1. Alice Beckholt RN, MS, CNS
CHLAMYDIA
Alice Beckholt RN, MS, CNS

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

3. Chlamydia trachomatis life cycle
Life cycle estimated at hours
Elemental body (EB)
Reticulate body (RB)

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

5. transmission
Sexual
Non-sexual

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

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

8. Complications - epididymitis
Fever
Unilateral scrotal pain
Swelling
Tenderness
PAIN!!

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

10. Symptoms in women Usually none Cervicitis Urethritis Vaginal discharge
Pelvic pain

11. Complications in women
Pelvic Inflammatory Disease
(PID)

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

13. Chlamydia in pregnancy and neonates
Preterm delivery
Neonatal conjunctivitis
Neonatal pneumonia

14. Lymphogranuloma venereum
LGV is caused by chlamydial serovars L1, L2, and L3
Genital ulcer
Lymphadenopathy
Proctitis
Systemic
Serovar-specific tests not widely available

15. Trachoma Caused by Chlamydia trachomatis Not sexually transmitted
Hygiene-related

16. Diagnosis
Cell culture

17. Diagnosis (continued)
Nucleic Acid Amplification Tests (NAATs)
Non-Amplification Tests

18. 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

19. Treatment (continued)
TREAT ALL PARTNERS WITHIN THE LAST DAYS, EVEN IF THEY ARE ASYMPTOMATIC !

20. Prevention, Education and Patient Counseling
Nature of the disease
Transmission
Risk reduction
Screening

21. Safe Sex
Nature o