engleski

Chlamydia trachomatis infections - current issues

Chlamydia trachomatis (CT) is responsible for a large number of human infections and is a leading causative agent of sexually transmitted diseases. It causes trachoma, inclusion conjunctivitis in children and adults, lymphogranuloma venereum and a whole range of urogenital clinical syndromes and perinatal infections. Asymptomatic infection of the lower urogenital tract is proved in 2-23% of sexually active women and in 10% of sexually active men. CT causes 30-50% of nongonococcal urethritis in men and even higher percentage of postgonococcal urethritis, and is the most frequent causative agent of epididymitis and prostatitis in adults up to 35 years of age. It causes 60% of nongonococcal cervicitis and is a leading cause of acute urethral syndrome in sexually active women. The consequences of its ascendant spreading are endometritis, salpingitis, perihepatitis, perisplenitis and periappendicitis. Possible complications are extrauterine pregnancy, tubal infertility and chronic pain in the lower abdomen. In pregnant women, CT can cause spontaneous abortions, premature rupture of the membranes and prematurity. Proctitis and proctocolitis are more common in homosexual men. Reactive arthritis is found in 1% of men with nongonococcal urethritis, of which one third have Reiter syndrome. The most common perinatal infections are conjunctivitis, interstitial pneumonia, otitis and rhinitis. Important biological feature of CT infection is the establishment of balance between the host and the parasite causing latent, resistant, inapparent, persistent infections. Healthy CT carriers are significant for the infection spreading. The initial ocular and genital infections result in minimal or no tissue lesions. Severe ocular lesions in trachoma depend on the recurrent infections, constant stimulation of the immune system and the development of hypersensitivity to chlamydia antigens, resulting in host`s disturbed immune response. Clinical presentation of CT infection in the upper genital tract and its complications are the result of the immune response to recurrent infections or to a persistent, chronic, asymptomatic infection, during which the binary division of reticular bodies and the synthesis of the structural proteins is stopped, but the replication of genomes and the synthesis of protein antigens continues, with HSp (heat-shock protein) of 60 KD being the most important protein which stimulates the immune reaction of the late hypersensitivity. The key factor for the prevention and control of CT infection is quick and effective therapy of both partners with primary aim to eradicate the causative agent. This particularly refers to chlamydial cervicitis in women, especially pregnant ones and chlamydial urethritis in men representing the reservoirs for horizontal and vertical transmission.

Chlamydia trachomatis

nije evidentirano