chlamydia - is one of the most common infectious diseases of our time, transmitted by sexual contact.According to the World Health Organization, the incidence rate is growing every year, and to date, almost 30% of the world population is infected with chlamydia.Due to the difficulty of diagnosis, clinical course of the disease and the numerous complications urogenialny chlamydia, flowing with the defeat of the cylindrical or transitional epithelium of the urogenital tract and monocytic series cells is a direct threat to the female and male reproductive health.However, this disease can be a cause of arthritis, conjunctivitis, lymphogranuloma venereum, pneumonia and cardiovascular pathologies.
Chlamydia - is an infectious
According to the sad statistics of the incidence rate increasing every year, and to date, almost 30% of the world population are carriers of Chlamydia infection.Pathogen chlamydia annually diagnosed in 90 million people.
Among teenage girls, sexually active, the prevalence of the disease is 10-15% among women - 5-20%, and among the representatives of a strong half of humanity - 10-20%.This is most often Chlamydia common in patients 18-30 years of age.
Chlamydia - is the intracellular obligate parasite with a unique cycle of development, which in the process of reproduction is capable of binary fission.He is characterized by two very different forms of existence, which are designated as ET (elementary bodies) and RT (reticular cells).
chlamydial elementary corpuscles, endowed with infectious properties, are capable of extracellular existence.They are transmitted from person to person, by endocytosis penetrate into the cell of a cylindrical or transitional epithelium, and there undergo further development cycle with the transformation in reticular cells (8 weeks).
RT - is a form of the pathogen, parasite and reproduce by dividing, while in the middle of the cage.Chlamydial microcolonies located inside the vacuole, which occupies most of the infected cell.After 24 hours, RT sealed, surrounded by a cell wall and are transformed into ET.Torn Thereafter, vacuole, agents and extend outwardly to penetrate the surrounding cellular structure.
In the case where kletka- "host" die before the formation of infectious EBs, the disease does not develop.
It should be emphasized that the infection of new cells and repeated cycles of hdamidy stimulate the immune response, the Sámi amplifying degree of pathological lesions.
Pathogen chlamydia is unstable in the environment and is sensitive to high temperatures, almost instantly loses its corrosive properties upon drying, exposure to chemicals and UV rays.
When urogentialnom chlamydia infection source is the man, as with severe signs of disease and asymptomatic disease.
The main transmission paths chlamydial infections include:
pathways ascending chlamydial infection
Today chlamydia pathogenesis has not been studied until the end, but, nevertheless, in clinical practice to allocate five stages of the disease:
Clinical signs of chlamydial infection are quite varied.In the case of the infection is often asymptomatic carriage celebrated or observed pronounced inflammation.In diseases of the lower genital tract in patients can be diagnosed such pathological conditions as urethritis, endocervite, coleitis, Bartholinitis, while ascending infection -. Endometriosis, salpingitis, pelvioperitonit etc.
Whenpenetration of infection in the female body often arise mucous or muco-purulent discharge, which differ from the normal yellowish tinge and an unpleasant odor.Sometimes a burning sensation in the area of the external genitalia and itching, abdominal pain, worse before menstruation, intermenstrual bleeding.Some patients will complain of general weakness, and they may be slightly rising body temperature.
During pregnancy, menopause, and in the period of increased hormonal activity (adolescent girls) chlamydial infection can cause vaginitis development.In this case, around the cervix observed maceration of stratified squamous epithelium, it becomes edematous and easily vulnerable (hypertrophic cervical ectopia).
through the cervical canal ascending chlamydial infection can spread or hematogenous lymphogenous way into the uterus, fallopian tubes, peritoneum and nearby pelvic organs.The most common manifestations of ascending infection is chlamydial salpingitis and oophoritis.They are characterized by blurred (subacute) for not prone to weighting.As a consequence, developing appendages obstruction, which is fraught with ectopic pregnancy, and this state is tubal infertility, miscarriage and development of adhesions in the pelvis.
In the early stages of the disease in males develop urethritis, which may last for several months.It is noted a slight inflammation of the urethra and the emergence of scarce glassy selections.Sometimes patients complain of itching and burning that appear in the process of urination.
in the urethra, scrotum, testicles and lower back pain often develop different intensity, as well as due to intoxication, body temperature can rise to 37 degrees.In clinical practice, there are cases of occurrence of bleeding during ejaculation, and at the end of urination.At the same time, urine may experience blurred because there are purulent yarns and cords.In
when chlamydia and form colonies in such a long remain on the mucosal surface, it comes to carriers of the infection.This condition is explained by the fact that the human immune system suppresses pathogen multiplication.According to many authors, the carriers are not able to infect their sexual partners, and therefore from an epidemiological point of view, they are absolutely safe.
the transition of chlamydia in the chronic stage, patients complain of discomfort in the perineum, pain around the anus and in the prostate, erectile dysfunction, frequent nocturnal urination, pain in the testicles, and painful ejaculation, changes in semen color and decrease its volume.
Note: the development of chlamydia in anorectal disease process are often asymptomatic.However, sometimes patients complain of itching and pain in the rectum, as well as the presence of discharge from the anus.
In the case where the chlamydial infection affects women in early pregnancy, such condition is fraught with the appearance of congenital malformations and primary placental insufficiency.As a result, women often occur in patients with miscarriage, as well as developing pregnancy is diagnosed.
at a later date childbearing Chlamydia is a direct threat of termination of pregnancy, triggers the development of secondary placental insufficiency and disturbance of development of amniotic fluid.
A morphological study of the deceased infants were detected chlamydia defeat of the meninges, lungs and vascular plexus.These data confirm the transplacental infection.
a consequence of hematogenous infection of the fetus occurs edematous hemorrhagic syndrome, pneumopathy, bleeding in the brain ventricles, liver, kidney and adrenal insufficiency.These factors often result in prenatal or early postnatal death of the child.
In some cases, an infectious agent only affects the placenta, which is why it developed compensatory-adaptive reactions.However, the protective function of the placenta is disturbed with the activation of the infectious process that ultimately leads to the formation of placental insufficiency.Due to the reduced supply of nutrients to the fetus develops chronic hypoxia and malnutrition.
When cervical form of chlamydia occur frequently preterm labor or premature rupture of membranes.When swallowing infected amniotic fluid before birth there is a defeat of his lungs and digestive tract.However, neonatal infection can occur during passage through the birth canal of infected mothers.
the diagnosis of chlamydial infection in the laboratory at the same time using several different methods: the culture method, PCR method immunnoflyuorestsentny, transcriptional amplification reaction and serological techniques.
should be noted that at inspection of scrapings (smear) can only be suspected chlamydia, and therefore this method is used in diagnostics as a quick analysis is not 100% and informative requires confirmation.
This technique involves placing a biological material on a sterile nutrient medium, where the pathogen in a specially created for this rapidly multiplies and often its colonies can even distinguish with the naked eye.Despite the fact that this is a lengthy process, it is considered one of the most informative, as it allows to establish the form and type of chlamydial infection and to determine the sensitivity of microorganisms to antibiotics.
PCR Polymerase chain reaction - a technique that provides for the connection of DNA molecules chlamydia with specially created primers.Today it is the most accurate and reliable of all.
Immunofluorescence method - the study of scrapings from the urethra, stained with special dyes to the use of a fluorescent microscope.In this case, detection of the pathogen is 70 of 100.
During the IFA diagnosis in the patient's blood detected specific antibodies (immunoglobulins), which are formed to chlamydia.However, as the biomaterial may be used from scraping the urethra.However, for foreign medical standards, this technique is not recommended for the diagnosis of chlamydial infection.
Very high precision diagnostic method based on the detection of RNA in the samples of the pathogen chlamydia.RNA molecules, in contrast to the DNA molecules are not determined after death, which allows more accurate assessment of the study.In this case, the biomaterial is used as a scraping from the urethra, vagina and cervical canal or urine of the patient.
This is an additional technique that allows to detect in the blood serum of the patient Chlamydia antibodies.
In that case, when a person is detected chlamydia tests to detect infection is recommended to hand over his sexual partner (even in the absence of symptoms).
shall be subject to three basic principles:
Pathogenetic therapy of chlamydial infection is considered effective only when the patient is prescribed drugs that have a high activity of Chlamydia.They should have good penetration power, that is, through the cell membrane to penetrate into the infected cell.At the same time prescribed treatment should be performed 2-3 weeks (the time of passage of chlamydia development cycles 6-7), and yet, in the appointment of medical therapy should be considered as possible infection, the clinical picture of the disease and topical diagnosis (localization of the pathological focus).
Chlamydia - a disease caused by intracellular infection.Therefore, when the treatment prescribed antibiotics that can penetrate and accumulate in infected cells by blocking intracellular protein synthesis.Earlier in the treatment of patients prescribed drugs teteratsiklinovogo number, but because of the duration of antibiotic therapy and the occurrence of severe side effects, for the moment they were replaced by macrolides.
Note: treatment of chlamydia in pregnancy is made by a specially composed schemes, effective in terms of perinatal pathology.
parallel with antibiotic therapy patients received immunomodulatory treatment.It aims to eliminate the immunological changes that occur in the body, the affected chlamydial infection.
is mandatory during the pathogenetic therapy performed prevention of intestinal dysbiosis, providing for the use of probiotics (products containing live lactic acid bacteria).
During the treatment etiotrop appointed local procedures (vaginal treatment with special disinfectants), as well as the antifungal drugs may be prescribed for the prevention of candidiasis.
Along with taking antibiotics cure chlamydia envisages fermentoterapii, vitamins, adaptogens and antihistamines.
In order to prevent further development and spread of diseases requires the timely and full recovery of patients who detected chlamydial infection, including asymptomatic carriers.
is mandatory should be identified and examined all the sexual partners of the patient chlamydia, after which they will be given preventive treatment.
health education among the population (promotion of a healthy sexual lifestyle and information about the ways of infection and clinical signs of the disease).