Статті в журналах: "Chlamydia infections Treatment Victoria"

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Wagg, Emma, Jane Hocking, and Jane Tomnay. "What do young women living in regional and rural Victoria say about chlamydia testing? A qualitative study." Sexual Health 17, no. 2 (2020): 160. http://dx.doi.org/10.1071/sh19182.

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Background Chlamydia trachomatis is the most commonly notified sexually transmissible infection in Australia, with almost 100000 cases diagnosed in 2018. Chlamydia is easy to diagnose and treat, but infections are underdiagnosed. Eighty per cent of chlamydia cases are asymptomatic. Without testing, infections will remain undetected. Several barriers to testing have been identified in previous research, including cost, privacy concerns for young rural people, knowledge gaps, embarrassment and stigma. The aim of this study was to investigate young regional and rural women’s understanding of chlamydia and factors that may prevent or delay testing. Methods: Semistructured interviews were conducted with 11 women aged between 18 and 30 years residing in north-east Victoria, Australia. Interviews were transcribed verbatim and analysed thematically. Results: Themes were grouped under four categories: (1) chlamydia and stigma; (2) the application of stigma to self and others; (3) factors affecting testing; and (4) knowledge. A chlamydia infection was associated with stigma. The young women in this study anticipated self-stigma in relation to a positive diagnosis, but resisted stigmatising others. Increased knowledge about chlamydia prevalence was associated with reduced self-stigma. The most consistent factor affecting testing decisions was personal risk assessment. Knowledge gaps about symptoms, testing and treatment were also identified, with participants not always accessing information from reputable sources. Conclusion: Chlamydia testing was viewed as a positive activity among this cohort. However, there is considerable perceived stigma about being diagnosed with an infection. Interventions that communicate prevalence, reduce stigma and provide factual information about testing and risk are still needed. Clinicians have an opportunity to convey this information at consultation. Health promotion workers should continue to develop and run campaigns at a community level to encourage regular screening.

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Pavlin, N., R. Parker, J. M. Gunn, C. K. Fairley, and J. Hocking. "56. TAKE THE SEX OUT OF STI SCREENING! VIEWS OF GPS AND YOUNG WOMEN ON IMPLEMENTING CHLAMYDIA SCREENING IN AUSTRALIA." Sexual Health 4, no. 4 (2007): 306. http://dx.doi.org/10.1071/shv4n4ab56.

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In-depth face to face interviews were carried out with a randomly selected sample of 20 General Practitioners (GPs) and 24 young women from across Victoria. We aimed to determine the attitudes of GPs and young women to chlamydia screening, what systems and education would be required to support chlamydia screening in general practice in Australia and in particular to explore how young women feel about being asked to test for chlamydia when they attend a GP for any reason. Both GPs and young women accept age-based screening for chlamydia and screening during a sexual health related consultation in general practice. Both feel that a large scale public education program, encompassing the high prevalence of chlamydial infection in young people in Australia, the asymptomatic nature of infection and the potential consequences if untreated, will be essential in ensuring the success of a chlamydia screening program in Australia. For the women, trust in their GP, was a major factor in the acceptability of chlamydia screening. They also felt chlamydia screening should be offered to all young women rather than targeted at 'high risk' women based on sexual history and they particularly emphasised the importance of normalising chlamydia screening. Women were clear that they did not want to be asked to provide a sexual history as part of being asked to have a chlamydia test. This finding has not been widely published in the literature and is worthy of comment. There is considerable evidence suggesting that GPs also regard sexual history taking as a barrier to STI testing in general practice. Chlamydia is an STI and notification and treatment of sexual partners is important. Understanding these concepts promotes young women's acceptance of chlamydia screening. However, is a detailed sexual history really an important precursor to a chlamydia test? Our study suggests maybe not.

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Goller, Jane L., Jacqueline Coombe, Meredith Temple-Smith, Helen Bittleston, Lena Sanci, Rebecca Guy, Christopher Fairley, et al. "Management of Chlamydia Cases in Australia (MoCCA): protocol for a non-randomised implementation and feasibility trial." BMJ Open 12, no. 12 (December 2022): e067488. http://dx.doi.org/10.1136/bmjopen-2022-067488.

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IntroductionThe sexually transmitted infection chlamydia can cause significant complications, particularly among people with female reproductive organs. Optimal management includes timely and appropriate treatment, notifying and treating sexual partners, timely retesting for reinfection and detecting complications including pelvic inflammatory disease (PID). In Australia, mainstream primary care (general practice) is where most chlamydia infections are diagnosed, making it a key setting for optimising chlamydia management. High reinfection and low retesting rates suggest partner notification and retesting are not uniformly provided. The Management of Chlamydia Cases in Australia (MoCCA) study seeks to address gaps in chlamydia management in Australian general practice through implementing interventions shown to improve chlamydia management in specialist services. MoCCA will focus on improving retesting, partner management (including patient-delivered partner therapy) and PID diagnosis.Methods and analysisMoCCA is a non-randomised implementation and feasibility trial aiming to determine how best to implement interventions to support general practice in delivering best practice chlamydia management. Our method is guided by the Consolidated Framework for Implementation Research and the Normalisation Process Theory. MoCCA interventions include a website, flow charts, fact sheets, mailed specimen kits and autofills to streamline chlamydia consultation documentation. We aim to recruit 20 general practices across three Australian states (Victoria, New South Wales, Queensland) through which we will implement the interventions over 12–18 months. Mixed methods involving qualitative and quantitative data collection and analyses (observation, interviews, surveys) from staff and patients will be undertaken to explore our intervention implementation, acceptability and uptake. Deidentified general practice and laboratory data will be used to measure pre-post chlamydia testing, retesting, reinfection and PID rates, and to estimate MoCCA intervention costs. Our findings will guide scale-up plans for Australian general practice.Ethics and disseminationEthics approval was obtained from The University of Melbourne Human Research Ethics Committee (Ethics ID: 22665). Findings will be disseminated via conference presentations, peer-reviewed publications and study reports.

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Kong, F., C. Kyle-Link, J. Hocking, and M. Hellard. "11. SEX AND SPORT: A COMMUNITY BASED PROJECT OF CHLAMYDIA TESTING AND TREATMENT IN RURAL AND REGIONAL VICTORIA." Sexual Health 4, no. 4 (2007): 288. http://dx.doi.org/10.1071/shv4n4ab11.

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Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.

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Petersen, Rodney W., Sepehr N. Tabrizi, Suzanne Garland, and Julie A. Quinlivan. "Prevalence of Chlamydia trachomatis in a public colposcopy clinic population." Sexual Health 4, no. 2 (2007): 133. http://dx.doi.org/10.1071/sh06050.

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Background: Chlamydia trachomatis is a major public health issue, with notifications of this sexually transmitted disease continuing to rise in Australia. Women attending colposcopy clinics are referred for treatment of cervical abnormalities often associated with human papilloma virus (HPV) infection. There is evidence that women who have acquired one sexually transmitted infection, such as HPV, are at higher risk of acquiring another. Women attending colposcopy clinics may therefore be at risk of undiagnosed infection with C. trachomatis. Aim: To determine the prevalence of C. trachomatis in women attending a public metropolitan colposcopy clinic in Victoria. Methods: A cross-sectional study was performed. Institutional ethics committee approval and informed consent were obtained. Consecutive women attending the colposcopy clinic completed a questionnaire and had a swab collected from the endocervix for analysis by polymerase chain reaction for C. trachomatis. Positive screens were treated in accordance with best practice. Data were analysed with Minitab Version 2004 (Minitab Inc, State College, PA, USA). Results: Of 581 women approached to participate in the trial, consent was obtained from 568 women (98%) and final outcome data was available on 560 women (99%). The overall rate of chlamydial infection was 2.1% (95% CI 1.5–2.7%). However, in women aged 25 years or less the rate was 5.8% (95% CI 3.8–7.8%) and in women over 25 years it was only 0.9% (95% CI 0.4–1.4%). Apart from age, no other demographic factor was significantly associated with chlamydial infection. Conclusion: Although the prevalence of chlamydial infection in the colposcopy clinic population as a whole does not warrant a policy for routine screening, screening directed at women aged 25 years or less would gain the greatest yields in terms of cost efficacy. Such a policy should be implemented as standard practice.

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Tomnay, Jane E., Rachelle L. Gebert, and Christopher K. Fairley. "A survey of partner notification practices among general practitioners and their use of an internet resource for partner notification for Chlamydia trachomatis." Sexual Health 3, no. 4 (2006): 217. http://dx.doi.org/10.1071/sh05052.

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Objectives: To determine in which circumstances Victorian general practitioners (GPs) offer chlamydia testing to patients, the attitudes of GPs in relation to contact tracing, how often GPs use a pre-printed partner letter and patient brochure and what proportion of GPs have immediate internet access in their consulting rooms. Methods: This study involved two parts, an initial survey of a sample of GPs in Victoria and a study of GP use of a website that provided treatment guidelines, a printable client brochure and a partner letter. Results: Of 418 eligible GPs, 221 (53%, 48–58%, 95% CI) returned completed surveys. Of these, 213 (97%, 93–99%, 95% CI) GPs believed that patients were largely responsible for notifying partners. Partner letters were rarely used: 167 (76%, 70–81%, 95% CI) GPs reported they never used partner letters, 18 (8%, 5–13%, 95% CI) GPs reported rare use and 23 (10%, 7–15%, 95% CI) GPs reportedusing them sometimes. Of the GPs, 181 (82%, 77–87%, 95% CI) reported they would find a partner letter and patient brochure on a website helpful. During the study, the website was accessed by 28 GPs (25%, 17–34%, 95% CI) in Gippsland and 17 GPs (8%, 5–13%, 95% CI) in Geelong who received positive chlamydia results on 110 and 208 clients respectively. Conclusions: GPs mostly considered patients responsible for partner notification but uncommonly used partner letters or an information brochure to assist them. Importantly, GPs reported that they could improve partner notification if further support was provided. In addition, when a website was provided with useful documents on it, up to 25% of GPs used it. This indicates that simple and inexpensive interventions can support GPs with strategies that may improve the control of chlamydia.

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Goller, Jane L., Jacqueline Coombe, Christopher Bourne, Deborah Bateson, Meredith Temple-Smith, Jane Tomnay, Alaina Vaisey, et al. "Patient-delivered partner therapy for chlamydia in Australia: can it become part of routine care?" Sexual Health 17, no. 4 (2020): 321. http://dx.doi.org/10.1071/sh20024.

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Abstract Background Patient-delivered partner therapy (PDPT) is a method for an index patient to give treatment for genital chlamydia to their sexual partner(s) directly. In Australia, PDPT is considered suitable for heterosexual partners of men and women, but is not uniformly endorsed. We explored the policy environment for PDPT in Australia and considered how PDPT might become a routine option. Methods: Structured interviews were conducted with 10 key informants (KIs) representing six of eight Australian jurisdictions and documents relevant to PDPT were appraised. Interview transcripts and documents were analysed together, drawing on KIs’ understanding of their jurisdiction to explore our research topics, namely the current context for PDPT, challenges, and actions needed for PDPT to become routine. Results: PDPT was allowable in three jurisdictions (Victoria, New South Wales, Northern Territory) where State governments have formally supported PDPT. In three jurisdictions (Western Australia, Australian Capital Territory, Tasmania), KIs viewed PDPT as potentially allowable under relevant prescribing regulations; however, no guidance was available. Concern about antimicrobial stewardship precluded PDPT inclusion in the South Australian strategy. For Queensland, KIs viewed PDPT as not allowable under current prescribing regulations and, although a Medicine and Poisons Act was passed in 2019, it is unclear if PDPT will be possible under new regulations. Clarifying the doctor–partner treating relationship and clinical guidance within a care standard were viewed as crucial for PDPT uptake, irrespective of regulatory contexts. Conclusion: Endorsement and guidance are essential so doctors can confidently and routinely offer PDPT in respect to professional standards and regulatory requirements.

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LINNEMANN, CALVIN C., CHARLES L. HEATON, and MICHAEL RITCHEY. "Treatment of Chlamydia trachomatis Infections." Sexually Transmitted Diseases 14, no. 2 (April 1987): 102–6. http://dx.doi.org/10.1097/00007435-198704000-00009.

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Goller, Jane L., Rebecca J. Guy, Judy Gold, Megan S. C. Lim, Carol El-Hayek, Mark A. Stoove, Isabel Bergeri, et al. "Establishing a linked sentinel surveillance system for blood-borne viruses and sexually transmissible infections: methods, system attributes and early findings." Sexual Health 7, no. 4 (2010): 425. http://dx.doi.org/10.1071/sh09116.

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Objective: To describe the attributes and key findings from implementation of a new blood-borne virus (BBV) and sexually transmissible infection (STI) sentinel surveillance system based on routine testing at clinical sites in Victoria, Australia. Methods: The Victorian Primary Care Network for Sentinel Surveillance (VPCNSS) on BBV and STI was established in 2006 at 17 sites. Target populations included men who have sex with men (MSM), young people and injecting drug users (IDU). Sites collected demographic and risk behaviour information electronically or using paper surveys from patients undergoing routine HIV or STI (syphilis, chlamydia (Chlamydia trachomatis)) or hepatitis C virus (HCV) testing. These data were linked with laboratory results. Results: Between April 2006 and June 2008, data were received for 67 466 tests and 52 042 questionnaires. In clinics providing electronic data, >90% of individuals tested for HIV, syphilis and chlamydia had risk behaviour information collected. In other clinics, survey response rates were >85% (HIV), 43.5% (syphilis), 42.7–66.5% (chlamydia) and <20% (HCV). Data completeness was >85% for most core variables. Over time, HIV, syphilis and chlamydia testing increased in MSM, and chlamydia testing declined in females (P = 0.05). The proportion of positive tests among MSM was 1.9% for HIV and 2.1% for syphilis. Among 16–24-year-olds, the proportion positive for chlamydia was 10.7% in males and 6.9% in females. Among IDU, 19.4% of HCV tests were antibody positive. Conclusions: The VPCNSS has collected a large, rich dataset through which testing, risk behaviours and the proportion positive can be monitored in high-risk groups, offering a more comprehensive BBV and STI surveillance system for Victoria. Building system sustainability requires an ongoing focus.

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Kalwij, S., M. Macintosh, and P. Baraitser. "Screening and treatment of Chlamydia trachomatis infections." BMJ 340, apr21 2 (April 21, 2010): c1915. http://dx.doi.org/10.1136/bmj.c1915.

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Miller, Joseph M., and David H. Martin. "Treatment of Chlamydia trachomatis Infections in Pregnant Women." Drugs 60, no. 3 (September 2000): 597–605. http://dx.doi.org/10.2165/00003495-200060030-00006.

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CHAISILWATTANA, PONGSAKDI, and NEWTON G. OSBORNE. "Antibiotic Treatment of Chlamydia trachomatis Infections in Gynecology." Journal of Gynecologic Surgery 9, no. 4 (January 1993): 241–42. http://dx.doi.org/10.1089/gyn.1993.9.241.

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Gray, Richard T., Denton Callander, Jane S. Hocking, Skye McGregor, Hamish McManus, Amalie Dyda, Clarissa Moreira, et al. "Population-level diagnosis and care cascade for chlamydia in Australia." Sexually Transmitted Infections 96, no. 2 (June 5, 2019): 131–36. http://dx.doi.org/10.1136/sextrans-2018-053801.

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ObjectivesKey strategies to control chlamydia include testing, treatment, partner management and re-testing. We developed a diagnosis and care cascade for chlamydia to highlight gaps in control strategies nationally and to inform efforts to optimise control programmes.MethodsThe Australian Chlamydia Cascade was organised into four steps: (1) annual number of new chlamydia infections (including re-infections); (2) annual number of chlamydia diagnoses; (3) annual number of diagnoses treated; (4) annual number of diagnoses followed by a re-test for chlamydia within 42–180 days of diagnosis. For 2016, we estimated the number of infections among young men and women aged 15–29 years in each of these steps using a combination of mathematical modelling, national notification data, sentinel surveillance data and previous research studies.ResultsAmong young people in Australia, there were an estimated 248 580 (range, 240 690–256 470) new chlamydia infections in 2016 (96 470 in women; 152 100 in men) of which 70 164 were diagnosed (28.2% overall: women 43.4%, men 18.6%). Of the chlamydia infections diagnosed, 65 490 (range, 59 640–70 160) were treated (93.3% across all populations), but only 11 330 (range, 7660–16 285) diagnoses were followed by a re-test within 42–180 days (17.3% overall: women 20.6%, men 12.5%) of diagnosis.ConclusionsThe greatest gaps in the Australian Chlamydia Cascade for young people were in the diagnosis and re-testing steps, with 72% of infections undiagnosed and 83% of those diagnosed not re-tested: both were especially low among men. Treatment rates were also lower than recommended by guidelines. Our cascade highlights the need for enhanced strategies to improve treatment and re-testing coverage such as short message service reminders, point-of-care and postal test kits.

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Nicolle, LE. "Sexually Transmitted Infections." Canadian Journal of Infectious Diseases and Medical Microbiology 16, no. 1 (2005): 9–10. http://dx.doi.org/10.1155/2005/958678.

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Sexually transmitted infections (STIs) other than HIV have reappeared as an important public health problem in developed countries (1). In the late 1970s and early 1980s, research and treatment of the 'classic' STIs - gonorrhea, syphilis and chlamydia - were a major focus of infectious diseases practice and research. There were large outbreaks of syphilis in parts of Canada (2), penicillin-resistantNeisseria gonorrhoeaewas a concern (3), and high rates ofChlamydia trachomatisinfection with complications of pelvic inflammatory disease and ectopic pregnancy were being reported (4,5). Then, HIV infection emerged, with its spectre of a wasting, early death. There was no effective treatment, and safe sexual practices were embraced and adhered to by high-risk populations as the only effective way to avoid infection. These practices effectively prevented other STIs; rates of syphilis, gonorrhea and chlamydia infection plummeted in developed countries (5). For at least a decade, it appeared that HIV might be an end to all STIs, at least for some parts of the world. STIs continued unabated in developing countries, as many epidemiological and therapeutic studies explored the association of STIs with HIV infection.

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Aftab, Rabia. "Chlamydia screening." InnovAiT: Education and inspiration for general practice 11, no. 7 (May 29, 2018): 366–70. http://dx.doi.org/10.1177/1755738018769688.

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Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life, adding economic burden and causing serious morbidity. Chlamydia infection is the most common bacterial STI, making up a large proportion of the over 1 000 000 STIs acquired every day. Although easily cured with antibiotics, untreated chlamydial infection can have serious consequences affecting reproductive health and the unborn child. Since chlamydia infection is typically asymptomatic, screening provides an opportunity to prevent complications and reduce transmission. With long waits for genitourinary medicine appointments and busy sexual health clinics, screening in primary care can help to improve chlamydia detection and treatment rates.

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Hwang, L., M. Shafer, K. Tebb, C. Wibbelsman, S. Cruz-Pecson, M. Pai-Dhungat, and B. Pantell. "TREATMENT AND FOLLOW-UP OF ADOLESCENTS WITH CHLAMYDIA TRACHOMATIS INFECTIONS." Journal of Investigative Medicine 52 (January 2004): S142. http://dx.doi.org/10.1097/00042871-200401001-00358.

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Stolz, E., M. J. A. M. Tegelberg-Stassen, A. H. Van der Willigen, J. C. S. Van der Hoek, Th Van Joost, L. Mooi, and J. H. T. Wagenvoort. "Quinolones in the treatment of gonorrhoea and Chlamydia trachomatis infections." Pharmaceutisch Weekblad 8, no. 1 (February 1986): 60–62. http://dx.doi.org/10.1007/bf01975482.

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Stolz, E., J. H. T. Wagenvoort, and A. H. van der Willigen. "Quinolones in the treatment of gonorrhoea and Chlamydia trachomatis infections." Pharmaceutisch Weekblad 9, S1 (February 1987): S82—S86. http://dx.doi.org/10.1007/bf02075269.

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Zsuzsanna, Gáll, Sánta Réka, Moréh Zsuzsanna, Cucerea Manuela, and Simon Márta. "Congenital Chlamydia Infection – case presentation." Bulletin of Medical Sciences 93, no. 1 (July 1, 2020): 16–19. http://dx.doi.org/10.2478/orvtudert-2020-0005.

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Abstract There are several pathogens involved in the etiology of neonatal infections. Based on etiology, these can be classified into materno-fetal and nosocomial infections. Bacteria of the Chlamydia family behave like intracellular parasites. The most well-known member is Chlamydia trachomatis, which is the cause of the most common sexually transmitted disease in developed societies. In this case, we present a 27-days-old girl who presented at our clinic with conjunctivitis, dyspnea and coughing. Laboratory and imaging findings reported leucocytosis, eosinophilia, and bronchopneumonia. Her condition improved rapidly during antibiotic treatment, but her conjunctivitis recurred. Serological tests confirmed Chlamydia infection of the newborn. She became asymptomatic after the whole family has been cured. In case of neonatal conjunctivitis, pneumonia and eosinophilia, Chlamydia should be considered and the whole family treated to prevent re-infections.

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Bouchemal, Kawthar, Christian Bories, and Philippe M. Loiseau. "Strategies for Prevention and Treatment of Trichomonas vaginalis Infections." Clinical Microbiology Reviews 30, no. 3 (May 24, 2017): 811–25. http://dx.doi.org/10.1128/cmr.00109-16.

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SUMMARY The last estimated annual incidence of Trichomonas vaginalis worldwide exceeds that of chlamydia and gonorrhea combined. This critical review updates the state of the art on advances in T. vaginalis diagnostics and strategies for treatment and prevention of trichomoniasis. In particular, new data on treatment outcomes for topical administration of formulations are reviewed and discussed.

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Cai, Tommaso, Sandra Mazzoli, Nicola Mondaini, Gianni Malossini, and Riccardo Bartoletti. "Chlamydia trachomatis infection: a challenge for the urologist." Microbiology Research 2, no. 1 (December 12, 2011): 14. http://dx.doi.org/10.4081/mr.2011.e14.

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<p>The role of <em>Chlamydia trachomatis</em> (Ct) in everyday clinical practice is now on the increase because Ct infections are the most prevalent sexually transmitted bacterial infections worldwide. Ct can cause urethritis, cervicitis, pharyngitis, or epididymitis, although asymptomatic infections are quite common. Ct infection remains asymptomatic in approximately 50% of infected men and 70% of infected women, with risk for reproductive tract sequelae both in women and men. A proper early diagnosis and treatment is essential in order to prevent persistent consequences. An accurate comprehension of the pathology, diagnosis and treatment of this entity is essential for the urologist. We review the literature about the new findings in diagnosis and treatment of Ct infection in sexually active young men.</p>

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Hoque, Syada Monira, Md Akram Hossain, Shyamal Kumar Paul, Chand Mahmud, Nazia Haque, and Md Annaz Mus Sakib. "Genital infections by Chlamydia trachomatis-An overview." KYAMC Journal 3, no. 1 (February 5, 2013): 244–49. http://dx.doi.org/10.3329/kyamcj.v3i1.13660.

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Genital infections by Chlamydia trachomatis are now recognized as highly prevalent sexually transmissible disease. In frequency, they surpass the classic sexually transmissible diseases such as syphilis and gonorrhea and thus constitute a serious public health problem. Chlamydia trachomatis is an obligate intracellular gram negative bacterium which have a unique growth cycle and are placed in their own family (Chlamydiae).Chlamydia trachomatis is now one of the most Prevalent bacteria found in classic sexually transmissible disease and as such constitutes a serious Public heath problem. World Heath Organization (WHO) estimated that 92 million new chlamydial infections occur worldwide annually affecting more women (50 Million) then men (42million). And highest chlamydial infected population were in south and South-east Asia (43million) then sub- Saharan Africa (16million)(WHO 2001).This review article is a discussion on history,epidemiology, pathogenesis, clinical features, diagnosis and modern trend of treatment, prevention of Chlamydial infections in age group. Effective delivery of prevention messages requires clientcentered counseling and education regarding specific actions that can reduce the risk for chlamydia transmission e.g., abstinence, condom use, limiting the number of sex partners,modifying sexual behaviors and vaccination.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13660 KYAMC Journal Vol. 3, No.-1, June 2012 pp.244-249

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Hamarsheh, Omar, Ahmad Amro, and Munir A. Al-Zeer. "In Vitro Antibacterial Activity of Selected Palestinian Medicinal Plants against Chlamydia trachomatis." Microbiology Research 12, no. 3 (August 8, 2021): 656–62. http://dx.doi.org/10.3390/microbiolres12030047.

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Chlamydia spp. are intracellular pathogens of humans and animals that cause a wide range of diseases such as blinding trachoma and sexually transmitted infections. According to the World Health Organization (WHO), there are more than 127 million new infections each year worldwide. Chlamydial urogenital infections can cause cervicitis, urethritis, pelvic inflammatory disease and infertility. From within an intracellular niche, termed an inclusion, the Chlamydiae complete their life cycle shielded from host defenses. The host cell defense response used to eliminate the pathogen must subvert this protective shield and is thought to involve the gamma interferon-inducible family of immunity related GTPase proteins and nitric oxide. Typically, azithromycin and doxycycline are the first line drugs for the treatment of chlamydial infections. Although C. trachomatis is sensitive to these antibiotics in vitro, currently, there is increasing bacterial resistance to antibiotics including multidrug-resistant C. trachomatis, which have been described in many instances. Therefore, alternative drug candidates against Chlamydia should be assessed in vitro. In this study, we tested and quantified the activity of plant extracts against Chlamydia-infected HeLa cells with C. trachomatis inclusions. The in vitro results show that post-treatment with Artemisia inculta Delile extract significantly inhibits Chlamydia infection compared to DMSO-treated samples. In conclusion, plant extracts may contain active ingredients with antichlamydial activity potential and can be used as alternative drug candidates for treatment of Chlamydia infection which has significant socio-economic and medical impact.

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Dukers-Muijrers, Nicole H. T. M., Petra F. G. Wolffs, Henry De Vries, Hannelore M. Götz, Titia Heijman, Sylvia Bruisten, Lisanne Eppings, et al. "Treatment Effectiveness of Azithromycin and Doxycycline in Uncomplicated Rectal and Vaginal Chlamydia trachomatis Infections in Women: A Multicenter Observational Study (FemCure)." Clinical Infectious Diseases 69, no. 11 (January 28, 2019): 1946–54. http://dx.doi.org/10.1093/cid/ciz050.

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Abstract Background Rectal infections with Chlamydia trachomatis (CT) are prevalent in women visiting a sexually transmitted infection outpatient clinic, but it remains unclear what the most effective treatment is. We assessed the effectiveness of doxycycline and azithromycin for the treatment of rectal and vaginal chlamydia in women. Methods This study is part of a prospective multicenter cohort study (FemCure). Treatment consisted of doxycycline (100 mg twice daily for 7 days) in rectal CT–positive women, and of azithromycin (1 g single dose) in vaginally positive women who were rectally untested or rectally negative. Participants self-collected rectal and vaginal samples at enrollment (treatment time-point) and during 4 weeks of follow-up. The endpoint was microbiological cure by a negative nucleic acid amplification test at 4 weeks. Differences between cure proportions and 95% confidence intervals (CIs) were calculated. Results We analyzed 416 patients, of whom 319 had both rectal and vaginal chlamydia at enrollment, 22 had rectal chlamydia only, and 75 had vaginal chlamydia only. In 341 rectal infections, microbiological cure in azithromycin-treated women was 78.5% (95% CI, 72.6%–83.7%; n = 164/209) and 95.5% (95% CI, 91.0%–98.2%; n = 126/132) in doxycycline-treated women (difference, 17.0% [95% CI, 9.6%–24.7%]; P < .001). In 394 vaginal infections, cure was 93.5% (95% CI, 90.1%–96.1%; n = 246/263) in azithromycin-treated women and 95.4% (95% CI, 90.9%–98.2%; n = 125/131) in doxycycline-treated women (difference, 1.9% [95% CI, –3.6% to 6.7%]; P = .504). Conclusions The effectiveness of doxycycline is high and exceeds that of azithromycin for the treatment of rectal CT infections in women. Clinical Trials Registration NCT02694497.

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Lau, Andrew, Jane S. Hocking, and Fabian Y. S. Kong. "Rectal chlamydia infections: implications for reinfection risk, screening, and treatment guidelines." Current Opinion in Infectious Diseases 35, no. 1 (November 26, 2021): 42–48. http://dx.doi.org/10.1097/qco.0000000000000804.

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Augenbraun, Michael H., and William M. McCormack. "Current treatment options for Neisseria gonorrhoeae and Chlamydia trachomatis anogenital infections." Current Opinion in Infectious Diseases 6, no. 1 (February 1993): 5–8. http://dx.doi.org/10.1097/00001432-199302000-00003.

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KOJIMA, Hiroyuki, and Chuzou MORI. "Minocycline Treatment of Genital Infections Caused by Chlamydia Trachomatis (C. trachomatis)." Journal of the Japanese Association for Infectious Diseases 59, no. 8 (1985): 824–30. http://dx.doi.org/10.11150/kansenshogakuzasshi1970.59.824.

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Hwang, L., M. Shafer, K. Tebb, C. Wibbelsman, S. Cruz-Pecson, M. Pai-Dhungat, and B. Pantell. "358 TREATMENT AND FOLLOW-UP OF ADOLESCENTS WITH CHLAMYDIA TRACHOMATIS INFECTIONS." Journal of Investigative Medicine 52, Suppl 1 (January 1, 2004): S142.1—S142. http://dx.doi.org/10.1136/jim-52-suppl1-358.

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Lipsky, Benjamin A., Kenneth J. Tack, Cho-Chou Kuo, San-pin Wang, and J. Thomas Grayston. "Ofloxacin treatment of Chlamydia pneumoniae (strain TWAR) lower respiratory tract infections." American Journal of Medicine 89, no. 6 (December 1990): 722–24. http://dx.doi.org/10.1016/0002-9343(90)90212-v.

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Stetsko, T. I. "BACTERIAL INTESTINAL INFECTIONS OF SWINE." Scientific and Technical Bulletin оf State Scientific Research Control Institute of Veterinary Medical Products and Fodder Additives аnd Institute of Animal Biology 23, no. 1 (December 2, 2022): 161–83. http://dx.doi.org/10.36359/scivp.2022-23-1.23.

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Bacterial intestinal infections are one of the main diseases in pigs of different ages. Bacterial diseases of the pig digestive tract lead to significant economic losses due to high mortality, reduced growth, treatment and prevention costs. The main bacterial intestinal infections of pigs are anaerobic enterotoxemia (clostridiosis), colibacillosis, intestinal salmonellosis, dysentery, proliferative enteropathy (ileitis). Anaerobic enterotoxemia of pigs is an acute toxic-infectious disease mainly of newborn piglets, caused by pathogenic bacteria of the genus Clostridium and characterized by hemorrhagic-necrotic inflammation of the intestinal mucosa, diarrhea and toxicosis. Swine colibacillosis is an intestinal infection caused by the enterotoxigenic Escherichia coli, which is able to produce enterotoxins that locally affect the intestines of pigs, causing diarrheal syndrome. Intestinal salmonellosis is a factorial infection. The causative agents are enteropathogenic salmonella (mainly Salmonella enterica serotype typhimurium), which cause inflammation and necrosis of the small and large intestine, leading to diarrhea, which may be accompanied by generalized sepsis. Dysentery is a severe enteroinfection of pigs caused by the anaerobic bacterium Brachyspira hyodysenteriae, characterized by fever, debilitating mucohemorrhagic diarrhea and dehydration, leading to high mortality among animals. Proliferative enteropathy is a sporadic disease of pigs caused by Lawsonia intracellularis. The acute form of ileitis, known as proliferative hemorrhagic enteritis, is characterized by intestinal hemorrhage and sudden death, and usually occurs in pigs older than 4 months. Diarrhea in piglets can also be caused by enterococci (Enterococcus spp.) and chlamydia (Chlamydia suis). Enterococcal bacteria cause diarrhea in newborn piglets, and intestinal chlamydia infections are mostly common in rearing piglets, and it is believed that most intestinal infections caused by chlamydia are subclinical. The literature review regarding the etiology, pathogenesis and clinical diagnosis of major bacterial intestinal infections in pigs is presented in the article.

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Cater, Kathryn, Ryszard Międzybrodzki, Vera Morozova, Sławomir Letkiewicz, Marzanna Łusiak-Szelachowska, Justyna Rękas, Beata Weber-Dąbrowska, and Andrzej Górski. "Potential for Phages in the Treatment of Bacterial Sexually Transmitted Infections." Antibiotics 10, no. 9 (August 24, 2021): 1030. http://dx.doi.org/10.3390/antibiotics10091030.

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Bacterial sexually transmitted infections (BSTIs) are becoming increasingly significant with the approach of a post-antibiotic era. While treatment options dwindle, the transmission of many notable BSTIs, including Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum, continues to increase. Bacteriophage therapy has been utilized in Poland, Russia and Georgia in the treatment of bacterial illnesses, but not in the treatment of bacterial sexually transmitted infections. With the ever-increasing likelihood of antibiotic resistance prevailing and the continuous transmission of BSTIs, alternative treatments must be explored. This paper discusses the potentiality and practicality of phage therapy to treat BSTIs, including Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Streptococcus agalactiae, Haemophilus ducreyi, Calymmatobacterium granulomatis, Mycoplasma genitalium, Ureaplasma parvum, Ureaplasma urealyticum, Shigella flexneri and Shigella sonnei. The challenges associated with the potential for phage in treatments vary for each bacterial sexually transmitted infection. Phage availability, bacterial structure and bacterial growth may impact the potential success of future phage treatments. Additional research is needed before BSTIs can be successfully clinically treated with phage therapy or phage-derived enzymes.

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Itoh, Ryota, Yusuke Kurihara, Michinobu Yoshimura, and Kenji Hiromatsu. "Bortezomib Eliminates Persistent Chlamydia trachomatis Infection through Rapid and Specific Host Cell Apoptosis." International Journal of Molecular Sciences 23, no. 13 (July 4, 2022): 7434. http://dx.doi.org/10.3390/ijms23137434.

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Chlamydia trachomatis, a parasitic intracellular bacterium, is a major human pathogen that causes millions of trachoma, sexually transmitted infections, and pneumonia cases worldwide. Previously, peptidomimetic inhibitors consisting of a hydrophobic dipeptide derivative exhibited significant inhibitory effects against chlamydial growth. Based on this finding, this study showed that both bortezomib (BTZ) and ixazomib (IXA), anticancer drugs characterized by proteasome inhibitors, have intensive inhibitory activity against Chlamydia. Both BTZ and IXA consisted of hydrophobic dipeptide derivatives and strongly restricted the growth of Chlamydia (BTZ, IC50 = 24 nM). In contrast, no growth inhibitory effect was observed for other nonintracellular parasitic bacteria, such as Escherichia coli. BTZ and IXA appeared to inhibit chlamydial growth bacteriostatically via electron microscopy. Surprisingly, Chlamydia-infected cells that induced a persistent infection state were selectively eliminated by BTZ treatment, whereas uninfected cells survived. These results strongly suggested the potential of boron compounds based on hydrophobic dipeptides for treating chlamydial infections, including persistent infections, which may be useful for future therapeutic use in chlamydial infectious diseases.

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Sherrard, Jackie, and Jorgen S. Jensen. "Chlamydia treatment failure after repeat courses of azithromycin and doxycycline." International Journal of STD & AIDS 30, no. 10 (July 23, 2019): 1025–27. http://dx.doi.org/10.1177/0956462419857303.

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A case is presented of a 22 year-old woman with genital Chlamydia trachomatis infection, which persisted for 8 months despite treatment with four 1g doses of azithromycin and both a 7-day and 14-day course of doxycycline. She denied any sexual contact during this time. Tests for other infections including extragenital sites were negative.

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Pais, Roshan, Rajneesh Jha, Yusuf Omosun, Qing He, Kohtaro Fujihashi, Carolyn Black, Joseph Igietseme, and Francis Eko. "Rectal immunization with an rVCG vaccine protects against genital Chlamydia challenge (VAC7P.962)." Journal of Immunology 192, no. 1_Supplement (May 1, 2014): 141.7. http://dx.doi.org/10.4049/jimmunol.192.supp.141.7.

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Abstract Pelvic inflammatory diseases consequent to Chlamydia trachomatis infections is a major public health challenge with frequent asymptomatic infections precluding in early diagnosis and treatment making clinical presentation of sequelae often the first indication of infection. Development of a safe, efficacious and affordable vaccine holds promise for the global spread of Chlamydia genital infections. Previously we have shown that intramuscular(IM) vaccination of Vibrio cholerae ghosts (VCG) expressing Porin B and PmpD showed protection of mice against intravaginal infections via the development of a cellular ( Th1) as well as humoral ( IgG2a and IgA) immunity. The present study was undertaken to examine the potential of rectal immunization for the induction of genital tract immunity against heterologous Chlamydia infection in mice. The impact of immunization with the VCG vaccine in combination with Flt3 Ligand (FL) on induction of immunity was also investigated. The results demonstrate that both IM and IR rVCG immunizations elicited high levels of antigen-specific Th1 cell-mediated and humoral immune responses that were enhanced following co-immunization with FL. Also, rectally immunized mice were significantly protected against heterologous infection with serovar E Chlamydia 2 weeks post immunization. These results highlight the potential of rectal immunization for eliciting immunity in the female genital tract against Chlamydia and other sexually transmitted diseases.

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Marinelli, Tess, Eric P. F. Chow, Jane Tomnay, Glenda Fehler, Catriona S. Bradshaw, Marcus Y. Chen, Dana S. Forcey, and Christopher K. Fairley. "Rate of repeat diagnoses in men who have sex with men for Chlamydia trachomatis and Neisseria gonorrhoeae: a retrospective cohort study." Sexual Health 12, no. 5 (2015): 418. http://dx.doi.org/10.1071/sh14234.

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Background Sexually transmissible infections (STIs) have increased rapidly among men who have sex with men (MSM). One of the most effective strategies to control STIs is partner notification. Inadequate partner notification may be associated with high rates of repeat diagnoses with STIs. The aim of this study is to estimate and compare the rate of chlamydia and gonorrhoea infection following primary infection to the overall clinic rate. Methods: A retrospective cohort analysis of MSM attending the Melbourne Sexual Health Clinic was conducted. For both infections, the overall incidence and that following diagnosis and treatment was calculated. Results: Of the 13053 MSM, the incidence of diagnoses for chlamydia and gonorrhoea was 8.5 (95% CI: 8.2–8.9) and 6.2 (95% CI: 5.9–6.5) per 100 person-years, respectively. Seventy per cent of chlamydia and 64% of gonorrhoea cases were retested at 10–365 days after diagnosis and treatment. Following diagnosis and treatment of chlamydia, the rate ratio in these individuals in the first quarter was 16- and 8-fold higher for chlamydia and gonorrhoea, respectively, compared with the background incidence of diagnoses. Similarly, following diagnosis and treatment of gonorrhoea, the rate ratio in these individuals in the first quarter was 18- and 10-fold higher for gonorrhoea and chlamydia, respectively. Conclusions: These data suggest that approximately half of MSM who test positive for chlamydia or gonorrhoea within 90 days after an initial infection represent contact with either a previous sexual partner or member of the same sexual network, the remainder representing the particularly high STI risk for these MSM.

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Domeika, M. "Chlamydia trachomatis infections in eastern Europe: legal aspects, epidemiology, diagnosis, and treatment." Sexually Transmitted Infections 78, no. 2 (April 1, 2002): 115–19. http://dx.doi.org/10.1136/sti.78.2.115.

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Dylewski, J., B. Clecner, J. Dubois, C. St-Pierre, G. Murray, C. Bouchard, and R. Phillips. "Comparison of spiramycin and doxycycline for treatment of Chlamydia trachomatis genital infections." Antimicrobial Agents and Chemotherapy 37, no. 6 (June 1, 1993): 1373–74. http://dx.doi.org/10.1128/aac.37.6.1373.

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Mishra, Manoj K., Kishore Kotta, Mirabela Hali, Susan Wykes, Herve C. Gerard, Alan P. Hudson, Judith A. Whittum-Hudson, and Rangaramanujam M. Kannan. "PAMAM dendrimer-azithromycin conjugate nanodevices for the treatment of Chlamydia trachomatis infections." Nanomedicine: Nanotechnology, Biology and Medicine 7, no. 6 (December 2011): 935–44. http://dx.doi.org/10.1016/j.nano.2011.04.008.

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Rothstein, David M., John van Duzer, Andrew Sternlicht, and Steven C. Gilman. "Rifalazil and Other Benzoxazinorifamycins in the Treatment of Chlamydia-Based Persistent Infections." Archiv der Pharmazie 340, no. 10 (October 2007): 517–29. http://dx.doi.org/10.1002/ardp.200700080.

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Dahlhausen, Katherine E., Ladan Doroud, Alana J. Firl, Adam Polkinghorne, and Jonathan A. Eisen. "Characterization of shifts of koala (Phascolarctos cinereus) intestinal microbial communities associated with antibiotic treatment." PeerJ 6 (March 12, 2018): e4452. http://dx.doi.org/10.7717/peerj.4452.

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Koalas (Phascolarctos cinereus) are arboreal marsupials native to Australia that eat a specialized diet of almost exclusively eucalyptus leaves. Microbes in koala intestines are known to break down otherwise toxic compounds, such as tannins, in eucalyptus leaves. Infections by Chlamydia, obligate intracellular bacterial pathogens, are highly prevalent in koala populations. If animals with Chlamydia infections are received by wildlife hospitals, a range of antibiotics can be used to treat them. However, previous studies suggested that koalas can suffer adverse side effects during antibiotic treatment. This study aimed to use 16S rRNA gene sequences derived from koala feces to characterize the intestinal microbiome of koalas throughout antibiotic treatment and identify specific taxa associated with koala health after treatment. Although differences in the alpha diversity were observed in the intestinal flora between treated and untreated koalas and between koalas treated with different antibiotics, these differences were not statistically significant. The alpha diversity of microbial communities from koalas that lived through antibiotic treatment versus those who did not was significantly greater, however. Beta diversity analysis largely confirmed the latter observation, revealing that the overall communities were different between koalas on antibiotics that died versus those that survived or never received antibiotics. Using both machine learning and OTU (operational taxonomic unit) co-occurrence network analyses, we found that OTUs that are very closely related to Lonepinella koalarum, a known tannin degrader found by culture-based methods to be present in koala intestines, was correlated with a koala’s health status. This is the first study to characterize the time course of effects of antibiotics on koala intestinal microbiomes. Our results suggest it may be useful to pursue alternative treatments for Chlamydia infections without the use of antibiotics or the development of Chlamydia-specific antimicrobial compounds that do not broadly affect microbial communities.

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Tisler-Sala, Anna, Sven-Erik Ojavee, and Anneli Uusküla. "Treatment of chlamydia and gonorrhoea, compliance with treatment guidelines and factors associatedwith non-compliant prescribing: findings form a cross-sectional study." Sexually Transmitted Infections 94, no. 4 (October 24, 2017): 298–303. http://dx.doi.org/10.1136/sextrans-2017-053247.

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ObjectivesProper antibiotic treatment of STI reduces transmission, antimicrobial resistance and serious disease complications. In this study, we assessed compliance with STI treatment guidelines for genital gonorrhoea and chlamydia infections in Estonia.MethodsPrescription data from the Estonian Health Insurance Fund on 7556 treatment episodes of 6499 patients treated for gonorrhoea or chlamydia during 2012–2014 were analysed to assess compliance with the guidelines and factors associated with it.ResultsBetween 1 January 2012 and 31 December 2014, a total of 6074 patients were treated for chlamydia and 425 for gonorrhoea in Estonia. Among all prescriptions, 48.6% were non-compliant with gonorrhoea treatment guidelines and 3.8% for chlamydia. Non-compliant antibiotic treatment for gonorrhoea was associated with patient gender (female (adjusted OR (AOR)) 3.0, 95% CI 1.6 to 5.9), region (east AOR 3.3, 95% CI 1.3 to 8.2; west AOR 6.5, 95% CI 2.2 to 19.7) and prescribing physician specialty (general healthcare doctors: AOR 5.6, 95% CI 2.3 to 13.8; gynaecologists: AOR 5.9, 95% CI 2.8 to 12.4). Non-compliant antibiotic treatment for chlamydia was associated with younger patient age (15–24 AOR 0.5, 95% CI 0.4 to 0.7), region (north AOR 1.9, 95% CI 1.4 to 2.6; west AOR 2.3, 95% CI 1.5 to 3.4) and multiple treatment episodes (AOR 2.7, 95% CI 2.1 to 3.9). Approximately 14% of prescriptions were multiple treatments for the same patient for the same infection over the 3-year period (6.1% for gonorrhoea and 14.5% for chlamydia).ConclusionThere are significant differences in terms of compliance with treatment guidelines for gonorrhoea and chlamydia, and several factors associated with non-compliance that can potentially be targeted with interventions. Future research should explore reasons clinicians do not follow guidelines and examine ways to improve practice among doctors and patients and assess factors associated with multiple treatments, particularly multiple treatments for the same STI.

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Platt, Laura, Heather Elder, Ingrid V. Bassett, Lauren Molotnikov, Monina Klevens, Erin O’Connor, Dylan Leach, Kathleen Roosevelt, and Katherine Hsu. "Chlamydia Treatment Practices and Time to Treatment in Massachusetts: Directly Observed Therapy Versus Pharmacy Prescriptions." Journal of Primary Care & Community Health 12 (January 2021): 215013272110440. http://dx.doi.org/10.1177/21501327211044060.

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Background Directly observed therapy (DOT) is recommended for the treatment of chlamydia, however pharmacy prescriptions are frequently used. Adherence to DOT and the association between treatment method and time to treatment is unknown. Methods We conducted a retrospective review of a randomized 2% of laboratory-confirmed chlamydia infections reported to the Massachusetts Department of Public Health from January 1, 2019 to May 31, 2019. Clinicians and pharmacies were contacted to ascertain treatment methods and timing. We assessed frequency of DOT and pharmacy prescriptions in the treatment of chlamydia infection in Massachusetts. We used log rank test to compare time to treatment initiation for patients receiving DOT versus pharmacy prescriptions. Data were stratified according to whether treatment was empiric or laboratory-driven. Key results We ascertained full outcomes for 199 patients. Eighty patients received DOT and 119 patients received pharmacy prescriptions. DOT was more common among those receiving empiric treatment and pharmacy prescriptions were more common among those receiving laboratory-driven treatment. The median time to treatment was 1.5 days for patients treated with DOT and 3 days for those treated with pharmacy prescriptions. For both groups, the median time to treatment for empiric therapy was 0 days and for laboratory-driven therapy was 4 days. The differences in time to treatment were not statistically significant. Conclusions Pharmacy prescriptions are frequently used for the treatment of chlamydia in Massachusetts. We did not observe a significant difference in the time to treatment between DOT and pharmacy prescriptions.

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van Aar, Fleur, Birgit H. B. van Benthem, Ingrid V. F. van den Broek, and Hannelore M. Götz. "STIs in sex partners notified for chlamydia exposure: implications for expedited partner therapy." Sexually Transmitted Infections 94, no. 8 (January 11, 2018): 619–21. http://dx.doi.org/10.1136/sextrans-2017-053364.

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ObjectivesExpedited partner therapy (EPT) may reduce chlamydia reinfection rates. However, the disadvantages of EPT for chlamydia include missing the opportunity to test for other STIs and unnecessary use of antibiotics among non-infected partners. As part of a larger study that investigated the feasibility of EPT in the Netherlands, we explored the frequency of STI among a potential EPT target population of chlamydia-notified heterosexual men and women attending STI clinics for testing.MethodsCross-sectional national STI/HIV surveillance data, which contain information on all consultations at STI clinics, were used to calculate STI positivity rates stratified by chlamydia notification and gender, and proportions of STI that were attributable to clients notified for chlamydia.ResultsOf all consultations in 2015 (n=101 710), 14 445 (14.4%) clients reported to be notified exclusively for chlamydia. Among chlamydia-notified clients, the chlamydia positivity rate was 34.2% (n=4947), and consequently 65.8% (n=9488) of them tested negative for chlamydia. Chlamydia-notified clients contributed to 10.2% of all gonorrhoea infections (n=174/1702) and 10.9% of all infectious syphilis, HIV and/or infectious hepatitis B infections (n=15/173).ConclusionImplementing EPT without additional STI testing for all partners of chlamydia-infected index patients implies that STIs other than chlamydia will be missed. Although the chlamydia positivity rate was high among chlamydia-notified partners, two-thirds would unnecessarily use azithromycin. An evaluation of EPT against the current partner treatment strategy is needed to carefully weigh the potential health gains against the potential health losses and to explore the characteristics of EPT-eligible partners.

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Thng, Caroline Chun Mei. "A Review of Sexually Transmitted Infections in Australia – Considerations in 2018." Academic Forensic Pathology 8, no. 4 (December 2018): 938–46. http://dx.doi.org/10.1177/1925362118821492.

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Sexually transmitted infections (STIs) bear a high burden of disease and, subsequently, high health costs globally. Chlamydia, gonorrhoea, syphilis, and trichomoniasis contribute to nearly one million infections every day worldwide. Sexually transmitted infections continue to be the most frequently notified condition to the Australian National Notifiable Diseases Surveillance System and the numbers continue to increase. Australia has achieved several significant successes in reducing STIs and blood-borne viruses (BBV) including the significant decrease in genital warts in those less than 30 years old since 2007 following the launch of human papillomavirus vaccines in women, the virtual elimination of mother to child transmission of HIV, and the increased uptake of successful hepatitis C treatment following the availability of direct acting antiviral treatment on the Pharmaceutical Benefits Scheme. However, several challenges remain, including the ongoing rise of chlamydia, gonorrhoea, and syphilis over the last five years; the emergence of antibiotic resistance; and the increasing disparity in the prevalence of STIs and BBV in men who have sex with men, young people, and Aboriginal and Torres Strait Islander people, and challenges in the delivery of services to rural and remote Australia. In this paper, we aim to provide a snapshot of the current landscape and challenges for chlamydia, gonorrhoea, mycoplasma, syphilis and HIV infections in Australia.

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Holló, Péter, Hajnalka Jókai, Krisztina Herszényi, and Sarolta Kárpáti. "Genitourethral infections caused by D–K serotypes ofChlamydia trachomatis." Orvosi Hetilap 156, no. 1 (January 2015): 19–23. http://dx.doi.org/10.1556/oh.2015.30078.

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Sexually transmitted infections of the urogenital tract are most commonly caused by the intracellular bacteria Chlamydia trachomatis worldwide, resulting the clinical picture of acute urethritis in men as well as urethritis and endocervicitis in women. As women often present with few symptoms only or a completely symptom-free disease course, one of the most important long-term complications is chronic pelvic inflammatory disease often followed by the development of infertility caused by chronic scar formation. Well-organized screening programs are considered to have a leading role in the prevention of disease spreading and long lasting unwanted complications. Antibiotic treatment options are often influenced by special circumstances, such as pregnancy and several complicated clinical forms. The aims of the authors are to give a concise review on the current knowledge regarding Chlamydia trachomatis infections and summarize typical clinical signs, modern diagnostic techniques as well as accepted treatment protocols and basic aspects of screening. Orv. Hetil., 2015, 156(1), 19–23.

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Thompson, Laura H., Zoann Nugent, John L. Wylie, Carla Loeppky, Paul Van Caeseele, James F. Blanchard, and Nancy Yu. "Laboratory Detection of First and Repeat Chlamydia Cases Influenced by Testing Patterns: A Population-Based Study." Microbiology Insights 12 (January 2019): 117863611982797. http://dx.doi.org/10.1177/1178636119827975.

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Objectives: The purpose of this study was to describe and explore potential driving factors of trends in reported chlamydia infections over time in Manitoba, Canada. Methods: Surveillance and laboratory testing data from Manitoba Health, Seniors and Active Living were analysed using SAS v9.4. Kaplan-Meier plots of time from the first to second chlamydia infection were constructed, and Cox proportional hazards regression was used to estimate the risk of second repeat chlamydia infections in males and females. Results: Overall, the number of reported infections found mirrored the number of tests conducted. From 2008 to 2014, the number of first infections found among females decreased as the number of first tests conducted among females also decreased. Between 2008 and 2012, the number of repeat tests among females increased and was accompanied by an increase in the number of repeat positive results from 2009 to 2013. From 2008 to 2016, the number of repeat tests and repeat positive results increased steadily among males. Conclusions: Chlamydia infection rates consistently included a subset composed of repeat infections. The number of cases identified appears to mirror testing volumes, drawing into question incidence calculations that do not include testing volumes. Summary Box: 1) What is the current understanding of this subject? Chlamydia incidence is high in Manitoba, particularly among young women and in northern Manitoba. 2) What does this report add to the literature? This report suggests that incidence calculated using case-based surveillance data alone does not provide an accurate estimate of chlamydia incidence in Manitoba and is heavily influenced by testing patterns. 3) What are the implications for public health practice? In general, improving testing rates in clinical practices as well as through the provision of rapid services in non-clinical venues could result in higher screening and treatment rates. In turn, this could lead to a better understanding of true disease occurrence.

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Pereverzev, A. P., A. S. Pereverzeva, G. P. Kovaleva, and O. D. Ostroumova. "Treatment of upper respiratory tract infections: the role of doxycycline." Medical alphabet, no. 23 (October 2, 2021): 29–36. http://dx.doi.org/10.33667/2078-5631-2021-23-29-36.

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Upper respiratory tract infections (URTI) are a large group of infectious diseases (mainly viral and bacterial), affecting the mucous of the nasal cavity, paranasal sinuses, pharynx and larynx. URTI are very common in inpatient and outpatient clinical practice. In this article, we present a clinical case of Patient N., 20 years old, consulted with upper respiratory tract damage caused by Chlamydia pneumoniae. The patient admitted to clinical diagnostic center on 07.07.2021 with complaints of pain in the left maxillary sinus with irradiation to the left temporal region, difficulty in nasal breathing, pain in the pharynx, aggravated by swallowing, and increased body temperature (37,5 °C). The patient was consulted by an interdisciplinary team (ENT doctor and clinical pharmacologist). After carrying out physical, instrumental and laboratory tests the diagnose Chlamydia pneumoniae - associated URTI was established and, the patient was prescribed doxycycline at a dose of 100 mg 2 two times a day on the 1st day following by 100 once a day for the next 6 days with a positive effect. The doxycycline was choisen because of a more favorable safety and efficacy profile compared to fluoroquinolones and some other antibacterial agents. After 7 days of treatment, the patient recovered completely. Among all doxycycline drugs available on the market of the Russian Federation, Doxycycline Express (JSC Pharmstandard-Leksredstva) stands out due to its high quality, bioequivalence to the original drug and comfortable regime of use due to the dosage form (dispersible tablets), that increases the patient’s compliance and allows it to be used by some special categories of patients (elderly and senile patients, patients with dysphagia, etc.

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Marcus, Ulrich, Massimo Mirandola, Susanne B. Schink, Lorenzo Gios, and Axel J. Schmidt. "Changes in the prevalence of self-reported sexually transmitted bacterial infections from 2010 and 2017 in two large European samples of men having sex with men–is it time to re-evaluate STI-screening as a control strategy?" PLOS ONE 16, no. 3 (March 15, 2021): e0248582. http://dx.doi.org/10.1371/journal.pone.0248582.

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Background/Objectives Many European countries reported increased numbers of syphilis, gonorrhoea and chlamydia diagnoses among men who have sex with men (MSM) in recent years. Behaviour changes and increased testing are thought to drive these increases. Methods In 2010 and 2017, two large online surveys for MSM in Europe (EMIS-2010, EMIS-2017) collected self-reported data on STI diagnoses in the previous 12 months, diagnostic procedures, STI symptoms when testing, number of sexual partners, and sexual behaviours such as condom use during the last intercourse with a non-steady partner in 46 European countries. Multivariate regression models were used to analyse factors associated with diagnoses of syphilis, gonorrhoea/chlamydia, and respective diagnoses classified as symptomatic and asymptomatic. If applicable, they included country-level screening rates. Results Questions on STI diagnoses and sexual behaviours were answered by 156,018 (2010) and 125,837 (2017) participants. Between 2010 and 2017, overall diagnoses with gonorrhoea/chlamydia and syphilis increased by 76% and 83% across countries. Increases were more pronounced for asymptomatic compared to symptomatic infections. The proportion of respondents screened and the frequency of screening grew considerably. Condomless anal intercourse with the last non-steady partner rose by 62%; self-reported partner numbers grew. Increased syphilis diagnoses were largely explained by behavioural changes (including more frequent screening). Gonorrhoea/chlamydia increases were mainly explained by more screening and a change in testing performance. A country variable representing the proportion of men screened for asymptomatic infection was positively associated with reporting symptomatic gonorrhoea/chlamydia, but not syphilis. Discussion/Conclusion The positive association of country-level screening rates with the proportion of symptomatic infections with gonorrhoea/chlamydia may indicate a paradoxical effect of screening on incidence of symptomatic infections. Treatment of asymptomatic men might render them more susceptible to new infections, while spontaneous clearance may result in reduced susceptibility. Before expanding screening programmes, evidence of the effects of screening and treatment is warranted.

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Van Eyk, Armorel D. "The treatment of sexually transmitted infections." South African Family Practice 58, no. 6 (December 16, 2016): 12–22. http://dx.doi.org/10.4102/safp.v58i6.4592.

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The high level of sexually transmitted infections (STIs) in South Africa can be attributed to a large number of factors including low socio-economic conditions, social stigma, gender inequalities, inability to access adequate health care systems and lack of preventative programmes. The main curable STIs consist of chlamydia, gonorrhoea, syphilis and trichomoniasis, most of which occur in the developing world. The inability to adequately treat the infections leads to morbidity and has wide-ranging consequences on reproductive health and the health of infants. Due to the inefficient treatment of STIs, the World Health Organisation (WHO) recommended and promoted the syndromic management of STIs in developing countries at the point of contact with the health service provider with the intention of improving the quality of care of these patients. The syndromic approach to STI management depends on patient symptoms and the signs presented at the clinical examination. The four main syndrome management protocols are for urethral discharge and swollen testes, genital ulcers, vaginal discharge and lower abdominal pain in women. After identification of a syndrome, combined therapy is utilised to treat the common causes of the infection. A diagnosis can be made quite rapidly without the need for expensive equipment and tests or special skills. Health care providers make use of flow charts or algorithms for diagnosis and treatment. Algorithms or flowcharts should be adapted to local conditions taking into consideration aetiology, local antimicrobial susceptibility patterns and drug availability. These protocols will help with the prevention and treatment STIs in South Africa.

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KONG, F. Y. S., S. N. TABRIZI, C. K. FAIRLEY, S. PHILLIPS, G. FEHLER, M. LAW, L. A. VODSTRCIL, M. CHEN, C. S. BRADSHAW, and J. S. HOCKING. "Higher organism load associated with failure of azithromycin to treat rectal chlamydia." Epidemiology and Infection 144, no. 12 (May 16, 2016): 2587–96. http://dx.doi.org/10.1017/s0950268816000996.

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SUMMARYRepeat rectal chlamydia infection is common in men who have sex with men (MSM) following treatment with 1 g azithromycin. This study describes the association between organism load and repeat rectal chlamydia infection, genovar distribution, and efficacy of azithromycin in asymptomatic MSM. Stored rectal chlamydia-positive samples from MSM were analysed for organism load and genotyped to assist differentiation between reinfection and treatment failure. Included men had follow-up tests within 100 days of index infection. Lymphogranuloma venereum and proctitis diagnosed symptomatically were excluded. Factors associated with repeat infection, treatment failure and reinfection were investigated. In total, 227 MSM were included – 64 with repeat infections [28·2%, 95% confidence interval (CI) 22·4–34·5]. Repeat positivity was associated with increased pre-treatment organism load [odds ratio (OR) 1·7, 95% CI 1·4–2·2]. Of 64 repeat infections, 29 (12·8%, 95% CI 8·7–17·8) were treatment failures and 35 (15·4%, 95% CI 11·0–20·8) were reinfections, 11 (17·2%, 95% CI 8·9–28·7) of which were definite reinfections. Treatment failure and reinfection were both associated with increased load (OR 2·0, 95% CI 1·4–2·7 and 1·6, 95% CI 1·2–2·2, respectively). The most prevalent genovars were G, D and J. Treatment efficacy for 1 g azithromycin was 83·6% (95% CI 77·2–88·8). Repeat positivity was associated with high pre-treatment organism load. Randomized controlled trials are urgently needed to evaluate azithromycin's efficacy and whether extended doses can overcome rectal infections with high organism load.

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