Ofloxacin versus doxycycline for treatment of cervical infection with Chlamydia trachomatis.

Women with culture-proven Chlamydia trachomatis cervical infection were randomized to receive either ofloxacin (300 mg) or doxycycline (100 mg), orally twice daily for 7 days. All 56 had negative cultures 5 to 9 days after treatment. Four weeks after treatment, 26 (93%) of 28 ofloxacin-treated patients and all 22 doxycycline-treated patients were cured. We conclude that 300 mg of ofloxacin given twice daily for 7 days provides effective therapy for chlamydial infection of the cervix.     

3199例妊娠女性沙眼衣原体感染的检测分析

目的了解无锡市不良妊娠女性沙眼衣原体(CT)的感染状况及其与流产的关系。方法选取2013年1月至2014年12月在该院就诊的妊娠女性3 199例,分为稽留流产组(2 633例)、不完全流产组(265例)、难免流产组(137例),先兆流产组(104例),对照组(60例,均为人工流产),采用荧光定量聚合酶链式反应(FQ-PCR)技术进行CT检测。结果稽留流产组、不完全流产组、难免流产组及先兆流产组的CT阳性率分别为5.62%、4.53%、5.11%和4.81%,均高于对照组阳性率(3.33%),但差异均无统计学意义(P0.05)。16~21岁和21~26岁妊娠女性CT阳性率最高,分别为7.06%和6.20%,但各年龄段CT阳性率比较差异无统计学意义(P0.05)。结论在妊娠女性中自然流产相对人工流产有较高的CT感染率,并且年轻女性CT感染率较高。     

围产期孕妇沙眼衣原体感染的治疗和新生儿肺炎关系研究

目的 探讨妊娠合并沙眼衣原体感染对新生儿的危害和防治策略。方法采用回顾性分析法对600例孕妇,对妊娠合并沙眼衣原体感染的153例孕妇病史与聚合酶链反应检测结果进行分析,同时选择同期无沙眼衣原体感染的孕妇90例作为对照比较。结果研究孕妇衣原体的感染率达25．5％,并发现感染时及时治疗的90例孕妇发生孕期、产时及新生儿并发症明显低于因各种原因未经治疗的孕妇。结论围产期孕妇感染对孕妇、胎儿、新生儿具有很大的危害,全面检查和及时治疗能有效防治,达到优生优育的目的。     

Relative resistance to erythromycin in Chlamydia trachomatis.

Recent Chlamydia trachomatis isolates were tested in a tissue culture system for susceptibility to tetracycline, erythromycin, rosaramicin, rifampin, and clindamycin. Rifampin was the most active drug (minimal inhibitory concentration, less than or equal to 0.02 microgram/ml). Tetracycline and rasaramicin were highly active, with a concentration of less than or equal to 0.25 microgram/ml being chlamydicidal. Clindamycin was least active on a weight basis, requiring up to 16 microgram/ml to prevent the passage of chlamydiae into a drug-free tissue culture system. Relative resistance to erythromycin was detected; two isolates were capable of limited replication in 1 microgram/ml.     

Diagnosis and treatment of Chlamydia trachomatis infection

Chlamydia trachomatis infection most commonly affects the urogenital tract. In men, the infection usually is symptomatic, with dysuria and a discharge from the penis. Untreated chlamydial infection in men can spread to the epididymis. Most women with chlamydial infection have minimal or no symptoms, but some develop pelvic inflammatory disease. Chlamydial infection in newborns can cause ophthalmia neonatorum. Chlamydial pneumonia can occur at one to three months of age, manifesting as a protracted onset of staccato cough, usually without wheezing or fever. Treatment options for uncomplicated urogenital infections include a single 1-g dose of azithromycin orally, or doxycycline at a dosage of 100 mg orally twice per day for seven days. The recommended treatment during pregnancy is erythromycin base or amoxicillin. The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend screening for chlamydial infection in women at increased risk of infection and in all women younger than 25 years.     

160例宫颈糜烂患者沙眼衣原体感染检测分析

目的：了解宫颈糜烂患者沙眼衣原体的感染情况及其临床意义.方法：选取在我院进行治疗的宫颈糜烂患者160例作为观察组,宫颈炎患者160例作为对照组.采用clearview衣原体试剂盒对两组患者进行沙眼衣原体检测,比较两组患者沙眼衣原体感染情况.结果：观察组患者沙眼衣原体例数和阳性检出率均明显高于对照组,差异具有统计学意义,P＜0.05.观察组患者中中重度糜烂患者阳性检出率明显高于轻度糜烂患者,差异具有统计学意义,P＜0.05.结论：综上所述,对宫颈糜烂患者进行早期沙眼衣原体检测,及时进行有效的药物治疗,能够有效控制糜烂的发展,保护女性身体健康,使用前景广阔,所以值得在临床推广.     

妊娠期妇女高危型人乳头瘤病毒感染与宫颈病变的相关性研究

目的探讨妊娠期妇女高危型人乳头瘤病毒(HR-HPV)感染与宫颈病变的相关性。方法选取重庆华西妇产医院就诊的18~43岁妊娠期妇女486例,行第二代分子杂交捕获技术(HC2-HPV-DNA)和超微病原体可视检测技术(TH)2种方法联合检测及电子阴道镜下病理活检,以病理活检结果为诊断宫颈病变的金标准。结果 486例妊娠期妇女HR-HPV检测阳性患者161例,阳性率33.12%(161/486);病理组织学诊断出宫颈癌(ICC)及癌前病变(CIN)24例;HPV阳性患者的宫颈癌及癌前病变22例,敏感性91.67%(22/24)。HR-HPV感染情况在不同年龄段分布,差异有统计学意义(P0.05),HR-HPV病毒载量及阳性表达率越高,宫颈病变的程度越高。结论妊娠期妇女不同年龄段的HR-HPV感染率不同;HR-HPV阳病毒载量与CIN及ICC发生有关,与宫颈病变的发生过程有关,但与宫颈病变的严重程度无关;妊娠期妇女HPV感染的宫颈病变阳性率和病毒载量与非妊娠期妇女相似;HC2-HPV-DNA法是目前筛查癌前病变及宫颈癌的最佳方法。     

Diagnosis of Chlamydia trachomatis infection

Important progress in the diagnosis of Chlamydia trachomatis (C. trachomatis) includes the development of nucleic acid amplification techniques such as polymerase chain reaction (PCR) and ligase chain reaction (LCR). Commercial kits are available, but they are costly, sporadic in availability, must be imported, and are economically beyond the reach of common people. To overcome this limitation, most research laboratories have standardized their in-house-developed PCR methods for diagnosing this infection. However, each laboratory has to spend a great deal of time and money to accomplish this. Published reports do not always elaborate the steps involved in standardizing a test so that it can immediately be reproduced in another setting. In the present study we attempted to elaborate the steps involved in standardizing a sensitive and specific PCR technique followed by hybridization with specific C. trachomatis probe to diagnose this infection in cervical, introital, and urine specimens, and used it to determine the infection rate in a clinical population.     

Nursing management of the patient with Chlamydia trachomatis infection

Information on the recognition and management of clinical syndromes commonly caused by Chlamydia should be widely disseminated. Clinicians must be able to make risk assessments on their patients who may have asymptomatic disease. Because chlamydial infections are often undiagnosed, infected patients continue to spread the organisms to their sexual partners and to neonates. Sexual contacts of patients with Chlamydia or gonorrhea should receive treatment regimens effective against both organisms. Patients who are infected with gonorrhea should receive treatment regimens effective against both organisms. Chlamydia culture is the gold standard for detection of the organism. Antigen detection methods have been developed that offer a low-cost alternative to culture, but these tests are not ideal. Chlamydia tests are not a substitute for clinical experience and risk assessment by the nurse practitioner.     

Demographic and reproductive factors for high seroprevalence of Chlamydia trachomatis among pregnant women in Japan

In order to elucidate demographic and reproductive factors associated with Chlamydia trachomatis seropositivity, serological screening and questionnaire survey were conducted on pregnant women in Nagasaki Prefecture, Japan. Serum samples were taken from 1718 pregnant women between September and December, 1996, at the cooperative obstetric hospitals and clinics, and tested for the presence of antibodies to C. trachomatis using the enzyme immunoassay. A questionnaire was administered on a sub-sample (n -409), among whom 85 (20.8%) were seropositive. A multiple logistic analysis revealed that four characteristics showed a significant association with the seropositivity: (i) experience of premarital pregnancy, (ii) non use of condoms, (iii) short duration of education, and (iv) more frequent induced abortion. The unsafe sexual behavior of young people lacking proper knowledge of how to prevent STD is the most important intervention target for control of the C. trachomatis epidemic in Japan.     

Incidence of Chlamydia trachomatis infections in pregnant patients in Vienna

Pregnant women were examined for chlamydia trachomatis-infection on a routine basis during a multicentric study in Vienna. Samples were taken from the cervix and fornix between the 30th and 34th week pregnancy. FTIC-conjugated monoclonal antibodies and immunofluorescence techniques were used to verify chlamydia trachomatis. Out of 1238 pregnant women, 101 (8.16%) were positive for chlamydia trachomatis. Since chlamydia infections can result in severe local or generalized complications and also spread to the newborn baby, screening investigations should be regularly performed during pregnancy and, if indicated, adequate treatment undertaken.     

子宫颈癌合并妊娠的诊断及处理——附5例临床分析

目的:探讨子宫颈癌合并妊娠的临床诊断和处理.方法:对5例子宫颈癌合并妊娠患者的临床资料进行回顾性分析.结果:3例子宫颈癌于孕早期确诊,1例子宫颈癌于孕中期确诊,1例于孕37+周确诊.3例子宫颈浸润癌于孕35 ～ 38+周终止妊娠,其中2例延迟10周和7个月处理,新生儿均存活.结论:子宫颈癌合并妊娠的临床表现和处理原则同非妊娠期.妊娠早期常规行妇科检查及宫颈细胞学检查可早期发现子宫颈癌.子宫颈癌合并妊娠的处理应依据肿瘤临床分期、疾病诊断时孕周以及患者意愿综合考虑给予个体化治疗.     

Addicted women. Profiles from the inner city.

This article has focused on addicted women and the contexts in which they present to the community nurse. An effort has been made to broaden the clinical applications to include the societal problems underlying addiction and the policy issues that must be addressed to solve them. Addicted women can be described from a societal dimension, in which the health care system reflects disarray and fiscal chaos, and from a community dimension. The two dimensions link the public and the private spheres. To evaluate addicted women and the options for their recovery more effectively, it is helpful to integrate the societal and personal milieu--public issues and the private lives that illustrate them. This is how policy is best formulated. The numbers of addicted women in the health care system reflect only the tip of the iceberg. Health care providers must strive to reach women who are outside of the health care system who have not been connected to a hospital, shelter, or home care agency. Researchers need to differentiate sample patient populations, and the patient selection bias needs to be addressed early on. A model of a community support for recovery located within a housing project was a viable option for reaching addicted women. The role of nurses is becoming increasingly unique. Nurses are skilled as caregivers and clinicians. They can open doors of opportunity for inner-city women and children by developing health-promotive programs in hospital settings for substance abusing women and by continuing to work with their colleagues in the community context. On both dimensions, nurses have front-line accessibility to women and children who are vulnerable. Often, commonality of gender strengthens the nurse/patient relationship and facilitates trust as well as empathy between female addicts and their nurse advocate counterparts. Never has the call to inner-city nurses been more compelling. The problems related to drug abuse and parenting are multidimensional. They resist easy definition and solution. Nurses have the education and the clinical expertise to provide front-line interventions for inner-city women who are addicted to drugs. Nurses are educated holistically as caregivers and teachers. Ideally, nurses can exert their strongest impact on health promotion in the neighborhoods of communities. In reality, this has not worked, and nurses remain part of a health care system that has failed inner-city poor women and their children. Nurses in hospitals and in community setting spend most of their time applying "bandages" to the psychologic and physical wounds that emerge from the addiction to drugs.(ABSTRACT TRUNCATED AT 400 WORDS)     

316例不孕症妇女解脲支原体和沙眼衣原体检测结果分析

目的了解不孕症妇女解脲支原体（Uu）和沙眼衣原体（CT）的感染状况及其与不孕症的关系。方法对316例患不孕症的妇女（不孕组）和250例正常生育的妇女（对照组）进行宫颈分泌物的uu和cT检测,比较两组妇女Uu与cT感染率差异,并分析原发性不孕症与继发性不孕症妇女感染率的差异。结果不孕组UU、CT感染检出率分别为30．7％、8．9％,明显高于对照组的9．2％和0．8％（P〈o．05）;原发性不孕妇女宫颈分泌物UU、CT感染检出率分别为11．9％、3．7％,而继发性不孕妇女宫颈分泌物UU、CT感染捡出率分别为40．6％、n．6％,UU感染检出率明显高于原发性不孕妇女（P〈O．05）,CT感染检出率明显高于原发不孕妇女（P〈O．05）。结论Uu和CT与妇女不孕密切相关,建议临床将UU、CT作为女性不孕就诊患者的常规检查项目。     

围产期孕妇沙眼衣原体感染的检测和治疗

目的 探讨妊娠合并沙眼衣原体感染(CT)对妊娠分娩以及新生儿的危害和防治策略.方法 采用回顾性分析法对2003年5月至2006年7月在本院产科检查的507例孕妇,对妊娠合并沙眼衣原体感染的136例孕妇病史与聚合酶链反应(PCR)检测结果进行分析,同时选择同期无沙眼衣原体感染的孕妇120例作为对照比较.结果 研究孕妇衣原体的感染率达26.8%,发现感染及时治疗的96例孕妇发生孕期、产时及新生儿并发症明显低于因各种原因未经治疗的孕妇(P＜0.05).结论 围产期孕妇CT感染对孕妇、胎儿、新生儿具有很大的危害,全面检查和及时治疗能有效防治CT达到优生优育的目的.     

In vitro evaluation of activities of azithromycin, erythromycin, and tetracycline against Chlamydia trachomatis and Chlamydia pneumoniae.

The in vitro activities of azithromycin (CP-62,993; Pfizer), erythromycin, and tetracycline were evaluated by inhibiting Chlamydia trachomatis and Chlamydia pneumoniae, formerly TWAR, propagation in vitro in McCoy cells, HeLa cells, and HL cells. Eleven clinical isolates of C. trachomatis (serovars D, E, F, J, K, and L2) and four strains of C. pneumoniae were tested with an inoculum of 10(3) inclusion-forming units in a 96-well microtiter plate. The MIC ranges of these antimicrobial agents against C. trachomatis were as follows: azithromycin, 0.125 to 0.5 microgram/ml; erythromycin, 0.25 to 0.1 microgram/ml; and tetracycline, 0.0625 to 1.0 microgram/ml. The MBC ranges, calculated from passage into antibiotic-free medium, were as follows: azithromycin, 0.125 to 4.0 micrograms/ml; erythromycin, 0.5 to 8.0 micrograms/ml; and tetracycline, 0.0625 to 4.0 micrograms/ml. The MIC ranges for C. pneumoniae in both HeLa and HL cells were as follows: azithromycin, 0.125 to 1.0 micrograms/ml; erythromycin, 0.0625 to 1.0 microgram/ml; and tetracycline, 0.125 to 1.0 microgram/ml. The MBC ranges were as follows: azithromycin, 0.25 to 1.0 microgram/ml; erythromycin, 0.25 to 1.0 microgram/ml; and tetracycline, 0.125 to 4.0 micrograms/ml. From the results of this in vitro study, azithromycin appears to be an effective antibiotic comparable to tetracycline and erythromycin for use in the treatment of both C. trachomatis and C. pneumoniae infections.     

Effective treatment of Chlamydia trachomatis infection during pregnancy to prevent perinatal and infant complications.

Chlamydia trachomatis is the most prevalent cause of sexually transmitted disease in the United States today. Prenatal health care providers must learn to recognize and effectively treat chlamydial infection in order to help prevent serious consequences in the pregnant woman and in the neonate. This article discusses the diagnosis and treatment of chlamydial infection during pregnancy and during the neonatal period. Patient education of women infected during pregnancy should include guidelines for helping parents and care providers monitor the neonate for signs of conjunctivitis and pneumonia.     

Sexually transmitted diseases in women. Chlamydia trachomatis and herpes simplex infections

C trachomatis infection is the most commonly reported STD in the United States, and the majority of women infected are asymptomatic. Screening is recommended for those at high risk, including women who are between 15 and 21 years of age, live in urban areas, are single, or have new or multiple sexual partners. The "gold standard" for diagnosis is chlamydial culture; however, techniques that use DNA and RNA amplification are nearly 100% sensitive and specific and may prove cost-effective. Doxycycline is a recommended first-line therapy, but certain other antibiotics may also be effective. Herpes simplex virus affects more than one third of the world's population. It is diagnosed by observation of shallow, tender ulcerations around the genitalia and by viral isolation using tissue culture. Initial treatment is with antiviral drugs, which may also be necessary episodically or as a suppressive regimen for recurrences. Patient education about prevention of these and other STDs, as well as the impact of such disease on sexual partners, is critical. Physicians should therefore become comfortable questioning and counseling patients about sexual issues and risks for STDs.     

Ocular Chlamydia trachomatis infection: elimination with mass drug administration

Introduction: Ocular Chlamydia trachomatis infection, the causative agent for trachoma, is responsible for 1.9 million cases of visual loss worldwide. Mass Drug Administration (MDA) with azithromycin to entire trachoma-endemic districts is part of the World Health Organization’s public health strategy for trachoma elimination.

Areas covered: Background on C. trachomatis and the epidemiology of trachoma are presented, followed by a review of the antibiotics for treatment and the need for a public health approach to trachoma elimination. The effectiveness of mass drug administration is presented, concluding with challenges to trachoma elimination in the future.

Expert opinion: MDA using azithromycin is a key component of the public health strategy for trachoma elimination. With high coverage in children, there is good evidence that MDA drops the community pool of infection. There are challenges to trachoma elimination by the year 2020, and the drug donation program for country MDAs will be integral to ongoing efforts.     

The effect of antibiotic treatment on active trachoma and ocular Chlamydia trachomatis infection

Antibiotics are one of four arms of the SAFE strategy for the control of trachoma, an eye infection that is responsible for more cases of blindness than any condition other than cataract. The evidence for the use of topical tetracycline and oral tetracycline, doxycycline, erythromycin, cotrimoxazole and azithromycin in trachoma are reviewed here and a number of issues are nominated as research and policy priorities.