Bacteriology - Chlamydia

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Chlamydiaceae family classification

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1. Genus Chlamydia -->
C. trachomatis
2. Genus Chlamydophila -->
C. psittaci
C. pneumoniae

Front 2

Chlamydia and staining:

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Classified as gram-negative because it stains red with gram staining. And has both inner and outer membrane. But, it does not have a peptidoglycan layer.

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In between the inner and outer cell membranes, chlamydia does not have peptidoglycan, but rather...

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CRP: cysteine-rich protein

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Do chlamydia need the host cell to live?

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Yuppers.They are obligate intracellular parasites.

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How do chlamydia produce nrg?

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They are unable to produce their own ATP, so they have to use ATP of the host-cell. They are also unable to synthesize amino acids, so they take from host cell. Chlamydia are pathetic thieves.

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Chlamydia life-cycle is complex as the bacteria can exist in two forms:

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1. elementary body (EB) - metabolically inert (does not divide), dense, round, small, infectious, and resistant to harsh conditions.
2. initial body (IB) - much larger than EB. synthesizes it's own dna, rna, and proteins, it requires ATP from host.

Front 7

Chlamydia lifecycle (4 steps)

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1. EB attaches to and enters columnar epithelial cells that line mucous membranes
2. w/in endosome EB inhibits phag-lyso fusion and transforms into IB
3. once enough IBs have formed, some transform back into EBs
4. life cycle is completed when the host cell liberates the EBs, which can now infect more cells.

Front 8

Where does chlamydia infect?

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columnar epithelial cells lining mucous membranes

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Do we develop long-lasting immunity to chlamydia?

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Nope. Can get repeated and chronic infections from chlamydia.

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Disease caused by:
C. trachomatus: serovar A, B, C

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Trachoma: type of chronic conjunctivitis that is currently the leading cause of preventable blindness in the world.

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Disease caused by C. trachomatis Serovar D-->K

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1. Inclusion conjunctivitis, usually in the newborn
2. infant pneumonia
3. cervicitis
4. nongonococcoal urethritis in men

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Disease caused by C. trachomatis, Serovar L1, L2, L3

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Lymphogranuloma venereum: infected macrophage reaches lymph node causing lymphogranuloma. mostly in sexual organs.

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Disease caused by Chlamydophila psittaci and pneumoniae

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atypical pneumonia

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C. trachomatis epidemiology
1. ocular
2. genital tract
3. lympho

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1. Ocular infections exists worldwide but is very often associated with poverty and overcrowded places.
2. Gential tract infxn also exists worldwide; is the leading STD in the US.
3. Lymphogranuloma venereum more common in africa, asia, south america - in US is mostly found in gay males

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Clinical symptoms of inclusive conjunctivitis caused by C. trachomatis, serovar D-->K infection:

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Inclusion conjunctivitis associated with genital chlamydia presents 5-12 days after birth with mucopurulent discharge, corneal infiltrate, vascularization, scarring - but less likely to cause blindness than the A, B, and C serotypes.

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Clinical symptoms of infant pneumonia caused by C. trachomatis, serovar D-->K infection:

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wheezing cough and pneumonia without fever. Often begun with conjuctivitis.

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Clinical symptoms of urogenital infection caused by C. trachomatis, serovar D-->K in females:

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Females are 80% asymptomatic
increased vaginal discharge, burning during urination, irritation in area around vagina, bleeding after sexual intercourse, lower abdominal pain, abnormal vaginal bleeding

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Clinical symptoms of urogenital infection caused by C. trachomatis, serovar D-->K in males:

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Males are 75% symptomatic
Clear, white, or yellow discharge from urethra, burning during urination, itching sensation

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Clinical symptoms of lymphogranuloma venereum caused by C. trachomatis, serovar L1, L2, and L3:
(two stages)

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first stage: 3-30 days a small painless lesion appears at site of inoculation, usually the prepuce or glans/vulva, vaginal wall
second stage: inflammation of lymph nodes (fever, headache, myalgia) Buboes (very large lymph nodes), ulcers, elephantiasis of genital area

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Diagnosis of chlamydial infections

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Cytology is not very sensitive.
Serology can be useful.
PCR is best.

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Treatment for chlamydial infections

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Tetracycline, erythromycin, sulfonamides - ampicillins and beta-lactams are not useful because of cell-wall situation
No vaccine

Front 22

Clamydophila psittaci
natural hosts

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birds (eg parrots), mammals

Front 23

Chlamydophila psittaci infects the __(a)__, causing __(b)__, or __(c)__.

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a. respiratory tract
b. fever, mild flu-like dsease, or
c. toxic pneumonitis after incubation period of two to four weeks.

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Chlamydophila pneumoniae, serogroup TWAR causes __(a)__, and in adults it is mostly __(b)__ or __(c)__.

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a. atypical pneumonia
b. asymptomatic
c. mild