衣原体 Chlamydia

Introduction Chlamydia has DNA, RNA and ribosomes. It proliferates by binary fission. It possesses an inner and outer membrane similar to Gram-negative bacteria. It has lipopolysaccharide but not peptidoglycan. It is sensitive to many antibiotics. Introduction

Introduction Chlamydia is small obligate intracellular parasite. Although Chlamydia can synthesize most of their metabolic intermediates, it is unable to synthesize its own ATP. This may be a reason for Chlamydia to be a intracellular parasitic microbe. Generally Chlamydia is considered to belong to bacteria. Introduction

Chlamydia has two unique forms when it proliferates in host cells: elementary body (EB) reticulate body (RB) Introduction

EB and RB ◇ EB: is smaller (0.25 to 0.3 µm in diameter), and has dense structure, and infectivity. ◇ RB: is larger (0.5 to 0.6 µm in diameter), and has loose structure, and no infectivity.

Classification Chlamydia only has one genus with three species and all the species can cause human diseases: C. trachomatis: causes trachoma (沙眼), urogenital infections, conjunctivitis (结膜炎，红眼睛), pneumonia and lympho-granuloma venereum (LGV,性病淋巴肉芽肿). Humans are the only natural host. C. pneumoniae: causes bronchitis, pneumonia and sinusitis. Humans are the only natural host. C. psittaci: causes pneumonia (psittacosis).

Developmental cycle

Staining methods Gram-negative but Gram stain is not used for identification. Giemsa stain is often used. EB is purple while RB is blue.

Staining methods Immunofluorescence using specific antibodies can stain the inclusion body brightly.

沙眼衣原体 Chlamydia trachomatis  

Chlamydia trachomatis has 3 serotypes: trachoma, LGV and mouse pneumonia. According to the antigenic difference of MOMP (major outer membrane protein), C. trachomatis subsp. trachoma has 14 serotypes and C. trachomatis subsp. LGV has 4 serotypes. 生物群

Chlamydia trachomatis has endotoxin-like substance and the MOMP can block the fusion of chlamydial endosome and cellular lysosome.

C. trachomatis subsp. trachoma: Among the 14 serotypes of C. trachomatis subsp. trachoma: 4 serotypes cause trachoma the first cause of blindness in the world Transmitted by eye-hand-eye pattern through direct or indirect (e.g., towel and toy) contact 12 serotypes cause inclusion conjunctivitis (e.g., swimming pool conjunctivitis) and non-gonococcal urethritis (NGU) NGU is a common STD with or without clinical symptoms 10 serotypes cause infant pneumonia

Chlamydia trachomatis subsp. LGV ◇ LGV serotype can cause lympho-granuloma venereum, a STD that is prevalent in Africa, Asia and South America. ◇ Occasionally, LGV serotype can cause conjunctivitis. ◇ Humans are the only natural host.

Laboratory diagnosis ◇Culture is the most specific method. Specimens are inoculated to susceptible cells and then the infected cells are examined for the presence of inclusion bodies after staining. ◇Microscopy: directly examine in the sample smear. ◇Serological examination: Due to its parasitic character, its specific antibody is usually low and do not distinguish between current and past infections. So serological examination is of little clinical importance. ◇ PCR and Southern hybridization.

Treatment and prevention ◇ Tetracyclines and erythromycin are used for treatment. ◇ No vaccine is practically used for prevention.

Chlamydia pneumoniae   肺炎衣原体

◇ Chlamydia pneumoniae only has one serotype and named as TWAR The name comes from the combination of names of the two original isolates with the same serological examination results: strain TW-183 from Taiwan in 1965 and strain AR-39 from America in 1983. ◇ This microbe is transmitted person-to-person by respiratory droplets. ◇ Chlamydia pneumoniae is the causative agent of atypical pneumonia.

◇ In addition, it can cause a pharyngitis, bronchitis and sinusitis. ◇ Culture is difficult so the serological tests are most commonly used. A four-fold rise in specific antibody titers in paired serum samples indicates the infection. ◇ Tetracycline and erythromycin are the choice of antibiotics. No vaccine is available.