Chlamydia

 is a common STD that can infect both men and women.

 It can cause serious, permanent damage to a woman’s reproductive system.
 This can make it difficult or impossible for her to get pregnant later on.
 Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that
occurs outside the womb).

Etiologic Agent-caused by bacteria called Chlamydia trachomatis

Mode of Transmission
 direct contact during oral, vaginal, or anal sex with someone who has the infection.
 A woman can also pass chlamydia to her baby during childbirth.

Incubation Period-7-21 days (14 days)

Period of Communicability
 The period of communicability is unknown. Relapses are common, and an infected
person may be intermittently infectious over many months.

Pathogenesis
 Chlamydia spp. are important causes of human disease for which no effective
vaccine exists. These obligate intracellular pathogens replicate in a specialized
membrane compartment and use a large arsenal of secreted effectors to survive in
the hostile intracellular environment of the host. In this Review, we summarize the
progress in decoding the interactions between Chlamydia spp. and their hosts that
has been made possible by recent technological advances in chlamydial proteomics
and genetics. The field is now poised to decipher the molecular mechanisms that
underlie the intimate interactions between Chlamydia spp. and their hosts, which
will open up many exciting avenues of research for these medically important
pathogens.

Pathology
 The Chlamydia bacteria invades and infects the host cells, which they depend on to
provide them with nutrients for survival. If the human cells infected by the bacteria
are starved of these nutrients, the bacteria die off too. Once the Chlamydia bacteria
are starved of nutrients such as vitamins or iron, they stop dividing and grow to an
abnormally large size. However, these aberrant cells can remain viable, as they can
adopt a normal state that is ready for division again once the host cell conditions
normalize. Studies have shown that around half of infections clear within a year,
while 80% disappear in two years and 90% within three years of initial infection.
However, some infections persist and may lead to serious problems such as pelvic
inflammatory disease in women and epididymis in men. The bacteria can cause
infertility in both men and women.
Clinical Manifestation
 Chlamydia trachomatis can also infect the rectum, either with no signs or symptoms
or with rectal pain, discharge or bleeding.
 Can also can get chlamydial eye infections (conjunctivitis) through contact with
infected body fluids.
Symptoms in women include
 Abnormal vaginal discharge, which may have a strong smell
 A burning sensation when urinating
 Pain during intercourse

Symptoms in men include

 Discharge from your penis
 A burning sensation when urinating
 Burning or itching around the opening of your penis
 Pain and swelling in one or both testicles (although this is less common)

Diagnostic Test
 Enzyme Immunoassay technique based on the direct detection
of Chlamydia trachomatis antigen in urethral or cervical swabs was used for the
rapid diagnosis of chlamydial genital infection.
 Tissue Culture- Chlamydia species are obligate intracellular bacteria that require
growth inside mammalian cells,  tissue culture system has been available that allows
easier laboratory culture of the Chlamydia species.
 Chlamydia Nucleic Acid Amplification Test (NAAT or NAT) - molecular test that
detects the genetic material (DNA) of Chlamydia trachomatis.

Treatment Modalities
 Azithromycin 1 g orally in a single dose
 Doxycycline 100 mg orally twice a day for 7 days

Alternative Regimens
 Erythromycin base 500 mg orally four times a day for 7 days OR
 Erythromycin ethylsuccinate 800 mg orally four times a day for 7 days
 Levofloxacin 500 mg orally once daily for 7 days
 Ofloxacin 300 mg orally twice a day for 7 days

Nursing Management
 advise abstinence from sex until treatment has been completed
 ensure partner is treated at the same time
 teach about all STI symptoms
 explain treatment regimens and side effects
 encourage safer sex methods
  stress importance of follow up and re-testing

Prevention and Control

 Use condoms.  sexual encounter reduce but don't eliminate the risk of infection.
 Limit your number of sex partners.  Having multiple sex partners puts you at a high
risk of contracting chlamydia and other sexually transmitted infections.
 Get regular screenings. If sexually active, advise to get regular screening
 Avoid douching. Douching decreases the number of good bacteria in the vagina,
which can increase the risk of infection.