enfermedad

1. Chlamydia trachomatis
aka: The Silent Disease
Presented By:
Tony Anderson &
Jeffrey Pounds

2. Species Information
• Family: Chlamydiaceae
• Genus: Chlamydia
• Species: C. trachomatis

3. What is Chlamydia trachomatis?
• C. trachomatis is a eukaryotic gram-negative
bacteria.
• It is a parasitic organism because it cannot
generate it’s own media to live, it requires other
cells to live in.
• It has two shapes, cocci and rod shaped, it can be
one of two shapes based on the stage the
organism is in. It is about 0.3 um in diameter.
• It is classified as a gram negative organism in that it
contains an outer lipopolysaccharide membrane,
but it lacks peptidoglycan in its cell wall.

4. Growth
Life cycle consist of two stages
• 1) Elementary body, this is the dispersal form,
it is found similar to a spore, it is in the stage
when outside of the cell, it can induce it’s on
endocytosis upon exposure to target cells. It
prevents phagolysomial fusion, which then
allows for intercellular survival of the bacteria.

5. Growth (continued)
• 2) The second phase is the reticulate body, it
is the result that occurs when the elementary
body germinates inside of the endsome of a
target cell. The reticulate body divides
through binary fusion in about 2 to 3 hours
per generation, and it incubates anywhere
from 7-21 days in the host. This stage
contains no cell wall making it look like part of
the cell, so it is virtually invisible to the body’s
natural immune system.

7. How is it diagnosed?
• The bacteria are too tiny to be seen with an ordinary
microscope and must be grown in tissue culture cells
or detected with fluorescent antibodies.
• The only way to fully determine if you have Chlamydia
is to get tested. Clinics used to have to swab the cervix
for females and scrape cells out of the urethra for
males. This was very uncomfortable and a painful
process.
• Since then a new procedure called Ligase chain
reaction (LCR) has been created, this can easily identify
the primers in the DNA of the bacteria, it is a lot less
invasive and can be done by just testing the urine.

10. Transmission
• It is transmitted from
penetrative sexual
contact.
• Contact needs to be
made between any of
the special membranes
of the eye, throat, anus,
or genitalia.

11. How infectious is it?
• After just one time of unprotected sex with an
infected person, about 10% of people will
catch the bacteria. The reason that it is such
an epidemic is due to it’s ability to hide inside
the cells of the genital tract in both men and
women, and can then be passed on in new
relationships leaving both partners completely
unaware.

12. Virulence factors
• There are many factors that contribute to the
pathogenicity of C. trachomatis. Colonies form after
the bacteria attaches to the sialic acid receptors in any
of the contact sites. It also has a unique cell wall
structure, that inhibits phagolysomial fusion in
phagocytes.
• The cell wall contains a lipopolysaccharide membrane
which classifies it as a Gram-negative organism but it
lacks a peptidoglycan in its cell wall. To make up for
this it has a cysteine –rich protein layer that is
equivalent to the peptidoglycan layer, this unique
structure allow for intracellular division and
extracellular survival.

14. Who does it infect
• Everyone, it is the most common bacterial
sexually transmitted infection affection millions
of people worldwide.
• Over the past 10 years Chlamydia infections
doubled to over 1,000,000 cases in the USA and
continues to rise, it is now the highest ever
nationally recorded disease in any year, with over
1 million new cases reported every year.
• It is most common in sexually active teenagers
from ages of 16 to 19, and is very prevalent in
women because of the lack of symptoms.

15. Chlamydia — Rates by state: United States and outlying areas, 2008
331
VT 192
324 300 198 NH 160
287 276 MA 271
280 371 375 458 RI 314
302 446 CT 357
314 340
NJ 258
377 314 DE 447
411
228 460 349 MD 439
407 395 183 405
332 422 287
DC 1177
Guam 396 414
409
455 Rate per 100,000
391
470 499 597 population
535 447
728
422 <=300 (n= 13)
528 300.1-400
711 (n= 17)
466
389 >400 (n= 24)
Puerto Rico 174
Virgin Is. 535
Note: The total rate of chlamydia for the United States and outlying areas
(Guam, Puerto Rico, and Virgin Islands) was 398.5 per 100,000 population.

16. Chlamydia — Rates by county: United States, 2008
Rate per 100,000
population
<=300.0 (n= 2,070)
300.1-400.0 (n= 390)
>400.0 (n= 681)

17. Chlamydia — Rates by region: United States, 1999–2008
Rate (per 100,000 population)
450
360
270
180
West
Midwest
Northeast
90 South
0
1999 2000 01 02 03 04 05 06 07 08

18. What does it effect?
• In women the infection can vary between having
absolutely no symptoms at all, to having a severe
illness associated with long-term complication, in
particular a women’s fertility.
• Women who don’t have symptoms can still be
experiencing the ongoing damage to the fallopian
tubes, and certain women would not know this
until years later. The bacteria can start in the
womb and travel up through the fallopian tubes
causing what is known as Pelvic Inflammatory
disease. This can cause severe fertility issues in
women.

20. What does it affect? (continued)
• In about 70% of men they display no symptoms.
When affected, men with signs or symptoms might
have a discharge from their penis or a burning
sensation when urinating. Men might also have
burning and itching around the opening of the
penis.
• Men or women who have receptive anal
intercourse may acquire Chlamydia infection in the
rectum, which can cause rectal pain, discharge, or
bleeding. Chlamydia can also be found in the
throats of women and men having oral sex with an
infected partner.

21. Complications
• For women the biggest complication is the Pelvic
Inflammatory disease (PID), it causes inflammation or
endometritis, which causes damage to the
reproductive organs. There is also risk that comes with
the inflammation of the other glands and ducts in the
lower vagina.
• Women also can experience a spread of the bacteria to
the liver, which causes inflammation at the liver edge
and the surrounding lining of the abdomen. This
results from the spread of the Chlamydia from the
fallopian tubes and up through the abdominal lining.

23. Complications (continued)
• Men also experience inflammation of the
reproductive organs, Although it does not cause
as much destruction in male reproductive system
as it does in the female reproductive system, it is
still unclear how much damage this actually
causes.
• In both sexes C. trachomatis can cause reactive
Arthritis, it affect the larger joints of the body
and occurs several weeks after infection.

24. Vaccines
• At this time there is no vaccine available for
this organism.
• The organism’s growth requirements make it
very hard for it to researched and examined
inside of a laboratory setting. It can only grow
in tissue media, and a lot of media is required
to acquire a small sample of the organism.

25. Prevention
• Wear condoms
• Limit the number of sexual
partners
• Practice monogamy
• Public awareness
campaigns
• Making sure health care
providers are more aware
of and recognize the
symptoms of Chlamydia.
Most Chlamydia infections
look like bladder infections.

26. Treatment
• Chlamydia can be easily treated and cured with
antibiotics. A single dose of azithromycin or a
week of doxycycline (twice daily) are the most
commonly used treatments.
• Tetracycline, chloramphenicol, rifampicin, and
fluroquinones can also be used. Pregnant women
are advised to take erythromycin for the
infection
• All sex partners should be evaluated, tested, and
treated. Persons with chlamydia should abstain
from sexual intercourse until they and their sex
partners have completed treatment, otherwise
re-infection is possible.

27. References
• Barnes, R.C. (1990). Infections Caused by Chlamydia trachomatis
Chapter 6 in Morse, et al, Sexually Transmitted Diseases. J.B.
Lippincott. Philadelphia
• The Boston Women's Health Collective (1992). The New Our Bodies
Ourselves. New York: Simon and Schuster.
• CDC. Recommendations for the Prevention and Management of
Chlamydia trachomatis Infections. MMWR 1993; 42 (RR-12).
• Coghlan, Andy (1996). Shapely Vaccine Targets Chlamydia. New
Scientist. 152: 18.
• Hatch, Thomas P. (1996). Disulfide Cross-Linked Envelope Proteins:
the Functional Equivalent of Peptidoglycan in Chlamydia? Journal of
Bacteriology. 178: 1-5.
• Hillis, Susan et al. (1995). Impact of a Comprehensive Chlamydia
Prevention Program in Wisconsin. Family Planning Perspectives. 27:
108-111.
• Madigan, Michael, Martinko, John, and Jack Parker (1997). Brock's
Biology of Microorganisms. eighth edition. New Jersey: Prentice
Hall.