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Berlin Brandenburg

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  • 1
    Language: English
    In: The Journal of infectious diseases, 01 January 2010, Vol.201(1), pp.42-51
    Description: Repeated Chlamydia trachomatis infections are common among young sexually active women. The relative frequency of reinfection and antibiotic treatment failure is undefined. Adolescent women enrolled in a longitudinal cohort had behavioral and sexually transmitted infection assessments performed every 3 months, including amplification tests for C. trachomatis, ompA genotyping, and interviews and diary entries to document sex partner-specific coitus and event-specific condom use. Repeated infections were classified as reinfection or treatment failure by use of an algorithm. All infections for which treatment outcomes were known were used to estimate the effectiveness of antibiotic use. We observed 478 episodes of infection among 210 study participants; 176 women remained uninfected. The incidence rate was 34 episodes/100 woman-years. Of the women who were infected, 121 experienced 1 repeated infections, forming 268 episode pairs; 183 pairs had complete data available and were classified using the algorithm. Of the repeated infections, 84.2% were definite, probable, or possible reinfections; 13.7% were probable or possible treatment failures; and 2.2% persisted without documented treatment. For 318 evaluable infections, we estimated 92.2% effectiveness of antibiotic use. Most repeated chlamydial infections in this high-incidence cohort were reinfections, but repeated infections resulting from treatment failures occurred as well. Our results have implications for male screening and partner notification programs and suggest the need for improved antibiotic therapies.
    Keywords: Anti-Bacterial Agents -- Therapeutic Use ; Azithromycin -- Therapeutic Use ; Chlamydia Infections -- Drug Therapy
    ISSN: 00221899
    E-ISSN: 1537-6613
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  • 2
    In: Sex Transm Dis, 2001, Vol.28(5), pp.247-251
    Description: BACKGROUND: The temporal pattern of partners and sexual encounters may be key factors in the acquisition and transmission of sexually transmitted diseases (STDs). Behavior among adolescent women is of particular interest because they frequently have the highest prevalence and incidence of infection. GOAL: To examine coital diary data collected during a 7-month longitudinal study of young women at high risk of STDs and to describe their sexual behaviors, with particular attention to issues of partner sequence and overlap. STUDY DESIGN: A 7-month longitudinal study of young women infected with or having a sexual contact infected with Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis attending the STD clinic or one of four neighborhood adolescent health clinics. Data were collected at enrollment and at 1, 3, 5, and 7-month follow-up visits. Coital diaries were kept between visits. RESULTS: The average frequency of coital events was 0.94 per week. The median number of sexual partners during the follow-up period was one, and overlapping of partnerships was an uncommon occurrence. The number of days between the last coital event of a current relationship and the first encounter of a new relationship differed for those choosing a new partner (mean, 20.6 days) and those who returned to a previous partner (mean, 7.9 days;P 〈 0.001). CONCLUSION: Although at high risk for STDs, high-risk behavior was not common among the study population. Partner choice and the behavior of these partners may be more important elements than personal high-risk behavior in accounting for the high prevalence of sexually transmitted infections among inner-city adolescent women.
    Keywords: Teenage Girls -- Sexual Behavior ; Sexually Transmitted Diseases -- Research;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 3
    In: Sexually Transmitted Diseases, 2016, Vol.43(12), pp.741-749
    Description: BACKGROUND: Sexual transmission rates of Chlamydia trachomatis (Ct) cannot be measured directly; however, the study of concordance of Ct infection in sexual partnerships (dyads) can help to illuminate factors influencing Ct transmission. METHODS: Heterosexual men and women with Ct infection and their sex partners were enrolled and partner-specific coital and behavioral data collected for the prior 30 days. Microbiological data included Ct culture, and nucleic acid amplification testing (NAAT), quantitative Ct polymerase chain reaction, and ompA genotyping. We measured Ct concordance in dyads and factors (correlates) associated with concordance. RESULTS: One hundred twenty-one women and 125 men formed 128 dyads. Overall, 72.9% of male partners of NAAT-positive women and 68.6% of female partners of NAAT-positive men were Ct-infected. Concordance was more common in dyads with culture-positive members (78.6% of male partners, 77% of female partners). Partners of women and men who were NAAT-positive only had lower concordance (33.3%, 46.4%, respectively). Women in concordant dyads had significantly higher median endocervical quantitative Ct polymerase chain reaction values (3,032) compared with CT-infected women in discordant dyads (1013 inclusion forming units DNA equivalents per mL; P 〈 0.01). Among 54 Ct-concordant dyads with ompA genotype data for both members, 96.2% had identical genotypes. CONCLUSIONS: Higher organism load appears associated with concordance among women. Same-genotype chlamydial concordance was high in sexual partnerships. No behavioral factors were sufficiently discriminating to guide partner services activities. Findings may help model coitus-specific transmission probabilities.
    Keywords: Chlamydia Infections -- Genetic Aspects ; Chlamydia Infections -- Development And Progression ; Virulence (Microbiology) -- Genetic Aspects ; Genotypes -- Health Aspects ; Disease Susceptibility -- Genetic Aspects;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 4
    In: Sexually Transmitted Diseases, 1992, Vol.19(2), pp.99-104
    Description: :
    Keywords: Gonorrhea ; Care and Treatment ; Chlamydia Infections ; Clinical Epidemiology ; Evaluation ; Sexually Transmitted Diseases ; Reporting ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 5
    In: Sexually Transmitted Diseases, 1989, Vol.16(2), pp.103-106
    Description: The present study was undertaken to evaluate the utility of a gram stain of endocervical secretions in the prediction of endocervical infection with Chlamydia trachomatis. Endocervical examinations, Gram stains and chlamydial cultures were performed on 214 women who were attending a sexually transmitted diseases clinic and were at increased risk for chlamydial infection. Almost 24% of the Gram stains were judged inadequate because of the presence of ectocervical material. However, significantly higher isolation rates for C. trachomatis were found for those women with valid smears and 10 or more polymorphonuclear cells on their smear (44% vs 19%, P = .0008). This relationship was independent of the presence of gonococcal infection. Based on the results of this study, endocervical Gram stains appear to be a valuable screening tool for chlamydial infection, particularly among those without mucopurulent discharge.
    Keywords: Chlamydia Infections -- Diagnosis ; Uterine Cervicitis -- Diagnosis;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 6
    In: Sexually Transmitted Diseases, 1991, Vol.18(1), pp.36-40
    Description: In developed nations, the most common sexually transmitted disease is infection with Chlamydia trachomatis. In the United States, the standard therapy for chlamydia infections involves a seven-day treatment period with tetracycline, erythromycin, or doxycycline. However, some cases require a longer treatment period, up to 21 days, to eliminate the infection. After the treatment period has ended, the patient is retested to make sure that the infection has been cured. This procedure is called a test-of-cure (TOC). But recurrent infections with the same strain of Chlamydia trachomatis, following seven days of treatment and TOC, are not uncommon, and may indicate that the standard therapy time should be increased. In an attempt to evaluate the relationship between the duration of treatment and the rate of recurrence of infection, the medical records of 2,983 patients, who were treated with the standard therapy for chlamydia infection, were reviewed. During a two-year follow-up period, the rate of recurrence of infection was 29 percent. Recurrence of infection was associated with young age, but not with gender or race. To determine if a longer treatment period could reduce the rate of recurrence of infection, 220 patients with chlamydia were treated with tetracycline for either 7 or 21 days. Among patients who returned, the recurrence rate was 14 percent for the seven-day treatment and 18 percent for the 21-day treatment. The difference in the recurrence rate between the two treatment groups was not statistically significant. It is concluded that a 21-day treatment period is no more effective than a seven-day treatment period in preventing recurrence of chlamydia infection. (Consumer Summary produced by Reliance Medical Information, Inc.)
    Keywords: Tetracyclines -- Evaluation ; Chlamydia Infections -- Drug Therapy ; Chlamydia Trachomatis;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 7
    In: Sexually Transmitted Diseases, 1992, Vol.19(6), pp.351-354
    Description: Control of bacterial sexually transmitted diseases (STD) depends on adequate antibiotic therapy. During a 4-week period, a survey concerning compliance was administered to all patients attending an STD clinic who were being treated with one of the standard antibiotic regimens for presumed gonococcal or chlamydial infections. Of the 497 eligible patients, 406 (81.7%) were surveyed between 24 hours and 72 hours after the end of treatment. Of those being treated with the standard 7-day regimen of tetracycline or erythromycin, 63.4% complied. Compliance was not associated with race, gender, symptoms, or antibiotic regimen. Those who were younger, were sexual contacts of an infected partner, or had gastrointestinal side effects were more likely not to comply with treatment.
    Keywords: Chlamydia Trachomatis ; Drug Therapy ; Neisseria Gonorrhoeae ; Patient Compliance ; Evaluation ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 8
    In: Sexually Transmitted Diseases, 1996, Vol.23(3), pp.226-229
    Description: BACKGROUND AND OBJECTIVES:: GOALS:: STUDY DESIGN:: The study population consisted of all 4,329 sexually active girls between the ages of 13 and 19 attending the four adolescent health clinics in Indianapolis, Indiana, during the period beginning October 1, 1985, and ending June 30, 1994. All girls were cultured for Chlamydia trachomatis, and behavioral data were collected for those attending the clinics before 1989. The trend in quarterly isolation rates was examined using linear regression analysis. RESULTS:: Results showed that there was a significant decrease (P = 0.0001), from 25.9% to 9.7%, in the first-visit chlamydial isolation rate over the study period. Behavioral data showed decreases in the frequency of sexual intercourse and in lifetime years of sexual activity, as well as an increase in condom use. CONCLUSIONS::
    Keywords: Chlamydia Infections ; Demographic Aspects ; Teenage Girls ; Health Aspects ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 9
    In: Sexually Transmitted Diseases, 1999, Vol.26(1), pp.26-32
    Description: OBJECTIVE:: To identify factors associated with subsequent sexually transmitted infection (STI) (within 1 year of initial infection) due to Chlamydia trachomatis, Neisseria gonorrhoeae or Trichomonas vaginalis. DESIGN:: SETTING:: PARTICIPANTS:: MAIN OUTCOME MEASURES:: RESULTS:: CONCLUSIONS::
    Keywords: Chlamydia ; Demographic Aspects ; Trichomonas Vaginalis ; Gonorrhea ; Teenage Girls ; Sexual Behavior ; Sexually Transmitted Diseases ; Risk Factors ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 10
    In: Sexually Transmitted Diseases, 1994, Vol.21(1), pp.47-52
    Description: Background and Objecfives: The prevalence of chlamydial infection decreases with age possibly in part because of increasing immunity.Goal of this Sfudy:To determine whether increased age is an independent predictor of decreased chlamydial infection and whether chlamydia-specific antibody titer and blastogenesis increase with age.Sfudy Design: Data from all patients cultured for Chlamydia frachomafis between January 1984 and August 1989 were examined and multiple logistic regression models were used to identify the independent predictors of culture positivity. Antichlamydial antibody titer and chlamydia-specific blastogenesis were examined for a subset of patients for correlation with age.Results: Young age was found to be predictive of chlamydial infection independent of all factors examined in men and women. Antibody titers had no relation to age (n = 245) whereas the level of blastogenesis correlated only weakly with age (n = 155).Conclusions: Assays of systemic immunity do not reflect the protection from chlamydial infection associated with age.
    Keywords: Chlamydia Infections -- Demographic Aspects ; Chlamydia Trachomatis -- Physiological Aspects;
    ISSN: 0148-5717
    E-ISSN: 15374521
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