Do host genetic traits in the bacterial sensing system play a role in the development of Chlamydia trachomatis-associated tubal pathology in subfertile women?

Background  

In women, Chlamydia (C.) trachomatis upper genital tract infection can cause distal tubal damage and occlusion, increasing the risk of tubal factor subfertility and ectopic pregnancy. Variations, like single nucleotide polymorphisms (SNPs), in immunologically important host genes are assumed to play a role in the course and outcome of a C. trachomatis infection. We studied whether genetic traits (carrying multiple SNPs in different genes) in the bacterial sensing system are associated with an aberrant immune response and subsequently with tubal pathology following a C. trachomatis infection. The genes studied all encode for pattern recognition receptors (PRRs) involved in sensing bacterial components.     

A large,population-based study of age-related associations between vaginal pH and human papillomavirus infection

Background  

Vaginal pH is related to genital tract inflammation and changes in the bacterial flora, both suggested cofactors for persistence of human papillomavirus (HPV) infection. To evaluate the relationship between vaginal pH and HPV, we analyzed data from our large population-based study in Guanacaste, Costa Rica. We examined vaginal pH and the risk of HPV infection, cytological abnormalities, and C. trachomatis infection.     

A discrepancy of <Emphasis Type="Italic">Chlamydia trachomatis</Emphasis> incidence and prevalence trends in Finland 1983–2003

Background  

Reported rates of Chlamydia trachomatis are on the rise contradicting the declining rates of C. trachomatis associated reproductive sequelae in Western countries. Population based evaluation of the real trend of C. trachomatis infection is important to contemplate prevention efforts. We studied C. trachomatis occurrence during the past 20 years in Finland comparing incidence rate data based on serology and reported C. trachomatis laboratory notifications.     

Is the role of Chlamydia trachomatis underestimated in patients with suspected reactive arthritis?

Reactive arthritis is usually caused by bacteria of either the enteric or genital tracts. In the genital tract, Chlamydia trachomatis is perhaps the only aetiological agent. In Iran, newer evidence suggests that as C. trachomatis is more commonly found in the general population than was previously believed, its role in reactive arthritis may well be currently overlooked. In this review, as well as emphasizing the potential role of C. trachomatis in reactive arthritis in patients from developing countries, we also make recommendations for further clinical studies to determine its prevalence. Moreover, we also stress the need for standardization of new testing methodologies for C. trachomatis, including the use of new commercial systems in an attempt to determine a truer picture of chlamydial infection in reactive arthritis.     

<Emphasis Type="Italic">Chlamydia trachomatis</Emphasis>growth inhibition and restoration of LDL-receptor level in HepG2 cells treated with mevastatin

Background  

Perihepatitis is rare but consistently occurring extragenital manifestation of untreated Chlamydia trachomatis infection. Despite of possible liver involvement in generalized C. trachomatis infection, the ability of the pathogen to propagate in the hepatic cells and its impact on liver functions is not thoroughly investigated. The effect of mevastatin, an inhibitor of 3-hydroxy-3-methylglutaryl CoA reductase, on C. trachomatis growth in human hepatoma cell line HepG2 has been studied. Bacterial growth was assessed by immunostaining with FITC-labeled monoclonal antibody against chlamydial lipopolysaccharide and by RT-PCR for two chlamydial genetic markers (16S rRNA and euo).     

<Emphasis Type="Italic">Chlamydia trachomatis</Emphasis>infection in early neonatal period

Background  

The clinical characteristics of Chlamydia trachomatis respiratory tract infections in Japanese neonates were investigated.     

Low Correlation of Serology with Detection of Chlamydia trachomatis by Ligase Chain Reaction and Antigen EIA

Summary The aim of the present study was to evaluate the diagnostic accuracy of serology by using new assays for the detection of genus and species-specific IgG, IgM, IgA and secretory IgA antibody in female sex workers. Cervical swabs and first void urine (FVU) from 314 female sex workers were submitted to nucleic acid amplification by ligase chain reaction (LCx, Abbott). Concomittantly, blood samples were tested for the presence of IgG, IgM and IgA antibodies using a genus-specific assay (rELISA, Medac) and species-specific test (SeroCT, Orgenics). Chlamydia trachomatis infection was detected in a total of 30 (9.6%) female sex workers by LCR. With rELISA, seroprevalences for IgG, IgM and IgA antibody to Chlamydia were 88.9%, 19.1% and 62.7%, respectively. IgG and IgA antibody prevalences against C. trachomatis (SeroCT) were 65.0% and 23.9%, respectively. In comparison to the positive LCR results obtained from cervical swab and/or FVU, the sensitivity of rELISA for Chlamydia IgG, IgA and IgM detection was 93.9%, 83.3% and 16.7%, respectively. With SeroCT, the sensitivity for C. trachomatis-specific IgG and IgA detection was 86.7% and 33.3%, respectively. The specificities of both serologic tests in comparison to LCR were very slow. C. trachomatis infection of the lower genital tract is very low. According to our results, serologic testing for Chlamydia can exclude active infection of the lower genital tract with a high reliability (≥ 95%). However, detection of C. trachomatis can only be reliably achieved by nucleic acid amplification assays. Received: June 25, 1999 · Revision accepted: January 19, 2000     

Diagnostic relevance of simultaneous testing for <Emphasis Type="Italic">Chlamydia trachomatis</Emphasis> and <Emphasis Type="Italic">Neisseria gonorrhoeae</Emphasis>

Background  

The prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection in a Swiss cohort among individuals consulting for screening or symptomatic reasons is not very well known.     

Incidence of pelvic inflammatory disease in a large cohort of women tested for Chlamydia trachomatis: a historical follow-up study

Background  

Chlamydia trachomatis is a highly prevalent sexually transmitted disease. Testing rates among young Norwegian women are high. Young women diagnosed with C. trachomatis are often worried about future complications.     

Risk of coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in Nova Scotia

BACKGROUND:

The frequency of Chlamydia trachomatis and Neisseria gonorrhoeae coinfection can vary depending on their individual incidence and prevalence rates.

OBJECTIVE:

To determine the frequency of C trachomatis and N gonorrhoeae coinfections by evaluating the results of testing in 2007 and 2008 to better inform testing and treatment decisions.

METHODS:

Specimens from the same patient submitted on the same day served as the basis for the present study. The age, sex and the source of the specimen were also linked to the accession number. Infection and coinfection rates were analyzed in both males and females.

RESULTS:

Concurrent testing was performed on 41,567 female specimens and 1827 male specimens, of which, 1495 female samples (3.6%) tested positive for C trachomatis infection and 88 (0.2%) tested positive for N gonorrhoeae infections. Only 31 females were coinfected; however, for those between 11 and 25 years of age, 25 of 61 females (40.1%) with N gonorrhoeae infection also tested positive for C trachomatis infection; conversely, 25 of 1248 females (2.0%) with C trachomatis infection also tested positive for N gonorrhoeae infection. For males, 213 (11.7%) tested positive for C trachomatis infection, and 59 (3.2%) tested positive for N gonorrhoeae infection. In 30 males with N gonorrhoeae between 11 and 25 years of age, and 149 males with C trachomatis, eight coinfections were observed (26.7% and 5.3%, respectively). Of those older than 25 years of age, only five of 905 men and six of 19,465 women were coinfected. None of the 10,935 women who were 30 years of age or older had coinfections.

CONCLUSION:

The N gonorrhoeae coinfection rate in males with C trachomatis may justify empirical antimicrobials; however, in females, the proportion of coinfected may not justify empirical treatment for N gonorrhoeae infection when the C trachomatis test is positive and N gonorrhoeae testing has not been performed.     

Comparative efficacies of different antibiotic treatments to eradicate nontypeable <Emphasis Type="Italic">Haemophilus influenzae</Emphasis>infection

Background  

Nonencapsulated and nontypeable Haemophilus influenzae (NTHi) is a major cause of human respiratory tract infections. Some strains of NTHi can cause invasive diseases such as septicemia and meningitis, even if H. influenzae is not generally considered to be an intracellular pathogen. There have been very few reports about the therapeutic efficacy of antibiotics against respiratory tract infection caused by NTHi in mice because it is difficult for H. influenzae to infect mice. Therefore, we evaluated the efficacy of antibiotics against NTHi in both a cell culture model and a mouse model of infection.     

Genetic variability of the P120' surface protein gene of <Emphasis Type="Italic">Mycoplasma hominis</Emphasis> isolates recovered from Tunisian patients with uro-genital and infertility disorders

Background  

Among the surface antigens of Mycoplasma hominis, the P120' protein was previously shown to elicit a subtle antibody response and appears to be relatively conserved. To get better insight into the evolution of this protein, we analysed the genetic variability of its surface exposed region in 27 M. hominis isolates recovered from the genital tract of Tunisian patients with infertility disorders.     

Rapid Detection of <Emphasis Type="Italic">Chlamydia trachomatis</Emphasis>and Typing of the Lymphogranuloma venereum associated L-Serovars by TaqMan PCR

Background  

Infection due to Chlamydia trachomatis is the most common sexually transmitted bacterial disease of global health significance, and especially the L-serovars causing lymphogranuloma venereum are increasingly being found in Europe in men who have sex with men.     

Isolation of chlamydia trachomatis from prostatic tissue of patients undergoing transurethral prostatectomy

Summary Chlamydia trachomatis was isolated from three of 100 prostatic tissue specimens obtained from patients undergoing transurethral resection of the prostate. All examined patients were free from symptoms of urethral or prostatic inflammation. Our findings are in accordance with the high incidence of asymptomatic chlamydial infection of the lower genital tract and the increasing evidence thatC. trachomatis can cause infection of the prostate.

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Isolation von Chlamydia trachomatis aus Prostatagewebe, das anläßlich transurethraler Prostatektomie entnommen wurde

Zusammenfassung Chlamydia trachomatis wurde aus drei von 100 Prostatageweben isoliert, die anläßlich von transurethraler Prostataresektion gewonnen wurden. Keiner der Patienten hatte Symptome einer Entzündung der Urethra oder Prostata. Unsere Befunde stehen in Übereinstimmung mit der hohen Inzidenz asymptomatischer Infektionen des unteren Genitaltraktes durch Chlamydien und der zunehmenden Beweislast, daßC. trachomatis Infektionen der Prostata verursachen kann.

     

Combination antibiotics as a treatment for chronic Chlamydia‐induced reactive arthritis: A double‐blind,placebo‐controlled,prospective trial

Objective

Chlamydia trachomatis and Chlamydophila (Chlamydia) pneumoniae are known triggers of reactive arthritis (ReA) and exist in a persistent metabolically active infection state in the synovium, suggesting that they may be susceptible to antimicrobial agents. The goal of this study was to investigate whether a 6‐month course of combination antibiotics is an effective treatment for patients with chronic Chlamydia‐induced ReA.

Methods

This study was a 9‐month, prospective, double‐blind, triple‐placebo trial assessing a 6‐month course of combination antibiotics as a treatment for Chlamydia‐induced ReA. Eligible patients had to be positive for C trachomatis or C pneumoniae by polymerase chain reaction (PCR). Groups received 1) doxycycline and rifampin plus placebo instead of azithromycin; 2) azithromycin and rifampin plus placebo instead of doxycycline; or 3) placebos instead of azithromycin, doxycycline, and rifampin. The primary end point was the number of patients who improved by 20% or more in at least 4 of 6 variables without worsening in any 1 variable in both combination antibiotic groups combined and in the placebo group at month 6 compared with baseline.

Results

The primary end point was achieved in 17 of 27 patients (63%) receiving combination antibiotics and in 3 of 15 patients (20%) receiving placebo. Secondary efficacy end points showed similar results. Six of 27 patients (22%) randomized to combination antibiotics believed that their disease went into complete remission during the trial, whereas no patient in the placebo arm achieved remission. Significantly more patients in the active treatment group became negative for C trachomatis or C pneumoniae by PCR at month 6. Adverse events were mild, with no significant differences between the groups.

Conclusion

These data suggest that a 6‐month course of combination antibiotics is an effective treatment for chronic Chlamydia‐induced ReA.

     

<Emphasis Type="Italic">Salmonella enterica</Emphasis>serotype Virchow associated with human infections in Switzerland: 2004-2009

Background  

Salmonellosis is one of the most important foodborne diseases and a major threat to public health. Salmonella serotype Virchow ranks among the top five serovars in Europe.     

Early cytokine profiles in the joint define pathogen clearance and severity of arthritis in Chlamydia‐induced arthritis in rats

Objective

Although Chlamydia trachomatis–induced arthritis is among the most common rheumatic diseases having an identified infectious trigger, the pathogenesis of this arthritis is not well defined. We sought to investigate the host–microbe interactions that contribute to the severity of arthritis initiated by chlamydial infection.

Methods

We established an experimental rat model of C trachomatis–induced arthritis that recapitulates many pathologic features of the clinical disease. The severity of the arthritis was defined using an established histopathologic scoring system. Host clearance of the pathogen and local cytokine production were examined by enzyme‐linked immunosorbent assays.

Results

Lewis rats were susceptible to C trachomatis–induced arthritis, whereas BN rats were relatively resistant to this disease. Significant differences in the histopathologic severity of arthritis were originally observed on day 21, and this prompted an examination of the acute phase of the arthritis. As early as day 5 after the onset of the arthritis, pathologic changes in Lewis rats were more severe than those in BN rats. An evaluation of the role of complement using cobra venom factor treatment excluded complement as being the key to differential sensitivity, because decomplementation did not eliminate the differences in arthritis severity between Lewis and BN rats. Host clearance, in contrast, was significantly different between the rat strains, with BN rats showing more prompt and effective clearance of the pathogen from both synovial tissues and spleen compared with Lewis rats. Local cytokine profiles demonstrated that host resistance was characterized by enhanced synovial expression of tumor necrosis factor α, interferon‐γ (IFNγ), and interleukin‐4.

Conclusion

These studies demonstrated that cytokines thought to be proinflammatory in nature can play an important role in host defense in infection‐triggered arthritis and serve to highlight the dynamic cytokine relationships that constitute effective host–pathogen interactions.

     

Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to <Emphasis Type="Italic">Helicobacter pylori</Emphasis>infection

Background  

Nodular lymphoid hyperplasia of gastrointestinal tract is a rare disorder, often associated with immunodeficiency syndromes. There are no published reports of its association with Helicobacter pylori infection.     

Serodiagnosis of <Emphasis Type="Italic">Helicobacter hepaticus</Emphasis> infection in patients with liver and gastrointestinal diseases: western blot analysis and ELISA using a highly specific monoclonal antibody for <Emphasis Type="Italic">H. hepaticus</Emphasis> antigen

Background  

Helicobacter hepaticus infection might be associated with liver and biliary tract diseases. To investigate its pathogenic role, the properties of anti-H. hepaticus serum antibody in patients with liver and diseases were elucidated.