不孕症与沙眼衣原体

女性沙眼衣原体感染是发病率最高的性感染性疾病,由于沙眼衣原体感染引起输卵管炎及盆腔炎,是导致输卵管性不孕症的重要原因,本文将近年来由沙眼衣原体感染导致的不孕症病理、诊断、治疗的现状加以总结.     

不孕症与沙眼衣原体

女性沙眼衣原体感染是发病率最高的性感染性疾病，由于沙眼衣原体感染引起输卵管炎及盆腔炎，是导致输卵管性不孕症的重要原因，本文将近年来沙眼衣原体感染导致的不孕症病理、诊断、治疗的现状加以总结。     

妊娠期沙眼衣原体感染

阴道分娩时沙眼衣原体传播给胎儿可致结膜炎和肺炎;妊娠期沙眼衣原体感染可能与某些并发症如早期破膜、早产、低出生体重和死产有关。沙眼衣原体感染也可能与流产后、剖宫产后和产后母体感染有关。美国疾病控制中心(CDC)推荐采用新的筛查和治疗方案,有利于预防新生儿病率。     

不孕症与沙眼衣原体

沙眼衣原体感染是发病率最高的性传播疾病,发病人数逐年增加。因沙眼衣原体感染引起输卵管炎及盆腔炎可致不孕症,预防及早期发现沙眼衣原体感染对减少不孕症的发生意义重大。沙眼衣原体感染症常无任何症状而呈慢性经过。首先引起宫颈管局部充血、水肿、粘液性分泌物增多,分泌物中可见多形核白细胞,此时,自觉症状轻微或无症状。如未治疗,感染可向上蔓延引起子宫内膜炎、输卵管炎、附件炎和盆腔炎。整个过程可无发热、腹痛、带下等症状。 诊断方法:①检测沙眼衣原体抗原:阳性率低,不能诊断宫颈以上部位的感染。但沙眼衣原体抗原阳性者输卵管粘连阻塞导致不孕的可能性很大。检查子宫内膜、输卵管、盆腔内有无感染,需检查沙眼衣原体抗体。②检测沙眼衣原体     

宫颈感染的抗生素应用

宫颈感染是常见的女性下生殖道感染,主要病原体为淋病奈瑟菌与沙眼衣原体。大部分患者无症状,但不及时诊治则可引起上生殖道感染。因此,对可疑宫颈感染患者应行淋病奈瑟菌与沙眼衣原体等病原体检测,依据美国疾病控制中心性传播疾病诊治规范及《中国宫颈炎诊治专家共识》,根据抗菌谱行规范化的诊断和治疗。     

沙眼衣原体感染致输卵管性不孕的研究进展

沙眼衣原体是最常见的性传播疾病的病原体之一。女性生殖道沙眼衣原体感染直接影响女性的生殖健康,并对优生优育构成危害,患者感染后常因无症状而未能及时接受治疗。持续性CT感染可引起输卵管损害,导致输卵管性不孕等严重后果。本文就沙眼衣原体的病原生物学特征,CT感染致输卵管性不孕不育的机制,女性生殖道CT感染症状、检测和治疗做一综述。     

女性泌尿生殖道沙眼衣原体感染

在许多国家和地区的性传播疾病中,沙眼衣原体感染的发病率和危害性已远超过淋球菌感染而居首位,成为严重的健康和社会问题。本文简述了近年来有关女性泌尿生殖道沙眼衣原体感染的各种临床综合征、实验室诊断以及治疗等方面的研究进展。     

沙眼衣原体、解脲支原体感染与男性不育

目的:了解沙眼衣原体、解脲支原体感染患者精子密度、活率和抗精子抗体的变化及其对生育影响。方法:选取沙眼衣原体、解脲支原体感染男性不育患者50例,测定其抗生素治疗前后的精液常规参数和抗精予抗体,进行动态分析和统计学比较。结果:治疗后精子密度。精子活率显著提高,畸形率和抗精子抗体滴度明显降低。结论:沙眼衣原体、解脲支原体感染从多方面影响男性生育能力。     

女性泌尿生殖道沙眼衣原体感染临床诊断方法

目前女性泌尿生殖道沙眼衣原体(chlamydia trachoma-tis,CT)感染,已成为威胁女性健康的严重问题,沙眼衣原体感染发病率逐年增高,实验检查诊断衣原体感染技术不断改进,目前有培养,抗原检测,核酸探针杂交,聚合酶链反应(polymerase chain reaction,PCR),以及在PCR基础上发展起来的LCR(ligase chain reaction),敏感性特异性更高,是女性CT感染检测的较好方法。一、女性泌尿生殖道沙眼衣原体感染的发病概况沙眼衣原体为专性细胞内寄生的原核细胞型微生物,可分为18个血清型,其中D-K血清型主要引起泌尿生殖道感染。CT在发达国家是最常见的性…     

妊娠与沙眼衣原体感染

沙眼衣原体 (ｃｈｌａｍｙｄｉａｔｒａｃｈｏｍａｔｉｓ ,ＣＴ)是引起女性生殖器官感染的常见病原体 ,孕妇是沙眼衣原体感染的特殊人群。近年来妊娠合并沙眼衣原体感染的发病率有逐渐上升的趋势 ,现就沙眼衣原体生物学特征、感染后临床表现及对母儿的影响、母婴传播途径以及诊治方法进行综述如下。1　沙眼衣原体的生物学特征沙眼衣原体是革兰氏染色阴性的原核细胞型微生物 ,含ＲＮＡ和ＤＮＡ ,有完整的细胞壁 ,按二分裂方式繁殖。沙眼衣原体虽有酶系统可进行一定的代谢活动 ,但是缺乏ＡＴＰ酶 ,因此必须寄生在宿主细胞内 ,利用感染细胞的能…     

Urine gonococcal/Chlamydia testing in adolescents

PURPOSE OF REVIEW: This review will highlight the recent literature findings regarding urine-based Chlamydia and gonorrhea testing in adolescents. RECENT FINDINGS: Rates of Chlamydia trachomatis are increasing, likely due to increased detection efficiency, but have not yet begun to decrease. Neisseria gonorrhoeae is at an all-time low. Urine-based testing for sexually transmitted infections is readily available and convenient but underutilized. Interesting approaches to a more universal screening program, including self-collected, mail-in urine samples, have been shown to be effective. SUMMARY: In spite of recommendations urging universal screening for C. trachomatis and N. gonorrhoeae and the availability of highly accurate and convenient tests, screening rates for adolescents and young adults remain below the universal recommendations. Strategies to improve screening rates should take advantage of urine-based screening methodologies for sexually transmitted infections because of their cost-effectiveness as well as the convenience for patient and provider.     

Chlamydia trachomatis infections: implications for pregnant adolescents and their infants

Objective: Chlamydia trachomatis infections are common in pregnant adolescents. Previous studies have shown that treating pregnant women of all ages with erythromycin prevents transmission of this infection to their infants. However, there are no published studies on the efficacy of aggressive screening and treatment of C. trachomatis in pregnant adolescents. This study was undertaken to determine if aggressive screening for C. trachomatis in pregnant adolescents and early treatment with erythromycin can prevent complications in their newborn infants.Methods: A group of pregnant adolescents enrolled at Teen Pregnancy Service of Milwaukee was evaluated prospectively for the presence of C. trachomatis infection. Screening was performed during the 1st and 3rd trimesters by enzyme immunoassay. Adolescents with positive enzyme immunoassays for Chlamydia were treated with erythromycin for 10 days. Those with negative enzyme immunoassays were enrolled as controls. All infants born to adolescents in both groups were followed for episodes of conjunctivitis, pneumonia, and wheezing during their 1st year of life.Results: Ninety mother/infant pairs were followed during the study period. Twenty-eight mothers (31%) had positive enzyme assay tests and all received erythromycin therapy. Nasopharyngeal cultures were obtained from 60 (67%) infants; all were negative. There were no significant differences in general characteristics, development of conjunctivitis (relative risk 1.27), wheezing (relative risk 0.91), or pneumonia (relative risk 1.12) between infants born to adolescents in either group.Conclusions: We conclude that aggressive screening and treatment of C. trachomatis infection in pregnant adolescents may prevent complications in their offspring.     

沙眼衣原体感染与妊娠

沙眼衣原体是目前感染率最高的性传播性疾病病原体,为引起妊娠期下生殖道感染的重要病原体。因其感染常呈亚临床状态,实验室检测对设备及技术要求高,临床医师相关知识欠缺,以及缺乏充足条件筛选高危人群并进行追踪治疗性伴侣,其潜在危害十分重大。妊娠期沙眼衣原体感染对妊娠有诸多不良影响：病原体本身造成的损伤机制及其引发的免疫反应是造成流产、胎儿生长受限、胎儿窘迫、胎膜早破、早产、低出生体质量儿、死胎、宫内感染、新生儿感染、产褥期感染和产后出血的原因之一。因此,有针对性地及时检查和治疗沙眼衣原体感染是降低母婴病率,提高围生期保健质量的重要举措。     

Screening for Chlamydia Trachomatis at a University Health Service

Chlamydia trachomatis is the most common sexually transmitted infection in the United States. The aim of this study was to determine the prevalence of Chlamydia in college family planning patients and to identify diagnostic indicators associated with Chlamydia. A thorough history and physical examination was performed, including culture for gonorrhea, cancer (papanicolaou test), and Chlamydia trachomatis. Chlamydia occurred in 12.6% of 419 subjects. The lack of signs and symptoms and the possibility of inaccurate historical data limit the clinical predictability of chlamydial infections. Routine screening of college women is recommended.     

Chlamydial conjunctivitis (in adults), uveitis,and reactive arthritis,including SARA. Sexually acquired reactive arthritis

This chapter deals with Chlamydia -induced ocular and rheumatic diseases of the adult. All of these may follow a primary urogenital infection with Chlamydia trachomatis in genetically predisposed patients. Besides the infection with Chlamydia trachomatis, infections with Chlamydia pneumoniae and Chlamydia psittaci are also discussed as possible causative agents. Chlamydial conjunctivitis is frequently a secondary infection, and the organism is transferred from the urogenital tract to the eye by autoinoculation. Uveitis and reactive arthritis are believed to be triggered - among other infections - by a preceding urogenital infection. Both of them are closely associated with HLA-B27 positivity. The simultaneous occurrence of uveitis and reactive arthritis is termed Reiter's syndrome.We report on clinical characteristics, diagnosis and the role of Chlamydia in the pathogenesis of chlamydial conjunctivitis, uveitis and reactive arthritis as well as on the currently recommended treatment regimens.     

Prevalence of Chlamydia trachomatis in the pregnant cervix

To determine the prevalence of infection and colonization with Chlamydia trachomatis in pregnant women of low socioeconomic status, 363 women (age range 15 to 48 years; median age 24) were screened. Cultures for C trachomatis were obtained prospectively. Chlamydia trachomatis was recovered from 16.8% of the patients. The incidence of infection ranged from 18.4% in the group age 15 to 19 through 13% in the group age 30 to 39, to 0% in the 40 and older group. Thus, in the population studies, C trachomatis was found more commonly in the younger age groups. The high isolation rates seen suggest that routine screening and treatment may be warranted to prevent spread of C trachomatis infections to sexual partners and neonates.     

Leukorrhea and bacterial vaginosis as in-office predictors of cervical infection in high-risk women

OBJECTIVE: To evaluate 1) whether microscopic detection of leukorrhea or bacterial vaginosis identifies patients at high risk for cervical infection with Chlamydia trachomatis or Neisseria gonorrhoeae, and 2) if pregnancy alters the predictive value of these findings. METHODS: Wet-mount screening examination of vaginal discharge was performed on all new patients seen at two resident-staffed clinics serving primarily indigent women. Leukorrhea was defined as >10 white blood cells per high-power field on microscopic examination; Amsel criteria were used to determine the presence of bacterial vaginosis, with a positive clue cell test result defined as >20% of epithelial cells. The diagnoses of C trachomatis and N gonorrhoeae infection were established by deoxyribonucleic acid amplification tests. RESULTS: The study population consisted of 194 women, 118 (61%) of whom were pregnant. Overall, 11% of women had positive cultures for chlamydia or gonorrhea. Although both leukorrhea and clue cells were independently associated with positive cervical cultures, multivariate analysis found that clue cells did not contribute to the predictive value of leukorrhea alone among both pregnant (relative risk [RR] = 15.7) and nonpregnant (RR = 58.7) women. Negative predictive values for the screening test were comparably high (98-100%), independent of pregnancy status. CONCLUSION: Leukorrhea, in the presence or absence of bacterial vaginosis, was strongly associated with cervical infections with C trachomatis or N gonorrhoeae among both pregnant and nonpregnant patients. In settings where patient follow-up is uncertain, on-site screening tests identify women for whom empiric antibiotic therapy for sexually transmitted diseases may be appropriate.     

The frequency of Chlamydia detection in gynecologic and obstetrical patients and newborns

Chlamydia trachomatis is said to play an important role in the pathogenesis of gynecologic, perinatal and neonatal infectious morbidity. Chlamydia trachomatis is responsible for several infectious syndromes in non-pregnant women, mothers and their offspring. We investigated the incidence of Chlamydia trachomatis in 353 non-pregnant and pregnant women without complaints and in 50 newborn. Chlamydia trachomatis was isolated from 6% of genital carcinoma, about 20% of different gynecological diseases and pregnant women within the first and third trimenon, 35% of puerperas and 10% of newborns. The prevalence of Chlamydia trachomatis antibody occurred in 34 to 55% of the non-pregnant and pregnant women and in 38% of the newborns. We propose a screening for Chlamydia trachomatis infection in high-risk patients and in pregnancy and a treatment of infected individuals.     

Chlamydien ― häufigste Sterilitätsursache der Frau

Chlamydia trachomatis is the most common cause of female infertility. The life time risk of aquiring a C. trachomatis infection is about 15% for women in Germany. More than 25% of all in vitro fertilisation patients are childless because of a former genital chlamydial infection. In these cases, direct detection by nucleic acid amplification tests (NAATs) almost always shows negative results, and positive C. trachomatis specific serology is the only test that indicates the cause. Approximately 1–2% of all German women suffer from tubal occlusion due to genital chlamydial infection. Chlamydia persist in the urogenital tract for years and can only be detected with sufficiently sensitivity by NAATs. Incidence can only be reduced by the general screening of young women and men using NAATs. Broadly based information campaigns for young people are a prerequisite for successful screening.     

Food for thought in women's health. The gynecologist: the new European gatekeeper in Chlamydia trachomatis infection

Genital Chlamydia trachomatis infection is the principal cause of bacterial sexually transmitted disease in industrialized countries. A wide spectrum of pathologic conditions has been associated with the disease ranging from urethritis, cervicitis, to pelvic inflammatory disease, ectopic pregnancy, tubal infertility and cervical neoplasia. Screening for genital Chlamydia infection may prevent its serious complications. The need of a comprehensive European screening policy has been recently underlined by PACMeR's scientific committee. Anyhow invitational screening programs are only at the beginning. Chlamydia trachomatis control 'orphan' and women's health at risk. Until organized programs are developed, implementation of opportunistic screening is mandatory. Since the infection is more commonly observed among juvenile females proper testing of the young women is recommended. As asymptomatic young women in reproductive age are more eager to visit gynaecologists for periodical gynaecological examination and councelling (cervical cytology, breast examination, contraception and family planning), gynaecologist represents the only specialist able to provide early diagnosis of Chlamydia trachomatis. Gynaecologists are called to play a new role in public healthcare, being 'gatekeepers' for the early detection of the disease, emphasizing their crucial part in young women's health.