title: Chlamydial infections in term and preterm neonates.
abstract: The aim of this study was to evaluate the incidence and morbidities of Chlamydia  trachomatis infections in newborn infants. Tissue culture and direct immunofluorescence (DIF) tests  were used to detect the presence of nasopharyngeal C. trachomatis infection in 35 preterm and 21  healthy term neonates. All infants were followed up clinically for 3 months, and enzyme-linked  immunosorbent assay analysis for serum antichlamydial IgG and IgM was performed on day 15 and week  6. Tissue culture and/or DIF studies showed that 10 of the preterm infants (28.57%), but none of  the term infants, were C. trachomatis-positive. The sensitivities of DIF and tissue culture were 40%  and 70%, respectively, demonstrating the diagnostic superiority of tissue culture tests for  detecting C. trachomatis. Only one asymptomatic preterm infant was found to be positive for  antichlamydial antibodies at the 6th week. All C. trachomatis-positive infants were given macrolide  antibiotics for 14 days. The study showed that male infants were more frequently infected, but types  of delivery, mean gestational ages, mean birth weights, and the need for mechanical ventilation were  similar in C. trachomatis-infected and uninfected preterm infants. However, the duration of oxygen  treatment was longer in infected preterm infants. Clinical conjunctivitis was more frequent in C.  trachomatis-infected infants (60%) than in uninfected infants (24%). C. trachomatis-positive infants  had pneumonia more frequently; however, all patients with pneumonia were negative for  antichlamydial IgM and IgG antibodies. Macrolide treatment for 2 weeks for nasopharyngeal C.  trachomatis positivity may have prevented C. trachomatis related pneumonia, but it may not have  significantly influenced the risk of pneumonia caused by other agents. Chlamydial infections may  lead to early and late respiratory problems in preterm infants. Nasopharyngeal screening may help  physicians detect C. trachomatis infections and provide a means of early diagnosis in this  vulnerable patient group.
authors.affiliation: Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Bekler
authors.forename: Nilgun
authors.initials: N
authors.lastname: Kultursay
authors.forename: Tijen
authors.initials: T
authors.lastname: Ozacar
authors.forename: Arzu
authors.initials: A
authors.lastname: Sayiner
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yalaz
authors.forename: Mete
authors.initials: M
authors.lastname: Akisu
mesh_terms: D000907:Antibodies, Bacterial / Q000032:analysis / Q000097:blood*; D001724:Birth Weight; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000276:immunology / Q000472:pathogenicity*; D003234:Conjunctivitis, Bacterial / Q000276:immunology / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D007231:Infant, Newborn; D018942:Macrolides / Q000627:therapeutic use; D008297:Male; D010100:Oxygen / Q000627:therapeutic use; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology; D011446:Prospective Studies; D012121:Respiration, Artificial; D012680:Sensitivity and Specificity; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D018942:Macrolides; D010100:Oxygen