Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey.
Jpn J Infect Dis. 2012;65(1):1-6.
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.
本研究旨在评估沙眼衣原体感染在新生儿中的发生率和发病率。采用组织培养和直接免疫荧光（DIF）检测法，对 35 例早产儿和 21 例健康足月儿的鼻咽部沙眼衣原体感染进行检测。所有婴儿均进行 3 个月的临床随访，并于第 15 天和第 6 周进行酶联免疫吸附试验分析血清抗沙眼衣原体 IgG 和 IgM。组织培养和/或 DIF 研究显示，10 例早产儿（28.57%）为沙眼衣原体阳性，而无 1 例足月产儿为阳性。DIF 和组织培养的敏感性分别为 40%和 70%，表明组织培养检测法在诊断沙眼衣原体感染方面具有优势。仅 1 例无症状的早产儿在第 6 周时抗沙眼衣原体抗体呈阳性。所有沙眼衣原体阳性婴儿均接受大环内酯类抗生素治疗 14 天。研究表明，男性婴儿感染更为常见，但在感染和未感染的早产儿中，分娩类型、平均胎龄、平均出生体重和机械通气需求相似。然而，感染早产儿的吸氧时间较长。感染沙眼衣原体的婴儿更常出现结膜炎（60%），而非感染的婴儿为 24%。感染沙眼衣原体的婴儿更常患肺炎；然而，所有肺炎患儿的抗沙眼衣原体 IgM 和 IgG 抗体均为阴性。对鼻咽部沙眼衣原体阳性的婴儿进行 2 周的大环内酯类治疗可能预防了沙眼衣原体相关肺炎，但可能不会显著影响其他病原体引起肺炎的风险。衣原体感染可能导致早产儿出现早期和晚期的呼吸道问题。对鼻咽部进行筛查可能有助于医生发现沙眼衣原体感染，并为这一脆弱患者群体提供早期诊断的方法。
