Chlamydia trachomatis infection in infants: a prospective study.

Abstract

SUMMARY In a prospective study of Chlamydia trachomatis infection in pregnancy, 198 mothers positive for chlamydial antigen were identified; the infants of 174 were followed for up to six months and C trachomatis was recovered in cell culture from 43 infants (25%). Conjuctivitis occurred in significantly more infants who were positive for C trachomatis (20 of 43, 47%) than in those who were negative (18 of 131, 14%). There were also significantly more lower respiratory tract infections among infants with positive cultures (six of 43, 14%, compared with three of 131, 2%). The chlamydial antigen enzyme linked immunosorbent assay (ELISA) was positive in 61 of 131 infants from whom C trachomatis was not recovered in cell culture. False positive results were usually associated with the isolation of Staphylococcus aureus from samples of pharyngeal aspirate.Our results confirm that C trachomatis infection is a common cause of neonatal conjunctivitis, and respiratory infection in the first few months of life, with an incidence of 8-2/1000 live births. Because the infection is easily treated by oral erythromycin, however, screening during pregnancy is not warranted.

Chlamydia trachomatis Infections in Neonates

“…There are documented cases of neonatal chlamydial infections after caesarean deliveries with ruptured membranes, and more rarely with intact membranes (Mohile et al, 2002). The prevalence of C. trachomatis infection among newborns after a caesarean section was found to be 8,3% (Bell et al, 1994;Preece et al, 1989;Yu et al, 2009). These data indicate that intrauterine C. trachomatis infections can occur in any phase of the pregnancy, however at a relatively low risk.…”

“…In the 1980's the incidence of chlamydial ophthalmia neonatorum was found 3 -250 cases per 1,000 live births, which has radically declined to 0,65 per 1,000 live births in Europe during the last three decades. This decreasing trend can be particularly observed in developed countries, where screening and treatment during pregnancy is a regular part of C. trachomatis surveillance (Darville, 2005;Di Bartolomeo et al, 2001;Krohn et al, 1993;Persson et al, 1983;Preece et al, 1989;Quirke & Cullinane, 2008).…”

“…Affected newborns would have most often been seen and treated by two or more physicians before establishing the definitive diagnosis of C. trachomatis infection. In case it is recognised promptly and treated adequately, a complete recovery can be expected without any late complications (Preece et a, 1989). Misdiagnosis or mistreatment with topical and/or inadequate medications will just facilitate the persistence of the disease.…”

“…The estimated data of neonatal prevalence rates range from 4 to 60 per 1000 live births depending on the population tested (Zar, 2005), which makes this microorganism the most frequent sexually transmitted pathogen in the industrialised countries, although detailed surveillance reports are nowadays still lacking. In a prospective study focusing on asymptomatic neonatal chlamydial colonisation and on symptomatic infection, the incidence per 1000 live birth was found to be 6,5 and 8,2 respectively, a summarised value of those represents a 14,7‰ prevalence of all chlamydia-positive infants (Preece et al, 1989).…”

“…Ascending chlamydial infections in pregnant women may result in intrauterine complications, such as chorioamnionitis and PROM. Subsequent transplacental infections occur predominantly in cases with ruptured membranes, and less frequently with intact membranes (Mohile et al, 2002;Preece et al, 1989). Affected fetuses are at a higher risk of being born preterm and of developing respiratory distress symptoms early after birth, though this is a rare kind of vertical transmission and an uncommon congenital condition due to C. trachomatis (Boo, 2008;Colarizi et al, 1996;López-Hurtado et al, 1999;Sollecito et al, 1992;Zar, 2005).…”