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Review article

Infection with Chlamydia Trachomatis Serovars D to K in Women

Deni Karelović

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Chlamydia trachomatis (CT) is the most common sexually transmitted bacterium, one of the leading causes of pelvic inflammatory disease (PID) and infertility in women. Chlamydiae are small gram-negative obligate intracellular microorganisms that preferentially infect squamocolumnar epithelial cells. CT is one of the four species which belong to the genus Chlamydia, the family Chlamydiaceae and the order Chlamydiales. The rates of Chlamydia infections are the highest in adolescent women. We must differentiate between non-complicated, complicated and persistent chlamydial infections.
In more than 80% of women the infection is asymptomatic, also known as silent infection. The infection could be manifested as urethritis, proctitis, and mucopurulent cervicitis (noncomplicated).
It may cause a wide spectrum of serious complications (complicated infections): PID, bartholinitis, perihepatitis (Fitz-Hugh-Curtis syndrome), reactive arthritis, ectopic pregnancy and disease in newborn. The CT infection can be diagnosed by cell-culture, direct immunofluorescence, enzyme immunoassay, direct DNA hybridization and more recently by nucleic acid amplification, a test currently considered to be the most acceptable thanks to its simplicity, sensitivity and specificity. Vaginal smear LCR is currently considered to be the test of choice. The preferred treatment for acute infection today is a single oral dose of 1g azithromycin, while the optimal treatment for persistent infection has not been yet established. All partners should be treated as well as abstain from sexual intercourse during 7 days after treatment in order to prevent reinfection. If treating the acute infection with first line antibiotics,
retesting is not necessary. The use of condoms provides the best protection. Screening of risk groups is an important measure in preventing serious consequences.


Chlamydia trachomatis, urogenital infections in women

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