Advertisement

Chlamydia

  • Albert John Phillips
Chapter
Part of the Current Clinical Practice book series (CCP)

Abstract

Chlamydia trachomatis is the most commonly reported infectious disease in the United States. The chapter explores in depth the essential elements of this unique organism and its clinical presentation. The practicing clinician must be well-versed in the multiple manifestations of the infectious diseases of C. trachomatis. Though infections are generally seen in younger, sexually active patients, the organism can affect both sexes and even the newborn. Included is a complete clinical description of the many ways chlamydial infections can present. How to test for the infection and make a diagnosis is included. A compelling argument is made for screening in certain populations because chlamydia can be asymptomatic. Untreated infection will cause long-term morbidity, especially in women. Treatment by specific antibiotics generally is well tolerated and provides excellent cure rates. A reference for which antibiotic and dose for each of the clinical situations is included to aid the clinician in choosing the optimal treatment.

Keywords

Pelvic Inflammatory Disease Chronic Prostatitis Direct Fluorescent Antibody False Positive Test Result Ligase Chain Reaction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Centers for Disease Control and Prevention. Sexually transmitted diseases surveillance. Atlanta, GA: Centers for Disease Control and Prevention; 2010. Available from: http://www.cdc.gov/std/stats10/surv2010.pdf.
  2. 2.
    Chesson HW, Blandford JM, Gift TL, et al. The estimated direct medical cost of sexually transmitted diseases among American youth, 2000. Perspect Sex Reprod Health. 2004;36(1):11–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Weinstock H, Berman S, Cates Jr W. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004;36:6–10.PubMedCrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010;59(RR-12):9.Google Scholar
  5. 5.
    Turner CF, Rogers SM, Miller HG, et al. Untreated gonococcal and chlamydia infection in a probability sample of adults. JAMA. 2002;287:726–33.PubMedCrossRefGoogle Scholar
  6. 6.
    Groseclose SL, Zaidi AA, DeLisle SJ, et al. Estimated incidence and prevalence of genital Chlamydia trachomatis infections in the United States, 1996. Sex Transm Dis. 1999;26(6):339–44.PubMedCrossRefGoogle Scholar
  7. 7.
    World Health Organization. Prevalence and incidence of selected sexually transmitted infections. Geneva: World Health Organization; 2011.Google Scholar
  8. 8.
    Sweet RL, Gibbs RS. Chlamydial infections. In: Sweet RL, Gibbs RS, editors. Infectious diseases of the female genital tract. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 57–100.Google Scholar
  9. 9.
    Miller WC, Ford CA, Morris M, et al. Prevalence of chlamydial and gonococcal infections among young adults in the United States. JAMA. 2004;291(18):2229–36.PubMedCrossRefGoogle Scholar
  10. 10.
    Kent CK, Chaw JK, Wong W, et al. Prevalence of rectal, utrethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical setting among men who have sex with men: San Francisco, California, 2003. Clin Infect Dis. 2005;41:67–74.PubMedCrossRefGoogle Scholar
  11. 11.
    Mimiaga MJ, Mayer KH, Reisner SL, et al. Asymptomatic gonorrhea and chlamydial infections detected by nucleic acid amplification tests among Boston area men who have sex with men. Sex Transm Dis. 2008;35:495.PubMedCrossRefGoogle Scholar
  12. 12.
    Forward KR. Risk of coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in Nova Scotia. Can J Infect Dis Med Microbiol. 2010;21(2):e84–6.PubMedGoogle Scholar
  13. 13.
    Jacobson DL, Peralta L, Graham NM, Zenilman J. Histologic development of cervical ectopy: relationship to reproductive hormones. Sex Transm Dis. 2000;27(5):252–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Quinn TC, Gaydos C, Shepherd M, Bobo L, et al. Epidemiologic and microbiologic correlates of Chlamydia trachomatis infection in sexual partnerships. JAMA. 1996;276(21):1737–42.PubMedCrossRefGoogle Scholar
  15. 15.
    Morre SA, Rozendaal L, van Valkengoed IG, et al. Urogenital Chlamydia trachomatis serovars in men and women with a symptomatic or asymptomatic infection: an association with clinical manifestations? J Clin Microbiol. 2000;38(6):2292–6.PubMedGoogle Scholar
  16. 16.
    Davies JA, Rees E, Hobson D, Karayiannis P. Isolation of Chlamydia trachomatis from Bartholin’s ducts. Br J Vener Dis. 1978;54(6):409–13.PubMedGoogle Scholar
  17. 17.
    Saul HM, Grossman MB. The role of Chlamydia trachomatis in Bartholin’s gland abscess. Am J Obstet Gynecol. 1988;158(3 Pt 1):76–7.PubMedGoogle Scholar
  18. 18.
    Bleker OP, Smalbraak DJ, Schutte MF. Bartholin’s abscess: the role of Chlamydia trachomatis. Genitourin Med. 1990;66(1):24–5.PubMedGoogle Scholar
  19. 19.
    Batteiger BE, Jones RB. Chlamydial infections. Infect Dis Clin North Am. 1987;1(1):55–81.PubMedGoogle Scholar
  20. 20.
    Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010;59:1.PubMedGoogle Scholar
  21. 21.
    Mutlu N, Mutlu B, Culha M, et al. The role of Chlamydia trachomatis in patients with non-bacterial prostatitis. Int J Clin Pract. 1998;52(8):540–1.PubMedGoogle Scholar
  22. 22.
    Ostaszewska I, Zdrodowska-Stefanow B, Badyda J, et al. Chlamydia trachomatis: probable cause of prostatitis. Int J STD AIDS. 1998;9(6):350–3.PubMedCrossRefGoogle Scholar
  23. 23.
    Ness RB, Markovic N, Carlson CL, Coughlin MT. Do men become infertile after having sexually transmitted urethritis? An epidemiologic examination. Fertil Steril. 1997;68(2):205–13.PubMedCrossRefGoogle Scholar
  24. 24.
    Thompson CI, MacAulay AJ, Smith IW. Chlamydia trachomatis infections in the female rectums. Genitourin Med. 1989;65(4):269–73.PubMedGoogle Scholar
  25. 25.
    Wexner SD. Sexually transmitted diseases of the colon, rectum, and anus. The challenge of the nineties. Dis Colon Rectum. 1990;33(12):1048–62.PubMedCrossRefGoogle Scholar
  26. 26.
    Silveira LH, Gutierrez F, Scopelitis E, et al. Chlamydia-induced reactive arthritis. Rheum Dis Clin North Am. 1993;19(2):351–62.PubMedGoogle Scholar
  27. 27.
    Hanada H, Ikeda-Dantsuji Y, Naito M, Nagayama A. Infection of human fibroblast-like synovial cells with Chlamydia trachomatis results in persistent infection and interleukin-6 production. Microb Pathog. 2003;34(2):57–63.PubMedCrossRefGoogle Scholar
  28. 28.
    Schachter J, Grossman M, Sweet RL, et al. Prospective study of perinatal transmission of Chlamydia trachomatis. JAMA. 1986;255(24):3374–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Bell TA, Stamm WE, Kuo CC, et al. Risk of perinatal transmission of Chlamydia trachomatis by mode of delivery. J Infect. 1994;29(2):165–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Jain S. Perinatally acquired Chlamydia trachomatis associated morbidity in young infants. J Matern Fetal Med. 1999;8(3):130–3.PubMedCrossRefGoogle Scholar
  31. 31.
    Weiss SG, Newcomb RW, Beem MO. Pulmonary assessment of children after chlamydial pneumonia of infancy. J Pediatr. 1986;108(5 Pt 1):659–64.PubMedGoogle Scholar
  32. 32.
    Johnson RE, Newhall WJ, Papp JR, et al. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections—2002. MMWR Recomm Rep. 2002;51(RR-15):1–38.Google Scholar
  33. 33.
    Schachter J, Moncada J, Liska S, et al. Nucleic acid amplification tests in the diagnosis of chlamydial and gonococcal infections of the oropharynx and rectum in men who have sex with men. Sex Transm Dis. 2008;35:637.PubMedCrossRefGoogle Scholar
  34. 34.
    Rabenau HF, Kohler E, Peters M, et al. Low correlation of serology with detection of Chlamydia trachomatis by ligase chain reaction and antigen EIA. Infection. 2000;28(2):97–102.PubMedCrossRefGoogle Scholar
  35. 35.
    Akande VA, Hunt LP, Cahill DJ, et al. Tubal damage in infertile women: prediction using chlamydia serology. Hum Reprod. 2003;18(9):1841–7.PubMedCrossRefGoogle Scholar
  36. 36.
    U.S. Preventive Services Task Force. Screening for chlamydial infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2007;147:128.CrossRefGoogle Scholar
  37. 37.
    Martin DH, Mroczkowski TF, Dalu ZA, et al. A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. The Azithromycin for Chlamydial Infections Study Group. N Engl J Med. 1992;327(13):921–5.PubMedCrossRefGoogle Scholar
  38. 38.
    Thorpe Jr EM, Stamm WE, Hook III EW, Gall SA, Jones RB, Henry K, et al. Chlamydial cervicitis and urethritis: single dose treatment compared with doxycycline for seven days in community based practices. Genitourin Med. 1996;72(2):93–7.PubMedGoogle Scholar
  39. 39.
    Somani J, Bhullar VB, Workowski KA, et al. Multiple drug-resistant Chlamydia trachomatis associated with clinical treatment failure. J Infect Dis. 2000;181(4):1421–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Augenbraun M, Bachmann L, Wallace T, et al. Compliance with doxycycline therapy in sexually transmitted diseases clinics. Sex Transm Dis. 1998;25(1):1–4.PubMedCrossRefGoogle Scholar
  41. 41.
    Silverman NS, Sullivan M, Hochman M, et al. A randomized, prospective trial comparing amoxicillin and erythromycin for the treatment of Chlamydia trachomatis in pregnancy. Am J Obstet Gynecol. 1994;170(3):829–32.PubMedCrossRefGoogle Scholar
  42. 42.
    Ridgway GL. Treatment of chlamydial genital infection. J Antimicrob Chemother. 1997;40(3):311–4.PubMedCrossRefGoogle Scholar
  43. 43.
    Westrom L, Joesoef R, Reynolds G, et al. Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic result. Sex Transm Dis. 1992;19:185–92.PubMedCrossRefGoogle Scholar
  44. 44.
    Buchan H, Vessey M, Goldacre M, Fairweather J. Morbidity following pelvic inflammatory disease. Br J Obstet Gynaecol. 1993;100:558–62.PubMedCrossRefGoogle Scholar
  45. 45.
    Haggerty CL, Schulz R, Ness RB, PID Evaluation and Clinical Health Study Investigators. Lower quality of life among women with chronic pelvic pain after pelvic inflammatory disease. Obstet Gynecol. 2003;102:934–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Golden MR, Whittington WL, Handsfield HH, et al. Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection. N Engl J Med. 2005;352(7):676–85.PubMedCrossRefGoogle Scholar
  47. 47.
    Ryan Jr GM, Abdella TN, McNeeley SG, et al. Chlamydia trachomatis infection in pregnancy and effect of treatment on outcome. Am J Obstet Gynecol. 1990;162(1):34–9.PubMedCrossRefGoogle Scholar
  48. 48.
    Cohen I, Veille JC, Calkins BM. Improved pregnancy outcome following successful treatment of chlamydial infection. JAMA. 1990;263(23):3160–3.PubMedCrossRefGoogle Scholar
  49. 49.
    Todd CS, Jones RB, Golichowski A, Arno JN. Chlamydia trachomatis and febrile complications of postpartum tubal ligation. Am J Obstet Gyncol. 1997;176:100–2.CrossRefGoogle Scholar
  50. 50.
    National Institute of Allergy and Infectious Disease. Workshop summary. Scientific evidence on condom effectiveness for sexually transmitted disease (STD) prevention. National Institutes of Health, Department of Health and Human Services; 2001. Available from: http://www.niaid.nih.gov/about/organization/dmid/Documents/condomreport.pdf.
  51. 51.
    Centers for Disease Control and Prevention. Condoms and STDs: fact sheet for public health personnel, National Center for HIV, STD and TB Prevention; 2011. Available from: www.cdc.gov/condomeffectiveness/latex.htm.
  52. 52.
    Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ. 2004;82:454–61.PubMedGoogle Scholar
  53. 53.
    Warner L, Stone KM, Macaluso M, et al. Condom use and risk of gonorrhea and chlamydia: a systematic review of design and measurement factors assessed in epidemiologic studies. Sex Transm Dis. 2006;33:36–51.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Obstetrics & Gynecology, Keck School of MedicineUniversity of Southern CaliforniaSanta MonicaUSA

Personalised recommendations