Chlamydia trachomatislower respiratory tract infection in infants

Abstract

Chlamydia trachomatis may be an important cause of lower respiratory tract infection (LRTI) in infants born to mothers amongst whom there is a high prevalence of sexually transmitted disease. A study of 100 ambulatory infants with signs of LRTI in South Africa showed that 6% had C. trachomatis infection. The majority of the infected infants had received chloramphenicol eye ointment as prophylaxis. Half had previously visited a health facility for the same illness but the infection has been misdiagnosed. Infants with C. trachomatis infection were According to the Centers for Disease Control (CDC) guidelines, 85% were younger than uninfected infants (mean (SD) age of 3.8 weeks (3.2) vs 8.7 weeks (5.4); p=0.03). Clinical signs significantly associated with chlamydial infection were the presence of eye discharge (p = 0.02) or conjunctivitis (p = 0.01). There was a greater rate of rhinorrhoea (p = 0.06) and wheeze (p = 0.03) amongst patients without chlamydial infection. H. influenzae, M. catarrhalis, S. pneumoniae, S. aureus and N. gonorrhoeae were cultured from five different patients infected with chlamydia. The majority of infants with chlamydial infection had mild disease requiring only outpatient anti- biotic therapy.

Chlamydiae in febrile children with respiratory tract symptoms and age-matched controls, Ghana

“…A study conducted in Alexandria and neighbouring rural areas in 2014 revealed the presence of C. pneumoniae in 31.4% of febrile children with respiratory infections using diagnostic real-time PCR [12] . Moreover, among 100 South African children with lower respiratory tract symptoms, 6% were reported to have C. trachomatis infections [13] .…”

Congenital Pneumonia

“…The "classical" presentation is the late onset type, which typically occurs around the sixth week of life. [33][34][35] The onset is an insidious development of nasal obstruction and/or discharge, tachypnea, and staccato cough, without fever or wheezing. Concomitant conjunctivitis is detected in half of the cases and serves as an important diagnostic clue to the diagnosis.…”

“…Its etiological role in bronchopulmonary dysplasia in this group of patients has, however, not been ascertained yet. 35,36…”

Chlamydia trachomatis Infections in Neonates

“…These may be the direct or indirect colonisation routes leading to the pharyngeal presence of C. trachomatis, which is the most frequent target site detected in about 70-77% of the infected neonates (Darville, 2005;Stenberg & Mårdh, 1990) and that serves as an infectious focus giving rise to recurrent conjunctivitis or pneumonia. Pharyngitis occasionally may persist up to 2 years of age or beyond (Bell et al, 1992;Mårdh, 2002;Rees et al, 1981, Zar et al, 1999. Fortunately, this type of colonisation remains often subclinical, as its progression to pneumonia is observed only in 30% of the cases (Chen et al, 2007).…”

“…Severe congenital pneumonia due to C. trachomatis may even lead to fatal consequences in very preterm babies (25-32 weeks of gestation) (Attenburrow & Barker, 1986). Respiratory failure may affect primarily very preterm, low birth-weight infants, but there are documented cases of these also among near term babies or in untreated neonatal pneumonia (Herieka & Dhar, 2001, Zar et al, 1999. C. trachomatis infection has been associated with seriously chronic, occasionally lethal forms of pulmonary disorders of ventilated preterm neonates.…”