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2016 ; 3
(9
): 390-403
Nephropedia Template TP
Microb Cell
2016[Sep]; 3
(9
): 390-403
PMID28357377
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Etiology, transmission and protection: Chlamydia trachomatis is the leading cause
of bacterial sexually transmitted infection (STI) globally. However, C.
trachomatis also causes trachoma in endemic areas, mostly Africa and the Middle
East, and is a leading cause of preventable blindness worldwide. Epidemiology,
incidence and prevalence: The World Health Organization estimates 131 million new
cases of C. trachomatis genital infection occur annually. Globally, infection is
most prevalent in young women and men (14-25 years), likely driven by
asymptomatic infection, inadequate partner treatment and delayed development of
protective immunity. Pathology/Symptomatology: C. trachomatis infects susceptible
squamocolumnar or transitional epithelial cells, leading to cervicitis in women
and urethritis in men. Symptoms are often mild or absent but ascending infection
in some women may lead to Pelvic Inflammatory Disease (PID), resulting in
reproductive sequelae such as ectopic pregnancy, infertility and chronic pelvic
pain. Complications of infection in men include epididymitis and reactive
arthritis. Molecular mechanisms of infection: Chlamydiae manipulate an array of
host processes to support their obligate intracellular developmental cycle. This
leads to activation of signaling pathways resulting in disproportionate influx of
innate cells and the release of tissue damaging proteins and pro-inflammatory
cytokines. Treatment and curability: Uncomplicated urogenital infection is
treated with azithromycin (1 g, single dose) or doxycycline (100 mg twice daily x
7 days). However, antimicrobial treatment does not ameliorate established
disease. Drug resistance is rare but treatment failures have been described.
Development of an effective vaccine that protects against upper tract disease or
that limits transmission remains an important goal.
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