This article will focus on a sexually transmitted infection that occurs in patients with venereologic dispensaries in Russia 2-3 times more often than gonorrhea, and, according to statistics, occupies a leading position among such infections in the world. All this about the disease is urogenital chlamydia. Often the asymptomatic course, difficulties in diagnosis and the uniqueness of the pathogen lead to the fact that from 15 to 20% of the sexually active population are infected or carriers. In our age of sexual emancipation and openness in matters of sexual intercourse, knowledge about urogenital chlamydia, ways of infection, complications and methods of prevention are becoming a necessity.
Not a virus, not a bacterium, and not a simple
The causative agent of urogenital chlamydia is Chlamydia trachomatis, a unicellular organism that belongs to coccal bacteria. But unlike them, chlamydia has a nucleus that contains DNA. At the same time, these organisms do not have their own resources to ensure division, and they use the host cell for their own reproduction, which makes it close to extracellular parasites viruses. And the trick is that this organism exists in two forms - bacterial and viral.
Each stage of its development has its own structure and its own functions. Outside of living cells, they behave like bacteria, and when they penetrate into them, they become similar to viruses - they lose their nuclear structure and behave like intracellular parasites.
Urogenital Chlamydia: Microbiology
Two different forms of existence of this microorganism are represented by elementary and reticular bodies. The extracellular form of chlamydia - the elementary body - has a very small size (up to 300 nanometers), a coccoid shape without flagella, a strong outer wall, membrane, cytoplasm and nucleus. It is in this form that these protozoa can long be viable in the external environment.
But the elemental form of chlamydia does not have a resource for division, so it tends to get inside the host cell. Having penetrated into it, chlamydia passes into the shape of the reticular body - they are large (up to 1 thousand nanometers), they do not have a nucleus and there is no constant structure. This life form uses the resources of the host cell for its division. The causative agent of urogenital chlamydia is trophic only to the cells of the mucous epithelium of the genital organs, having penetrated into which it multiplies and destroys them, affecting an increasing number of epithelial cells. Within 3 days from one pathogen is formed up to 1 thousand new. And it is in this form that the chlamydia inside the epithelial cell is almost invulnerable. The life cycle of the pathogen consists of 6 stages and is presented in the figure.
Unique chlamydia
A feature of these microorganisms is that they carry out aerobic metabolism inside the cell, but outside the "host" they can exist in the form of anaerobic (which do not need oxygen) microorganisms. Under adverse environmental conditions (for example, exposure to antibiotics), chlamydia can go into such an anaerobic form and remain in it until “better times”. In addition to the fact that the parasite can wait out adverse conditions inside the body, it is able to exist in the external environment. So, in conditions of high humidity (baths, saunas, pools), they remain viable for up to a week even at temperatures up to 200 ° C. Pathogenicity in the environment decreases under ultraviolet radiation, under the influence of temperatures (in boiling water, chlamydia die in a minute), under the influence of disinfectants of increased concentrations.
How chlamydia harms the body
The pathogenic effect of the pathogen is manifested in three forms:
- During the division of the parasite in the epithelial cells, it secretes special proteins - endotoxins, which cause inflammatory processes in the human body. It is endotoxins that lead to fever, low-grade fever, and headaches.
- After active reproduction inside the host cell, when the number of young chlamydia becomes critical, other poisons, exotoxins, are released to destroy the membrane. Accumulating, they can cause local bleeding in the area of the colony of the parasite, swelling of the mucous membranes and pain.
- During the period of intracellular parasitization, chlamydia activate surface proteins to resist the protective mechanisms of the host cell. These proteins affect the overall resistance of neighboring cells and lead to the spread of infection.
Genital infection
The causative agent of urogenital chlamydia leads to the development of an inflammatory infectious disease that has several names: genital, vaginal, or chlamydia trachomatis. This pathogen is trophic to the cells of the cylindrical epithelium of the anal genital mucous membranes. The disease occurs in representatives of all age categories, urogenital chlamydia is manifested in women and men (and with different symptoms), it is also possible to detect in children. Chlamydia, genital herpes, and human papillomavirus are the three most common sexually transmitted infections. Although the ratio of incidence in women and men is 1 to 1, urogenital chlamydia is registered in women 2 times more often than in men, which is most likely associated with more frequent examinations of women by gynecologists.
Ways of infection in the body
As already emphasized, this is an infection, which, first of all, is transmitted sexually (genital-genital, genital-oral, genital - anal). Women are more susceptible to infection and infection from a partner with unprotected contact will occur in 1 out of 4 cases.
Infection can enter the body through the household through bedding, towels, and other items (such as benches in a bathhouse).
Infection of newborns is possible antenatally - in the prenatal period (through the placenta or infected amniotic fluid) and internally - during childbirth, if the mother is infected. Chlamydia enters the baby’s oropharynx, respiratory tract, eyes, genitals, and rectum. Symptoms and course of the disease in newborns are usually more pronounced, infection can lead to conjunctivitis, pneumonia, inflammation in the affected area.
Features and stages of the disease
The statistics is inexorable: every year up to 1 billion infected people are registered in the world, in Russia in 33% of cases of women and 45% of men this sexually transmitted infection is diagnosed. And such a wide spread of chlamydia is associated with the features and stages of the disease:
- Latent, incubation or latent periods can last from 1 week to several years. At this time, the infection proceeds without symptoms and does not bother the person. Identification of infection is possible only with the help of laboratory diagnosis of urogenital chlamydia.
- The acute period of the disease lasts up to 2 weeks. Symptoms of urogenital chlamydia at this stage are discomfort, mild itching and mucous discharge from the vagina or urethra. Symptoms are not so acute, and at the end of this phase they often disappear, and the disease proceeds to the next stage.
- Chronic urogenital chlamydia. It is accompanied by an exacerbation of thrush, pulling pains appear in the lower abdomen in the weaker sex. Urogenital chlamydia in men at this stage causes pain in the perineum.
The asymptomatic course of the disease leads to the fact that those infected for a long time may not be aware of the existing threat and infect others with it. And they will be forced to consult a doctor by the complications of chlamydia that have arisen.
What is the danger of this infection?
If treatment of urogenital chlamydia has not been carried out, a chronic infection can lead to the following complications:
- Inflammation of the urethra (urethritis) in men.
- Inflammation of the cervix in women (cervitis).
- Damage to the uterine mucosa (endometritis).
- Inflammation of the prostate (prostatitis).
- If an infection enters the bloodstream through damaged blood vessels, it causes Reiter's disease when the urethra, joints and conjunctiva of the eye are inflamed.
- Infertility in both women and men.
And this is not a complete list of troubles. In women, the infection is often multifocal, with concomitant infections, the consequences of which can be bartholinitis (inflammation of the glands of the vestibule of the vagina), damage to both the vagina and uterus, salpingitis (infection spreads to the fallopian tubes), and palvioperitonitis (inflammation of the peritoneum in the pelvic area). In men, prostatitis can lead to erectile dysfunction and inflammation in the testicles (epididymitis). That is why it is so important to begin treatment of urogenital chlamydia in the first stages of its detection. The insidiousness of this silent infection should not weaken the attention to the health and well-being of patients.
Chlamydia in an “interesting position”
In the early stages of pregnancy, infection with the chlamydia of the expectant mother can lead to the development of placental insufficiency. And this is hypoxia (oxygen starvation) of the fetus. In the best case, this is an increased muscle tone in a child. At worst, it’s an intrauterine fetal arrest or miscarriage. In addition, the child may experience hydrocephalus, liver and kidney damage, vitamin deficiency, and iron deficiency anemia.
But do not immediately panic. Modern medicine has enough tools to cure the expectant mother without harming the baby. And yet, when planning a pregnancy, you should not risk it, but undergo an examination with a gynecologist.
Diagnostic methods for urogenital chlamydia
Often the symptoms of this disease does not allow to determine the presence of chlamydia. Diagnosis of urogenital chlamydia is carried out in laboratories using various types of tests that will detect the infection already at the stage of incubation development:
- The most effective method is polymerase chain reaction (100% efficiency). Results are ready for 2 days, confirmation is not required. For analysis, a scraping of the mucous membranes is taken.
- Enzyme-linked immunosorbent assay - diagnosis of urogenital chlamydia by antibodies to the pathogen in the blood. The method differentiates the stage of development of the disease, but its accuracy is 60%.
- The cultural method is the sowing of your material on the medium with the determination of sensitivity to antibiotics. Long, expensive, but highly accurate analysis (up to 90%). In addition, such a sowing will reveal which antibiotics your chlamydia is sensitive to, and not your husband or neighbor.
- General smear (microscopy with staining) - the accuracy of this method is up to 15%. For analysis, a smear of the mucous membranes is taken, it gives reason only to suspect the presence of chlamydia.
- Immunofluorescence analysis - Chlamydia stained with a special composition glow when examined with a fluorescence microscope. Accuracy - up to 50%, the whole analysis will take no more than an hour.
- Mini tests that are sold in pharmacies. Simple and cheap, but accuracy is only up to 20%.
Kill in the bud
Chlamydia must be treated immediately after detection! The effectiveness of treatment is directly related to the stage of detection of infection. The treatment regimen should be prescribed only by a doctor, taking into account all the results of the tests. In Russia, the drug of choice in accordance with all standards adopted "Azithromycin" (single dose) or "Doxycycline" (course 7 days). In addition to antibiotics, antifungal ("Flucanazole"), immunostimulating ("Interferon") drugs and topical agents are included in the treatment regimen.
It is mandatory to conduct control studies on urogenital chlamydia. Clinical recommendations include abstinence from sexual contact, exclusion of alcohol and restriction of dairy products. In addition, it is advisable to undergo examination and sexual partner.
Prevention
In the dispensary treatment of infection, the prevention of urogenital chlamydia is an activity standard for all genital infections, namely:
- Control of persons in contact with the infected.
- Monitoring compliance with prescriptions and the thoroughness of treatment.
- Prophylactic examination of the decreed contingent.
All women are subject to mandatory control when they are sent to terminate pregnancy, childbirth and all couples who turn to family planning centers.
What will aggravate the course of chlamydia
During the treatment of the disease, it is necessary to refuse to take oral contraceptives and switch to mechanical methods of protection (condoms). This is how you can avoid re-infection.
Intrauterine contraceptives should also be removed. In addition, they do not protect against infection. There is evidence that the spiral contributes to the upward spread of chlamydia.
The use of steroid drugs against the background of chlamydia can provoke infertility, inflammation and prostate tumors, and an increase in the inflammatory processes of the female genital organs.
Imidazole drugs and nonspecific antibiotics can lead to microflora dysbiosis and even more difficult and prolonged treatment.
The combination of chlamydia and surgery is very dangerous. Starting from adhesions in the reproductive ducts of women and ending with the introduction of infection beyond the genitourinary system. Before surgery, it is advisable to be screened for chlamydia.
What does traditional medicine advise
If the diagnosis of chlamydia in Russia began in the 1990s, how did our grandmothers bear and give birth to children? Was there really chlamydia? A reasonable question - of course, there were. And there were miscarriages, and abortions, and fetal developmental arrest. Simply, medicine did not diagnose these cases as consequences of chlamydia.
Traditional healers offer many methods of both local and general strengthening treatment for this infection. In particular, when treating a bacterial infection, it is advisable to add parsley, celery, basil, caraway seeds, cloves, mint, saffron to your diet. Nobody canceled the strengthening and stimulating effect on the immune system of ginseng, lemongrass, eleutherococcus, echinacea.
And yet, deciding to use the prescriptions of our grandmothers, do not forget to consult your doctor: modern medicine has not been as conservative as we used to think.