Alice Beckholt RN, MS, CNS CHLAMYDIA Alice Beckholt RN, MS, CNS

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

Chlamydia trachomatis life cycle Life cycle estimated at 24-72 hours Elemental body (EB) Reticulate body (RB)

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

transmission Sexual Non-sexual

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

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

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

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

Symptoms in women Usually none Cervicitis Urethritis Vaginal discharge Pelvic pain

Complications in women Pelvic Inflammatory Disease (PID)

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

Chlamydia in pregnancy and neonates Preterm delivery Neonatal conjunctivitis Neonatal pneumonia

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

Trachoma Caused by Chlamydia trachomatis Not sexually transmitted Hygiene-related

Diagnosis Cell culture

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

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

Treatment (continued) TREAT ALL PARTNERS WITHIN THE LAST 60-90 DAYS, EVEN IF THEY ARE ASYMPTOMATIC !

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

Safe Sex Nature o