chlamydia sexually transmitted infection notes by SANJU SAHpptx.pptx

Chlamydia is a common sexually transmitted infection (STI) caused by the bacterium Chlamydia trachomatis. Often asymptomatic, it can cause serious reproductive health issues if untreated, including infertility. Easily diagnosed through testing and treatable with antibiotics, regular screening is essential to prevent complications and transmission.

1. CHLAMYDIA Presented by: SANJU SAH MSc . Public Health Microbiology St. Xavier’s college, Maitighar , Kathmandu

2. INTRODUCTION Chlamydia is a common STD which infects both men and women.   It is caused by bacteria called Chlamydia trachomatis .  Women can get chlamydia in the cervix, rectum, or throat . Men can get chlamydia in the urethra (inside the penis), rectum, or throat.

3. TISSUE DAMAGE INDUCED BY Chlamydia trachomatis Nongonococcal urethritis (NGU) : Caused by : Serovars D, E, F,…to K. In male : Urethritis, infection could extend to epididymitis and prostatitis but rarely to testicles, ( Orchitis is very rare) One third of patients have Reiter’s Syndrome (HLA-B27),Acute aseptic arthritis and urethritis. In female : Cervicitis and Pelvic inflammatory disease: Endometritis , Salpingitis . Exposure to Antibiotics or Interferone - Gamma results in persistence infection. Tubal factor infertility and ectopic pregnancy.

4. TISSUE DAMAGE INDUCED BY Chlamydia trachomatis 2. Lymphogranuloma venereum (LGV): more invasive infection Caused by serovars : L1, L2, and L3. Enters small skin breaks of external genitalia. Papules in the external genitalia Herpetic – like Ulcer of genitalia. More invasive infection. Painful swelling of inguinal and perirectal lymph nodes. Lymphatic Obstruction; Elephantiasis of Genitalia.

5. RISK FACTORS One can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia . If one had chlamydia and were treated in the past , can still get infected again. This can happen if people have unprotected sex with someone who has chlamydia . Pregnant women can transmit chlamydia to her baby during childbirth.

6. SYMPTOMS Some of the most common symptoms include: burning sensation during urination yellow or green discharge from the penis or vagina pain in the lower abdomen pain in the testicles painful sexual intercourse in women ( dyspareunia) . In some women, the infection can spread to the fallopian tubes, which may cause a condition called pelvic inflammatory disease (PID). PID is a medical emergency. The symptoms of PID are: fever severe pelvic pain nausea abnormal vaginal bleeding between periods

7. SYMPTOMS It’s also possible to get a chlamydia infection in the anus. In this case, the main symptoms are often discharge, pain, and bleeding from this area. If anyone have oral sex with someone who has the infection, they may get it in their throat. They may notice a sore throat, cough, or fever .

8. LAB DIAGNOSIS Collection of specimens : for the chlamydial infections ocular, urethral, vagina cervical specimens are best collected by scraping the mucosa . in addition, depending upon the site of involvement, blood, respiratory secretions, sputum, lung and other tissues can be collected . In case of LGV ( Lymphogranuloma venereum ), pus from the bubo should be collected.

9. LAB DIAGNOSIS These specimens are processed as : 1. Light Microscopy : C. trachomatis infections of conjunctiva, urethra and cervix may be diagnosed by demonstrating typical reniform inclusion bodies surrounding the nucleus after Giemsa staining, Macchiavello , Castaneda Methods. As the inclusion bodies possess a glycogen matrix, therefore, they may be stained with iodine solution also. This method has low specificity and sensitivity.

10. LAB DIAGNOSIS 2. Immunofluorescence : Species or genus specific antigens are stained with fluorescent labelled antibodies(usually monoclonal antibodies ). The method has 90% sensitivity and 95% specificity. And quick method. With in one hour , the results can be obtained.

11. LAB DIAGNOSIS 3. ELISA for the detection of Chlamydial antigens: soluble genus specific antigen captured by antibody attached to a solid surface like plastic body or microtitre well are detected. the detection is based on enzyme-labelled detector system and a chromogenic substrate. The sensitivity and specificity of ELISA is similar to that of Immunofluorescence.

12. LAB DIAGNOSIS 4. DNA probes: DNA hybridization can be used for the direct detection of C. trachomatis in conjunctival and cervical smears. 5. Chemiluminiscence assay: acridium -ester-labelled stranded DNA Probe is used which is specifically complementary to RNA of C. trachomatis or others based on need. The DNA-RNA hybrid is detected in luminometer which measures light emitted by the acridium ester label. Sensitivity and specificity is 95%.

13. LAB DIAGNOSIS 6 . PCR: The omp1 gene and the 16s rRNA gene can be amplified and detected by PCR. detecting these DNA has specificity upto 95% for identification upto species level and strains.

14. LAB DIAGNOSIS Isolation of Chlamydiae : may be isolated in mice or yolk sac of 6-8 days old chick embryo and cell cultures.

15. LAB DIAGNOSIS Detection of Chlamydial antibody : antibodies against C. psittaci and serovars L1-L3 of C. trichomatis can be detected by complement fixation. Antibodies againt C. trachomatis and C. pneumoniae can be detected by microimmunofluorescence , using elementary bodies of standard serovars , immunoperoxidase and ELISA tests. High level of IgM and IgG are also taken as diagnostic.

16. LAB DIAGNOSIS Skin test ( Frei's test) : mainly for LGV diagnosis. heat inactive LGV (0.1 ml) is grown in yolk sac of embryonated egg. Is injected intradermally on the forearm and a control prepared from uninfected yolk sac on the fore arm. a positive reaction is indicated by an inflammatory nodule in 2 days and reaching maximum in 4-5 days, measuring at least 7 mm in diameter. this tst becomes positive 2-6 weeks after infection and remains postive for several years. but because of more rapid and sensitive tests this method is not used.

17. Treatment antibiotic of choice is doxycycline in adults and erythromycin in babies. generally given from 1 week to 3 weeks Azithromycin is often used in opthalmic and naso pharyngeal cases.