新生儿肺炎支原体肺炎与沙眼衣原体肺炎的临床特征比较

目的探讨新生儿肺炎支原体肺炎与沙眼衣原体肺炎的临床特征。方法回顾性分析2017年1月至2018年12月130例新生儿肺炎患儿病例资料,根据感染类型分为肺炎支原体肺炎组(68例)与沙眼衣原体肺炎组(62例)。比较两组患儿发病月份分布情况、临床特征及X线胸片表现。结果肺炎支原体肺炎主要流行于8～12月,沙眼衣原体肺炎主要流行于4～8月,且肺炎支原体肺炎组9～11月患病率高于沙眼衣原体肺炎组,6～7月患病率低于沙眼衣原体肺炎组,差异有统计学意义(P0.05)。肺炎支原体肺炎组患儿咳嗽、发热、气促发生率均高于沙眼衣原体肺炎组,发绀及眼部分泌物发生率低于沙眼衣原体肺炎组,差异有统计学意义(P0.05)。两组患儿X线表现均以间质性肺炎最为常见,且各肺炎类型比较,差异均未见统计学意义(P0.05)。结论肺炎支原体肺炎组患儿易出现咳嗽、气促及肺部中细湿啰音等表现,沙眼衣原体肺炎患儿易出现发绀、咳嗽等表现,应及早诊断并采取相应治疗措施,以促进各临床症状的好转。     

新生儿沙眼衣原体肺炎30例临床分析

目的：探讨沙眼衣原体（CT）所致新生儿肺炎的流行病学情况和临床特点。方法：收集150例肺炎新生儿的鼻咽分泌物,用聚合酶链反应方法检测CT。结果：CT感染阳性率为20%（30/150）,经阴道分娩儿CT感染率（29%,26/91）明显高于剖宫产儿（7%,4/59）（P〈0.01）,农村CT感染率（29%,17/59）高于城市（14%,13/91）（P〈0.05）。临床表现以咳嗽、气促、肺部罗音为主。结论：CT是新生儿肺炎的常见病原体,CT感染与分娩方式有关。     

TaqMan PCR技术同步检测沙眼衣原体及肺炎衣原体的DNA

我们自行设计了针对沙眼衣原体、肺炎衣原体的特异性引物、Taq Man荧光探针,对这2种病原体核酸进行双重扩增荧光探针杂交检测,取得满意结果。     

新生儿沙眼衣原体肺炎的表现及其相关检查

沙眼衣原体（chlamydiatyachomatis，CT）感染是西方国家最常见的性传播疾病，孕妇宫颈CT阳性绿2％～47％，其所生的新生儿23％～70％可被CT感染，是引起新生儿结膜炎和CT肺炎的主要病原菌。我科对住院的新生儿肺炎50例患儿经鼻咽部分泌物McCoy细胞培养，证实为新生儿CT肺炎，并直接涂片镜检检测CT，先报告如下：     

新生儿沙眼衣原体肺炎30例临床治疗体会

沙眼衣原体是引起人类眼、呼吸道、泌尿生殖道疾病的重要病原之一。孕妇宫颈沙眼衣原体阳性率为2％～47％。沙眼衣原体阳性孕妇所生婴儿20％～50％发生沙眼衣原体结膜炎，10％～20％发生沙眼衣原体肺炎。作者2004年3月-2004年12月收治新生儿沙眼衣原体肺炎30例，现分析如下。     

新生儿沙眼衣原体肺炎30例临床治疗体会

沙眼衣原体是引起人类眼、呼吸道、泌尿生殖道疾病的重要病原之一。孕妇宫颈沙眼衣原体阳性率为2%~47%。沙眼衣原体阳性孕妇所生婴儿20%~50%发生沙眼衣原体结膜炎,10%~20%发生沙眼衣原体肺炎[1]。作者2004年3月~2004年12月收治新生儿沙眼衣原体肺炎30例,现分析如下。1临床资料本组30例患儿均符合沙眼衣原体肺炎诊断标准[2]。男21例,女9例,早产儿7例,足月儿23例。顺产26例,剖宫产4例,均有羊膜早破。体重1.9~4.5 kg,出生时间17~28 d。临床表现为轻度咳嗽18例,百日咳样咳嗽12例,气急26例,口吐白沫17例,紫绀13例,三凹征15例,低热11例,两肺呼吸音…     

小鼠沙眼衣原体肺炎的诱生及检测

目的探讨沙眼衣原体小鼠肺炎感染模型的建立及检测。方法用沙眼衣原体小鼠肺炎株(MoPn)鼻腔吸入感染C57BL／6小鼠。用过氧化物酶连接的鼠抗衣原体脂多糖单抗染色及RT—PCR，检测衣原体在小鼠肺组织的生长；通过肺组织髓过氧化物酶检测，确定肺炎症细胞类型。结果一定剂量的衣原体MoPn经鼻腔吸人可引起小鼠衣原体肺炎，以肺组织衣原体生长及肺组织大量中性粒细胞浸润为特征。结论小鼠可作为研究沙眼衣原体肺炎有价值的动物模型。     

婴儿沙眼衣原体肺炎两种病原学检测方法的对比研究

为探讨消眼衣原体肺炎在婴儿肺炎中的发病情况及沙眼衣原体快速检测法的可靠性,采用单克隆抗体免疫荧光法作对照,对７５例肺炎婴儿和３０例正常儿进行沙眼衣原体检测。结果显示：婴儿沙眼衣原体肺炎中新生儿占６６．７％,６个月以下占１００％。ＤＩＦＡ沙眼衣原体检出率为１６％,快速酶反应检测法沙眼衣原体检出率为１４．７％。     

应用HeLa—229细胞分离肺炎患儿沙眼衣原体

为明确肺炎患儿中沙眼衣原体感染，协助临床诊断。应用ＨｅＬａ－２２９细胞对４９例肺炎患儿的咽部分泌物进行沙眼衣原体分离培养，通过特异的单克隆荧光抗体进行鉴定；同时应用酶疫吸附试验检测患儿血清中ＩｇＭ。     

Pneumonia due to Chlamydia trachomatis in Japanese infants

Sera from 109 Japanese infants with pneumonia were tested for antibody to Chlamydia trachomatis (C. trachomatis) L2 strain by an indirect immunofluorescence (IF) technique. Nasopharyngeal swabs were also collected to isolate C. trachomatis. Clinical specimens were inoculated onto cycloheximide-treated McCoy cells and DEAE-dextran-treated HeLa 229 cells. Of 109 patients, 32 (29%) were positive for IgM antibodies (titer, greater than or equal to 1:16) to C. trachomatis. C. trachomatis was isolated from 21 (66%) of 32 IgM antibody-positive infants as compared with 5 (7%) of 77 IgM antibody-negative infants. Detectable levels of IgM antibody were common in infants during the first four months of life. Clinical characteristics of pneumonia of these IgM antibody-positive patients were also described. This is the first report of serology and clinical characteristics of C. trachomatis pneumonitis from Asian countries including Japan.     

Epidemiology, clinical aspects and therapy of infections with Chlamydia trachomatis serotype D-K

Chlamydia trachomatis serotype D-K is one of the most important pathogens of communicable diseases. 3 to 5 million new infections are observed annually in the USA. 10% to 30% of young sexually active persons in the age group 15 to 20 years are affected. The organism was isolated from 20% to 30% of patients attending dispensaries for sexually transmitted diseases, 5% to 10% of gynaecological outpatients, 1% to 8% of pregnant women and 0% to 5% of asymptomatic control persons. In men, C. trachomatis was found in 30% to 70% of patients with urethritis (15% to 25% simultaneously with gonorrhoea), in 30% to 60% of persons suffering from nongonoccocal urethritis and in 65% to 70% with postgonoccocal urethritis. 20% of newborns from mothers with positive cultures develop pneumonia and 37% conjunctivitis. Complications such as endometritis, salpingitis, periappendicitis, perihepatitis, ectopic pregnancy, premature birth, proctitis, cystitis, deferenitis, epididymitis, reactive arthritis, morbus Reiter, conjunctivitis, pneumonia (in infants and adults) may cause long lasting disease and may leave behind irreversible sequelae. Treatment with tetracyclines or erythromycin is always effective.     

Macrolide and fluoroquinolone resistance is uncommon in clinical strains of Chlamydia trachomatis

We analyzed the 23S rRNA, gyrA and parC genes of Chlamydia trachomatis DNAs from men with urethritis and determined microbiological outcomes of an extended-release azithromycin (azithromycin-SR) regimen (2 g once daily for 1 day) and a sitafloxacin regimen (100 mg twice daily for 7 days) for chlamydial urethritis to clarify the macrolide and fluoroquinolone resistance status of clinical strains of C. trachomatis. We amplified the portions of 2 alleles of the 23S rRNA gene and the gyrA and parC genes from C. trachomatis DNAs in 284 first-voided urine specimens from men with chlamydial urethritis by PCR and sequenced their PCR products. We enrolled 369 men with chlamydial urethritis, comprising 314 and 55 treated with the azithromycin-SR regimen and the sitafloxacin regimen, respectively. Alleles 1 and/or 2 of the 23S rRNA gene were analyzed in 162 specimens. No mutations were found in the sequenced regions, including the central portion of domain V. The gyrA and parC genes were analyzed in 118 and 113 specimens, respectively. No amino acid changes were found within the quinolone resistance-determining region of the gyrA gene and in the sequenced region of the parC gene. The microbiological outcomes of the azithromycin-SR and sitafloxacin regimens were assessed in 176 and 30 men, respectively. The eradication rates were 96.0% (95% CI 93.1%–98.9%) for the azithromycin-SR regimen and 100% for the sitafloxacin regimen. Clinical strains of C. trachomatis with macrolide and/or fluoroquinolone resistance would be uncommon, and azithromycin or fluoroquinolone regimens could be recommended as treatments for chlamydial infections.     

Chlamydia trachomatis infections in adolescents

The guidelines of the Centers for Disease Control should be applied with appreciation of their limitations. The serious sequelae of chlamydial infections in young patients warrant vigorous antichlamydial therapy and specific microbiologic diagnosis. Until public health authorities implement control programs, the efforts of individual practitioners will probably be the mainstay of the flight against C. trachomatis.     

Cervicovaginal coinfections with human papillomavirus and Chlamydia trachomatis

Human papillomavirus (HPV) and Chlamydia trachomatis (CT) are the two most common sexually transmitted pathogens, and infection with either reportedly was associated with cervical intraepithelial neoplasia (CIN) in women. In view of their similar mode of transmission, CT infection was examined as a possible HPV cofactor in the etiology of CIN disease. In total, 129 women were included in the study, of whom 80 were negative (mean age 34.17 +/- 6.9) and 49 were positive (mean age 33.16 +/- 6.8) for HPV DNA (assessed by PCR). CT DNA was determined in endocervical and first-catch urine specimens by PCR. Whereas HPV-positive and HPV-negative women were similar with respect to age (p = 0.419) and pregnancy outcomes (p = 0.628), the number of smokers (p = 0.001), women with multiple male sex partners (p = 0.002) or with abnormal cytology (p < 0.001) was higher in the HPV-positive group. There was an increase in CT infection rate in HPV-positive (29/49) as compared to HPV-negative (10/80) women (p < 0.01). Within HPV-positive patients, there was no significant difference between CT-positive and CT-negative patients with regards to the risk factors studied. Collectively, this suggests that CT infection is a cofactor of HPV in CIN disease development, possibly by modulating the host's immunity and/or precipitation of chronic inflammation.     

In-vitro activity of gatifloxacin against Chlamydia trachomatis and Chlamydia pneumoniae

We compared the activity of gatifloxacin, a new quinolone, ofloxacin and erythromycin against five isolates of Chlamydia trachomatis and 20 isolates of Chlamydia pneumoniae, including TW183 and clinical isolates from the USA and Japan. Testing was done in cycloheximide-treated HEp-2 cells. Gatifloxacin was slightly less active against C. trachomatis and slightly more active against C. pneumoniae than ofloxacin, with MICs at which 90% of the isolates had no inclusions and minimal chlamydicidal concentrations at which 90% of the isolates had no inclusions after passage of 0.25 mg/L. Gatifloxacin was less active than erythromycin for both species.     

Antibiotic Susceptibility of Chlamydia trachomatis

The antibiotic susceptibility of Chlamydia trachomatis isolates was determined in a tissue culture system. Representatives of all currently recognized serotypes of trachoma-inclusion conjunctivitis agents were tested. Tetracycline and erythromycin yielded similar results, with 1.0 μg/ml preventing chlamydial replication. Rifampin was the most active antibiotic, with 0.25 μg/ml completely suppressing inclusion formation of all strains. Fifty percent end points were usually achieved at one-fourth to one-eighth the 100% suppression level. Penicillin was not as effective, and the assays were often irregular. Antibiotic susceptibility of these chlamydiae was essentially the same, regardless of serotype, anatomic site infected, geographic origin, or antibiotic use in the community.     

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.     

PCR detection and differentiation of Chlamydia pneumoniae, Chlamydia psittaci and Chlamydia trachomatis.

A PCR-based system was developed for the detection and differentiation of Chlamydia trachomatis, Chlamydia psittaci and Chlamydia pneumoniae. A conserved 145 bp fragment of the chlamydial omp1 gene was amplified from all three species. The three species were then differentiated from each other by digestion of this PCR product with restriction enzymes Eco RI and either Hind III or Pst I. The system was shown to work for two strains of C. pneumoniae, 11 strains of C. psittaci and 10 serovars of C. trachomatis, and had a sensitivity of less than 10 chlamydial elementary bodies. This method was also applicable to the detection of C. trachomatis in conjunctival and nasopharyngeal swabs.