Three chlamydia species can cause human diseases, u. a. sexually transmitted diseases and respiratory infections. Most are sensitive to macrolides (eg. As azithromycin), tetracyclines (z. B. doxycycline) and fluoroquinolones.
Chlamydiae are immovable, obligate intracellular bacteria. They contain DNA, RNA and ribosomes and produce their own proteins and nucleic acids. However, they depend on for three of their four nucleoside of the host cell and use the adenosine triphosphate (ATP) of the host to synthesize the chlamydial protein.
Three chlamydia species can cause human diseases, u. a. sexually transmitted diseases and respiratory infections. Most are sensitive to macrolides (eg. As azithromycin), tetracyclines (z. B. doxycycline) and fluoroquinolones. Chlamydiae are immovable, obligate intracellular bacteria. They contain DNA, RNA and ribosomes and produce their own proteins and nucleic acids. However, they depend on for three of their four nucleoside of the host cell and use the adenosine triphosphate (ATP) of the host to synthesize the chlamydial protein. Chlamydia include 9 species; 3 causing them diseases in humans: Chlamydia trachomatis Chlamydia pneumoniae Chlamydia psittaci Chlamydia species can cause a persistent infection that is often subclinical. C. trachomatis C. trachomatis occurs with 18 immunologically defined serovars: A, B, Ba, and C cause trachoma. K D to cause sexually transmitted diseases ( “Sexually Transmitted Diseases”, STDs), which are located on the grinding surface of the skin. L1, L2 and L3 cause STDs, leading to an invasive lymph node disease (lymphogranuloma venereum). In the US, C. trachomatis is the most common bacterial cause of STDs, including nichtgonorrhöischen urethritis and epididymitis in men; Cervicitis, urethritis and pelvic inflammatory disease (PID, pelvic inflammatory disease) in women and proctitis, lymphogranuloma venereum, and reactive arthritis (Reiter’s syndrome) in both sexes. Transmission of C. trachomatis from mother to child causes neonatal conjunctivitis and pneumonia. A universal prenatal screening and treatment of pregnant women have greatly reduced the incidence of C. trachomatis infections in infants in the United States. The organism can be isolated in adults from the rectum, and throat (usually in men who have sex with men [MSM]). Rectal infection with L2 strains can cause severe proctocolitis, which can mimic an acute inflammatory bowel disease in HIV-positive MSM. C. pneumoniae C. pneumoniae can cause pneumonia (especially in children and young adults), which can not be distinguished from one caused by Mycoplasma pneumoniae pneumonia clinically. In some patients with C. pneumoniae pneumonia, hoarseness and sore throat may be preceded by the cough, which be persistent and can be complicated by bronchospasm. 6 to 19% of community-acquired pneumonia cases caused by C. pneumoniae; Outbreaks of pneumonia due to C. pneumoniae represent a particular risk for people is (eg. As nursing homes, schools, military facilities, prisons) in closed populations. Seasonal variations in the incidence have been observed. C. pneumoniae was also considered as an infectious trigger of reactive airway disease. C. psittaci C. psittaci causes psittacosis (ornithosis). Strains that cause human diseases, mostly of birds psittacids (z. B. parrots) purchased and cause disseminated disease with pneumonitis. Outbreaks in poultry workers in slaughterhouses, turkeys and ducks handle occurred. Diagnostic nucleic acid-based tests C. trachomatis is best in genital samples by nucleic acid amplification (NAAT) detected because these procedures are not allowed if they nohc for use by the FDA, are more sensitive than cell culture and be less stringent requirements for sample collection. NAATs for genital infection can be performed using samples obtained non-invasively, such as urine or vaginal swab by the patient or physician. Serological tests are of limited use, except for the diagnosis of lymphogranuloma venereum and psittacosis. C. pneumoniae is diagnosed with a culture of respiratory specimens or NAAT tests. There is a commercially available, approved by the FDA NAAT for C. pneumoniae, available as part of a panel that tests simultaneously on multiple respiratory pathogens. Close contact with birds, especially parrots or parakeets, is an important initial indication for the diagnosis of infection with C. psittaci. The diagnosis is confirmed by serological tests. A culture is not usually available There are no FDA-approved NAATs for C. psittaci. cause screening procedures Since genital Chlamydiennfektionen are so common and often asymptomatic or only weak or non-specific symptoms (especially in women), is a routine screening of asymptomatic individuals at high risk of sexually transmitted diseases recommended by the CDC (s.2015 Sexually Transmitted Diseases treatment Guidelines). Among the persons who should be screened, include the following. Non-pregnant women (including women who have sex with women) are screened annually if they are sexually active and ? 25 years old A history of a previous sexually transmitted disease have show (z. B. a new sex partner Sexual behavior at high risk or multiple sex partners have to work in the sex sector, inconsistent use of condoms) have a partner who has an STD or sexual behavior with a high risk shows women <35 years be screened if they are admitted to a correctional facility. Pregnant women are screened during their first prenatal check-up; those ? 25 years or with risk factors be screened again in the third trimester. Straight active men are not screened, except in circumstances with a high prevalence of chlamydial infections, including clinics for teenagers or sexually transmitted diseases or when shooting in prisons. Men who have sex with men are screened when they have been sexually active within the last year: for receptive anal intercourse urine test: carried pharyngeal swab therapy azithromycin or doxycycline therapy of uncomplicated lower genital infection: In insertiven anal rectal swabs In oral sex typically with a single dose of azithromycin (1 g po) or with a 7-day treatment with doxycycline (100 mg po 2 times daily) or certain fluoroquinolones (z. B. levofloxacin 500 mg po 1 time daily). In simultaneous gonorrhea and chlamydia infection is suspected, a standard treatment is done. PID, lymphogranuloma venereum or epididymitis are usually treated for 10 days with doxycycline. Specific infections are discussed elsewhere in the MSD Manual: psittacosis and C. pneumoniae pneumonia, lymphogranuloma venereum, and urethritis, epididymitis, reactive arthritis, neonatal conjunctivitis, and neonatal pneumonia, trachoma and inclusion conjunctivitis. Important points C. trachomatis causes trachoma or sexually transmitted diseases; a transmission from the mother to the child can cause neonatal conjunctivitis and / or pneumonia. C. pneumoniae can cause pneumonia (especially in children and young adults and in closed populations). C. psittaci is a rare cause of pneumonia (psittacosis), which is usually acquired from psittacine birds (eg. B. parrots). Diagnose C. trachomatis and C. pneumoniae infections NAATs. Asymptomatic patients at high risk be screened for sexually transmitted chlamydial infection. Treatment is with azithromycin or doxycycline.