Prevalence and persistence of asymptomatic Chlamydia trachomatis infections in urine specimens from Danish male military recruits

Danish male military recruits (n = 388) were included in a follow-up study to investigate the prevalence and persistence of asymptomatic Chlamydia trachomatis infections. Urine specimens were collected at enrolment and after approximately six months. C. trachomatis was detected by polymerase chain reaction (Amplicor, Roche). Questionnaires were filled out concerning sexual behaviour and clinical symptoms. The prevalence of asymptomatic C. trachomatis in Danish male military recruits was 4.6% (18 out of 388). From five C. trachomatis-positive men no follow-up sample was obtained. From the remaining 13 C. trachomatis-positive men four (31%) were treated for C. trachomatis between the two visits (outside the study protocol). Of the remaining nine men, one cleared the infection and eight men (89%) had a persistent infection. The number of lifetime sexual partners was associated with the presence of C. trachomatis at enrolment. Although based on small numbers, this follow-up study shows, in contrast to women with asymptomatic C. trachomatis infections, a high percentage of C. trachomatis persistence in asymptomatically infected males.     

衣原体直肠炎的诊治1例

衣原体直肠炎在临床上较为罕见, 通常为性传播。本文报道1例衣原体直肠炎的典型内镜下表现, 并介绍其病理表现及诊治方法, 为临床工作提供参考。     

Evaluation of amplicor chlamydia PCR and LCX chlamydia LCR to detect Chlamydia trachomatis in synovial fluid

OBJECTIVES: PCR has been successfully used in research for the detection of C. trachomatis DNA in synovial samples. However, each research laboratory has developed its own PCR, making inter-laboratory comparisons difficult. To allow for standardization we evaluated two commercially available amplification systems originally designed for the examination of urogenital samples (Roche Amplicor Chlamydia PCR and Abbott LCX Chlamydia LCR), using them to analyse spiked and clinical synovial fluid (SF) samples from reactive arthritis (ReA), undifferentiated arthritis (UA), and rheumatoid arthritis (RA) patients. We compared their sensitivity in assays of clinical SF samples with our in-house developed C. trachomatis specific nested PCR. METHODS: SF was spiked with purified C. trachomatis elementary bodies (EB) and analyzed by the commercial assays. Clinical SF samplesfrom ReA (n=21), UA (n=79) and RA (n=50) patients were examined by the two commercial assays and our in-house PCR. RESULTS: Using SF samples spiked with defined numbers of C. trachomatis EB, the sensitivity of the commercial tests was high and similar to published PCR sensitivity. In clinical SF specimens the commercial assays was also able to detect CT; however, the in-house PCR was more sensitive. Out of 10 PCR-positive SF samples Amplicor tested positive in only 4/10 and LCX in only 3/10. The in-house PCR detected chlamydial DNA in synovialfluidfrom 5/21 ReA (24%), 5/79 UA (6%) and in none of the 50 RA patients. CONCLUSION: Commercial amplification assays allow the detection of C. trachomatis in clinical specimens, although with a lower sensitivity than optimized PCR. Potential explanations are discussed.     

Screening for rectal chlamydia infection in a genitourinary medicine clinic

Our department has been offering routine rectal chlamydia testing to all individuals reporting ano-receptive sex since 2002. We wanted to determine the prevalence of rectal chlamydia and if there were any factors associated with a positive diagnosis. A retrospective case-notes analysis was performed of all individuals tested for rectal chlamydia from November 2002 until March 2005. In total, 1187 case-notes were examined. Overall, the prevalence of chlamydia infection was 8.5%; in asymptomatic individuals, it was 5.1%. There was a positive association with chlamydia infection in patients who were HIV-positive, those who reported rectal symptoms and from samples in which microscopy of a rectal smear demonstrated >10 polymorphonuclear cells/high power field. The findings support our continuing to offer rectal chlamydia screening to patients attending our service. Chlamydia trachomatis infection should be considered as a possible diagnosis in patients who present with rectal symptoms outside a genitourinary medicine clinic setting.     

应用决策树模型对深圳市社区妇女生殖道沙眼衣原体感染筛查的成本效果评估

目的 评估在社区妇女人群中结合妇女病普查普治及"两癌"筛查项目开展生殖道沙眼衣原体感染筛查和病例管理干预措施的成本效果.方法 借助于人群衣原体感染患病率调查结果,建立决策分析模型,模型参数来源于筛查项目记录、成本调查和文献回顾.模型估算1万例20～35岁社区妇女在开展筛查干预项目和未开展项目下预期产生的主要成本、获得的...     

Toxoplasmosis in military personnel involved in jungle operations

Tropical diseases, mainly leishmaniasis and malaria, increased among Colombian military personnel due to intensive operations in the jungle in the last ten years; as a result the Colombian army developed important preventive strategies for malaria and leishmaniasis. However, no knowledge exists about toxoplasmosis, an emergent disease in military personnel. We compared the prevalence of IgG anti-Toxoplasma antibodies by ELISA and of parasitaemia by a real time PCR assay, in 500 professional soldiers that operated in the jungle with a group of 501 soldiers working in an urban zone (Bogotá). We found that the prevalence was significantly different between both groups of soldiers (80% in soldiers operating in jungle vs. 45% in urban soldiers, adjusted OR 11.4; CI 95%: 3.8-34; p<0.0001). All soldiers operating in the jungle drink unboiled and chlorine untreated lake or river water. In urban soldiers, these risk factors along with eating wild animal meat or eating tigrillo (little spotted cat) were significantly associated with a higher prevalence. Characteristic toxoplasmic choriorretinal lesions were found in 4 soldiers that operated in the jungle (0.8%) and in one urban soldier (0.19%). All soldiers before being deployed in jungle operations should be tested for Toxoplasma antibodies and to receive adequate health information about the routine use of personnel filters to purify their water for consumption.     

沙眼衣原体耐药性的分子机制研究的新进展

沙眼衣原体(Ct)感染如果未得到及时治疗,会引起严重及复杂的并发症。目前大环内酯类和喹诺酮类药物是治疗Ct感染的一线药物,但Ct对这几种药物产生耐药的报道越来越多,给临床治疗带来了挑战。众多研究表明,Ct产生耐药的机制比较复杂,与多种基因突变有关。     

Outbreak of hepatitis A in Korean military personnel

This report describes a hepatitis A outbreak among Korean military personnel. Each case of hepatitis A in this outbreak was defined as a person who had symptoms compatible with acute viral hepatitis A and had positive HAV IgM between May 2 and August 14, 2007 in Inje district, Gangwon, Korea. We tested 70 cases with symptoms for HAV IgM, and 67 cases showed positive results. They included 4 sergeants, 1 officer and 62 privates. A positive result for HAV IgG among asymptomatic military personnel was seen in 11.8% of cases. This epidemic occurred after a heavy rainfall in the military compound area where drinking water was supplied by the stream water. After the outbreak, the supply of drinking water was switched to a public water system. All of 178 military personnel who had no HAV IgG were vaccinated on July 26, 2007. The outbreak was resolved after the control measures were implemented.     

A comparison of oxytetracycline and trimethoprim in the treatment of chlamydia trachomatis urethritis

Summary The effect of trimethoprim was compared with that of oxytetracycline in the treatment of uncomplicated urethritis and/or cervicitis. Twenty-six patients treated with oxytetracycline were all microbiologically cured. Of 19 patients treated with trimethoprim, ten (53%) still harboured the chlamydia after two weeks. The superiority of tetracycline was even more pronounced following the evaluation of dysuria and discharges. 85% of the patients treated with oxytetracycline and 6% of those treated with trimethoprim had neither dysuria nor discharge after the completion of treatment. The patients who failed to be cured by trimethoprim were all successfully treated with oxytetracycline.

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Vergleich von Oxytetracyclin und Trimethoprim in der Therapie der Chlamydia trachomatis-Urethritis

Zusammenfassung Die Wirkung von Trimethoprim in der Behandlung der unkomplizierten Urethritis und/oder Cervicitis wurde mit der von Oxytetracyclin verglichen. Sechsundzwanzig Patienten, die Oxytetracyclin erhalten hatten, wurden alle mikrobiologisch geheilt. Von neunzehn mit Trimethoprim behandelten Patienten wiesen zehn (53%) nach zwei Wochen immer noch Chlamydia auf. Die Überlegenheit von Tetracyclin war bei der Beurteilung von Dysurie und Fluor noch ausgeprägter — 85% der mit Oxytetracyclin und 6% der mit Trimethoprim behandelten Patienten klagten nach Abschluß der Behandlung weder über Dysurie noch über Fluor. Alle Patienten, die durch Trimethoprim nicht geheilt wurden, wurden anschließend erfolgreich mit Oxytetracyclin behandelt.