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lecture29-chlamydia-131112214406-phpapp01.pdf

  1. 1. ‫الرحيم‬ ‫الرحمن‬ ‫ا‬ ‫بسم‬ ‫الرحيم‬ ‫الرحمن‬ ‫ا‬ ‫بسم‬ GENUS: CHLAMYDIA Prof. Khalifa SifawGhenghesh
  2. 2.  Small Gram-negative bacteria (Stain poorly with Gram’s stain)  Like Bacteria  Have both DNA and RNA, Ribosomes, a Cell wall, and Divide by Binary fission  Like Viruses  Obligate intracellular parasites  Differ from Bacteria  Have no peptidoglycan in their cell wall  Can not produce their own ATP  Require to use host ATP (Energy parasite)
  3. 3. Chlamydia species  C. trachomatis  3 biovars  Those causing trachoma and inclusion conjunctivitis (TRIC)  Those causing lymphogranuloma venereum (LGV)  The one causing mouse pneumonitis (MoPn)  C. psittaci > Infect both mammals and birds  C. pneumoniae > both humans and animals  C. pecorum > Some infect mammals
  4. 4.  Trachoma biovars  14 Serovars: A-K  Serovars A, Ba, B, C  Classic trachoma  Serovars D-K  Inclusion conjunctivitis and Genital infections  LGV biovars  3 Serovars: L1, L2, L3
  5. 5.  Can be stained with Giemsa stain  Elementary body (EB)  Extracellular, infectious metabolically inert form of chlamydiae  Reticulate body (RB)  Intracellular, non-infectious, metabolically active particle
  6. 6. Infection to Humans  Ocular infection  Trachoma > in countries where sanitation and hygiene standards are poor  Spread by eye seeking flies, or fingers, from one patient to another  Blindness  “Trachoma belt” > North Africa to South-East Asia  Adult inclusion conjunctivitis (paratrachoma)  Acute stage >> follicular conjunctivitis  Self-limited
  7. 7.  Chlamydial ophthalmia neonatrum (inclusion blennorrhoea)  5-21 days after birth  If not treated > after 1 year > secondary bacterial infection > ocular damage and even blindness  Source:  infected genital tract of the mother
  8. 8.  Genital infection  C. trachomatis is the Commonest cause of non-gonococcal urethritis in males (30%)  LGV  In both males and females in tropics and subtropics
  9. 9.  In females  Mucopurulent cervicitis and urethritis  Vaginitis and vaginal discharge  Asymptomatic females if not treated  Ascending infection >> Pelvic inflammatory disease (endometritis or salpingitis or both)  Tubal damage >> ectopic pregnancy and infertility
  10. 10.  Infection in pregnancy  C. psittaci  Miscarriage or intra-uterine death  Patients had contact with sheep  C. trachomatis  Isolated from abortion products
  11. 11.  Respiratory infection  C. pneumoniae  3rd or 4th cause of pneumonia  Pharyngitis, bronchitis, otitis and sinusitis  C. psittaci  Psittacosis in humans from avian strains  Disease ranges from an influenza-like illness, to severe illness with typhoidal state ad pneumonia.
  12. 12.  C. trachomatis  Pneumonitis in neonates (infection acquired from the mother)
  13. 13. Laboratory Diagnosis  Cultivation  MacCoy cells treated with cycloheximide  Organism detected by staining for inclusions or EBs  Detects only living cells  Antigen detection  Using probes for DNA or mRNA that identify the infected cells  PCR  Amplification of parts of the genome
  14. 14. Chlamydia trachomatis from a urethral scrape
  15. 15.  Serology  Micro-immunofluorescence test  Using Ags from all chlamydial strains to detect species-specific and serovar-specific Ab  Complement fixation test  Detecting Ab in serum directed against group Ag
  16. 16. Chlamydia psittaci Direct FA stained mouse brain impression smear
  17. 17. Treatment and Control  Chemotherapy  Tetracycline in adults and Erythromycin in babies  For 3 weeks  Azithromycin  Single dose  Contact tracing  Partners of index cases (even if clinically normal)  Neonatal infection  Both parents should be treated
  18. 18.  Animal contact  Avoidance of contact with sources of infection (specially pregnant women)  Sheep, milking and shearing  Control of importation of psittacine birds  Hygiene

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