scholarly journals Where to go to in chlamydia control? From infection control towards infectious disease control

2021 ◽  
pp. sextrans-2021-054992
Author(s):  
Jan E A M van Bergen ◽  
Bernice Maria Hoenderboom ◽  
Silke David ◽  
Febe Deug ◽  
Janneke C M Heijne ◽  
...  
Keyword(s):  
Chlamydia Infection ◽  
Limited Evidence ◽  
Future Directions ◽  
Tubal Factor Infertility ◽  
Effectiveness Analysis ◽  
Population Prevalence ◽  
Tubal Factor ◽  
Health Relevance ◽  
Asymptomatic Infections

ObjectivesThe clinical and public health relevance of widespread case finding by testing for asymptomatic chlamydia infections is under debate. We wanted to explore future directions for chlamydia control and generate insights that might guide for evidence-based strategies. In particular, we wanted to know the extent to which we should pursue testing for asymptomatic infections at both genital and extragenital sites.MethodsWe synthesised findings from published literature and from discussions among national and international chlamydia experts during an invitational workshop. We described changing perceptions in chlamydia control to inform the development of recommendations for future avenues for chlamydia control in the Netherlands.ResultsDespite implementing a range of interventions to control chlamydia, there is no practice-based evidence that population prevalence can be reduced by screening programmes or widespread opportunistic testing. There is limited evidence about the beneficial effect of testing on pelvic inflammatory disease prevention. The risk of tubal factor infertility resulting from chlamydia infection is low and evidence on the preventable fraction remains uncertain. Overdiagnosis and overtreatment with antibiotics for self-limiting and non-viable infections have contributed to antimicrobial resistance in other pathogens and may affect oral, anal and genital microbiota. These changing insights could affect the outcome of previous cost–effectiveness analysis.ConclusionThe balance between benefits and harms of widespread testing to detect asymptomatic chlamydia infections is changing. The opinion of our expert group deviates from the existing paradigm of ‘test and treat’ and suggests that future strategies should reduce, rather than expand, the role of widespread testing for asymptomatic chlamydia infections.

scholarly journals MiR-378b Modulates Chlamydia-Induced Upper Genital Tract Pathology

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 566
Author(s):  
Stephanie R. Lundy ◽  
Kobe Abney ◽  
Debra Ellerson ◽  
Joseph U. Igietseme ◽  
Darin Carroll ◽  
...  
Keyword(s):  
Host Responses ◽  
Chlamydia Infection ◽  
Chlamydia Trachomatis Infection ◽  
Host Immune Responses ◽  
Tubal Factor Infertility ◽  
Evolutionarily Conserved ◽  
Duration Of Infection ◽  
Tubal Factor ◽  
Pathologic Lesions ◽  
Mammalian Gene Expression

Genital Chlamydia trachomatis infection causes severe reproductive pathologies such as salpingitis and pelvic inflammatory disease that can lead to tubal factor infertility. MicroRNAs (miRNAs) are evolutionarily conserved regulators of mammalian gene expression in development, immunity and pathophysiologic processes during inflammation and infection, including Chlamydia infection. Among the miRNAs involved in regulating host responses and pathologic outcome of Chlamydia infection, we have shown that miR-378b was significantly differentially expressed during primary infection and reinfection. In this study, we tested the hypothesis that miR-378b is involved in the pathological outcome of Chlamydia infection. We developed miR-378b knockout mice (miR-378b−/−) using Crispr/Cas and infected them along with their wild-type (WT) control with Chlamydia to compare the infectivity and reproductive pathologies. The results showed that miR-378b−/− mice were unable to clear the infection compared to WT mice; also, miR-378b−/− mice exhibited a relatively higher Chlamydia burden throughout the duration of infection. However, gross pathology results showed that miR-378b−/− mice had significantly reduced uterine dilatations and pathologic lesions after two infections compared to WT mice. In addition, the pregnancy and fertility rates for infected miR-378b−/− mice showed protection from Chlamydia-induced infertility with fertility rate that was comparable to uninfected WT mice. These results are intriguing as they suggest that miR-378b is important in regulating host immune responses that control Chlamydial replication and drive the inflammation that causes complications such as infertility. The finding has important implications for biomarkers of Chlamydial complications and targets for prevention of disease.

Microbiologic study of chronic inflammation associated with tubal factor infertility: role of Chlamydia trachomatis

1987 ◽  
Vol 47 (2) ◽  
pp. 274-277 ◽  
Author(s):  
Jeanine Henry-Suchet ◽  
Christine Utzmann ◽  
Jean De Brux ◽  
Pierre Ardoin ◽  
François Catalan
Keyword(s):  
Chlamydia Trachomatis ◽  
Chronic Inflammation ◽  
Tubal Factor Infertility ◽  
Tubal Factor

scholarly journals Evaluation of a PGP3 ELISA for surveillance of the burden of Chlamydia infection in women from Australia and Samoa

2019 ◽  
Vol 77 (3) ◽  
Author(s):  
Rami Mazraani ◽  
Peter Timms ◽  
Philip C Hill ◽  
Tamaailau Suaalii-Sauni ◽  
Tavita Niupulusu ◽  
...  
Keyword(s):  
Chlamydial Infection ◽  
Chlamydia Infection ◽  
Epidemiological Analysis ◽  
Tubal Factor Infertility ◽  
Epidemiological Tool ◽  
Tubal Factor ◽  
Current Infection ◽  
A Current ◽  
Fertile Women ◽  
Chlamydial Infections

ABSTRACT Serological assays can be used to investigate the population burden of infection and potentially sequelae from Chlamydia. We investigated the PGP3 ELISA as a sero-epidemiological tool for infection or sub-fertility in Australian and Samoan women. The PGP3 ELISA absorbance levels were compared between groups of women with infertility, fertile, and current chlamydial infections. In the Australian groups, women with chlamydial tubal factor infertility had significantly higher absorbance levels in the PGP3 ELISA compared to fertile women (P < 0.0001), but not when compared to women with current chlamydial infection (P = 0.44). In the Samoan study, where the prevalence of chlamydial infections is much higher there were significant differences in the PGP3 ELISA absorbance levels between chlamydial sub-fertile women and fertile women (P = 0.003). There was no difference between chlamydial sub-fertile women and women with a current infection (P = 0.829). The results support that the PGP3 assay is effective for sero-epidemiological analysis of burden of infection, but not for evaluation of chlamydial pathological sequelae such as infertility.

scholarly journals Diagnostic laparoscopy in the evaluation of tubal factor in cases of infertility

2017 ◽  
Vol 6 (4) ◽  
pp. 1275 ◽  
Author(s):  
Arpana Dipakbhai Chaudhari ◽  
Anilkumar Mathurbhai Baria ◽  
Upendra Rameshbhai Chaudhari ◽  
Grishma T. Dixit ◽  
Nilesh Thakor
Keyword(s):  
Diagnostic Laparoscopy ◽  
Age Group ◽  
Secondary Infertility ◽  
Tubal Patency ◽  
Infertile Women ◽  
Medical College ◽  
Tubal Factor Infertility ◽  
Tubal Factor ◽  
Tubal Disease

Background: Tubal factor infertility accounts for a large portion of female factor infertility. The most prevalent cause of tubal factor infertility is pelvic inflammatory disease and acute salpingitis. Tubal patency can be diagnosed by hysterosalpingography (HSG) or laparoscopy with chromopertubation. The aim of this study was to determine the role of laparoscopy in the evaluation of tubal factor in infertile women.Methods: Sixty women presenting with complaints of primary and secondary infertility were investigated for tubal disease by laparoscopy at at Smt. NHL Municipal Medical College, Ahmedabad during July 2011 to September 2013. Tubal patency was tested by chromopertubation using Methylene blue dye.Results: Thirty-five (58.3%) patients were in primary infertility group while 25 (41.7%) patients were in secondary infertility group. 80% women were in the age group of 21 to 30 years. In 49% of women, the duration of infertility was between 2 to 4 years whereas 17% cases had been infertile for 6 to 10 years. Diagnostic laparoscopy and findings of chromopertubation revealed unilateral blockage in 37% of cases, bilateral blockage had seen in 23% of cases, endometriosis was seen in 9% of cases and adhesion in 7% of cases.Conclusions: Unilateral and bilateral tubal blockade was detected in 60% of cases of infertile women.

scholarly journals Hysterosalpingography as a diagnostic tool in patients with infertility

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Naseem Akhtar ◽  
Mussarat Naveed ◽  
Noreen Akmal
Keyword(s):  
Diagnostic Tool ◽  
Tubal Factor Infertility ◽  
Tubal Factor ◽  
Infertile Patients

To evaluate the role of HSG as a diagnostic tool in a tubal factor infertility. HSG was performed on 100 infertile patients after excluding other causes of infertility. Tubal factor was found in 34% of patients as a cause of infertility.

On Future Directions in Pathology

1982 ◽  
Vol 40 ◽  
pp. 274-277
Author(s):  
Benjamin F. Trump ◽  
Irene K. Berezesky ◽  
Raymond T. Jones
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Clinical Pathology ◽  
Future Directions ◽  
Diagnostic Pathology ◽  
The Past ◽  
Transmission Electron ◽  
Organ Systems ◽  
The Many

The role of electron microscopy and associated techniques is assured in diagnostic pathology. At the present time, most of the progress has been made on tissues examined by transmission electron microscopy (TEM) and correlated with light microscopy (LM) and by cytochemistry using both plastic and paraffin-embedded materials. As mentioned elsewhere in this symposium, this has revolutionized many fields of pathology including diagnostic, anatomic and clinical pathology. It began with the kidney; however, it has now been extended to most other organ systems and to tumor diagnosis in general. The results of the past few years tend to indicate the future directions and needs of this expanding field. Now, in addition to routine EM, pathologists have access to the many newly developed methods and instruments mentioned below which should aid considerably not only in diagnostic pathology but in investigative pathology as well.

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