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Chlamydia Trachomatis Kayona Greer Oklahoma City Community College Chlamydia is the most common sexually transmitted disease in humans worldwide. The origin is unknown, but is cause by the bacterium Chlamydia trachomatis, which is an obligate intracellular, non-motile, gram-negative human pathogen. They are also aerobic, eukcryotic cells and are usually coccoid or rod shaped. Chlamydia trachomatis was the first chlamydial agent discovered in humans, identified in 1907. Chlamydia is transmitted through contact with secretions during vaginal, anal, or oral sex. It can also be passed from infected mother to baby during vaginal childbirth. Chlamydia trachomatis has two strains, one being trachoma, which attacks epithelial cells of mucous membranes lungs, eyes, and genitourinary tract. It is also the leading cause of preventable blindness. The other strain is lymphogranuloma venereum (LGV), which is more severe and systemic, invading lymphatic tissues and primarily among homosexual men. Some virulent factors of Chlamydia are that it has a unique cell wall, which contains an outer lipopolysaccharide membrane, but no peptidoglycan. It also attaches to the body sites that are inaccessible to phagocytes, T-cells and B-cells. The disease also has a two phase life cycle with an inactive, infectious form of cells called elementary bodies (Ebs), which are protected by a rigid, impervious envelope, which attaches to and enters the host cell. After entering the host cell, the Ebs began their second life cycle as an active, noninfectious reticulate body (Rb). Rbs are energy parasites and have a deficient enzyme system for catabolizing glucose and synthesizing ATP. Rbs have ribosomes and can synthesize proteins, DNA, and RNA. Since Chlamydia trachomatis cannot make its own ATP, it needs a host organism to survive. Glycogen synthesis and use of glucose derivatives plays a supporting role in chlamydial metabolism. Chlamydia tracomatis uses metabolic products such as pyruvate, glycerol-3-phosphate, NADH dehydrogenases, and cytochrome oxidase to produce energy. Incubation period of Chlamydia is usually 1 to 3 weeks after exposure. Chlamydia is known as the “Silent Epidemic” in women because you may not have any symptoms. It may linger for months or years before being noticed. In at least 75% of Chlamydial cases, women have no symptoms, meaning that it can be passed to their partners and they not know it. Symptoms for females may include unusual vaginal bleeding or discharge, pain in lower abdomen or pelvic pain, painful sexual intercourse, fever, painful urination, and/or urinary urgency. Male symptoms include white discharge from penile area, pain when urinating, fever, and/or swollen or tender testicles. If not treated, Chlamydia may cause serious reproductive problems in women like Pelvic Inflammatory Disease (PID), which is an infection of the uterus, fallopian tubes, and/or ovaries. It causes scarring of the reproductive area, later causing chronic pelvic pain, difficulty becoming pregnant, ectopic pregnancy, and infertility. In men it may cause urthritis, prostatitis, and sterility if not treated. Laboratory test used to diagnose Chlamydia are swab test, where specimen is collected from an infected site, which are the cervix, the penis, or the anus. Urine collection is the other test used to diagnose the infection. The drug of choice for Chlamydia is azithromycin (Zithromax). It is an antibacterial macrolide and its actions are to inhibit protein synthesis having a bacteriostatic or bactericidal effect. Some side effects of the medication include nausea and vomiting, tinnitus, diarrhea, anorexia, abdominal cramps, rash, or pruritis. Some adverse effects include vaginitis, stomatitis, hearing loss, superinfections, hepatotoxicity, or anaphylaxis. Other drugs to treat Chlamydia are doxycycline, tetracycline, and erythromycin. The best way to prevent Chlamydia is by abstinence. If abstinence does not work, then condoms should be used and the number of sex partners should be limited. Sexually active individuals should be tested each year. If the disease is contracted, then it is important that the whole dose of antibiotic be taken to prevent reoccurrence and partner(s) should be treated as well. Chlamydia is curable. Chlamydia is the major cause of genital diseases and eye diseases and leading cause of infertility in women. Women who have or has had the infection are at an increased risk for developing cervical cancer and are five times more likely to contact HIV. Some statistics states that in 2007 there were 1.1 million people diagnosed with Chlamydia in the United States, which was a 7.5% increase from 2006. That means close to 3 million individuals were actually infected. Approximately 1 in 68 people have the disease. Females between the ages of 15 to 24 have the highest Chlamydia rate. Chlamydia causes more than 250,000 cases of epididymitis in the United States each year and causes 250,000 to 500,000 Pelvic Inflammatory Disease cases each year in the United States. Universal screening could prevent up to 60,000 cases of PID and 8,000 cases of chronic pelvic pain annually. Cost from Chlamydia and its complications total about 24 billion dollars per year. The countries/continents with the highest cases are South and Southeast Asia and Sub-Saharan Africa. The highest rate of new cases per year occurs in Africa. References 1. Chlamydia Trachomatis. (2010, April 11). Retrieved April 01, 2010, from Wikipedia: http://en.wikipedia.org/wiki/Chlamydia_trachomatis 2. Chlamydia: Symptoms, Signs, Treatment & Testing. (2010, April 14). Retrieved April 03, 2010, from Avert: http://www.avert.org/chlamydia.htm 3. Comparison of Gen-Probe Transcription.2008. p.3892-3895. Journal of Clinical Microbiology, Vol.46, No. 12. http://jcm.asm.org/cgi/reprint/46/12/3892? 4. Fact Sheet: Chlamydia. (2006, Dec 19). Retrieved March 31, 2010, from Center for Disease Control and Prevention: http://www.cdc.gov/std/healthcom/fact_sheet.htm 5. Global Prevalence and Incidence of Selected Curable Sexually Transmitted Infections. (1999). Retrieved April 02, 2010, from World Health Organization: http://www.who.int/docstore/niv/GRSTI/003.htm 6. Structural and Functional Analyses of the Major Outer Membrane Protein of Chlamydia Trachomatis. (2010, June 29). p.6222-6235. Journal of Bacteriology. Vol. 189, No.17. American Society for Microbiology: http://jb.asm.org/cgi/content/abstract/189/17/6222? 7. Talaro, Kathleen Park.2009. The Biology of Chlamydia and Related Forms, p. 642-644. Foundations In Microbiology, 7th ed. McGraw-Hill Companies, Inc, New York, NY.