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Chlamydial and Gonococcal Infections

Chlamydial and Gonococcal Infections. An STD About to Happen!. Cell Monolayer Infected with Chlamydia and Stained with Chlamydia Specific Fluorescent Antibodies. Cell cytoplasma counter stained red. Chlamydial inclusions stained apple green.

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Chlamydial and Gonococcal Infections

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  1. Chlamydial and Gonococcal Infections

  2. An STD About to Happen!

  3. Cell Monolayer Infected with Chlamydia and Stained with Chlamydia Specific Fluorescent Antibodies Cell cytoplasma counter stained red Chlamydial inclusions stained apple green

  4. Electron Micrograph of a Chlamydia Infected Endocervix Columnar epithelial cells Chlamydial inclusion Microabscess

  5. Gonococcal Urethritis

  6. Gram Negative Intracellular Diplococci (GNID)

  7. Nongonococcal Urethritis

  8. Inflammation Without GNID

  9. Etiology of Nongonococcal Urethritis Chlamydia trachomatis 20-40% Mycoplasma genitalium 15-25% Ureaplasma urealyticum 10-20% Trichomonas vaginalis 5-15% Adenovirus 1-4% Herpes simplex virus 1-2%

  10. Mycoplasma genitalium

  11. Adenovirus Urethritis O’Mahony C. International J STI and AIDS. 2006;17:203

  12. Epidydimitis Scrotalerythema Discharge

  13. Gonococcal Endocervicitis

  14. Chlamydial Endocervicitis

  15. Etiology of PID

  16. Diagnosis of PID History • Lower abdominal pain of less than 15 days duration • Constant pain • Onset within 7 days of menstruation • Fever and/or chills • Sexual history

  17. Diagnosis of PID Signs • Bilateral adnexal tenderness • Cervical motion pain • Adnexal mass • Endocervical discharge

  18. Maternal Chlamydial Infection 65% of infants are infected 5% of infants develop pneumonia 30 – 50% of infants develop conjunctivitis

  19. Proportion of Chlamydial and Gonococcal Infections that are Asymptomatic

  20. Epidemiology

  21. Gonorrhea — Rates: United States, 1941–2008

  22. Gonorrhea — Rates: Total and by sex: United States, 1989–2008

  23. Gonorrhea — Rates by region: United States, 1999–2008

  24. Gonorrhea — Rates by County: United States, 2008

  25. Chlamydia — Rates: Total and by sex: United States, 1987–2007 Note: As of January 2000, all 50 states and the District of Columbia had regulations requiring the reporting of chlamydia cases.

  26. Chlamydia — Rates by County: United States, 2008

  27. Gonorrhea — Age- and sex-specific rates: United States, 2008

  28. Diagnosis

  29. Gram Negative Intracellular Diplococci (GNID)

  30. One Step Methylene Blue Stain

  31. Performance of Urethral and Endocervical Culture for N. gonorrhoeae and C. trachomatis *Assuming no mistakes are made in specimen labeling and laboratory procedures.

  32. Performance of the Pace 2 Gonococcal DNA Hybridization Assay in Women

  33. Nucleic Acid Amplification Test (NAAT) Sensitivity for Chlamydial Infections PCR-polymerase chain reaction. TMA-transcription mediated amplification. SDA-strand displacement amplification. Cook RL, et al. Annals Int Med. 2005; 142: 914

  34. Performance of a NAAT for the Detection of N. gonorrhoeae Koumans EH, et al. Clin Infect Dis 1998;27:1171.

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