Chlamydia trachomatis (KT) najčešća je spolno prenosiva bakterija, jedan od vodećih uzroka zdjelične upalne bolesti (engl. pelvic infl ammatory disease - PID) i neplodnosti žena. Malena je, gram-negativna, obligatno intracelularna bakterija, koja najčešće infi cira skvamokolumnarni epitel. Jedna je od četiri specijesa koji pripada koljenu Chlamydia, porodici Chlamydiaceae i redu Chlamydiales. Infekcija je najčešća u adolescentica. Treba razlikovati nekompliciranu, kompliciranu i perzistentnu klamidijsku infekciju. U više od 80% žena je asimptomatska, pa se naziva i tiha infekcija. Može se manifestirati: mukopurulentnim cervicitisom, uretritisom, proktitisom (nekomplicirana). Može uzrokovati ozbiljne komplikacije (komplicirana infekcija): PID, bartolinitis, perihepatitis (Fitz-Hugh-
Curtisov sindrom), reaktivni artritis, tubarnu neplodnost, ektopičnu trudnoću i bolest novorođenčeta. Infekcija KT-om može se dijagnosticirati: kulturom stanica, direktnom imunofluorescencijom,
enzimskim testovima, tekućinskom hibridizacijom i testovima amplifi kacije nukleinske kiseline koji su zbog praktičnosti, osjetljivosti i specifi čnosti najprihvatljiviji. Ligase chain reaction iz obriska rodnice danas je test izbora. U liječenju akutne infekcije 1 gram azitromicina per os jednokratno liječenje je izbora, dok optimalno liječenje perzistentne infekcije do danas nije egzaktno definirano. Liječiti treba sve spolne partnere, uz apstinenciju od spolnog odnosa 7 dana nakon liječenja, radi sprečavanja reinfekcije. Ako se akutna infekcija liječi
antibioticima prvog izbora (azitromicin i doksiciklin), ponovno testiranje nije potrebno. Upotreba kondoma je najbolja zaštita.
Probir rizičnih skupina je važna mjera u sprečavanju ozbiljnih posljedica.Chlamydia trachomatis (CT) is the most common sexually transmitted bacterium, one of the leading causes of pelvic inflammatory disease (PID) and infertility in women. Chlamydiae are small gram-negative obligate intracellular microorganisms that preferentially infect squamocolumnar epithelial cells. CT is one of the four species which belong to the genus Chlamydia, the family Chlamydiaceae and the order Chlamydiales. The rates of Chlamydia infections are the highest in adolescent women. We must differentiate between non-complicated, complicated and persistent chlamydial infections.
In more than 80% of women the infection is asymptomatic, also known as silent infection. The infection could be manifested as urethritis, proctitis, and mucopurulent cervicitis (noncomplicated).
It may cause a wide spectrum of serious complications (complicated infections): PID, bartholinitis, perihepatitis (Fitz-Hugh-Curtis syndrome), reactive arthritis, ectopic pregnancy and disease in newborn. The CT infection can be diagnosed by cell-culture, direct immunofluorescence, enzyme immunoassay, direct DNA hybridization and more recently by nucleic acid amplification, a test currently considered to be the most acceptable thanks to its simplicity, sensitivity and specificity. Vaginal smear LCR is currently considered to be the test of choice. The preferred treatment for acute infection today is a single oral dose of 1g azithromycin, while the optimal treatment for persistent infection has not been yet established. All partners should be treated as well as abstain from sexual intercourse during 7 days after treatment in order to prevent reinfection. If treating the acute infection with first line antibiotics,
retesting is not necessary. The use of condoms provides the best protection. Screening of risk groups is an important measure in preventing serious consequences
