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Source: Knodel
LC. Sexually Transmitted Diseases. In: DiPiro, JT, Talbert RL, Yee
GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic
Approach. 8th edition. http://www.accesspharmacy.com/content.aspx?aid=8004605.
Accessed July 16, 2012.
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- Sexually transmitted infection (STI)
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- C. trachomatis is an obligate
intracellular parasite with some similarities to viruses and bacteria.
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- Requires cellular material from host cells for replication.
- Maintains cellular identity throughout development.
- Frequent coinfection with gonorrhea.
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- Most common STI in the United States
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- Mutually monogamous sexual relationship between uninfected
partners
- Barrier contraceptive methods
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- Patients who seek STI testing should be screened
for syphilis and HIV.
- Annual screening recommended by CDC for sexually active females:
- 25 years of age or younger
- With new sex partners or multiple sex partners
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- Unprotected sex
- Number of sexual partners
- Sexual preference
- Age: Two-thirds of STIs occur in persons in their teens and
twenties.
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- Chlamydial genital infections more frequently asymptomatic,
and when present, symptoms tend to be less noticeable (Table 1).
- Nearly two-thirds of infants acquire chlamydial infection
after endocervical exposure, with primary morbidity associated with
seeding of infant’s eyes, nasopharynx, rectum, or vagina.
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Means of Confirmation
and Diagnosis
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- Cell culture is reference standard but 3- to 7-day delay
in results has led to use of tests that rapidly detect chlamydial
antigens and nucleic acid.
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- Culture of endocervical or urethral epithelial cell scrapings
- Most specific method (close to 100%)
- Sensitivity is as low as 70%.
- Results available in 3–7 days.
- Non-culture tests:
- Enzyme immunosorbent assay
(EIA), DNA hybridization, nucleic acid amplification tests (NAATs)
- Allow rapid identification of chlamydial antigens and
nucleic acid.
- Technically less demanding
- Less costly, and in some situations have greater sensitivity ...