The early and late dermal immune responses induced by ocular exposure to live organisms can be transferred to unexposed mice by serum and lymphoid cell transfers, respectively. It appears that successful murine ocular sensitization by human C. trachomatis serovar A elementary bodies is an ability manifested by live organisms and not by inactivated but antigenic organisms. MH - Animal ; Antibodies, Bacterial/ANALYSIS ; Chlamydia trachomatis/ *IMMUNOLOGY/RADIATION EFFECTS ; Chlamydia Infections/IMMUNOLOGY/ PATHOLOGY ; Conjunctiva/*IMMUNOLOGY ; Enzyme-Linked Immunosorbent Assay ; Immunization, Passive ; Lymphocytes/IMMUNOLOGY ; Mice ; Mice, Inbred Strains ; Skin/IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, Non-P.H.S. SO - Infect Immun 1986 Oct;54(1):9-12 28 UI - 87007112 AU - R:as:anen L ; Lehtinen M ; Lehto M ; Paavonen J ; Leinikki P TI - Polyclonal response of human lymphocytes to Chlamydia trachomatis. AB - The mitogenicity of Chlamydia trachomatis was investigated. Umbilical cord blood cells from healthy newborns were used. These cells were stimulated in cultures with partially purified C. trachomatis elementary bodies. Proliferation of cultured lymphocytes and secreted immunoglobulins and leukocyte migration inhibitory factor were measured in the culture supernatants. Our results showed that C. trachomatis is able to elicit polyclonal antibody, lymphokine, and DNA synthesis. MH - Antibodies, Bacterial/*BIOSYNTHESIS ; Antibody Formation ; Cells, Cultured ; Chlamydia trachomatis/*IMMUNOLOGY ; Fetal Blood ; Human ; IgM/BIOSYNTHESIS ; Infant, Newborn ; Leukocyte Migration Inhibitory Factors/BIOSYNTHESIS ; *Lymphocyte Transformation ; Lymphocytes/*IMMUNOLOGY SO - Infect Immun 1986 Oct;54(1):28-31 29 UI - 87003437 AU - Ryan RW ; Kwasnik I ; Steingrimsson O ; Gudmundsson J ; Thorarinsson H ; Tilton RC TI - Rapid detection of Chlamydia trachomatis by an enzyme immunoassay method. AB - Chlamydia trachomatis has been shown to be a major cause of sexually transmitted diseases in the United States. An enzyme immunoassay (Abbot Laboratories) has been developed that detects chlamydial antigen directly in the urogenital specimens of patients. We have evaluated specimens from 1,074 patients belonging to one of three risk groups. Three swabs were collected from each patient--one each for Neisseria gonorrhoeae, chlamydia cell culture, and enzyme immunoassay. When compared with cell culture, the sensitivity and specificity of the enzyme immunoassay for symptomatic males and females attending a sexually transmitted disease clinic was 82% and 100%, and 91.3% and 95.0%, respectively. A moderate risk group, consisting of female patients seen at either urology or gynecology clinics for genitourinary symptoms was also evaluated. The sensitivity and specificity of the test on this group was 96% and 96.7%. A population of females at low risk were also screened for chlamydial infection. In this group, the sensitivity and specificity of the enzyme immunoassay was 89.3% and 93.2%, respectively. This rapid test is a highly specific and sensitive procedure for the detection of chlamydial antigen in genital specimens from high risk female patients as well as symptomatic males. MH - Antigens, Bacterial/*ANALYSIS ; Chlamydia trachomatis/IMMUNOLOGY/ *ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS ; False Negative Reactions ; False Positive Reactions ; Female ; Human ; Immunoenzyme Technics ; Male ; Predictive Value of Tests ; Support, Non-U.S. Gov't SO - Diagn Microbiol Infect Dis 1986 Sep;5(3):225-34 30 UI - 87000517 AU - Potts MJ ; Paul ID ; Roome AP ; Caul EO TI - Rapid diagnosis of Chlamydia trachomatis infection in patients attending an ophthalmic casualty department. AB - Direct immunofluorescence (DIF) techniques were compared with conventional cell culture for the diagnosis of ocular infections with Chlamydia trachomatis. The DIF test was found to have a sensitivity of 100% and a specificity of 97.5%. Of 178 patients studied, 19 patients (11%) were positive by DIF and 15 (8.4%) by conventional cell culture technique. Four patients who had previous treatment with chloramphenicol eye drops were negative by cell culture but positive by the DIF test. The DIF test is considered to be a rapid, accurate test with a number of advantages over culture techniques for the detection of C. trachomatis. The importance of appropriate referral of positive patients to prevent more serious sequelae due to C. trachomatis infection is discussed. MH - Adolescence ; Adult ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS/DRUG THERAPY ; Chloramphenicol/THERAPEUTIC USE ; Comparative Study ; Conjunctiva/ MICROBIOLOGY ; Eye Diseases/*DIAGNOSIS ; Female ; Fluorescent Antibody Technic ; Human ; Infant ; Infant, Newborn ; Male ; Middle Age SO - Br J Ophthalmol 1986 Sep;70(9):677-80 31 UI - 86266875 AU - Nettleman MD ; Jones RB ; Roberts SD ; Katz BP ; Washington AE ; Dittus RS ; Quinn TS TI - Cost-effectiveness of culturing for Chlamydia trachomatis. A study in a clinic for sexually transmitted diseases. AB - We have evaluated the cost-effectiveness of using cell culture to test for chlamydial infections in 9979 patients at a clinic for sexually transmitted diseases. From results of cultures, we have established prevalence data and, using decision-theory analysis, have calculated costs and probabilities of various outcomes. According to their histories and presenting signs and symptoms, patients were classified as at high or low risk for chlamydial infections. Empiric treatment of all patients attending the clinic was the most cost-effective strategy, followed by empiric treatment of high-risk women and culture-based treatment of low-risk women. Obtaining cultures for men at high and low risk was not cost-effective. If universal treatment is not provided, the most cost-effective strategy appears to be empiric therapy in patients at high risk for chlamydial infections and therapy based on diagnostic test results in women at low risk. MH - Adolescence ; Adult ; Aged ; Bacteriological Technics/ECONOMICS ; Cells, Cultured ; Child ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/COMPLICATIONS/DIAGNOSIS/DRUG THERAPY/*ECONOMICS ; Cost Benefit Analysis ; Female ; Human ; Male ; Middle Age ; Risk ; Sexually Transmitted Diseases/ *ECONOMICS/MICROBIOLOGY ; Support, U.S. Gov't, P.H.S. ; Tetracycline/THERAPEUTIC USE SO - Ann Intern Med 1986 Aug;105(2):189-96 32 UI - 86191101 AU - Stamm WE TI - Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infections using antigen detection methods. AB - Rapid antigen detection methods have great potential value in managing sexually transmitted gonococcal and chlamydial infections. Ideally, such tests should be rapid, technically simple, inexpensive, accurate, and applicable to all sites of infection commonly sampled (cervix, urethra, pharynx). For gonorrhea, the Gram stain fulfills these criteria in men with symptomatic urethritis, but lacks sensitivity when used at other sites or in asymptomatic patients. Antigen detection for gonorrhea would thus be of greatest value in 1) the diagnosis of gonococcal cervical infections in women with mucopurulent cervicitis or pelvic inflammatory disease, 2) the diagnosis of gonococcal proctitis in homosexual men, and 3) in situations requiring lengthy specimen transport. Because culture confirmation of Chlamydia trachomatis infections is not widely available, antigen detection tests could be of great value in management of these infections. Major uses include 1) confirming infection in women with cervicitis, endometritis, and pelvic inflammatory disease; 2) screening for asymptomatic infections in high risk groups of women; and 3) confirmation of Chlamydia trachomatis infections in infants and in adult males. The currently available methods for diagnosis of gonococcal and chlamydial infection by antigen detection are reviewed herein. Continued experience with antigen detection tests in well defined populations having high and low risk of gonococcal and chlamydial infection is needed to more fully determine how best to utilize these assays. MH - Adnexitis/DIAGNOSIS ; Adult ; Antigens, Bacterial/*ANALYSIS ; Cervicitis/DIAGNOSIS ; Chlamydia trachomatis/*IMMUNOLOGY ; Chlamydia Infections/*DIAGNOSIS/IMMUNOLOGY ; Comparative Study ; Drug Resistance, Microbial ; Endometritis/DIAGNOSIS ; False Positive Reactions ; Female ; Fluorescent Antibody Technic ; Gentian Violet ; Gonorrhea/*DIAGNOSIS/IMMUNOLOGY ; Human ; Immunoenzyme Technics ; Infant, Newborn ; Male ; Neisseria Gonorrhoeae/*IMMUNOLOGY ; Phenazines ; Proctitis/DIAGNOSIS ; Review ; Sexually Transmitted Diseases/*DIAGNOSIS/IMMUNOLOGY ; Urethritis/DIAGNOSIS SO - Diagn Microbiol Infect Dis 1986 Mar;4(3 Suppl):93S-99S 33 UI - 86157219 AU - Bell TA ; Grayston JT TI - Centers for Disease Control guidelines for prevention and control of Chlamydia trachomatis infections. Summary and Commentary. AB - Recent guidelines issued by the Centers for Disease Control discuss prevention and control of Chlamydia trachomatis infection. Chlamydia trachomatis is the commonest sexually transmitted infection in the United States. The rate of infection has increased in the past 10 years. The guidelines do not discuss control of trachoma and only briefly discuss lymphogranuloma venereum. Education of health care professionals and the public about C. trachomatis is recommended, along with the establishment of a nationwide surveillance system. MH - Adnexitis/DRUG THERAPY/MICROBIOLOGY ; Adolescence ; Adult ; Anti-Infective Agents/THERAPEUTIC USE ; Centers for Disease Control (U.S.) ; Chlamydia trachomatis ; Chlamydia Infections/ DIAGNOSIS/DRUG THERAPY/OCCURRENCE/*PREVENTION & CONTROL ; Doxycycline/THERAPEUTIC USE ; Female ; Human ; Infant ; Infant, Newborn ; Male ; Pregnancy ; Sexually Transmitted Diseases/ PREVENTION & CONTROL ; Tetracycline/THERAPEUTIC USE ; United States SO - Ann Intern Med 1986 Apr;104(4):524-6 34 UI - 86144240 AU - Sanders LL Jr ; Harrison HR ; Washington AE TI - Treatment of sexually transmitted chlamydial infections. AB - Tetracycline hydrochloride, 500 mg orally four times a day for seven days, remains the treatment of choice for C trachomatis infections in men and nonpregnant women. Either erythromycin, 500 mg orally four times daily for seven days, or an equivalent dosage of another erythromycin product is an alternative treatment for patients who cannot tolerate tetracycline and for pregnant women. These two treatment regimens can be generalized to include nongonococcal urethritis and mucopurulent cervicitis. However, other treatment regimens that are effective against C trachomatis may not be effective for treating nongonococcal urethritis or mucopurulent cervicitis not caused by C trachomatis. The optimal treatment for pregnant women with C trachomatis infections and women with acute PID has not been established. Additional treatment trials with both groups of patients are needed to determine the effectiveness of antimicrobial agents in addition to those currently used, to establish the appropriate dose of each antimicrobial agent, and to clarify the appropriate duration of treatment. All individuals who are sexual partners of patients with nongonococcal urethritis, mucopurulent cervicitis, and acute PID (within the 30 days prior to onset of their symptoms or time of positive clinical evaluation findings) should be examined for sexually transmitted disease and treated promptly with a regimen effective against uncomplicated gonorrhea and chlamydial infections. Prompt treatment of sexual partners reduces the rate of treatment failure due to reinfection, reduces the transmission of infection, and reduces the frequency of occurrence of adverse sequelae of infection. MH - Acute Disease ; Adnexitis/DRUG THERAPY ; Anti-Infective Agents/ *THERAPEUTIC USE ; Cervicitis/DRUG THERAPY ; Chlamydia trachomatis ; Chlamydia Infections/*DRUG THERAPY ; Clinical Trials ; Female ; Human ; Male ; Pregnancy ; Pregnancy Complications, Infectious/DRUG THERAPY ; Review ; Sexually Transmitted Diseases/*DRUG THERAPY ; Urethritis/DRUG THERAPY SO - JAMA 1986 Apr 4;255(13):1750-6 35 UI - 86140851 AU - Numazaki K ; Chiba S ; Kogawa K ; Umetsu M ; Motoya H ; Nakao T TI - Chronic respiratory disease in premature infants caused by Chlamydia trachomatis. AB - The relation between chronic respiratory disease and infection with Chlamydia trachomatis in premature infants was investigated to ascertain the aetiological importance of intrauterine C trachomatis infection and chronic respiratory disease in premature infants. Serum IgM antibodies against C trachomatis were determined by enzyme linked fluorescence assay. Sections of lung tissues obtained by biopsy and at necropsy were also tested for the presence of antigens using fluorescein conjugated monoclonal antibodies to C trachomatis. Of 16 sera from premature infants with chronic respiratory diseases clinically diagnosed as bronchopulmonary dysplasia or the Wilson-Mikity syndrome, five had IgM antibodies to C trachomatis L2 strain by enzyme linked fluorescence assay (titre greater than or equal to 1/500). Of 37 sera from premature infants with extremely low birth weights, two had IgM antibodies to C trachomatis. No specific IgM antibody was detected in 31 neonates who showed raised serum IgM concentrations but who did not have respiratory tract symptoms. C trachomatis was identified from two specimens of lung tissue obtained at necropsy from premature infants with chronic respiratory disease positive for IgM antibody. These findings indicate the aetiological importance of intrauterine C trachomatis infection in chronic respiratory disease in premature infants. MH - Case Report ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*COMPLICATIONS ; Chronic Disease ; Female ; Fetal Diseases/COMPLICATIONS ; Human ; IgM/ANALYSIS ; Infant, Newborn ; Infant, Premature, Diseases/*ETIOLOGY ; Lung Diseases/*ETIOLOGY/ IMMUNOLOGY/RADIOGRAPHY ; Male ; Pregnancy SO - J Clin Pathol 1986 Jan;39(1):84-8 36 UI - 86320150 AU - Harrison HR ; Magder LS ; Boyce WT ; Hauler J ; Becker TM ; Stewart JA ; Humphrey DD TI - Acute Chlamydia trachomatis respiratory infection in childhood. Serologic evidence. AB - Serum samples from 184 infants and children whose blood was drawn during a clinic visit were tested for antibody to Chlamydia trachomatis, Epstein-Barr virus, and cytomegalovirus. Lifetime illness history was obtained from clinic records. Fifteen percent had anti-C trachomatis IgM antibody. Anti-C trachomatis IgM without IgG was significantly associated with upper respiratory tract syndromes within the 14 days prior to phlebotomy in 6- to 10-year-old patients. This association was not due to polyclonal activation from Epstein-Barr virus infection. A definitive study of chlamydial illness in children rather than infants appears to be indicated. MH - Acute Disease ; Adolescence ; Antibodies, Bacterial/ANALYSIS ; Antibodies, Viral/ANALYSIS ; Antigens, Viral/IMMUNOLOGY ; Capsid/ IMMUNOLOGY ; Child ; Child, Preschool ; Chlamydia trachomatis/ IMMUNOLOGY ; Chlamydia Infections/*DIAGNOSIS/IMMUNOLOGY ; Cytomegaloviruses/IMMUNOLOGY ; Epstein-Barr Virus/IMMUNOLOGY ; Female ; Human ; IgG/ANALYSIS ; IgM/ANALYSIS ; Infant ; Infant, Newborn ; Male ; Respiratory Tract Infections/*DIAGNOSIS/ IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Am J Dis Child 1986 Oct;140(10):1068-71 37 UI - 86319048 AU - Marton A ; Szirmai Z ; Szever Z ; L:aszl:o V TI - Serological studies in Chlamydia trachomatis associated pneumonia of infants. AB - Serological results provided evidence for the clinical diagnosis of chlamydial pneumonia in 8 out of 51 cases. Elevated chlamydia-specific IgM titres (128-2048) and IgG titres (128-2048) were recorded in 5 and 8 infants, respectively. High titres of chlamydial antibodies (512-8192) in the sera of mothers of seropositive children proved genital Chlamydia trachomatis infection. MH - Antibodies, Bacterial/*ANALYSIS ; Antigens, Bacterial/ANALYSIS ; Chlamydia trachomatis/*IMMUNOLOGY/ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS/IMMUNOLOGY ; Fluorescent Antibody Technic ; Human ; IgG/ANALYSIS ; IgM/ANALYSIS ; Infant ; Infant, Newborn ; Pneumonia/*DIAGNOSIS/IMMUNOLOGY SO - Acta Microbiol Hung 1986;33(1):51-4 38 UI - 86303012 AU - Batteiger BE ; Newhall WJ 5th ; Terho P ; Wilde CE 3d ; Jones RB TI - Antigenic analysis of the major outer membrane protein of Chlamydia trachomatis with murine monoclonal antibodies. AB - We prepared monoclonal antibodies against prototype strains of the 15 serovars of Chlamydia trachomatis and identified a subset of reagents that reacted with the major outer membrane protein(s) (MOMPs) of one or more serovars. We then determined the specificities of these anti-MOMP monoclonal antibodies by radioimmunoassay and immunoblot assays against the 15 serovars of C. trachomatis and a C. psittaci strain. We identified 14 different anti-MOMP antibody specificities, including serovar-, several orders of subspecies-, and species-specific determinants. In addition, one antibody reacted with all C. trachomatis serovars and a C. psittaci strain, indicating the presence of a genus-specific epitope on MOMP. Many of the cross-reactions of the subspecies-specific antibodies were similar to those previously reported by use of the microimmunofluorescence technique. We also observed a number of cross-reactions that were unexpected but consistent with data derived by the microimmunofluorescence test. All antibodies, except the genus-specific antibodies, reacted with whole elementary bodies in a radioimmunoassay, suggesting surface exposure of the epitopes. These data confirm and extend previous observations that MOMPs among C. trachomatis serovars are antigenically complex and diverse. In addition, these data indicate that the cross-reaction patterns of some monoclonal antibodies directed against MOMP are similar to those detected by the microimmunofluorescence test and are consistent with the hypothesis that such determinants are contained within MOMPs. MH - Animal ; Antibodies, Monoclonal/*IMMUNOLOGY ; Antigenic Determinants ; Bacterial Outer Membrane Proteins/*IMMUNOLOGY ; Chlamydia trachomatis/*ANALYSIS/IMMUNOLOGY ; Cross Reactions ; Mice ; Species Specificity ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Infect Immun 1986 Sep;53(3):530-3 39 UI - 86286104 AU - Bialasiewicz AA ; Jahn GJ TI - Epidemiology of chlamydial eye diseases in a mixed rural/urban population of West Germany. AB - 4260 conjunctival specimens of 2850 outpatients with keratoconjunctivitis of presumed infectious etiology were studied. Two thousand six hundred sixty-eight specimens (63%) revealed growth of bacteria, and 80 (2%) growth of fungi. One hundred ninety-nine specimens (5%) were McCoy cell culture or direct stain (monoclonal antibody or Giemsa) positive for Chlamydia trachomatis. two patients had a C. psittaci infection (ELISA techniques). In patients with keratoconjunctivitis of bacterial etiology, overall incidence of McCoy cell culture-proven chlamydial infections was 7%; in the 20 to 30-year age group it was 12.5%. Simultaneous infections of chlamydiae and other bacteria were seen in 34 patients. Since sensitive and specific tests to diagnose chlamydial infections are available, ophthalmologists may be able to prevent these infections by agent-specific antibiotic therapy. MH - Adult ; Bacterial Infections ; Chlamydia trachomatis ; *Chlamydia Infections/DRUG THERAPY ; Erythromycin/ADVERSE EFFECTS/ THERAPEUTIC USE ; Germany, West ; Human ; Infant ; Infant, Newborn ; Keratoconjunctivitis/*ETIOLOGY/OCCURRENCE ; Rural Population ; Social Class ; Tetracycline/THERAPEUTIC USE ; Urban Population SO - Ophthalmology 1986 Jun;93(6):757-62 40 UI - 86285913 AU - Hoyme UB ; Kiviat N ; Eschenbach DA TI - Microbiology and treatment of late postpartum endometritis. AB - Eighteen vaginally delivered women who developed late postpartum endometritis seven to 42 days after delivery were prospectively studied. Multiple microorganisms were recovered from the endometrium, including Chlamydia trachomatis, genital mycoplasmas, and a wide variety of bacteria. Erythromycin therapy was successful in ten of the 13 women who were followed. MH - Adolescence ; Adult ; Bacterial Infections/*DIAGNOSIS/DRUG THERAPY ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/DIAGNOSIS/DRUG THERAPY ; Endometritis/DRUG THERAPY/*ETIOLOGY ; Endometrium/MICROBIOLOGY ; Erythromycin/ *THERAPEUTIC USE ; Female ; Follow-Up Studies ; Human ; Mycoplasma Infections/DIAGNOSIS/DRUG THERAPY ; Pregnancy ; Prospective Studies ; Puerperal Infection/DRUG THERAPY/*ETIOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Time Factors SO - Obstet Gynecol 1986 Aug;68(2):226-32 41 UI - 86276933 AU - Yong EC ; Chi EY ; Chen WJ ; Kuo CC TI - Degradation of Chlamydia trachomatis in human polymorphonuclear leukocytes: an ultrastructural study of peroxidase-positive phagolysosomes. AB - We have previously shown that human polymorphonuclear leukocytes (PMNs) killed organisms belonging to both human biovars of Chlamydia trachomatis. However, the mechanism of destruction was still unclear. We therefore conducted an ultrastructural and cytochemical study to investigate the mechanism of chlamydial degradation. PMNs were inoculated with the trachoma serovar B (B/TW-5/OT) or with the lymphogranuloma venereum serovar L2 (L2/434/Bu) for 15, 30, 60, or 120 min and then fixed and processed for transmission electron microscopy. Diaminobenzidine, a cytochemical marker, was used to demonstrate the localization of intracellular peroxidase. Ultrastructural evidence is presented showing the progressive degradation of chlamydiae over a 2-h period within peroxidase-positive phagolysosomes. Pretreatment of organisms with normal or immune serum was not required for the process of degradation. MH - Chlamydia trachomatis/*METABOLISM ; Human ; Immune Sera/ IMMUNOLOGY ; Luminescence ; Lysosomes/MICROBIOLOGY ; Myeloperoxidase/ANALYSIS ; Neutrophils/ENZYMOLOGY/*MICROBIOLOGY/ ULTRASTRUCTURE ; Organoids/*MICROBIOLOGY ; Peroxidases/*ANALYSIS ; Phagosomes/MICROBIOLOGY ; Support, U.S. Gov't, P.H.S. ; Vacuoles/*MICROBIOLOGY SO - Infect Immun 1986 Aug;53(2):427-31 42 UI - 86276684 AU - Inman RD ; Chiu B ; Johnston ME ; Falk J TI - Molecular mimicry in Reiter's syndrome: cytotoxicity and ELISA studies of HLA-microbial relationships. AB - The pathogenic links between HLA antigens, certain bacterial infections and arthritis have not yet been characterized. The hypothesis of cross-reactivity between HLA B27, the marker of disease susceptibility for these disorders, and the provocative microorganism has been suggested by studies of Klebsiella and ankylosing spondylitis. The present study examines the possibility of molecular mimicry between HLA B27 and two organisms implicated more directly in reactive arthritis, Yersinia enterocolitica and Chlamydia trachomatis. Antibodies against these organisms were obtained both from patients and from antisera raised in rabbits. Neither source of antibacterial antibody was specifically cytotoxic for HLA B27-positive lymphocytes, even when the target cells were derived from patients with recent infections due to these organisms. In addition, monoclonal antibodies against HLA B27 (M1 and M2) showed no reactivity with antigens from these organisms in an ELISA system. These data do not support the notion of molecular mimicry as being the basis of immunogenetic susceptibility to reactive arthritis and Reiter's syndrome following infections with Y. enterocolitica and C. trachomatis. MH - Antigens, Bacterial/*IMMUNOLOGY ; Chlamydia trachomatis/ *IMMUNOLOGY ; Cross Reactions ; Cytotoxicity, Immunologic ; Enzyme-Linked Immunosorbent Assay ; Human ; HLA Antigens/ *IMMUNOLOGY ; Reiter's Disease/*IMMUNOLOGY ; Support, Non-U.S. Gov't ; Yersinia enterocolitica/*IMMUNOLOGY SO - Immunology 1986 Jul;58(3):501-6 43 UI - 86276526 AU - Arya OP ; Hobson D ; Hart CA ; Bartzokas C ; Pratt BC TI - Evaluation of ciprofloxacin 500 mg twice daily for one week in treating uncomplicated gonococcal chlamydial, and non-specific urethritis in men. AB - Ciprofloxacin, a quinolone antibacterial, was evaluated in the treatment of gonococcal, chlamydial, gonococcal and chlamydial, and non-gonococcal non-chlamydial urethritis. The dosage regimen used was 500 mg orally twice a day for seven days. Of the 56 patients evaluated 22 had gonococcal infection only, 13 were infected with Chlamydia trachomatis only, seven had combined infection, and 14 were harbouring neither of these organisms. Neisseria gonorrhoeae was cleared in all the 29 patients with or without chlamydial infection. Of those who denied having sexual intercourse during the follow-up period, post gonococcal urethritis (PGU) developed in 12 (63%) out of 19, C trachomatis was isolated again from 11 (78%) out of 14, and urethritis recurred in five (55%) out of nine patients with non-gonococcal non-chlamydial infection. There was also evidence that the dosage regimen used was only partially effective against Ureaplasma urealyticum. MH - Adult ; Chlamydia Infections/*DRUG THERAPY ; Drug Evaluation ; Gonorrhea/*DRUG THERAPY ; Human ; Male ; Quinolines/ *ADMINISTRATION & DOSAGE/THERAPEUTIC USE ; Urethritis/*DRUG THERAPY SO - Genitourin Med 1986 Jun;62(3):170-4 44 UI - 86273783 AU - Kaz:ar J ; Stencl J ; Lok:sa V ; Ta:covsk:y L ; Kov:a:cov:a E TI - Evidence of Chlamydia trachomatis infection in gynaecological patients. AB - Direct microscopic examination of cervical smears taken from gynaecological patients and stained by Giemsa and Gimenez revealed the presence of chlamydial inclusions in 2 and elementary bodies in 6 out of 40 samples tested. Attempts of demonstration of chlamydiae from cervical smears of further patients in chick embryo yolk sacs and cycloheximide-treated McCoy cells using the centrifugation of infectious inocula succeeded in 4 and 9 cases of 71 patients examined, respectively. One isolated strain behaved as Chlamydia trachomatis based on its sensitivity to sulfadiazine, absence of killing the intraperitoneally inoculated mice, demonstration of its inclusions by iodine staining and by detection of its elementary bodies by immunofluorescence technique using mouse serum directed to C. trachomatis but not C. psittaci serotypes. At the same time, 11 of 68 patient sera tested by microimmunofluorescence test contained IgG antibodies to genitourinary serotypes of C. trachomatis, suggesting the previous contact of patients with sexually-transmitted chlamydiae. The results obtained indicate that chlamydiae may pose a public health problem in women of sexually active age also in Czechoslovakia. MH - Adult ; Antibodies, Bacterial/ANALYSIS ; Cervicitis/DIAGNOSIS/ ETIOLOGY ; Chlamydia trachomatis/CLASSIFICATION/IMMUNOLOGY/ ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS ; Female ; Genital Diseases, Female/*DIAGNOSIS/ETIOLOGY ; Human ; Middle Age ; Salpingitis/DIAGNOSIS/ETIOLOGY ; Serotyping SO - Czech Med 1986;9(2):70-7 45 UI - 86269833 AU - W:lner-Hanssen P TI - Oral contraceptive use modifies the manifestations of pelvic inflammatory disease. AB - A case-control study was performed on 94 women with acute salpingitis and 12 women with salpingitis and perihepatitis; all patients included in the study were infected with Chlamydia trachomatis, and all had been subjected to diagnostic laparoscopy. None of the 12 patients with, but 38 (40%) of the 94 patients without, perihepatitis used oral contraceptives (P = 0.002). The geometric mean titre of serum IgG antibodies to C. trachomatis was higher among patients with (1:1021) than among patients without (1:69) perihepatitis (P = 0.0001). Oral contraceptive users had lower geometric mean titre of antibodies to the organism (1:25) than non-users (1:109, P = 0.001). The study suggests that oral contraceptive use may modify the clinical manifestations of chlamydial pelvic inflammatory disease. MH - Acute Disease ; Adnexitis/*PREVENTION & CONTROL ; Antibodies, Bacterial/ANALYSIS ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*PREVENTION & CONTROL ; Contraceptives, Oral/ *THERAPEUTIC USE ; Female ; Hepatitis/COMPLICATIONS/PREVENTION & CONTROL ; Human ; Salpingitis/COMPLICATIONS SO - Br J Obstet Gynaecol 1986 Jun;93(6):619-24 46 UI - 86267956 AU - Persson K ; R:onnerstam R ; Svanberg L ; Polberger S TI - Neonatal chlamydial conjunctivitis. AB - Maternal chlamydial antibodies were determined in cord sera of 41 infants who developed neonatal chlamydial conjunctivitis and compared with the antibody profile of infants who had been exposed to Chlamydia trachomatis at birth by their isolation positive mothers but in whom conjunctivitis did not develop. No protective effect could be attributed to maternal antibodies transferred to the infants. Paired sera samples were collected from 18 infants with chlamydial conjunctivitis. Chlamydial IgM antibodies were detected in four of these 18 cases at the time diagnosis was established by isolation. An additional eight cases had developed chlamydial IgM at the time the convalescent sera samples were taken, on average on day 40. At that time symptoms had disappeared after systemic treatment had been given. Thus chlamydial IgM antibodies were eventually shown in two thirds of infants with chlamydial conjunctivitis who were all systemically treated and clinically healed. These data suggest a cautious assessment of chlamydial IgM in the diagnosis of chlamydial pneumonia. MH - Adult ; Antibodies, Bacterial/*ANALYSIS ; Chlamydia trachomatis/ *IMMUNOLOGY ; Chlamydiaceae Infections/COMPLICATIONS ; Conjunctivitis, Inclusion/*IMMUNOLOGY ; Female ; Fetal Blood/ IMMUNOLOGY ; Genital Diseases, Female/ETIOLOGY ; Human ; IgG/ ANALYSIS ; IgM/ANALYSIS ; Immunity, Maternally-Acquired ; Infant, Newborn SO - Arch Dis Child 1986 Jun;61(6):565-8 47 UI - 86241890 AU - Gilbert GL TI - Chlamydial infections in infancy. AB - Non-gonococcal ophthalmia neonatorum was the first recognized manifestation of sexually transmitted chlamydial infection and for many years it was thought to be the only manifestation in infants born to infected mothers. In the 20 years since techniques for isolation of Chlamydia trachomatis in cell culture were described, many important effects of chlamydial infection, including afebrile pneumonia in infants, have been established. Prospective studies have determined the incidence of chlamydial infection in pregnant women and the risk of transmission of infection to their infants. They have shown that these are among the commonest perinatal infections. It is estimated that at least 1% of infants in this community have chlamydial conjunctivitis and up to 5/1000 will develop pneumonia. Chlamydial infections are characterized by a subacute onset and, without appropriate treatment, a prolonged course. Although they are rarely fatal, symptoms are sometimes severe and there may be long-term sequelae. The recent development of rapid and relatively inexpensive methods for direct detection of chlamydiae in clinical specimens will facilitate the diagnosis and treatment of infections in infants. MH - Chlamydia trachomatis ; *Chlamydia Infections/COMPLICATIONS/ DIAGNOSIS/DRUG THERAPY/TRANSMISSION ; Conjunctivitis, Inclusion/ DIAGNOSIS/ETIOLOGY ; Erythromycin/THERAPEUTIC USE ; Human ; Infant ; Infant, Newborn ; Pneumonia/DIAGNOSIS/ETIOLOGY ; Review SO - Aust Paediatr J 1986 Feb;22(1):13-7 48 UI - 86236632 AU - Watt PJ TI - Pathogenic mechanisms of organisms virulent to the eye. AB - Gonococci possess long range adhesins in the form of pili permitting initial contact with conjunctival cells. Subsequently sticky surface protein (Protein II) bonds the gonococcus close to the host cell surface. Damage is mediated both by the intracellular uptake and the introduction of pores in the host cell membrane. Unlike gonococci, pseudomonas can only attach to damaged cells but once the eye is invaded a wide range of enzymes and toxins leads to rapid tissue destruction. The mechanisms by which Chlamydia trachomatis induce trachoma are ill-understood but involve intense antigenic stimulation. Methods are now available to investigate the antigenic structure of chlamydia at sub-molecular levels; such an approach is required for the development of a vaccine against trachoma. MH - Antigens, Bacterial/IMMUNOLOGY ; Antigens, Surface/IMMUNOLOGY ; Bacterial Outer Membrane Proteins/IMMUNOLOGY ; Bacterial Proteins/ PHYSIOLOGY ; Cell Adhesion ; Chlamydia trachomatis/*PATHOGENICITY/ ULTRASTRUCTURE ; Conjunctivitis/*ETIOLOGY ; Epithelium/ ULTRASTRUCTURE ; Human ; Keratitis/ETIOLOGY ; Microscopy, Electron ; Neisseria Gonorrhoeae/*PATHOGENICITY/ULTRASTRUCTURE ; Pili, Bacterial/ULTRASTRUCTURE ; Pseudomonas Aeruginosa/ *PATHOGENICITY ; Review ; Support, Non-U.S. Gov't ; Trachoma/ ETIOLOGY ; Virulence SO - Trans Ophthalmol Soc UK 1986;105 ( Pt 1):26-31 49 UI - 86235933 AU - Martin DH ; Pastorek JG 2d ; Faro S TI - In-vitro and in-vivo activity of parenterally administered beta-lactam antibiotics against Chlamydia trachomatis. AB - The extended-spectrum penicillins ticarcillin, mezlocillin, and piperacillin might be useful as single agents for the treatment of pelvic infections in women if it could be shown that these drugs are active against Chlamydia trachomatis. We found that the MIC90 (concentration at which 90% of strains are inhibited) values of ticarcillin, mezlocillin, and piperacillin were 16, 16, and 64 micrograms/ml, respectively. Several cephalosporins were found to have MICs for C. trachomatis of greater than 200 micrograms/ml. Ten women with postpartum endometritis who were colonized with C. trachomatis had repeated chlamydial cultures following treatment with beta-lactam antibiotics. All seven cases treated with ticarcillin plus clavulanic acid (a beta-lactamase inhibitor) or piperacillin alone had C. trachomatis-negative cultures after treatment. Three of four of these women had negative cultures at a second follow-up visit. In contrast, the three women treated with a cephalosporin were culture-positive at their first follow-up clinic visit. These data suggest that there is a correlation between the in-vitro measurement of beta-lactam antibiotic activity against C. trachomatis and the microbiologic outcome of treatment. We conclude that the extended-spectrum penicillins deserve further evaluation as single agents for the treatment of pelvic infections in women at high risk for C. trachomatis infections. MH - Adult ; Antibiotics, Lactam/ADMINISTRATION & DOSAGE/ *PHARMACODYNAMICS/THERAPEUTIC USE ; Cefoxitin/THERAPEUTIC USE ; Cephalosporins/PHARMACODYNAMICS/THERAPEUTIC USE ; Cephamycins/ THERAPEUTIC USE ; Chlamydia trachomatis/*DRUG EFFECTS/ISOLATION & PURIFICATION ; Chlamydia Infections/DRUG THERAPY ; Clavulanic Acids/THERAPEUTIC USE ; Clindamycin/THERAPEUTIC USE ; Clinical Trials ; Drug Therapy, Combination ; Endometritis/DRUG THERAPY/ MICROBIOLOGY ; Female ; Gentamicins/THERAPEUTIC USE ; Human ; In Vitro ; Infant ; Infusions, Parenteral ; Male ; Mezlocillin/ PHARMACODYNAMICS ; Microbial Sensitivity Tests ; Penicillin G/ PHARMACODYNAMICS ; Piperacillin/PHARMACODYNAMICS/THERAPEUTIC USE ; Pregnancy ; Puerperium ; Support, Non-U.S. Gov't ; Ticarcillin/ PHARMACODYNAMICS/THERAPEUTIC USE SO - Sex Transm Dis 1986 Apr-Jun;13(2):81-7 50 UI - 86227935 AU - Schachter J ; Grossman M ; Sweet RL ; Holt J ; Jordan C ; Bishop E TI - Prospective study of perinatal transmission of Chlamydia trachomatis. AB - During a five-year period, 262 (4.7%) of 5,531 pregnant women had positive cervical cultures for Chlamydia trachomatis, and 131 of their infants were followed up prospectively to ascertain the outcome of chlamydial exposure during the birth process. Culture-confirmed inclusion conjunctivitis of the newborn was seen in 23 (18%) of the infants. Chlamydial pneumonia was diagnosed in 21 (16%) of the infants at risk. Chlamydia trachomatis was recovered from 47 of the infants (36%), while 79 (60%) showed serologic evidence of infection. Subclinical rectal and vaginal infections were detected in 14% of infants at risk. In our population, 2.8% of newborn infants show serologic evidence of perinatal chlamydial infection and 1.4% develop either chlamydial pneumonia or conjunctivitis. Incidence rates of this magnitude indicate the need for programs aimed at preventing perinatal transmission of C trachomatis. MH - Antibodies, Bacterial/ANALYSIS ; Chlamydia trachomatis/IMMUNOLOGY/ ISOLATION & PURIFICATION ; Chlamydia Infections/CONGENITAL/ *TRANSMISSION ; Conjunctivitis, Inclusion/DRUG THERAPY/ TRANSMISSION ; Erythromycin/THERAPEUTIC USE ; Female ; Human ; IgG/ANALYSIS ; IgM/ANALYSIS ; Infant ; Infant, Newborn ; Ophthalmia Neonatorum/DRUG THERAPY/TRANSMISSION ; Pneumonia/ MICROBIOLOGY/TRANSMISSION ; Pregnancy ; Pregnancy Complications, Infectious/*TRANSMISSION ; Prospective Studies ; Support, U.S. Gov't, P.H.S. SO - JAMA 1986 Jun 27;255(24):3374-7 51 UI - 86227934 AU - Rapoza PA ; Quinn TC ; Kiessling LA ; Green WR ; Taylor HR TI - Assessment of neonatal conjunctivitis with a direct immunofluorescent monoclonal antibody stain for Chlamydia. AB - Chlamydial conjunctivitis was diagnosed by direct immunofluorescent monoclonal antibody staining of conjunctival smears in 46 of 100 consecutive neonates with conjunctivitis. The remaining 54 infants had bacterial conjunctivitis most commonly caused by Staphylococcus, Streptococcus, and Haemophilus species. A comparison of the direct test with chlamydial cultures demonstrated a sensitivity of 100% and a specificity of 94%, whereas Giemsa stain had a sensitivity of 42% and a specificity of 98%. Nineteen percent of infants treated with oral erythromycin for chlamydial infections in accordance with Centers for Disease Control guidelines had clinical and laboratory evidence of persistent chlamydial conjunctivitis. We conclude that Chlamydia trachomatis is a major cause of neonatal conjunctivitis that can be effectively and rapidly diagnosed by direct immunofluorescent monoclonal antibody staining of conjunctival smears. Further evaluation of treatment regimens appears to be warranted. MH - Antibodies, Bacterial/DIAGNOSTIC USE ; Antibodies, Monoclonal/ DIAGNOSTIC USE ; Azure Stains ; Chlamydia trachomatis/IMMUNOLOGY/ ISOLATION & PURIFICATION ; Conjunctivitis, Bacterial/ *MICROBIOLOGY ; Conjunctivitis, Inclusion/*DIAGNOSIS/DRUG THERAPY ; Erythromycin/THERAPEUTIC USE ; Evaluation Studies ; Fluorescent Antibody Technic ; Human ; Infant ; Infant, Newborn ; Ophthalmia Neonatorum/DRUG THERAPY/*MICROBIOLOGY ; Prospective Studies ; Stains and Staining/METHODS ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - JAMA 1986 Jun 27;255(24):3369-73 52 UI - 86225650 AU - Chernesky MA ; Mahony JB ; Castriciano S ; Mores M ; Stewart IO ; Landis SJ ; Seidelman W ; Sargeant EJ ; Leman C TI - Detection of Chlamydia trachomatis antigens by enzyme immunoassay and immunofluorescence in genital specimens from symptomatic and asymptomatic men and women. AB - Chlamydia trachomatis antigens were detected in populations with the following infection prevalences: 26.5% (36 of 136) of men and 27.7% (48 of 173) of women attending a sexually transmitted disease clinic, 16.3% (53 of 324) of women attending a Planned Parenthood clinic, and 3.4% (4 of 117) of an obstetrics and gynecologic practice. Compared with cell culture of the combined female cervical specimens (15.8% prevalence), the respective sensitivities of Chlamydiazyme (Abbott Laboratories, North Chicago, Illinois) and Microtrak (Syva, Palo Alto, California) were 98.3% and 87.9%, specificities were 97.5% and 98.4%, positive predictive values were 87.7% and 92.7%, and negative predictive values were 99.7% and 97.5%. Both assays were 70.0% sensitive with male urethral specimens, and the other parameters of performance ranged between 84.0% and 97.2%. The antigen detection assays, compared with culture, performed equally well in subjects without or with clinical signs. MH - Adult ; Antigens, Bacterial/*IMMUNOLOGY ; Cells, Cultured ; Cervicitis/MICROBIOLOGY ; Cervix Uteri/MICROBIOLOGY ; Chlamydia trachomatis/*IMMUNOLOGY ; Chlamydia Infections/DIAGNOSIS/ *IMMUNOLOGY ; Female ; Fluorescent Antibody Technic ; Human ; Immunoenzyme Technics ; Male ; Urethra/MICROBIOLOGY ; Urethritis/ MICROBIOLOGY SO - J Infect Dis 1986 Jul;154(1):141-8 53 UI - 86224562 AU - Forbes BA ; Bartholoma N ; McMillan J ; Roefaro M ; Weiner L ; Welych L TI - Evaluation of a monoclonal antibody test to detect chlamydia in cervical and urethral specimens. AB - The MicroTrak Chlamydia trachomatis Direct Specimen Test (MT; Syva Co., Palo Alto, Calif.) was compared with cell culture in two patient populations. The sensitivity of the MT for a low-prevalence group was significantly lower (59.6%) than that for a high-prevalence group (84.4%). The results underscored the need to run the MT in parallel with culture initially if the prevalence of chlamydial infections is unknown and questioned the usefulness of the MT as a screening test for chlamydia in low-prevalence populations. MH - Antibodies, Bacterial ; Antibodies, Monoclonal/*DIAGNOSTIC USE ; Antigens, Bacterial/ANALYSIS ; Cervix Uteri/*MICROBIOLOGY ; Chlamydia trachomatis/*IMMUNOLOGY/ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS/OCCURRENCE ; Comparative Study ; Female ; Human ; Male ; Urethra/*MICROBIOLOGY SO - J Clin Microbiol 1986 Jun;23(6):1136-7 54 UI - 86224510 AU - Puolakkainen M ; Vesterinen E ; Purola E ; Saikku P ; Paavonen J TI - Persistence of chlamydial antibodies after pelvic inflammatory disease. AB - The persistence of chlamydial immunoglobulin G (IgG) antibodies and long-term sequelae of pelvic inflammatory disease (PID) were studied in 70 women who had been treated for PID 3 to 6 years previously. Fifty-one women had had PID associated with Chlamydia trachomatis infection (Chlamydia group), and 19 women had had PID not associated with C. trachomatis (non-Chlamydia group). Chlamydial IgG antibodies, as determined by the indirect immunofluorescence test with inclusions of C. trachomatis L2 as antigens, persisted at stable levels in 43% of the women for up to 6 years; 43% of the women showed a decrease in IgG titer, and 13% showed an increase. IgA antibody levels in serum correlated with IgG antibody levels in serum and with the presence of cervical IgA antibodies. Both serum antibodies and cervical IgA antibodies were more often found in the Chlamydia group. Forty-two percent of the women were infertile. Every fifth subsequent pregnancy was ectopic. The presence of cervical IgA antibodies might protect the women from tubal damage. MH - Adnexitis/*IMMUNOLOGY ; Antibodies, Fungal/*METABOLISM ; Cervix Uteri/IMMUNOLOGY/MICROBIOLOGY ; Chlamydia trachomatis/*IMMUNOLOGY/ ISOLATION & PURIFICATION ; Chlamydia Infections/*IMMUNOLOGY ; Female ; Follow-Up Studies ; Human ; IgA/METABOLISM ; IgG/ METABOLISM ; Infertility, Female/IMMUNOLOGY/MICROBIOLOGY ; Recurrence ; Support, Non-U.S. Gov't ; Urethra/MICROBIOLOGY SO - J Clin Microbiol 1986 May;23(5):924-8 55 UI - 86222672 AU - Register KB ; Morgan PA ; Wyrick PB TI - Interaction between Chlamydia spp. and human polymorphonuclear leukocytes in vitro. AB - Chlamydia psittaci and Chlamydia trachomatis elementary bodies (EB) incubated in the presence of complement or specific antibody or both caused chemotaxis of human polymorphonuclear leukocytes (PMN) in vitro. Reticulate bodies and culture supernatants had no effect on these cells. The ability of chlamydiae to enter and survive in PMN under nonopsonizing conditions was investigated by measuring the association of 3H-labeled EB and of inclusion-forming units with these phagocytes. Both assays indicated that C. psittaci as well as C. trachomatis EB are efficiently internalized. The mechanism by which this is accomplished is distinct from classical phagocytosis in that it is not dependent upon the presence of complement or antibody. Furthermore, uptake of at least C. psittaci appeared to be rapid, with no additional increase occurring after 15 min. The majority of cell-associated chlamydiae were rendered acid soluble or noninfectious within 1 h. Subsequently, there was a small but steady loss of infectivity for up to 10 h, which may have been due to the conversion of EB to the noninfectious reticulate-body form of the organism. However, even at 10 h after entry a small percentage of bacteria was still capable of infecting a second target cell. This is noteworthy in that PMN are relatively short-lived cells, and after lysis, intracellular organisms may be free to infect adjacent tissue. Electron microscopic observations were consistent with the data on uptake and persistence. The ability of a small percentage of infecting chlamydiae to maintain infectivity in PMN for at least several hours may enable these organisms subsequently to establish productive infection in permissive host cells. MH - Blood Bactericidal Activity ; Chemotaxis, Leukocyte ; Chlamydia psittaci/IMMUNOLOGY ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*IMMUNOLOGY ; Complement Activation ; Human ; Microscopy, Electron ; Neutrophils/*IMMUNOLOGY ; Phagocytosis ; Support, U.S. Gov't, P.H.S. SO - Infect Immun 1986 Jun;52(3):664-70 56 UI - 86214679 AU - Wilson MC ; Millan-Velasco F ; Tielsch JM ; Taylor HR TI - Direct-smear fluorescent antibody cytology as a field diagnostic tool for trachoma. AB - A recently developed direct-smear fluorescent antibody (DFA) cytology method of detecting chlamydial infection was evaluated in an area where trachoma is endemic. Four hundred seventy-five children aged 2 to 10 years were examined, and adequa. The DFA cytologic technique has a high specificity (100%) but a low sensitivity (8%). It offers a number of advantages over existing laboratory methods for diagnosing trachoma in the field. It is a rapid, simple, and easily transferred test that has a high specificity. Although DFA cytology shares the low sensitivity of other laboratory methods of diagnosing trachoma, we believe its logistical advantages make it the laboratory test of choice. MH - Antibodies, Monoclonal/DIAGNOSTIC USE ; Child ; Child, Preschool ; Chlamydia trachomatis/IMMUNOLOGY ; Conjunctiva/MICROBIOLOGY ; Female ; *Fluorescent Antibody Technic ; Human ; Male ; Methods ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Trachoma/ *DIAGNOSIS SO - Arch Ophthalmol 1986 May;104(5):688-90 57 UI - 86208006 AU - Burman LG TI - Significance of the sulfonamide component for the clinical efficacy of trimethoprim-sulfonamide combinations. AB - The reasons for combining trimethoprim (TMP) with sulfonamides (SUL) are still mainly theoretical but are supported by results from experimental infections and treatment of specific pathogens in humans, such as Branhamella catarrhalis, Neisseria gonorrhoeae, Brucella, Nocardia asteroides and perhaps Bordetella pertussis and Chlamydia trachomatis. Addition of SUL to TMP confers a therapeutic advantage also in patients with complicated urinary tract infection but probably not in young women with acute cystitis. Conditions that may enable TMP-SUL synergy in vivo can be expected to occur only in occasional cases of infection due to staphylococci, streptococci, Haemophilus or enteric bacteria. This fact together with ethical problems and availability of alternative therapies make further evaluations of the clinical significance of the SUL component of TMP-SUL very difficult. Although the use of TMP alone has shown promise in exacerbations of chronic bronchitis the role of the SUL component in TMP-SUL treatment of infections outside the urinary tract remains to be defined in comparative clinical trials. MH - Aged ; Anti-Infective Agents/*THERAPEUTIC USE ; Brucellosis/DRUG THERAPY ; Clinical Trials ; Comparative Study ; Drug Combinations/ METABOLISM/THERAPEUTIC USE ; Drug Synergism ; Female ; Gonorrhea/ DRUG THERAPY ; Human ; Kinetics ; Lymphogranuloma Venereum/DRUG THERAPY ; Male ; Microbial Sensitivity Tests ; Nocardia Infections/DRUG THERAPY ; Review ; Sulfamethoxazole/METABOLISM/ *THERAPEUTIC USE ; Tissue Distribution ; Trimethoprim/METABOLISM/ *THERAPEUTIC USE ; Urinary Tract Infections/DRUG THERAPY SO - Scand J Infect Dis 1986;18(2):89-99 58 UI - 86199395 AU - Shafer MA ; Vaughan E ; Lipkin ES ; Moscicki BA ; Schachter J TI - Evaluation of fluorescein-conjugated monoclonal antibody test to detect Chlamydia trachomatis endocervical infections in adolescent girls. AB - We evaluated the fluorescein-conjugated monoclonal antibody (FA) test for screening for Chlamydia trachomatis endocervical infection in a general adolescent clinic. Three hundred sixty-three consecutive adolescent girls, ages 13 to 20 years (mean 17.3 years) were examined. Forty-five (12%) FA smears had insufficient cells. Reason for visit included non-lower genital tract-related disorders in 241 (76%) girls, and lower genital tract-related disorders in 77 (24%). C. trachomatis was isolated by tissue culture in 46 (14%) patients, and Neisseria gonorrhoeae by culture in 22 (7%), and Trichomonas vaginalis was identified by wet mount in 13 (5%). Compared with our tissue culture technique, the performance of the FA test was as follows: sensitivity 61% (28 of 46), specificity 97% (264 of 272), positive predictive value 78% (28 of 36), and negative predictive value 94% (264 of 282). There was no significant difference in test performance by race, although the sensitivity rate (64%) of the test in blacks was twice that (30%) in nonblacks. This apparent difference in test performance by race may actually represent variations in group characteristics, including exposure rate, susceptibility, and number of inclusion forming units available for tissue culture of Chlamydia in blacks compared with nonblacks. In our adolescent clinic, the tissue culture is superior to FA in detecting Chlamydia. We recommend that the FA test be used where tissue culture isolation for Chlamydia is not readily available, where known or predicted chlamydial infection rates are high, and where known or predicted numbers of inclusion forming units of Chlamydia in tissue culture are high. MH - Adolescence ; Adult ; Antibodies, Monoclonal/*DIAGNOSTIC USE/ IMMUNOLOGY ; Cervicitis/DIAGNOSIS/ETIOLOGY ; Chlamydia trachomatis/GROWTH & DEVELOPMENT/*IMMUNOLOGY ; Chlamydia Infections/DIAGNOSIS/*IMMUNOLOGY ; Evaluation Studies ; Female ; Fluorescent Antibody Technic ; Human ; Racial Stocks ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, Non-P.H.S. ; Support, U.S. Gov't, P.H.S. SO - J Pediatr 1986 May;108(5 Pt 1):779-83 59 UI - 86198016 AU - Forsey T ; Darougar S ; Treharne JD TI - Prevalence in human beings of antibodies to Chlamydia IOL-207, an atypical strain of chlamydia. AB - Samples of serum from 18353 persons from the U.K. and abroad, were tested for type-specific antibodies to Chlamydia spp. Antibodies to an atypical strain, Chlamydia IOL-207, were detected in each population tested. Overall, the prevalence of these antibodies (19.9%) was similar to that of antibodies to C. trachomatis (21.6%). In the U.K., antibodies to C. IOL-207 were rare in children under the age of 5 years but became more common with increasing age. In adults the prevalence of these antibodies increased annually between 1979 and 1984. Antibodies to C. IOL-207 were not associated with sexually transmitted disease and only rarely with ocular disease. Their association with a common complaint such as mild respiratory illness is postulated. The presence of these antibodies within a population may lead to the over-diagnosis of C. trachomatis infections or psittacosis if only genus-specific serological tests are used. MH - Adolescence ; Adult ; Age Factors ; Antibodies, Bacterial/ *ANALYSIS ; Child ; Child, Preschool ; Chlamydia/*IMMUNOLOGY ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/ IMMUNOLOGY/MICROBIOLOGY/*OCCURRENCE ; Eye Diseases/IMMUNOLOGY/ MICROBIOLOGY ; Female ; Genital Diseases, Female/MICROBIOLOGY ; Genital Diseases, Male/MICROBIOLOGY ; Human ; IgA/ANALYSIS ; IgG/ ANALYSIS ; IgM/ANALYSIS ; Infant ; Infant, Newborn ; Male ; Middle Age SO - J Infect 1986 Mar;12(2):145-52 60 UI - 86197808 AU - Levitt D ; Danen R ; Bard J TI - Both species of chlamydia and two biovars of Chlamydia trachomatis stimulate mouse B lymphocytes. AB - We have investigated the ability of both species of chlamydiae (C. trachomatis and C. psittaci), two major biovars of C. trachomatis (lymphogranuloma venereum and trachoma), and the two developmental forms of chlamydia (reticulate and elementary bodies) to stimulate murine spleen lymphocytes. All of these forms of the bacteria induce potent proliferation and differentiation to plaque-forming cells by B lymphocytes in vitro. Chlamydiae induce a broad antibody response, suggesting that stimulation is polyclonal in nature. Although all chlamydiae possess a lipopolysaccharide (LPS) genus-specific molecule similar to LPS found on Re mutant enterobacteria, polyclonal B cell stimulation is likely caused by molecules other than LPS, since i) polymyxin B failed to inhibit chlamydia-induced immunostimulation and ii) C3H/HeJ mice (LPS nonresponders) produced normal numbers of PFC after culture with chlamydia (but not LPS). Thus, a cross-species moiety that is not LPS is responsible for polyclonal stimulation by chlamydia. Because these bacteria can exist in latent forms in an animal, and all forms are immunostimulatory, the question of whether these bacteria can alter immune responses if released during other infections or immunizations has been raised. MH - Animal ; B Lymphocytes/*IMMUNOLOGY/METABOLISM ; Cell Separation ; Chlamydia psittaci/ANALYSIS/*IMMUNOLOGY ; Chlamydia trachomatis/ ANALYSIS/*IMMUNOLOGY ; Hemolytic Plaque Technic ; Immunoglobulins/ BIOSYNTHESIS ; Lipopolysaccharides/PHARMACODYNAMICS ; *Lymphocyte Transformation ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C3H ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - J Immunol 1986 Jun 1;136(11):4249-54 61 UI - 86196616 AU - Newhall WJ 5th ; Terho P ; Wilde CE 3d ; Batteiger BE ; Jones RB TI - Serovar determination of Chlamydia trachomatis isolates by using type-specific monoclonal antibodies. AB - A panel of 15 monoclonal antibodies was prepared that could distinguish among the 15 serovars of Chlamydia trachomatis. Twelve of these antibodies were specific for a single serovar (A, B, C, D, E, F, G, H, I, K, L1, and L2) and three were specific for two serovars (B/Ba, C/J, and C/L3). Ten of the serovar-specific and two of the bispecific antibodies were shown by immunoblotting to recognize epitopes on the major outer membrane protein. These data provide evidence that such epitopes are closely correlated with and may be partly responsible for the antigenic variations detected by microimmunofluorescence that distinguish the currently recognized serovars. When used in a radioimmunoassay, these antibodies correctly identified the serovar of 17 strains that had been serotyped by the microimmunofluorescence test. In addition, we found that the chlamydial antigen derived from 1.0 cm2 of an infected HeLa cell monolayer was sufficient to allow serotyping with these antibodies. Thus, these monoclonal antibodies may provide a rapid and reliable alternative to mouse immunization and microimmunofluorescence for serotyping of clinical isolates. MH - Animal ; Antibodies, Bacterial/IMMUNOLOGY ; *Antibodies, Monoclonal ; Antibody Specificity ; Antigenic Determinants/ IMMUNOLOGY ; Antigens, Bacterial/*IMMUNOLOGY ; Chlamydia trachomatis/*CLASSIFICATION/IMMUNOLOGY/ISOLATION & PURIFICATION ; Human ; Immunosorbent Technics ; Mice ; Mice, Inbred BALB C ; Radioimmunoassay ; Serotyping ; Support, U.S. Gov't, P.H.S. SO - J Clin Microbiol 1986 Feb;23(2):333-8 62 UI - 86196615 AU - Howard LV ; Coleman PF ; England BJ ; Herrmann JE TI - Evaluation of chlamydiazyme for the detection of genital infections caused by Chlamydia trachomatis. AB - Chlamydiazyme is a 4-h enzyme-linked immunoassay that detects an antigen of Chlamydia trachomatis directly in clinical specimens. This immunoassay was compared with cell culture for the diagnosis of chlamydial infections of the genital tract. The assay was evaluated at five clinics with a total of 1,277 cervical specimens of which 239 were culture positive. At three of these clinics where urethral samples were taken from males, 99 of 363 samples were culture positive. The sensitivity of the assay averaged 89.5% for detecting cervical infections and 78.8% for detecting male urethral infections. Specificity was 97.0% when samples from either males or females were tested. Some patients who were culture negative were infected with chlamydiae according to both Chlamydiazyme and a monoclonal antibody test that detected a chlamydial antigen distinct from the antigen detected by Chlamydiazyme. If the 15 females and 2 males who were positive by both immunoassays but culture negative were considered positive for chlamydial infection, the specificity of the assay was 98.4% in females and 97.7% in males. Chlamydiazyme is a simple and relatively rapid immunoassay that has sufficient sensitivity and specificity to supplant culture in the detection of genital chlamydial infections. MH - Antigens, Bacterial/*ANALYSIS/IMMUNOLOGY ; Cell Line ; Cervix Diseases/DIAGNOSIS/IMMUNOLOGY ; Chlamydia trachomatis/GROWTH & DEVELOPMENT/IMMUNOLOGY/*ISOLATION & PURIFICATION ; Chlamydia Infections/DIAGNOSIS/IMMUNOLOGY ; Comparative Study ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technic ; Genital Diseases, Female/*DIAGNOSIS/IMMUNOLOGY ; Genital Diseases, Male/*DIAGNOSIS/IMMUNOLOGY ; Human ; Male ; Urethral Diseases/DIAGNOSIS/IMMUNOLOGY SO - J Clin Microbiol 1986 Feb;23(2):329-32 63 UI - 86196551 AU - Lipkin ES ; Moncada JV ; Shafer MA ; Wilson TE ; Schachter J TI - Comparison of monoclonal antibody staining and culture in diagnosing cervical chlamydial infection. AB - We compared a fluorescein-conjugated monoclonal antibody (FA) direct specimen test (MicroTrak; Syva Co., Palo Alto, Calif.) with culture (TC) in McCoy cells (vials, with blind passage and iodine staining of inclusions) for diagnosis of Chlamydia trachomatis infection in the cervix. Duplicate specimens were collected from 1,230 women, but for 262 of these subjects, both results were unavailable (150 FA smears were inadequate, indicating a need for clinical training in specimen collection), leaving 968 comparisons. Prevalence of chlamydiae by culture was 13% (126/968). Compared with TC results, the sensitivity of FA was 70% (88/126) and the specificity was 94% (795/842). There was a 91% agreement (883/968). The predictive value of a positive FA test was 65% (88/135), and that of a negative FA was 95% (795/833). We reexamined 38 smears for which paired results were discrepant, and the reread would have changed the result in only 5 of these. TC is less than 100% sensitive and some FA-positive, TC-negative specimens represent positive specimens not detected by TC. Unfortunately, it is not possible to identify which results in this group are truly false-positive. Clearly, the FA procedure has a performance profile which would make it a useful tool in screening high-risk populations (particularly when TC is not available) but it is less suited to screening low-risk populations, for which false-positive results are more important. The greater utility of the FA procedure in a venereal disease clinic was confirmed by testing 172 evaluable specimen pairs, of which 34 (20%) were Chlamydia isolate positive.(ABSTRACT TRUNCATED AT 250 WORDS) MH - Antibodies, Monoclonal/DIAGNOSTIC USE ; Antigens, Bacterial/ ANALYSIS ; Cell Line ; Cervix Diseases/*DIAGNOSIS/MICROBIOLOGY ; Chlamydia trachomatis/GROWTH & DEVELOPMENT/IMMUNOLOGY/*ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS/MICROBIOLOGY ; Comparative Study ; False Positive Reactions ; Female ; *Fluorescent Antibody Technic ; Human ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - J Clin Microbiol 1986 Jan;23(1):114-7 64 UI - 86183952 AU - Kiviat NB ; W:lner-Hanssen P ; Peterson M ; Wasserheit J ; Stamm WE ; Eschenbach DA ; Paavonen J ; Lingenfelter J ; Bell T ; Zabriskie V ; et al TI - Localization of Chlamydia trachomatis infection by direct immunofluorescence and culture in pelvic inflammatory disease. AB - Fifty-five women with suspected pelvic inflammatory disease underwent diagnostic laparoscopy and endometrial and tubal biopsy, with specimens for isolation of Chlamydia trachomatis and for staining with a species-specific monoclonal fluorescein-conjugated antibody to C. trachomatis were obtained from the urethra, rectum, endocervix, endometrium, tubes, and cul-de-sac. C. trachomatis was isolated from 21 patients (38%), including 10 (18%) who had positive endometrial or tubal cultures. The fluorescein-conjugated antibody stain was positive for 43 (86%) of 50 culture-positive specimens, for 14 (18%) of 78 culture-negative specimens from 21 patients who had positive cultures from other sites, and for one (0.5%) of 192 specimens from 34 patients who had negative cultures at all sites. Thus the sensitivity of direct fluorescein-conjugated antibody for culture-positive specimens was 86% and the specificity for specimens from culture-negative patients was 99%. Twelve upper genital tract specimens were positive by fluorescein-conjugated antibody only. Fluorescein-conjugated antibody staining of 50 paraffin-embedded endometrial aspirates showed extracellular or intracellular elementary bodies and or cytoplasmic inclusions in all of seven culture-positive specimens, in four of six culture-negative specimens from patients who had positive cultures at other sites, and in none of 34 specimens from patients with negative cultures. Thus fluorescein-conjugated antibody staining is useful for confirming the role of C. trachomatis in endometritis and salpingitis. It is more sensitive than culture for detection of chlamydia in endometrial or tubal specimens and is able to confirm that the organism is actually present in endometrial tissue (rather than simply reflecting contamination from the cervix) in women with clinical evidence of pelvic inflammatory disease. MH - Adnexitis/*DIAGNOSIS/MICROBIOLOGY ; Antibodies, Bacterial/ ANALYSIS ; Chlamydia trachomatis/IMMUNOLOGY/*ISOLATION & PURIFICATION ; Chlamydia Infections/*DIAGNOSIS/MICROBIOLOGY ; Comparative Study ; Endometritis/DIAGNOSIS ; Fallopian Tubes/ MICROBIOLOGY ; Female ; Fluorescent Antibody Technic ; Human ; Rectum/MICROBIOLOGY ; Salpingitis/DIAGNOSIS ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Time Factors ; Urethra/ MICROBIOLOGY ; Uterus/MICROBIOLOGY SO - Am J Obstet Gynecol 1986 Apr;154(4):865-73 65 UI - 86176622 AU - Stolz E ; Tegelberg-Stassen MJ ; Van der Willigen AH ; Van der Hoek JC ; Van Joost T ; Mooi L ; Wagenvoort JH TI - Quinolones in the treatment of gonorrhoea and Chlamydia trachomatis infections. AB - 123 Female patients suffering from uncomplicated urogenital gonorrhoea were treated with either 200 mg or 400 mg enoxacin. The cure rate in the 400 mg group was 100%; the cure rate in the 200 mg group was 95.7% 212 Male patients suffering from urethral gonorrhoea were treated with either 250 mg or 500 mg ciprofloxacin (one tablet). Cure rates in both groups were 100%. Post-gonococcal urethritis was observed in 31 out of 85 (36%) patients in the first, and 21 out of 79 (27%) in the second group. In a pilot study 42 male patients suffering from non-gonococcal urethritis were treated during one week with I g ciprofloxacin daily. In 22 patients Chlamydia trachomatis was isolated from the urethra: in 20 of these 22 cases Chlamydia trachomatis could not be cultured after treatment (cure rate 91%), but in 4 of these 20 cases (20%) and in 8 of the 20 Chlamydia trachomatis negative cases (40%) urine-sediment abnormalities were present after treatment. MH - Adolescence ; Adult ; Aged ; Anti-Infective Agents, Urinary/ *THERAPEUTIC USE ; Chlamydia trachomatis ; Chlamydia Infections/ *DRUG THERAPY/MICROBIOLOGY ; Clinical Trials ; Female ; Gonorrhea/ *DRUG THERAPY/MICROBIOLOGY ; Human ; Male ; Middle Age ; Quinolines/*THERAPEUTIC USE ; Urethritis/DRUG THERAPY SO - Pharm Weekbl [Sci] 1986 Feb 21;8(1):60-2 66 UI - 86175935 AU - Brunham RC ; Binns B ; McDowell J ; Paraskevas M TI - Chlamydia trachomatis infection in women with ectopic pregnancy. AB - Fifty women with ectopic pregnancy and 49 control women with intrauterine pregnancy were interviewed and evaluated for evidence of Chlamydia trachomatis infection. Among women with ectopic pregnancy, 14 women were wearing an intrauterine contraceptive device or had a tubal ligation (group A), and 36 women had no readily identifiable risk factors (group B). Group B women had greater total numbers of sexual partners than did control women with intrauterine pregnancy (P less than .005). Group B women more often had C trachomatis antibody than group A (P = .03) and control women (P = .002). Of 27 C trachomatis cultures from fallopian tube tissue from women with ectopic pregnancy, none were positive. Fallopian tube tissue distant from the site of ectopic implantation was available for histopathology of 41 cases. Nine (22%) had extensive subepithelial plasma cell infiltration. All nine were among group B women (P = .06) and all seven with plasma cell salpingitis who were tested for C trachomatis antibody were seropositive (P = .004). It is concluded that a subset of women with ectopic pregnancy were at increased risk for acquiring a sexually transmitted disease by virtue of their sexual behavior and that women in this subset frequently have serologic evidence of C trachomatis infection and histologic evidence of plasma cell salpingitis. Because few of these women recall having had pelvic infection, the authors speculate that subclinical C trachomatis tubal infection producing plasma cell salpingitis may commonly underly ectopic pregnancy. MH - Adolescence ; Adult ; Antibodies, Bacterial/ANALYSIS ; Canada ; Cervix Uteri/MICROBIOLOGY ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*COMPLICATIONS/ETIOLOGY ; Female ; Human ; IgG/ANALYSIS ; Intrauterine Devices ; Plasma Cells/PATHOLOGY ; Pregnancy ; Pregnancy Complications, Infectious/*ETIOLOGY ; Pregnancy, Ectopic/*ETIOLOGY/MICROBIOLOGY ; Risk ; Salpingitis/ *COMPLICATIONS/PATHOLOGY ; Sex Behavior ; Sterilization, Tubal ; Support, Non-U.S. Gov't SO - Obstet Gynecol 1986 May;67(5):722-6 67 UI - 86168962 AU - Cevenini R ; Rumpianesi F ; Sambri V ; La Placa M TI - Antigenic specificity of serological response in Chlamydia trachomatis urethritis detected by immunoblotting. AB - Sera from 19 patients with Chlamydia trachomatis culture positive non-gonococcal urethritis were studied for the presence of antibodies to chlamydial proteins by immunoblotting. Ten C trachomatis negative patients with non-gonococcal urethritis and 10 healthy controls were also studied. Acute phase sera from C trachomatis positive patients with non-gonococcal urethritis reacted only with the major outer membrane protein whereas all the convalescent phase serum samples reacted with the major outer membrane protein and with a 60,000 and a 62,000 molecular weight protein. Some sera also reacted with a 45,000 molecular weight protein. Five of 10 convalescent phase samples from patients with C trachomatis negative non-gonococcal urethritis showed a reaction pattern comparable with that observed in convalescent sera from C trachomatis from C trachomatis positive patients with non-gonococcal urethritis. Sera from healthy seronegative subjects were negative by blotting. MH - Antibodies, Viral/*BIOSYNTHESIS ; Antigenic Determinants/ *ANALYSIS ; Antigens, Viral/IMMUNOLOGY ; Bacterial Outer Membrane Proteins/IMMUNOLOGY ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/*IMMUNOLOGY ; Electrophoresis, Polyacrylamide Gel ; Human ; IgG/BIOSYNTHESIS ; IgM/BIOSYNTHESIS ; Male ; Molecular Weight ; Time Factors ; Urethritis/*IMMUNOLOGY SO - J Clin Pathol 1986 Mar;39(3):325-7 68 UI - 86167317 AU - Young E ; Taylor HR TI - Immune mechanisms in chlamydial eye infection. Development of T suppressor cells. AB - In vitro proliferation assays of whole peripheral blood mononuclear leukocytes (PBML) and PBML depleted of suppressor T cells were performed in cynomolgus monkeys after they had received one, two, or repeated ocular inoculations with Chlamydia trachomatis. Whole PBML responded only weakly to chlamydial antigen, and responses to concanavalin A were depressed for 12 wk following ocular infection. Depletion of the suppressor T cell population did not result in increased chlamydia-specific proliferation until 14-20 wk after initial antigen contact, suggesting that circulating suppressor T cells are not responsible for the initiation of the chronic state. MH - Animal ; Chlamydia trachomatis/IMMUNOLOGY ; Chlamydia Infections/ *IMMUNOLOGY ; Concanavalin A/IMMUNOLOGY ; Conjunctivitis, Inclusion/*IMMUNOLOGY ; Leukocytes/IMMUNOLOGY ; Lymphocyte Transformation ; Macaca fascicularis ; Support, U.S. Gov't, P.H.S. ; T Lymphocytes/*IMMUNOLOGY SO - Invest Ophthalmol Vis Sci 1986 Apr;27(4):615-9 69 UI - 86162306 AU - Wakefield D ; Easter J ; Robinson P ; Graham D ; Penny R TI - Chlamydial antibody crossreactivity with peripheral blood mononuclear cells of patients with ankylosing spondylitis: the role of HLA B27. AB - We have previously reported the association of Chlamydia trachomatis with HLA B27+ related diseases. To investigate the possibility that chlamydial antibodies serve to localize the immune response in such diseases, we examined the crossreactivity of chlamydial antibodies (rabbit anti-D and anti-L2 serotypes) with peripheral blood mononuclear cells of patients with ankylosing spondylitis (AS) and anterior uveitis (AU) and with human and bovine ocular tissue and cells in culture. Our results indicate a significantly increased percentage binding of chlamydial antibody (D serotype) to the mononuclear cells of HLA B27+ patients with AS when compared with HLA B27- patients with AS (12.9% +/- 2.2 versus 5.4% +/- 2.2), B27+ controls (5.5% +/- 1.5) and B27- controls (6.1% +/- 1.0). There was no significant difference between controls and HLA B27+ patients with AU (6.6% +/- 1.9) and B27- patients with AU (8.7% +/- 1.1). This crossreactivity could not be blocked by monoclonal HLA B27 antibody. Chlamydial antibodies (D and L2) crossreact with human and bovine conjunctiva but not uvea, tissue culture derived iris fibroblasts or smooth muscle cells. Our results provide additional support for the concept of crossreactivity between antibodies to microbial agents and peripheral blood mononuclear cells of patients with HLA B27+ AS. MH - Adolescence ; Adult ; Aged ; Antibodies, Bacterial/*IMMUNOLOGY ; Antibodies, Monoclonal/IMMUNOLOGY ; Cells, Cultured ; Chlamydia trachomatis/*IMMUNOLOGY ; Cross Reactions ; Female ; Human ; HLA Antigens/*IMMUNOLOGY ; Lymphocytes/*IMMUNOLOGY ; Male ; Middle Age ; Spondylitis, Ankylosing/*IMMUNOLOGY ; Support, Non-U.S. Gov't ; Uveitis, Anterior/IMMUNOLOGY SO - Clin Exp Immunol 1986 Jan;63(1):49-57 70 UI - 86155996 AU - Paavonen J ; Critchlow CW ; DeRouen T ; Stevens CE ; Kiviat N ; Brunham RC ; Stamm WE ; Kuo CC ; Hyde KE ; Corey L ; et al TI - Etiology of cervical inflammation. AB - We studied the relationships of selected microbial, clinical, demographic, and behavioral variables to mucopurulent cervicitis in two clinical settings, a sexually transmitted disease clinic and a student health clinic. From each clinic, we studied a group of women referred for suspected mucopurulent cervicitis and a representative sample of other women attending the clinic. After the women were stratified by patient group and summary odds ratios for all groups were obtained, mucopurulent cervicitis was most strongly associated with the isolation of Chlamydia trachomatis; other variables associated with mucopurulent cervicitis included the isolation of Ureaplasma urealyticum, Gardnerella vaginalis, and Trichomonas vaginalis, the presence of serum antibody to C. trachomatis, the clinical diagnosis of bacterial vaginosis, and oral contraceptive use (positive associations) or isolation of yeast (negative association). After adjustment for cervical culture results for C. trachomatis, mucopurulent cervicitis was positively associated with oral contraceptive use (p = 0.02) and isolation of U. urealyticum (p = 0.02) and negatively associated with isolation of yeast (p = 0.03). Among women with a positive cervical culture for C. trachomatis, isolation of U. urealyticum was significantly associated with mucopurulent cervicitis, while among the subgroup of women with a negative cervical culture for C. trachomatis and positive serum antibody to C. trachomatis, oral contraceptive use was strongly associated with mucopurulent cervicitis. These results confirm that in both clinical settings C. trachomatis is the major cause of mucopurulent cervicitis. The roles of U. urealyticum, T. vaginalis, G. vaginalis, bacterial vaginosis, and oral contraceptive use in the etiology of mucopurulent cervicitis deserve further study. MH - Adult ; Antibodies, Bacterial/ANALYSIS ; Cervicitis/DIAGNOSIS/ *ETIOLOGY ; Cervix Uteri/MICROBIOLOGY ; Chlamydia trachomatis/ IMMUNOLOGY/ISOLATION & PURIFICATION ; Contraceptives, Oral ; Female ; Haemophilus vaginalis/ISOLATION & PURIFICATION ; Human ; Support, U.S. Gov't, P.H.S. ; Trichomonas Vaginalis/ISOLATION & PURIFICATION ; Ureaplasma/ISOLATION & PURIFICATION SO - Am J Obstet Gynecol 1986 Mar;154(3):556-64 71 UI - 86152068 AU - Swenson CE ; Sung ML ; Schachter J TI - The effect of tetracycline treatment on chlamydial salpingitis and subsequent fertility in the mouse. AB - The effect of tetracycline X HCl, administered for 14 days starting before or after intraovarian bursa inoculation of the mouse pneumonitis biovar of Chlamydia trachomatis, was examined in mice. Mice that received no antibiotic developed acute salpingitis and subsequent hydrosalpinx. Only one of ten mated mice at 42-51 days after inoculation showed a normal, bilateral pregnancy. Initiation of tetracycline treatment two days prior to inoculation completely prevented the pathology associated with tubal chlamydial infection and fertility was as high (eight of ten) as in mice inoculated with sterile tissue culture supernate (eight of 11). Initiation of treatment one week after inoculation prevented permanent tubal damage (two of 20 vs. 12 of 20; P = .001) and infertility (bilateral pregnancies, six of ten vs. one of ten; P = .027) in some, but not all, infected mice. Therapy began two weeks after inoculation resulted in a marginal improvement in the frequency of apparently normal oviducts (16 of 24 vs. eight of 20; P = .053) but not in fertility (bilateral pregnancies, four of 12 vs. one of ten; P = 0.19). This model may be of value in studies of the treatment of upper genital tract infection with C. trachomatis. MH - Animal ; Antibodies, Bacterial/ANALYSIS ; Chlamydia trachomatis/ IMMUNOLOGY ; Chlamydia Infections/*DRUG THERAPY/IMMUNOLOGY/ PATHOLOGY ; Female ; Infertility, Female/*ETIOLOGY ; Male ; Mice ; Oviducts/PATHOLOGY ; Pregnancy ; Salpingitis/*DRUG THERAPY/ IMMUNOLOGY/PATHOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Tetracycline/*THERAPEUTIC USE ; Time Factors SO - Sex Transm Dis 1986 Jan-Mar;13(1):40-4 72 UI - 86152066 AU - Miettinen A ; Saikku P ; Jansson E ; Paavonen J TI - Epidemiologic and clinical characteristics of pelvic inflammatory disease associated with Mycoplasma hominis, Chlamydia trachomatis, and Neisseria gonorrhoeae. AB - We studied selected epidemiologic, clinical, serologic, and microbiologic findings and their interrelationships among 57 women with acute pelvic inflammatory disease (PID). Cervical cultures positive for Neisseria gonorrhoeae alone and for both N. gonorrhoeae and Chlamydia trachomatis were associated with young age, nulliparity, and use of birth-control pills. Positive serologic findings for C. trachomatis were associated with the isolation of C. trachomatis and/or N. gonorrhoeae from the cervix and predicted the presence of a pelvic mass. High levels of antibody to Mycoplasma hominis were associated with increasing age and parity, and predicted a low concentration of C-reactive protein (CRP), a long hospital stay, and a high convalescent-phase erythrocyte sedimentation rate (ESR). Women with recurrent PID had higher titers of antibody to C. trachomatis than those with primary PID. The use of an intrauterine contraceptive device predicted high CRP, high acute-phase ESR, long hospital stay, and was frequently associated with positive serologic tests for M. hominis. These results demonstrate that the clinical picture of PID depends not only on the microorganisms involved but also on many epidemiologic factors such as age, contraceptive method, and parity. MH - Acute Disease ; Adnexitis/*MICROBIOLOGY ; Adult ; Age Factors ; Antibodies, Bacterial/ANALYSIS ; Cervix Uteri/MICROBIOLOGY ; Chlamydia trachomatis/IMMUNOLOGY/*ISOLATION & PURIFICATION ; Chlamydia Infections/MICROBIOLOGY ; Contraception/METHODS ; Female ; Gonorrhea/MICROBIOLOGY ; Human ; Middle Age ; Mycoplasma/ IMMUNOLOGY/*ISOLATION & PURIFICATION ; Mycoplasma Infections/ MICROBIOLOGY ; Neisseria Gonorrhoeae/IMMUNOLOGY/*ISOLATION & PURIFICATION ; Parity ; Support, Non-U.S. Gov't SO - Sex Transm Dis 1986 Jan-Mar;13(1):24-8 73 UI - 86149438 AU - Heggie AD ; Wyrick PB ; Chase PA ; Sorensen RU TI - Cell-mediated immune responses to Chlamydia trachomatis in mothers and infants. AB - Cell-mediated immunity to Chlamydia trachomatis was studied in pregnant women with chlamydial infection of the cervix, in infants born vaginally to these women, and in infants presenting with chlamydial conjunctivitis. Uninfected pregnant women and their infants were studied as controls. McCoy cell cultures were used to isolate C. trachomatis from clinical specimens. Cell-mediated immunity was measured by lymphocyte proliferative responses in vitro to stimulation by chlamydial antigens. Chlamydial IgG antibody in serum specimens was detected by a microenzyme-linked immunosorbent assay technique. The mean lymphocyte proliferative responses to chlamydial antigens were greater in infected women than in uninfected women both during pregnancy and in the postpartum period. Lymphocyte responsiveness in infected pregnant women, however, was less than in postpartum women. Despite failure to detect chlamydial infection in exposed infants, lymphocyte proliferative responses were greater in umbilical cord blood and later in peripheral blood samples from neonates born to infected mothers than in infants born to uninfected mothers. These responses were also greater in infants with chlamydial conjunctivitis than in infants of uninfected mothers. These data suggest that cellular immune responses to chlamydial antigens are increased in infected mothers and infants and that infants may acquire chlamydial cell-mediated immunity transplacentally. MH - Antibodies, Viral/ANALYSIS ; Antigens, Bacterial/PHARMACODYNAMICS ; Chlamydia trachomatis/*IMMUNOLOGY ; Cytomegaloviruses/ IMMUNOLOGY ; Dose-Response Relationship, Drug ; Female ; Fetal Blood/ANALYSIS ; Human ; Immunity, Cellular ; Infant, Newborn ; Kinetics ; Lymphocyte Transformation/DRUG EFFECTS ; *Maternal-Fetal Exchange ; Pregnancy ; Support, U.S. Gov't, P.H.S. SO - Proc Soc Exp Biol Med 1986 Apr;181(4):586-95 74 UI - 86145364 AU - Babin V ; Ojanlatva A TI - The impact of chlamydia infections on teen mothers and their children. AB - Chlamydia trachomatis recently has emerged as the most frequently diagnosed sexually transmitted disease (STD) agent. An estimated three million cases are diagnosed annually in the United States. Because the infection is not reportable, only estimates can be made. The most common STD, it also is often transmitted to infants through infected mothers. Prevention and treatment of the disease in newborns require different procedures from those for gonorrhea, as do diagnostic and treatment methods for infected adults. Chlamydia also appears to pose a threat to pregnancy. MH - Adolescence ; Adult ; Cervix Uteri/MICROBIOLOGY ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/ *COMPLICATIONS/IMMUNOLOGY/TRANSMISSION ; Conjunctiva/MICROBIOLOGY ; Conjunctivitis/ETIOLOGY ; Female ; Fetal Death/ETIOLOGY ; Gestational Age ; Human ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Newborn, Diseases/ETIOLOGY ; Nasopharynx/ MICROBIOLOGY ; Pneumonia/ETIOLOGY ; Pregnancy ; *Pregnancy in Adolescence ; Pregnancy Complications, Infectious ; Risk ; Socioeconomic Factors SO - J Sch Health 1986 Jan;56(1):17-9 75 UI - 86143517 AU - FitzSimmons J ; Callahan C ; Shanahan B ; Jungkind D TI - Chlamydial infections in pregnancy. AB - Chlamydia trachomatis is recognized as a common sexually transmitted cervical pathogen that may be transmitted to the neonate at delivery. Neonatal infection may be manifested as conjunctivitis, pneumonitis or both. Additionally, cervical infection may be related to premature rupture of the membranes and premature delivery. Women registering for prenatal care in the first half of pregnancy were cultured for Chlamydia to further define its role as a cause of perinatal complications and to evaluate a method of preventing transmission to the neonate. Positive cultures were obtained in 33 of 221 women evaluated (14.9%). No significant differences were found in pregnancy or neonatal complications between the groups with positive and negative cultures. Women with positive cultures were treated at 36 weeks' gestation with erythromycin; 18 received an adequate course of therapy. Of these 18, 16 returned with their infants four to eight weeks postpartum. No symptoms of conjunctivitis or pneumonitis were noted at that time, and cultures of the conjunctiva and nasopharynx were negative in all the infants. Thus, surveillance for Chlamydia and treatment late in pregnancy appear to have no adverse impact on pregnancy and effectively block vertical transmission of the organism. MH - Chlamydia trachomatis ; Chlamydia Infections/*DIAGNOSIS/DRUG THERAPY ; Comparative Study ; Erythromycin/THERAPEUTIC USE ; Female ; Human ; Infant, Newborn ; Infant, Newborn, Diseases/ ETIOLOGY ; Male ; Pregnancy ; Pregnancy Complications, Infectious/ *DIAGNOSIS/DRUG THERAPY ; Vaginal Smears SO - J Reprod Med 1986 Jan;31(1):19-22 76 UI - 86136670 AU - Golomb J ; Vardinon N ; Homonnai ZT ; Braf Z ; Yust I TI - Demonstration of antispermatozoal antibodies in varicocele-related infertility with an enzyme-linked immunosorbent assay (ELISA). AB - To assess the existence of a possible immunologic factor in varicocele-associated infertility, we searched for antispermatozoal antibodies in serum, seminal plasma, and bound to spermatozoa in 32 infertile men with varicocele and 22 infertile patients without palpable varicocele, with the use of an enzyme-linked immunosorbent assay. In addition, we performed morphologic and microbiologic analyses of the semen and urethral smears for isolation of Chlamydia trachomatis. Twenty-nine men from the varicocele group (90.6%) demonstrated antispermatozoal antibodies, compared with only 9 men (40.9%) in the control group. The antibodies in both groups, when present, were mainly serum and seminal plasma immunoglobulins IgA and IgM. A significant quantitative difference between the varicocele and control groups was also observed for serum IgA, seminal plasma IgA and IgM, and sperm-bound IgG, IgA, and IgM. Oligozoospermia and asthenozoospermia were significantly more prevalent in the varicocele men. An asymptomatic genital tract infection with C. trachomatis, Ureaplasma urealyticum, and Escherichia coli was traced in 40.6% of the varicocele men and in 45.5% of the control group. No interaction could be demonstrated between the infection and antispermatozoal antibody formation. These data suggest that an immunologic factor may play a role in varicocele-associated infertility; however, its impact on reproduction has yet to be assessed. MH - Antibodies/*ANALYSIS ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/COMPLICATIONS ; Enzyme-Linked Immunosorbent Assay ; Escherichia Coli Infections/COMPLICATIONS ; Human ; IgA/ANALYSIS ; IgM/ANALYSIS ; Infertility, Male/ETIOLOGY/ *IMMUNOLOGY ; Male ; Semen/MICROBIOLOGY ; Spermatozoa/*IMMUNOLOGY ; Ureaplasma/ISOLATION & PURIFICATION ; Varicocele/COMPLICATIONS/ *IMMUNOLOGY SO - Fertil Steril 1986 Mar;45(3):397-402 77 UI - 86111630 AU - Wenman WM ; Meuser RU TI - Chlamydia trachomatis elementary bodies possess proteins which bind to eucaryotic cell membranes. AB - 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 L2 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 neutralizing activity. Our data suggest that these putative chlamydial adhesins play a key role in the early steps of chlamydia-host cell interaction and that antibody directed against them may be protective. MH - Adhesiveness ; Bacterial Proteins/*ANALYSIS/IMMUNOLOGY/METABOLISM ; Cell Membrane/*METABOLISM ; Chlamydia trachomatis/*ANALYSIS/ IMMUNOLOGY ; Electrophoresis, Polyacrylamide Gel ; Female ; Hela Cells ; Human ; Immunologic Technics ; In Vitro ; Molecular Weight ; Neutralization Tests ; Support, Non-U.S. Gov't SO - J Bacteriol 1986 Feb;165(2):602-7 78 UI - 86092151 AU - Schachter J ; Sweet RL ; Grossman M ; Landers D ; Robbie M ; Bishop E TI - Experience with the routine use of erythromycin for chlamydial infections in pregnancy. AB - In an effort to prevent perinatal acquisition of Chlamydia trachomatis, we offered treatment with erythromycin ethylsuccinate (400 mg four times a day for seven days, given at 36 weeks' gestation) to 184 pregnant women with cervical chlamydial infections. Thirty-two women refused treatment; 24 of their infants were followed and served as the controls. Therapy was discontinued by 5 of 10 women who had gastrointestinal disturbances. Forty-seven women who completed therapy refused infant follow-up; in four (9 percent) of these women, therapy had failed to eradicate the infection. Sixty women and 59 infants completed the entire protocol; 55 (92 percent) of the women had negative cultures for chlamydia at follow-up. Chlamydial infection developed in 4 (7 percent) of the 59 infants of treated mothers, as compared with 12 (50 percent) of the 24 infants of untreated mothers; this difference was significant (P less than 0.001). With a success rate of 92 percent (98 of 107 patients) in treating maternal infection and with a relatively low intolerance rate (3 percent; 5 of 152), this regimen appears to be an effective, although not ideal, therapy for chlamydial infection in pregnant women. We conclude that in settings in which the prevalence of chlamydia infection is high, a routine program of screening pregnant women for cervical C. trachomatis, followed by treatment of those infected, would be cost effective and would reduce infant morbidity. MH - Cervix Diseases/*DRUG THERAPY/MICROBIOLOGY ; Chlamydia trachomatis/ISOLATION & PURIFICATION ; Chlamydia Infections/*DRUG THERAPY/MICROBIOLOGY/PREVENTION & CONTROL ; Clinical Trials ; Conjunctivitis, Inclusion/PREVENTION & CONTROL ; Drug Tolerance ; Erythromycin/*ANALOGS & DERIVATIVES/ADVERSE EFFECTS/THERAPEUTIC USE ; Female ; Follow-Up Studies ; Human ; Infant, Newborn ; Male ; Pneumonia/PREVENTION & CONTROL ; Pregnancy ; Pregnancy Complications, Infectious/*DRUG THERAPY/MICROBIOLOGY ; Support, U.S. Gov't, P.H.S. SO - N Engl J Med 1986 Jan 30;314(5):276-9 79 UI - 86080241 AU - Bard J ; Levitt D TI - Chlamydia trachomatis (L2 serovar) binds to distinct subpopulations of human peripheral blood leukocytes. AB - We have previously shown that infants with pneumonitis caused by Chlamydia trachomatis, an obligate intracellular bacterium, possess increased percentages of B lymphocytes but not T lymphocytes in their peripheral blood. It was then demonstrated that chlamydiae induce proliferation in vitro of human peripheral blood B lymphocytes and, in the presence of T cells, differentiation of B cells to immunoglobulin-secreting cells. In this study, we show that C. trachomatis (L2 serovar) binds preferentially to 50% of human B lymphocytes from peripheral blood but only to a small percentage, if any, of T cells. Both monocytes and granulocytes bind and ingest chlamydiae. Despite chlamydial binding to B cells and ingestion by monocytes, no uptake by B cells and limited growth (fewer than 0.5% inclusion-containing cells) in monocytes occur. There is a dramatic decrease in the percentage of cells associated with the bacteria after culture. These results are the first demonstration of binding of C. trachomatis (L2 serovar) to lymphocytes and represent a direct step toward correlating physical interactions between bacteria and lymphocytes with specific immunostimulatory activities in vitro. MH - Adhesiveness ; Adult ; B Lymphocytes/IMMUNOLOGY/MICROBIOLOGY ; Cells, Cultured ; Chlamydia trachomatis/GROWTH & DEVELOPMENT/ *PHYSIOLOGY ; Fluorescent Antibody Technic ; Granulocytes/ MICROBIOLOGY ; Human ; Leukocytes/CLASSIFICATION/*MICROBIOLOGY ; Lymphocyte Transformation ; Monocytes/MICROBIOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; T Lymphocytes/ MICROBIOLOGY SO - Clin Immunol Immunopathol 1986 Feb;38(2):150-60