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S E X U A L L Y T R A N S M I T T E D D I S E A S E S Neonatal conjunctivitis and pneumonia
due to chlamydia infection

Genital chlamydia infection is the most commonly reported sexually transmitted infection inyoung adults and teenagers in the United Kingdom, particularly affecting those having unsafesexual intercourse with multiple sexual partners. Infants born to women with untreated infectionare at risk of chlamydial conjunctivitis and pneumonia. The prevalence, consequences, preventionand treatment of chlamydia infection and disease in both women and infants are described.
Carol Pellowe
Chlamydiae are small Gram-negative
in September 2002. A further 16 areas were replicate inside cells, i.e. they are obligate added in January 2004, covering 25% of all screening programme by 2008. The focus of Robert J. Pratt
ribosomes and a cell wall, and dividing by bacterial cells, chlamydiae lack the cellular women aged 16-24 years of age attending a chemistry to produce their own energy and variety of healthcare settings, for example general practices, contraceptive clinics and reproduce. There are several different types young people’s services4. The screening method is simple and involves the collection Chlamydia trachomatis, a common cause of urine samples and self-collected vulvo- genital disease, such as urethritis, cervicitis Keywords
transmit C. trachomatis infection to their years old4. Although this rate is less thanthat seen in GUM clinics, it demonstrates a Key points
Pellowe, C., Pratt, R.J. (2006) Neonatal
chlamydia infection. Infant 2(1): 16-17.
antenatal care, it is highly likely that many 1. Genital Chlamydia trachomatis is the Consequences of chlamydia
infections were diagnosed in GUM clinics, infection
with chlamydia have no symptoms ofinfection.
disease, the health consequences of C. infection can spread into the pelvic area trachomatis infection can be serious.
transmission of C. trachomatis from V O L U M E 2 I S S U E 1 2 0 0 6 infant
S E X U A L L Y T R A N S M I T T E D D I S E A S E S nitrate solution has been used but this is less effective in preventing conjunctivitis pregnant women are routinely screened for conjunctivitis comparing the topical use of nitrate solutions have proved inconclusive6.
bacterial resistance, and in resource-poor countries, also have the advantage of being An alternative option is to give systematic FIGURE 1 Chlamydia infection can be
pre-term babies is more serious, presenting has proved cost effective in countries with transmitted from infected mothers to their initially with respiratory distress followed prevalence rates of chlamydia greater than 3%6. As the UK prevalence is far less than apnoea6. If left untreated, infants are at infected mother to infant, as the eyes are pulmonary disease, including asthma6.
down the birth canal (FIGURE 1).
neonatal conjunctivitis in both developed Treatment
be fully operational until 2008 and, even prophylaxis is given before or immediately A variety of antimicrobial drugs can be use still present with undiagnosed infection.
infection in adults, including azithromycin, Neonatal chlamydia infection
doxycline, erythromycin and amoxicillin.
the possibility of chlamydia as the cause of In order to prevent re-infection, current chlamydia during birth frequently develop treatment rather than prophylaxis remains eyes, sometimes referred to as Ophthalmia References
infection with C. trachomatis is the 1. Fenton K.A., Ward H. National chlamydia screening
Erythromycin is generally well tolerated, programme in England: Making progress. Sex Trans Infect 2004; 80(5): 331-33.
2. Health Protection Agency. Rates of increases in
countries and it is a significant cause of sexually transmitted infection slows. CDR Weekly.
this condition in the developing world6.
stenosis6. Follow-up should be carried out 2005; 15(26): 2-5.
Conjunctivitis develops between 5-14 days in all treated infants as subsequent courses 3. Department of Health. The national strategy for
sexual health and HIV. London: DoH. 2001.
4. LaMontagne D.S., Fenton K.A., Randall S., Anderson
affecting the other after 2-7 days. Oedemaand erythema of the eyelids is common, Preventing neonatal conjunctivitis
S., Carter P. on behalf of the National Chlamydia
Screening Steering Group.
Establishing the National
Chlamydia Screening Programme in England: Results from the first full year of screening. Sex later6. Although chlamydia conjunctivitis is antimicrobial ophthalmic ointments or eye Trans Infect 2004; 80(5) 335-41.
5. Mangione-Smith R., O’Leary J., McGlynn E.A. Health
usually mild, infection of the hair follicles and cost-benefits of chlamydia screening of young will increase the amount of discharge and women. Sex Transm Dis 1999; 26(6): 309-16.
where prenatal screening for chlamydia is 6. Zar H.J. Neonatal chlamydial infections. Pediat
frequent cause of neonatal conjunctivitis unavailable, prophylaxis is an option.
Drugs 2005; 7(2): 103-10.
7. Health Protection Agency. General Information –
Chlamydia. Available at would need to be primarily active against Neisseria gonorrhoeae, as this does the most infant VO L U M E 2 I S S U E 1 2 0 0 6


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Nederlands tijdschrift voor geneeskunde

fa r m a c o t h e r a p i e De Beers-lijst als hulpmiddel om ernstige geneesmiddelbijwerkingen R.W.Vingerhoets, R.J.van Marum en P.A.F.Jansen *– Geneesmiddelbijwerkingen zorgen vooral bij ouderen voor een sterk verhoogd risico op ziekenhuis-opname en sterfte. – De meeste geneesmiddelbijwerkingen zijn vermijdbaar indien het voorschrijfpatroon wordt aan-gepast. – Beers et al. hebben een

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