CHLAMYDIA Alice Beckholt RN MS CNS Chlamydia trachomatis

CHLAMYDIA Alice Beckholt RN, MS, CNS

Chlamydia trachomatis, a really weird bacterium • • Intermediate between virus and bacteria Obligate intracellular parasite Kills the host cell Susceptible to some antibiotics

Chlamydia trachomatis life cycle • Life cycle estimated at 24 -72 hours • Elemental body (EB) • Reticulate body (RB)

Virulence factors • Gram negative? • Most infections are asymptomatic, but infectious • Also causes LGV and trachoma

transmission • Sexual • Non-sexual

Symptoms of genital chlamydia • Usually none • The vast majority of persons with chlamydial infections are blissfully unaware

Symptoms in men • Non-gonococcal urethritis (NGU) • Discharge • Dysuria

Complications - epididymitis • • • Fever Unilateral scrotal pain Swelling Tenderness PAIN!!

Reiter’s syndrome • • Arthritis Conjunctivitis Urethritis Also known as reactive arthritis

Symptoms in women • • • Usually none Cervicitis Urethritis Vaginal discharge Pelvic pain

Complications in women • Pelvic Inflammatory Disease • • (PID)

Chlamydia and HIV Untreated Chlamydia can increase the risk of HIV transmission

Chlamydia in pregnancy and neonates • Preterm delivery • Neonatal conjunctivitis • Neonatal pneumonia

Lymphogranuloma venereum • LGV is caused by chlamydial serovars L 1, L 2, and L 3 • Genital ulcer • Lymphadenopathy • Proctitis • Systemic • Serovar-specific tests not widely available

Trachoma • Caused by Chlamydia trachomatis • Not sexually transmitted • Hygiene-related

Diagnosis • Cell culture

Diagnosis (continued) • Nucleic Acid Amplification Tests (NAATs) • Non-Amplification Tests

Treating Chlamydia • Recommended regimens for uncomplicated infections • Azithromycin 1 gram orally once • Doxycycline 100 mg twice daily for 7 days • Alternative regimens for uncomplicated infections • Erythromycin • Ofloxacin • Levofloxacin • Amoxacillin