Lower genital tract infections with Chlamydia trachomatis are predominantly asymptomatic in men and women. Chlamydia is one of the most common sexually transmitted diseases in the U.S. There are poor statistics in the Developing countries to support the prevalence. This infection is easily spread because it often causes no symptoms and may be unknowingly passed to sexual partners. Chlamydia trachomatis infection most commonly affects the urogenital tract.
In men, the infection usually is symptomatic, with dysuria and a discharge from the penis. Untreated chlamydial infection in men can spread to the epididymis.
Most women with chlamydial infection have minimal or no symptoms, but some develop pelvic inflammatory disease. Chlamydial infection in new-borns can cause ophthalmia neonatorum. In fact, about 75% of infections in women and 50% in men are without symptoms. Many times the patients present with signs and symptoms not pointing to the diagnosis of chlamydial infections.
For women. If left untreated, chlamydia infection can cause pelvic inflammatory disease which can lead to damage of the fallopian tubes (the tubes connecting the ovaries to the uterus) or even cause infertility (the inability to have children). Untreated chlamydia infection could also increase the risk of ectopic pregnancy.
Furthermore, chlamydia may cause premature births and the infection can be passed along from the mother to her child during childbirth, causing an eye infection, blindness, or pneumonia in the new-born. For men. Chlamydia can cause a condition called Nongonococcal urethritis (NGU) — an infection of the urethra (the tube by which men and women pass urine), epididymitis — an infection of the epididymis (the tube that carries sperm away from the testes), or Proctitis. Chlamydial infections are missed with evidence based diagnosis because chlamydia often occurs without symptoms, people who are infected may unknowingly infect their sex partners.
Many doctors recommend that all persons who have more than one sex partner should be tested for chlamydia regularly, even in the absence of symptoms.
Serology is not recommended for diagnosing chlamydial infections, with the exception of infection in neonates, patients with tubal factor infertility and occasionally for LGV infections when bubo aspirates are not available. Serology is often not available except in reference laboratories.
Culture is the only procedure that confirms the presence of viable organisms. Antigens, nucleic acids or antibodies can be present in the absence of viable infectious particles. A number of commercial EIAs are available for the detection of chlamydial antigens in clinical specimens. These products use either monoclonal or polyclonal antibodies to detect chlamydial lipopolysaccharide (LPS), which is more soluble than the major outer membrane protein (MOMP). Most EIAs take several hours to perform and are suitable for batch processing.
In India it is domain of the STD specialists to identify the disease early and treat promptly as we have no facilities to make a specific diagnosis in our Laboratories. Majority of developed Nations going in for nucleic acid based tests for optimal diagnosis. Susceptibility testing has had little clinical utility to date, but concerns about antimicrobial resistance in chlamydia persist.
Antibiotic-resistant C trachomatis can be induced in the laboratory by sub inhibitory concentrations of antimicrobials. Chlamydial species are susceptible to the tetracycline, macrolide and fluoroquinolone classes of antibiotics. The most active of these – doxycycline, erythromycin, azithromycin, rifampin, Ofloxacin and clindamycin – are usually used to treat chlamydial infections. However the optimal available treatment continues to be best option in developing countries.
Chlamydial infections are least diagnosed scientifically and most commonly treated sexually transmitted infections in most of the developing countries. Too many sex partners carry common risk for Chlamydiae Infection.
About the Author
Dr.T.V.Rao MD Professor of Microbiology – Freelance writer on Know your Microbe online