William M. Geisler, Robert J. Suchland, William L. H. Whittington, Walter Age. Stamm, Quantitative Culture out-of Chlamydia trachomatis: Matchmaking away from Addition-Developing Products Manufactured in Culture to help you Medical Symptoms and you will Severe Tenderness inside the Urogenital State, The brand new Record off Contagious Infection, Regularity 184, Situation ten, , Pages 1350–1354,
Abstract
The partnership off Chlamydia trachomatis addition-building units for the quantitative people so you can scientific symptoms and you will pain in the urogenital disease try reviewed in 1179 clients browsing an intimately transmitted problems clinic. 450 ifu), number and you may reputation regarding cervical launch, ?29 polymorphonuclear cells (PMNL) for each and every highest-power occupation (hpf) on Gram spot (2050 vs. 320 ifu), and you will diagnoses out-of mucopurulent cervicitis (MPC; 2550 compared to. 3 hundred ifu) and pelvic inflammatory condition (PID; 3000 vs. 578 ifu). From inside the men, better addition-building unit matters was for the urethral discharge (85 vs. forty-two ifu), count and you will reputation away from release, and ?10 PMNL/hpf (95 against 
. fifty ifu). These contacts persisted for the multivariate studies. Ergo, chlamydial duplication are for the MPC and PID in women, urethritis into the people, and you may soreness both in. While the infections with a high addition matters could be the extremely transmissible, personality and you can remedy for people with our chlamydia-associated syndromes plays a role in manage apps
Knowing the relationships of Chlamydia trachomatis urogenital disease so you can clinical manifestations and severe pain is important in most useful knowing the epidemiology and you can pathogenesis of these infection. Health-related signs for the reason that C. trachomatis almost certainly show the fresh new joint negative effects of head chlamydial replication and you can server inflammatory responses [ 1]. The relationship anywhere between effective chlamydial replication and you can clinical manifestations will likely be reviewed utilizing the quantity of inclusion-forming tools produced in cell structure culture once the a quantitative level of your quantity of viable infectious primary bodies inside genital secretions. The number of inclusion-forming tools inside the society can be considered to be a great surrogate to have infectivity otherwise transmissibility [ 2]. Because of the usage of a large database you to allowed getting adjustment regarding prospective confounding products, i held a corner-sectional studies to assess the relationship ranging from chlamydial inclusion-building gadgets into the quantitative cultures which have systematic manifestations and degree of serious inflammation from inside the urogenital chlamydial illness
Procedures
Patient people and studies collectionThe investigation population contains 671 ladies and you may 933 heterosexual men that has a community-documented urogenital chlamydial infection during the Social Wellness, Seattle and you will Queen State Intimately Sent Disease Infirmary off Could possibly get 1995 because of December 1999. Research data was indeed throughout the clinic’s automatic database, with intercourse-particular standardized scientific number versions. People with coexisting gonococcal infection or infection because of nonfusing C. trachomatis phenotypes have been excluded as a way off handling possible confounders one ydial introduction-developing unit counts so you’re able to medical signs [ 3, 4]. People that have repeat bacterial infections with the exact same serovar within thirty days or mixed serovar problems had been omitted, since their introduction perform violate freedom from the multivariate studies
Source and characterization ofC. trachomatis isolatesThe methods used for specimen collection, isolation of C. trachomatis identification and quantification of inclusions, and serotyping have been described in detail elsewhere [ 2, 5]. In brief, specimens were collected, were stored in chlamydia transport medium at 4°C, and were transported within 24 h to the laboratory. Each specimen was inoculated onto McCoy cells and overlaid with growth medium. Chlamydial inclusions were detected with a genus-specific antichlamydial lipopolysaccharide monoclonal antibody conjugated with fluorescein. The average inclusion count per 100-?L well was determined by counting 3 fields and multiplying the average count by a predetermined conversion factor based on magnification with a Zeiss epifluorescence microscope. Inclusions were counted individually in cultures with <100 inclusions. All technicians who determined inclusion-forming unit counts used the same standardized method [ 5]. For serotyping, chlamydial strains were cultured in 96-well microtiter plates and were serotyped by using subspecies- and serovar-specific monoclonal antibodies. Serovars were additionally grouped as B complex (serovars B, Ba, D, Da, D ? , E, L1, L2, and L2a), intermediate group FG (serovars F and G), and C complex (serovars A, C, H, I, Ia, I ? , J, K, and L3) [ 6–8]. The nonfusing chlamydial phenotype was detected visually by observing inclusion morphology during serotyping [ 5]