Recognition and Treatment of Chlamydial Infections
In mid-February, a deputy director of the Institute of Virology under the China's national CDC brought from Guangzhou to Beijing two lung tissues from a deceased SARS patient, the portion reserved for it in the first Nanfang Hospital autopsy. The samples were then divided into three parts one for Hong Tao, the CDC's chief virologist and also a CAE member, to conduct an electron microscope examination, one for the virolo-gist Li Dexin to run the polymerase chain reaction (or PCR) testing, and the third for the bacterium cultivation purpose. Hong Tao soon found chlamydia, a bacterium notorious for being the cause of a common sexually transmitted disease but less fatal, on an electron microscopy and concluded that chlamydia was the pathogen of the atypical pneumonia. The Chinese CDC then held a press conference on February 18, during which the Director Li Liming announced Hong's discovery. Because Hong is an elite CAE member and authority of virology and possesses resources, the...
What causes arterial inflammation in the first place A possible contender is Chlamydia pneumoniae, a bacterium that can cause pneumonia, bronchitis, and sinus infections. C. pneumoniae routinely shows up in atherosclerotic plaques. In 2002, British researchers showed that five weeks of antibiotic therapy improved blood vessel function in people with angina who also had this bacterium in their blood.
This type of pneumonia is caused by a newly recognized strain of chlamydia. Chlamydial pneumonia is the second leading cause of pneumonia in children over age five, after mycoplasma pneumonia. Most infections in children are mild, and recovery is slow but complete the cough may last two or more weeks. Patients are infectious as long as they cough, and antibiotics do not reduce the infectious period. While one attack conveys a short-term immunity, it is possible to get chlamy-dial pneumonia more than once. Cause This type of pneumonia is caused by a tiny organism (Chlamydia pneumoniae) similar to both viruses and bacteria that live within human cells. Because it responds to antibiotics, it is classified as a bacterium. It is related to the germ that causes the sexually transmitted disease Chlamydia.
Instead of adhesive pili and Hia, the majority of nontypable H. influenzae isolates produce two alternate adhesins high molecular weight surface-exposed proteins called HMW1 and HMW2. These two adhesins share significant sequence identity with each other and are similar to filamentous hemagglutinin (FHA), an adhesin and colonization factor expressed by Bordetella pertussis. HMW1 and HMW2 have distinct adhesive specificities and may function at different steps in the infection process. The receptors for the HMW adhesins appear to be negatively charged gly-coconjugates that have not yet been completely defined. Nontypable H. influenzae encodes several other adhesive factors, including two Hsp-70-related proteins, which can mediate bacterial binding to sulfoglycolipids. Interestingly, other heat shock proteins have been implicated in the adherence of other microbial pathogens including Helicobacter pylori, Mycoplasma, and Chlamydia trachomatis.
Both innate and acquired host antimicrobial defense systems are operative on skin. Humoral and cell-mediated immune responses derive from Langerhans cells, keratinocytes, and endothelial cells that produce cytokines and lymphocytes. The skin-associated lymphoid tissue forms a protective barrier that can capture virtually any antigen that enters the skin. IgA and IgG antibodies are secreted by the eccrine sweat glands and are spread over the skin surface where they can exhibit antimicrobial effects and interfere with microbial adherence. The immunological factors important in the lower genital tract have been reviewed by Bulmer and Fox (18). Cervical mucus contains antibodies, in particular, secretory IgA, which are bactericidal in the presence of lysozyme and complement and can agglutinate bacteria and opsonize them for phagocytosis. Circulating antibodies to specific microorganisms can be demonstrated to result from many genital infections, but there is scant evidence of any...
Chlamydia The most common sexually transmitted disease (STD) in the United States, infecting more than 4.5 million people each year. It is a serious but easily cured disease that is three times more common than gonorrhea, six times more common than genital herpes, and 30 times more common than syphilis. Between 1988 and 1992, the rate of reported cases of chlamydia more than doubled. sexually active teens have high rates of chlamydia infections. The organism that causes chlamydia (Chlamydia trachomatis) is classified as a bacterium, even though it is similar to a virus. It is a parasite that like a virus cannot reproduce outside living cells, but it is enough like bacteria to be vulnerable to antibiotics. Most girls experience no symptoms at all but even if a girl has no symptoms, she can infect her sex partner. About 20 percent notice a heavy, yellow vaginal discharge. If chlamydia affects the urinary tract, there may be pain, burning, or a frequent urge to urinate.
Medical issue best resolved by the relevant medical authorities. In early February 2003, a team of Beijing experts led by Deputy Health Minister Ma Xiaowei visited Guangdong to understand more about the disease.17 In mid-February 2003, the Director of the Chinese Center for Disease Control and Prevention Li Liming was reported to have said that pneumonia was common and recurrent during the winter-spring period and could be attributed to many causes, and in this instance the causative agent was considered to be a curable disease. He further gave the assurance that there was no cause for panic.18 In fact, one of the early findings by the Chinese Center for Disease Control and Infection, in collaboration with the Guangdong Center for Disease Control and Prevention, was that the cause of the outbreak was Chlamydia, a sexually-transmitted disease.19 This was later found to be untrue.
Cream, spermicidal Like spermicidal jelly, foams, and vaginal suppositories, spermicidal creams are a form of birth control that are really designed for use with a barrier such as a diaphragm, cervical cap, or intrauterine device (IUD). Like jellies and vaginal suppositories, creams can be used for extra protection with a condom. Creams come in a tube with a plastic applicator. While jellies are clear, creams are white. Like condoms and jellies, creams are available without prescription at most drugstores. Deposited just outside the entrance to the cervix at the top of the vagina, cream keeps sperm from entering the cervix and kills them as well. Like jellies, creams increase protection against gonorrhea and chlamydia.
In eukaryotic cells large portions of genomes are rendered transcriptionally inactive by heterochroma-tinization, a local DNA compaction that is readily observed by light microscopy. Bacterial chromosomes are too small for locally compacted regions to be seen consequently, we can only guess about their existence. However, evidence is accumulating that bacteria have systems that condense entire chromosomes. In Caulobacter crescentus two cell types exist swarmer cells and stalk cells. When a swarmer cell differentiates into the stalked form, the nucleoid changes from a compact to a more open structure, possibly reflecting an activation of the genome. In a second example, a histone H1-like protein in Chlamydia trachomatis probably causes chromosomal condensation during the conversion of the metabolically active reticulate body to the inactive, extracellular elementary body form. Another example occurs during sporulation in Bacillus. In this case the chromosome of the spore is bound with...
Crystalline surface layers identified on other pathogens of humans and animals, including species of Bacteroides, Brucella, Chlamydia, Cardiobacterium, Rickettsia, Wolinella, Treponema, Clostridium, and Bacillus, may be of similar functional relevance as virulence factors.
Furthermore, evidence for an involvement of an immune response towards heat shock proteins (HSPs) in the development of arteriosclerosis is accumulating (for a recent review, see 37 ). Heat shock proteins are among the most highly conserved protein families and are ubiquitously expressed in almost all mammalian tissues. In particular prokaryotic and human HSP60 share a high amino acid sequence homol-ogy ( 70 ). Immunologic cross-reaction between bacterial (e.g., Chlamydial) and human HSP60, which has been detected on the surface of stressed endothelial cells, might be involved in atherogenesis. Both, bacterial and human HSP60 signal through TLR4 and or TLR2 and lead to the activation of NF-KB-dependent proinflammatory gene targets 38-41 . Chlamydial HSP60 was shown to lead to human SMCs proliferation in a TLR4-dependent manner 41 . Nasal vaccination with mycobacterial HSP65 has been demonstrated to reduce inflammation and decrease atherosclerosis in aortic arches in LDL...
Gentamicin A broad-spectrum antibiotic of the aminoglycoside class that is derived from the fungi of the genus Micromonospora. Gentamicin is used to treat bacterial infections of the blood, central nervous system (meningitis), urinary tract, respiratory tract, digestive system, skin, bone, and soft tissue. In women living with HIV, gentamicin is used to treat PELVIC INFLAMMATORY DISEASE, a condition that develops when sexually transmitted infections such as chlamydia or gonorrhea are untreated. Gen-tamicin is available in a variety of forms, including topical cream, eye drops, ointment, and injectable solution. Gentamicin works by interfering with production of proteins in bacteria and ultimately kills them. It is relatively toxic compared to other antibiotics used for similar conditions and is used primarily when less toxic antibiotics are not effective or cannot be tolerated. Gentamicin works best when combined with drugs from other antibiotic classes. Standard gentamicin may be...
R-M systems are almost ubiquitous among prokary-otes. Over 3000 have been identified. The most complete documentation is that for Type II systems. This is a result of the many in vitro screens for sequence-specific endonucleases put to effective use in the search for enzymes with different specificities. The endonucleases identified include more than 200 different sequence specificities. Type II restriction enzymes have been detected in 12 of the 13 phyla of Bacteria and Archaea. The lack of representation in one phylum, Chlamydia, could result from a sampling bias, but it could reflect the fact that the available genomic sequences are from parasitic species that grow within eukaryotic cells.
Chk 1 See chokh mutant 2 Checkpoint kinases CHK1 and CHK2 3 Choline kinases 4 Carboxylterminal Src kinase homologous
Chlamydia Genus of minute prokaryotes that replicate in cytoplasmic vacuoles within susceptible eukaryotic cells. Genome about one-third that of E. coli. C. trachomatis causes trachoma in man C. psittaci causes economically important diseases of poultry. chloramphenicol An antibiotic from Streptomycetes venezuelae that inhibits protein synthesis in prokaryotes and in mitochondria and chloroplasts by acting on the 50S ribo-somal subunit. It is relatively toxic, but has a wide spectrum of activity against Gram-positive and Gram-negative cocci and bacilli (including anaerobes), Rickettsia, Mycoplasma and Chlamydia.
Although many microorganisms are phagocytosed and destroyed with comparable ease by macrophages, there are certain pathogens that parasitize macrophages and replicate within them (see Chapter 6). When the macrophage is activated, these intracellular pathogens may be inhibited or destroyed. Listeria, Salmonella, Brucella, Mycobacteria, Chlamydia, Rickettsia, Leishmania, Toxoplasma, Trypanosoma and Legionella pneu-mophilia have been found capable of invading and inhabiting non-activated macrophages (Nathan et al., 1980). Mycobacterium tuberculosis may release certain substances such as sulfolipids that interfere with fusion of primary lysosomes with phagosomes and thereby avoid exposure to the macrophages' lysosomal enzymes (Shurin and Stossel, 1978). Leishmania and Mycobacterium lepraemurium survive within secondary lysosomes despite exposure to lysosomal enzymes this may be due to the resistance of the microbial cell wall to the macrophages' degradative enzymes (Nathan et al., 1980)....
Pap smear screening The need for rigorous surveillance in HIV infection has given rise to the argument for routine Pap smear screening in HIVpositive women. At the time of screening, it is equally important to examine the vulva and vagina, culture the cervix for STDS (gonorrhea and chlamydia), and diagnose and treat any vaginitis present, including atrophic vaginitis. Management strategies also include liberal referrals for colposcopic evaluation, particularly for vulvar and vaginal lesions that cannot be definitively diagnosed, so that colposcopically directed biopsies can be obtained.
Doxycyclin Doxycycline Broad-spectrum tetracycline antibiotic used for treatment of chronic bronchitis, brucellosis, chlamydial, rickettsial and mycoplasma infections. Also used prophylactically for malaria in regions where the parasite is resistant to chloroquine and or pyrimethamine-sulfadoxine.
At the minimum, these diseases cause discomfort. Left untreated, some STDs can cause serious long-term health problems. For example, gonorrhea and chlamydial infections can cause pelvic inflammatory disease, infertility, and ectopic pregnancy. Several common STDs adversely affect pregnancy, resulting in spontaneous abortion, stillbirth, and premature delivery. Genital infections due to human papillomavirus are associated with cervical cancer, one of the most common cancers in women throughout the world today. Moreover a pregnant woman can pass an infection to her baby. Infections in newborns include syphilis, herpes, gonococcal conjunctivitis (an eye disease that can lead to blindness), and chlamydial pneumonia, an infection of the lungs that can develop into a chronic respiratory disease. The possibility that STDs act as cofactors to facilitate HIV spread was an important public health question in the 1990s. HIV has spread at a startling rate through heterosexual contact in some...
Topical microbicide An antibacterial or antifun-gal compound that can be applied directly to the lining of the vagina before intercourse to thwart sexually transmitted microbes that cause diseases such as gonorrhea, syphilis, genital herpes, chlamydia, hepatitis B, and HIV infections. Today, the development of safe, effective, female-controlled topical microbicides that will block the transmission of HIV and other STD agents is a global priority and a central focus of the STD research program of the National Institute of Allergy and Infectious Diseases (NIAID). The goal is to develop safe antimicrobial products that effectively fight a combination of infectious agents, whether they are viral, bacterial, or protozoan.
A limited number of wild-type gram-negative bacteria are viable without LPS. In the case of S. paucimobilis, no typical LPS is present in the outer membrane but, instead, the bacterium produces a glycosphingolipid-a modified ceramide derivative containing glucuronic acid and an attached trisaccharide. This lipid functionally replaces LPS in the formation of a stable outer membrane. In the case of N. meningitidis, mutants lacking the typical LOS-form are viable only if capsular polysaccharide is present and it is conceivable that the lipid anchor for this class of capsule partially replaces lipid A. However, there are other changes in outer membrane phospholipids and defects in expression of surface lipoproteins that may also help maintain viability. It is currently unclear whether this phenomenon extends beyond N. meningitidis. Perhaps the smallest wild-type LPS structure consists of only lipid A and a Kdo-trisaccharide, and is produced by members of the genus Chlamydia. Presumably,...
Trifluridine An antiviral used for topical treatment of infections caused by herpes simplex virus. In people infected with HIV, it has been used topically to treat skin, genital, and perianal HSV infections resistant to acyclovir. Trifluridine works by interfering with DNA synthesis in infected cells. It has been shown to be effective for treatment, but not prevention, of herpes virus infections. It is not effective against bacterial, fungal, or chlamydial infections. Available as a sterile solution for administration into the eyes. The most common effect of the optical solution is mild, transient burning when dropping it into the eye. Also called trifluo-rothymidine. (Trade name is Viroptic.)
It often bleeds when touched with a cotton applicator or cervical spatula. A purulent exudate is often observed. cervical cancer can also give this appearance. Most infectious cervicitis is due to sexually transmitted infection, often chlamydia, gonorrhea, or trichomonas. In HIVpositive women, viral infections may be isolated from cervical secretions and may cause local infections including cytomegalovirus, herpes simplex virus, and even HIV itself. All vaginal infections should be treated and followed up.
Given the excellent activity of a number of the new quinolones against S. pneumoniae, and the fact that they are equally potent against sensitive and penicillin- and macrolide-resistant S. pneumoniae 2 , these compounds have also been examined for their activity against other organisms important in respiratory tract infections. Like ciprofloxacin, essentially all the third- and fourth-generation quinolones exhibit excellent activity versus Haemophilus influenzae 2,43 and Legionella pneumophila 2,43-46 . The third- and fourth-generation agents that have been tested against Chlamydia pneumoniae, with the exception of temaflox-acin, exhibit improved activity over second-generation quinolones. Levofloxacin, trovafloxacin, and moxifloxacin are two- to fourfold more potent than earlier agents, while grepafloxacin, gatifloxacin, gemifloxacin, sitafloxacin, and spar-floxacin are the most active, with MIC90s as low as 0.03-0.06 g ml 43,47,48 . Overall, a number of these new agents are very...
A number of infectious agents have been associated with atherosclerotic cardiovascular disorders, including Chlamydia pneumoniae 47 , Helicobacter pylori 48 , cytomegalovirus (CMV) 49 , Epstein-Barr virus 50 , human immunodeficiency virus 51 , herpes simplex viruses (HSV)1 52 , HSV2 53 , and hepatitis B 54 and C 55 . More recent models emphasize the relationship of atherosclerosis to total infectious burden rather than specific pathogens 56 . The above mentioned infectious agents or derived PAMPs have been shown to signal through one or more TLRs (Fig. 2). Furthermore, the recently identified cytoplasmatic PRR NOD1 (nucleotide-binding oligomerization domain) has been proposed to be involved in Chlamydia and Helicobacter induced signal transduction 57, 58 . It is intriguing to
The essential features of the lipid A assembly pathway and its key enzymes appear to be conserved in different bacteria, although there are some subtle species-specific variations. There are clearly differences in the specificity of the acyltransferases and, in the family Rhizobium, phosphatases are required to generate the phosphate-free lipid A. Also, in Pseudomonas aeruginosa and N. meningitidis, the sequential dependence of the terminal steps in lipid A assembly (i.e. addition of Kdo to lipid IVA prior to full acylation) is not conserved. Some bacteria, for example, H. influenzae, have a monofunctional Kdo transferase, and the Chlamydia WaaA-homolog is trifunctional.
All of the fluoroquinolones are effective in single-dose treatment of uncomplicated urethral, anal, and oropharyngeal gonorrhoea 51 , although such regimes are ineffective for chlamydial disease. Ofloxacin for 7 days is reliably effective in chlamydial urethritis in men, although possibly less so in women, but there are little data on genital Mycoplasma infection. Preliminary data on trovafloxacin suggest high efficacy at low single doses in gonorrhoea 52 and, after multiple dosing, for chlamydial sexually transmitted diseases (STDs). However, fluoroqui-nolones are not indicated in syphilis, and results in bacterial vaginosis suggest only a secondary role.
Bartholin's duct A duct that drains one of the two Bartholin's glands, located at each side of the vaginal opening also called the ductus sublin-gualis major. cysts or abscesses may form in Bartholin's duct as a result of an acute infection such as gonorrhea or chlamydia and may become a recurrent or chronic abscess, secondary to obstruction in the duct. The cystic mass may be small or large, sterile or infected, asymptomatic or very tender. Treatment is with local heat or sitz-baths, along with a broad-spectrum antibiotic where purulence is noted.
Inclusion bodies within cells, often of virus particles, although this term is more common in the older literature. 2. Infectious extracellular form of Chlamydia, consisting of electron-dense nuclear material and a few ribosomes surrounded by a rigid trilaminar wall. Once taken up by cells, these reorganize into reticulate bodies.
Chlamydia, Spiroplasma Alteromonas i. Microviridae The genus Microvirus includes the phage X174 and related phages of enterobacteria and is characterized by large capsomers. Similar phages occur in so taxonomically distinct bacteria as Bdellovibrio, Chlamydia, and Spiroplasma.
Direct fluorescent antibody staining A type of medical test that is performed on a sample of tissue or fluid from a part of the body. It is used to test for legionella virus infection as well as chlamydia and syphilis infections. A swab of tissue from the patient is stained for fluorescence to see whether it matches the known fluorescence of the particular virus.
Tancy, frequency, or urgency new onset amenor-rhea intermenstrual bleeding or any change in menstrual pattern dyspareunia or bleeding following sexual activity. Periodic assessments generally include an interval sexual history, careful inspection of external genitalia, speculum examination, gonorrhea and chlamydia cultures, bimanual pelvic examination, microscopic wet mount, and VDRL. Tests are ordered as needed. Appropriate treatment plans are developed as needed. Client education is geared to the reasons for particular visits, but safe sex counseling should be reintroduced each time.
In addition to advancing age, factors that increase the risk of developing dementia are a family history of Alzheimer's disease, possession of the e4 ApoE allele (a genetic variant that increases the risk of Alzheimer's disease), traumatic brain injury, and exposure to toxic substances. Some new research suggests a causal role for certain types of viral infections, including herpes simplex virus type 1 and chlamydia, but these findings remain highly controversial.
The treatment of gonococcal infection has changed over the past decades due to the development of partial or complete resistance of this organism to many antibiotics. The list of recommendations proposed by the Centers for Disease Control (CDC) in 1993 take into account the need to treat this disease at the time of the clinic visit with a single dose because many patients are not compliant with regimens that require repeated administration of the medication. In addition, coinfection with Chlamydia trachomatis is a very common occurrence, and the treatment should also eliminate this organism.
While it may not have an obvious cause, PID often occurs from an untreated sexually transmitted disease such as gonorrhea or chlamydia. It also may occur after childbirth, abortion, or miscarriage. Young, sexually active girls and those who use the intrauterine birth control device are at higher risk.
Pneumonia can be caused by viruses, mycoplasmas, cocci, protozoa, bacilli, chlamydia, fungi, and rickettsiae, as well as by oil aspiration, radiation, chemicals, vegetable dusts, infections associated with silo-filler's disease, and chemical irritants. There are more than 50 potential causes.
Severe acute respiratory syndrome (SARS) is a respiratory disease newly identified in this century. The outbreak was officially recognized by the World Health Organization (WHO) in Vietnam in February 2003.6 Further investigations revealed that the outbreak was first started in Guangdong Province, China, in November 2002.7 Subsequent to its introduction to Hong Kong in mid-February 2003, the virus spread across Vietnam, Singapore, Canada, and elsewhere. In the early stage of the SARS pandemic, several pathogens were claimed to be the causative agents. Pathogens like chlamydia and paramyxoviruses were reported to be isolated from some SARS patients.6 The documentation of two human H5N1 influenza cases in February 2002 in Hong Kong also suggested the possibility of the emergence of a pandemic avian influenza virus in humans. On 17 March 2003, an international collaborative research network was set up by WHO to investigate the cause of SARS. By the end of March, colleagues from three...
Prostaglandins (substances that cause the contractions of the uterus and fallopian tubes and are thought to aid in the sperm's passage to the womb), vitamin C, zinc, cholesterol, and a few other elements. Healthy semen, in other words, does not contain anything that is harmful to health. In the age of AIDS, however, it is important to remember that, along with blood and vaginal secretions, semen is one of the primary carriers of HIV (it can also carry the organisms that cause GONORRHEA, HEPATITIS B, and CHLAMYDIA, among other illnesses). Use of condoms and vaginal spermicidal cream or jelly can reduce women's chances of acquiring the virus during sexual intercourse use of condoms can reduce men's chances also. Treating gonorrhea, chlamydial infections, trichomonas, and other sexually transmitted diseases in HIV-infected men significantly reduces the amount of HIV in semen. It does not, however, eliminate HIV completely, so bareback activities should not be performed even when on haart...
The advent of genomics should greatly improve our understanding of bdellovibrio biology and thereby its relation with the environment. Looking at the metabolic properties of this particular microbial predator, a few comparisons with other organisms can already be drawn transport of exogenous phosphorylated nucleo-sides, sometimes accompanied by a marked reduction in de novo nucleotide biosynthesis capabilities, has been shown in intracellular parasites of eucaryotic cells such as Rickettsia, Mycoplasma and, Chlamydia (Stephens et al., 1998 Fraser et al., 1995 Moulder, 1991). This type of adaptation points to converging pheno-typic evolution between intracellular parasites, although the biochemical mechanisms widely differ. Similarly, it will be possible to assess the dynamics of genome evolution and reduction by looking for missing genes and for the ones pointing to the particular lifestyle of this organism when the Bdellovibrio genome becomes available. Moulder, J.W. 1991....
The epidemiological association with HPV has been controversial. Studies investigating this hypothesis (most of which examined a limited number of viral subtypes) have produced mixed but mostly negative results (37,38). Laser or cryogenic treatment for prior HPV also has been suggested as a possible precipitating factor for VVS. Recent case-control studies utilizing physician-reported diagnoses found no increased risk associated with prior HPV infection, genital warts, chlamydia, genital herpes, or gonorrhea (34). Emerging data on host factors, such as reduced immune cell function (30-32) and genetic susceptibility to chronic inflammation (27-29), support the hypothesis that either bacterial or viral infections, or other potential inflammatory triggers (exposure to noxious chemicals, laser treatment, semen allergy), may play a role in VVS pathogenesis.