Chlamydia trachomatis (chlamydia trachomatis)

At present, 14 serovars of the biovar Chlamydia trachomatis (chlamydia trachomatis) are known, which cause more than 20 nosological forms:

• serovars A, B, B1, C cause trachoma and conjunctivitis with intracellular inclusions;
• serovars D, G, H, I, J, K cause urogenital chlamydia, conjunctivitis, pneumonia of newborns, Reiter's syndrome;
• serovars L1, L2, L1a, L2a - cause venereal lymphogranuloma.

[1], [2], [3], [4], [5], [6], [7], [8], [9],

Trachoma

Trachoma is a chronic infectious disease characterized by affection of the conjunctiva and cornea, resulting, as a rule, in blindness. When trachoma (from the Greek trachys - rough, uneven) the surface of the cornea looks uneven, tuberous as a result of granulomatous inflammation,

Pathogen trachoma Chlamydia trachomatis (chlamydia trachomatis) was discovered in the cells of the cornea in 1907 S. Provatsek and L. Halbersthtelter, who proved the contagiousness of the disease by infecting orangutans with material from scrapings of the conjunctiva of a sick person. The bacterium is found in the cytoplasm of the cells of the conjunctival epithelium in the form of inclusions Provacek-Halbersthtelter body.

Epidemiology of trachoma

Trachoma - anthroponosis, transmitted by contact-household way (through the hands, clothes, towels). Susceptibility is high, especially in childhood. Foci of the disease are identified. Trachoma is a disease of an endemic nature. The disease occurs in Asian, African countries. Central and South America with a low standard of living and sanitary culture of the population.

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Pathogenesis and trachoma symptoms

The causative agent in the form of elementary bodies penetrates through the mucous membranes of the eyes and multiplies intracellularly. The follicular kerato-conjunctivitis develops, which progresses over many years and ends with the formation of scar connective tissue, which leads to blindness. Often the conditionally pathogenic flora is activated, as a result of which the inflammatory process acquires a mixed character.

Immunity after a previous illness is not produced.

Microbiological diagnosis of trachoma

To diagnose trachoma, scrapings from the conjunctiva are examined. Preparations are stained according to Romanovsky-Giemsa, while cytoplasmic inclusions of violet color with a red center, located near the nucleus Provacek-Halberstelter's body, are found in the smears.

RIF and ELISA are used to detect the antigen.

It is possible to isolate the pathogen in a cell culture in vitro. McGoy, HeLa-229, L-929, and other cultures are used for shining purposes.

Treatment of Trachoma

Antibiotics of the tetracycline group, interferon inducers and immunomodulators are used.

Prevention

Specific prophylaxis of trachoma is not developed. It is important to comply with personal hygiene measures and improve the sanitary and hygienic culture of the population.

Urogenital chlamydia (non-gonococcal urethritis)

Urogenital chlamydia (non-gonococcal urethritis) is an acute or chronic sexually transmitted disease affecting the genitourinary system, characterized by a slow course with the subsequent development of infertility.

Chlamydia trachomatis, serovars DK, in addition to the pathology of the urogenital tract, can cause eye damage (conjunctivitis with inclusions), as well as Reiter's syndrome.

Epidemiology of urogenital chlamydiosis

Urogenital chlamydia is anthroponous infection, the source of infection is a sick person. The path of infection is contact, predominantly sexual. Possible contact-household way (in such cases, develops family chlamydia), as well as infection if it gets on the mucous membrane of the eyes during bathing (conjunctivitis of swimming pools).

The disease is very common (up to 40-50% of all inflammatory diseases of the genitourinary system, the system is caused by chlamydia ), but may remain unrecognized (in 70-80% of cases the infection is asymptomatic).

[14], [15], [16], [17], [18]

Pathogenesis and symptoms of urogenital chlamydiosis

Chlamydia trachomatis (chlamydia trachomatis) affects the epithelium of the mucosa of the urogenital tract. In men, the urethra is primarily infected , in women - the cervix. In this case, there may be a slight itching, mucopurulent discharge. In the future there is an ascending infection. As a result of inflammatory processes, male and female infertility develops.

Chlamydia occur as an infection, in association with gonococci and other pathogenic and opportunistic pathogens. Infection of the pregnant woman is a danger for both the mother and the fetus: premature birth, postpartum complications, neonates may have conjunctivitis, meningoencephalitis, sepsis, pneumonia. Possible infection when passing a child through the birth canal of an infected mother.

Along with the damage to individual organs for chlamydia, systemic manifestations are also characteristic (Reiter's syndrome). It is characterized by damage to the genitourinary organs (prostatitis), eye disease (conjunctivitis) and joints (arthritis). The disease proceeds with remissions and repeated attacks. The development of the disease is associated with chlamydial antigens, which provoke immunopathological processes in genetically predisposed individuals (70% of cases have histocompatibility antigen HLA B27).

Immunity after the transferred infection is not formed. In the blood of infected people, specific antibodies are found that do not have a protective function.

Microbiological diagnosis of urogenital chlamydiosis

The material for the study is scrapings from the epithelium of the urethra, cervical canal, conjunctiva. A microscopic method of investigation is possible - the preparations are stained by Romanovsky-Giemsa and Gram. With the help of RIF and ELISA, antigens of chlamydia are determined in the test material. Complex definition of immunoglobulins of classes M, G, A in RNGA ,. RIF and ELISA is the most reliable method and allows you to determine the stage of development. Used PCR and DNA hybridization method. When the urogenital tract is affected, cultivation of the pathogen on cell cultures is used.

Treatment of urogenital chlamydiosis

Apply antibiotics tetracycline, macrolides, fluoroquinolones for a long time (14-21 stumps), as well as preparations of interferon, inducers of interferon and immunomodulators.

Prophylaxis of urogenital chlamydiosis

Specific prophylaxis of urogenital chlamydiosis has not been developed. Important measures are nonspecific prevention of sexually transmitted diseases, timely detection and rehabilitation of patients with urogenital chlamydia.

Venereal lymphogranuloma

Venereal lymphogranuloma is a disease characterized by affection of genital organs and regional lymph nodes and symptoms of infection generalization. The disease is caused by Chlamydia trachomatis (chlamydia trachomatis), serovars L1, L2, L1a, L2a

Epidemiology of venereal lymphogranuloma

The source of the infection is a sick person. The path of battle is contact-sexual, much less often contact-household. Infection is endemic in countries with a hot climate - in East Asia, Central and South America, single cases are found everywhere. The susceptibility of the population is elevated.

[19], [20], [21], [22], [23]

Pathogenesis and symptoms of venereal lymphogranuloma

The entrance gates of infection are the mucous membranes of the genital organs, where chlamydia multiply. On the genitals appear sores. Then the microbes penetrate into the regional (usually inguinal) lymph nodes. Inflamed lymph nodes are opened with the formation of fistulas with purulent discharge. A few months later, there are destructive changes in the surrounding tissues - abscesses of the rectum.

Immunity

After the transferred disease there is a strong immunity.

Microbiological diagnosis of venereal lymphogranuloma

The material for the study is pus from buboes, a biopsy of affected lymph nodes. Conduct a microscopy of smears-prints, isolate the pathogen on cell cultures and in chick embryos. Serologic method is used to determine antibodies in the microimmunofluorescence reaction. With the help of an allergic test, the presence of HRT to the antigens of the pathogen is established (Frey's intradermal test).

Treatment of venereal lymphogranuloma

Antibiotic therapy with tetracycline drugs and macrolides.

Prophylaxis of venereal lymphogranuloma

Specific prophylaxis of venereal lymphogranuloma has not been developed, measures of nonspecific prevention of sexually transmitted infections are important.