Chlamydia trachomatis

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Chlamydia trachomatis
C. trachomatis inclusion bodies (brown) in a McCoy cell culture.
C. trachomatis inclusion bodies (brown) in a McCoy cell culture.
Scientific classification
Kingdom: Bacteria
Phylum: Chlamydiae
Order: Chlamydiales
Family: Chlamydiaceae
Genus: Chlamydia
Species: C. trachomatis
Binomial name
Chlamydia trachomatis
Busacca, 1935

Chlamydia trachomatis is one of three bacterial species in the genus Chlamydia, family Chlamydiaceae, class Chlamydiae, phylum Chlamydiae, domain Bacteria. C. trachomatis has only been found living inside the cells of humans, causing the following conditions:

In men

In women

In both sexes

C. trachomatis has also been detected in some patients with temporomandibular joint (TMJ) disease. It may be treated with any of several antibiotics: azithromycin, erythromycin or doxycycline/tetracycline.

C. trachomatis was the first chlamydial agent discovered in humans. It comprises two human biovars: trachoma and lymphogranuloma venereum (LGV). Many, but not all, C. trachomatis strains have an extrachromosomal plasmid. Chlamydia species are readily identified and distinguished from other chlamydial species using DNA-based tests. Most strains of C. trachomatis are recognized by monoclonal antibodies [mAbs] to epitopes in the VS4 region of MOMP. However, these mAbs may also crossreact with the other two Chlamydia species, Chlamydia suis and Chlamydia muridarum.


Antimicrobial Regimen

  • 1 Chlaymydial infections [1]
  • 1.1 Chlamydial Infections in Adolescents and Adults
  • Preferred regimen (1): Doxycycline 100 mg PO bid for 7 days
  • Preferred regimen (2): Azithromycin 1 g PO in a single dose
  • Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days
  • Alternative regimen (2): Erythromycin ethylsuccinate 800 mg PO qid for 7 days
  • Alternative regimen (3): Levofloxacin 500 mg PO qd for 7 days
  • Alternative regimen (4): Ofloxacin 300 mg PO bid for 7 days.
  • Note: Patients should be instructed to refer their sex partners for evaluation, testing, and treatment if they had sexual contact with the patient during the 60 days preceding onset of the patient's symptoms or chlamydia diagnosis.
  • 1.2 Chlamydial Infections in patients with HIV Infection
  • Preferred regimen (1): Doxycycline 100 mg PO bid for 7 days
  • Preferred regimen (2): Azithromycin 1 g PO in a single dose
  • Preferred regimen (3): Azithromycin 1 g PO in a single dose
  • Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days
  • Alternative regimen (2): Erythromycin ethylsuccinate 800 mg PO qid for 7 days
  • Alternative regimen (3): Levofloxacin 500 mg PO qd for 7 days
  • Alternative regimen (4): Ofloxacin 300 mg PO bid for 7 days.
  • 1.3 Pregancy
  • 1.4 Management of sex partners
  • Preferred regimen (1): Doxycycline 100 mg PO bid for 7 days
  • Preferred regimen (2): Azithromycin 1 g PO in a single dose
  • Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days
  • Alternative regimen (2): Erythromycin ethylsuccinate 800 mg PO qid for 7 days
  • Alternative regimen (3): Levofloxacin 500 mg PO qd for 7 days
  • Alternative regimen (4): Ofloxacin 300 mg PO bid for 7 days.
  • Note (1): Recent sex partners (i.e., persons having sexual contact with the infected patient within the 60 days preceding onset of symptoms or Chlamydia diagnosis) should be referred for evaluation, testing, and presumptive dual treatment.
  • Note (2): If the patient’s last potential sexual exposure was >60 days before onset of symptoms or diagnosis, the most recent sex partner should be treated.
  • Note (3): To avoid reinfection, sex partners should be instructed to abstain from unprotected sexual intercourse for 7 days after they and their sexual partner(s) have completed treatment and after resolution of symptoms, if present
  • 2. Chlamydial infection among neonates
  • 2.1 Ophthalmia Neonatorumcaused by C. trachomatis
  • Preferred regimen: Erythromycin base or ethylsuccinate 50 mg/kg/ day PO qid for 14 days
  • Alternative regimen: Azithromycin suspension 20 mg/kg /day PO qd for 3 days
  • Note: The mothers of infants who have chlamydial infection and the sex partners of these women should be evaluated and treated.
  • 2.2 Infant Pneumonia
  • 3.Chlamydial infection among infants and childern
  • 3.1 Infants and childern who weigh < 45 kg
  • Preferred regimen: Erythromycin base or ethylsuccinate 50 mg/kg/ day PO qid for 14 days
  • 3.2 Infants and childern who weigh ≥45 kg but who are aged <8 years
  • 3.3 Infants and childern aged ≥8 years
  • Preferred regimen (1): Azithromycin 1 g PO in a single dose
  • Preferred regimen (2): Doxycycline 100 mg PO bid for 7 days
  • 4. Lymphogranuloma venereum (LGV) [2]
  • Preferred regimen: Doxycycline 100 mg PO bid for 21 days
  • Alternative regimen: Erythromycin base 500 mg PO qid for 21 days
  • Note (1): Azithromycin 1 g PO once weekly for 3 weeks is probably effective based on its chlamydial antimicrobial activity. Fluoroquinolone-based treatments might also be effective, but extended treatment intervals are likely required.
  • Note (2): Pregnant and lactating women should be treated with Erythromycin. Azithromycin might prove useful for treatment of LGV in pregnancy, but no published data are available regarding its safety and efficacy. Doxycycline is contraindicated in pregnant women.
  • Note (3): Persons with both LGV and HIV infection should receive the same regimens as those who are HIV negative. Prolonged therapy might be required, and delay in resolution of symptoms might occur.
  • Note (4): Persons who have had sexual contact with a patient who has LGV within the 60 days before onset of the patient’s symptoms should be examined and tested for urethral, cervical, or rectal chlamydial infection depending on anatomic site of exposure. They should be presumptively treated with a chlamydia regimen ( Azithromycin 1 g PO single dose OR Doxycycline 100 mg PO bid for 7 days).

Gallery

External links

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Template:WikiDoc Sources

  1. Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.
  2. Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 "Public Health Image Library (PHIL)".