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Chlamydia trachomatis is an important cause of sexually transmitted infections (STI) in Western countries. It is often asymptomatic, and thus, left untreated, and can have severe negative consequences, such as tubal infertility or adverse pregnancy outcomes. Other sexually transmitted microorganisms, such as Neisseria gonorrhoeae and Trichomonas vaginalis, as well as normal residents of the vaginal flora, such as genital mycoplasmas, also negatively impact human sexual and reproductive health. We evaluated the reliability of the Seegene Allplex STI Essential Assay for C. trachomatis detection using the real-time qPCR routinely used in our diagnostic laboratories as the gold standard. The Seegene assay displayed a sensitivity of 97.8% and a specificity of 98.9%. As this assay can also detect six other urogenital pathogens, we applied it to 404 samples from women who attended Lausanne University Maternity Hospital and obtained the following prevalence rates: 2.5% for C. trachomatis, 3.5% for Mycoplasma hominis, 6.3% for Ureaplasmaurealyticum, and 27.7% for Ureaplasmaparvum. Two samples were positive for Trichomonas vaginalis, and one sample was positive for Mycoplasma genitalium. Bacterial vaginosis was present in 4.5% of the cases and was strongly associated with M. hominis. Finally, we confirmed the association between C. trachomatis infection and pre-term birth (p = 0.03) but could not detect any association of this condition with other urogenital pathogens (Mycoplasma/Ureaplasma). In conclusion, given its high sensitivity and specificity for C. trachomatis DNA detection as well as its multiplex format, which simultaneously provides results for six other urogenital pathogens, the Seegene Allplex™ STI Essential Assay represents an appealing diagnostic tool in modern microbiology laboratories.

Chlamydia trachomatis is an important cause of sexually transmitted infections (STI) in Western countries. It is often asymptomatic, and thus, left untreated, and can have severe negative consequences, such as tubal infertility or adverse pregnancy outcomes. Other sexually transmitted microorganisms, such as Neisseria gonorrhoeae and Trichomonas vaginalis, as well as normal residents of the vaginal flora, such as genital mycoplasmas, also negatively impact human sexual and reproductive health. We evaluated the reliability of the Seegene Allplex STI Essential Assay for C. trachomatis detection using the real-time qPCR routinely used in our diagnostic laboratories as the gold standard. The Seegene assay displayed a sensitivity of 97.8% and a specificity of 98.9%. As this assay can also detect six other urogenital pathogens, we applied it to 404 samples from women who attended Lausanne University Maternity Hospital and obtained the following prevalence rates: 2.5% for C. trachomatis, 3.5% for Mycoplasma hominis, 6.3% for Ureaplasmaurealyticum, and 27.7% for Ureaplasmaparvum. Two samples were positive for Trichomonas vaginalis, and one sample was positive for Mycoplasma genitalium. Bacterial vaginosis was present in 4.5% of the cases and was strongly associated with M. hominis. Finally, we confirmed the association between C. trachomatis infection and pre-term birth (p = 0.03) but could not detect any association of this condition with other urogenital pathogens (Mycoplasma/Ureaplasma). In conclusion, given its high sensitivity and specificity for C. trachomatis DNA detection as well as its multiplex format, which simultaneously provides results for six other urogenital pathogens, the Seegene Allplex™ STI Essential Assay represents an appealing diagnostic tool in modern microbiology laboratories.

Assisted reproductive technologies (ART) are one of the most effective ways in fighting infertility, but their effectiveness is influenced by various factors. Our study focuses on examining importance of risk factors underlying ART failure related to altered microbiome pattern in the female reproductive system. The case-control study was based on conducting a laboratory examination of 129 infertile couples applied to the Department of Assisted Reproductive Technologies due to failure of in vitro fertilization (IVF), whereas control group consisted of females with successful progressive pregnancy after ART. Chlamydia, herpes virus and cytomegalovirus were assessed by using PCR and ELISA, whereas culture method was used to detect Trichomonas vaginalis in vaginal swabs and ejaculate applying Trichomonas Modified CPLM Medium (HiMedia, India) followed by microscopy. In addition, the qualitative and quantitative composition of the vaginal biocenosis was studied with multiplex RT-PCR by using Femoflor-16 kit (DNA-technologies, Russia). Serological tests were based on measuring IgG and IgA antibodies against Chlamydia trachomatis in ELISA (diagnostic kits purchased from Vektor Best, Russia; NovaTec, Germany; ImmunoComb, Israel) as well as antibodies against immediate early HSV-1/2 proteins (BioService, Russia) and immediate early HHV-5 proteins (Vector Best, Russia). C. trachomatis and herpesvirus DNA was measured by using PCR diagnostic kits Amplisens (Interlabservice, Russia). It was found that sexually transmitted infection agents were highly prevalent in infertile couples applying to the hospital for IVF. Significant factors for non-pregnancy were vaginal dysmicrobiocenosis (OR = 7.5 (95% CI 1.04—54.1), p = 0.02) and detected T. vaginalis (OR = 2.6 (95% CI 1.12—6.4), p = 0.01). Dysbiosis of the reproductive system, including those occurring due to trichomonas infection is associated with lowered ART effectiveness. It is evident to timely detect urogenital infections and dysbiosis while preparing infertile couples for IVF cycles.

Bachelor thesis deals with infections affecting the urogenital tract of women in fertile age. The theoretical part is focused on all producers of urogenital infections causing complications for women, which include the total discomfort as in sex, difficulty in urination or postinflammatory complications for example infertility, but also discusses the adverse effects of infections on pregnancies and newborns. The practical part was conducted with professional assistance of staff in the microbiology laboratory synlab czech s.r.o in České Budějovice. There I learned to process sampled biological material (vaginal / cervical swab, urine), types of used agars to cultivation (UriSelect, KA, Sabouraud agar, GAR and MHA), various identification methods to confirm the microbe predetermined Dr. microbiologist according to macroscopic features and preparation with Gram-staining, among them Clumping factor, latex agglutination, PYR - test CAMP - test, IBK and instrument identification by MALDI - TOF. Then I made the cultivation for the presence of Mycoplasma hominis, Ureaplasma urealyticum and testing for the presence of antigen Chlamydia trachomatis by ELISA. And finally I performed the antimicrobial susceptibility testing with disk diffusion method. From processing of the results I found that among 148 women over a period of 1 to 18 September 2015 were most often found in samples of bacterial agens, particularly coagulase - negative Staphylococci, E. coli and Streptococcus agalactiae. I didn't find of Chlamydia trachomatis in any sample the selected group of women, Mycoplasma hominis was isolated only from one sample and Ureaplasma urealyticum was among five women.

U ljudi je Chlamydia trachomatis važan uzročnik infekcija urogenitalnog sustava i oka. Diljem svijeta serovari D-K najčešći su uzročnici bakterijskih infekcija koje se prenose spolnim putem. Spolnim se putem prenose i serovari L1- L3, koji uzrokuju venerični limfogranulom. Infekcije serovarima D-K C. trachomatis mogu se očitovati širokim spektrom bolesti kao što su: akutni uretritis, epididimitis, proktitis, cervicitis, salpingitis, endometritis, konjunktivitis i pneumonija u novorođenčeta. Međutim većina zaraženih žena i muškaraca nema očitih simptoma infekcije. Neprepoznata i neliječena klamidijska infekcija genitalnog trakta u žena može imati teške posljedice kao što su: zdjelična upalna bolest, neplodnost i izvanmaternično začeće. U članku su iznesene spoznaje o mikrobiologiji, patogenezi, epidemiologiji, kliničkim manifestacijama, laboratorijskoj dijagnostici i liječenju različitih infekcija uzrokovanih D-Lserovarima C. trachomatis., Chlamydia trachomatis is an important urogenital and ocular pathogen in humans. C. trachomatis serovars D-K are the most common causes of sexually transmitted infections worldwide, and the L1-L3 serovars cause lymphogranuloma venereum. Infections with C. trachomatis serovars D-K may manifest a wide spectrum of diseases that include acute urethritis, epididymitis, proctitis, cervicitis, salpingitis, endometritis, conjunctivitis and neonatal pneumonia. However, most women and men who are infected are asymptomatic. Unrecognized and untreated genital chlamydial infections in women may lead to serious sequelae, such as pelvic inflammatory disease, infertility and ectopic pregnancy. This article presents the microbiology, pathogenesis, epidemiology, clinical manifestations, laboratory diagnostics and treatment options of diverse infections caused by C. trachomatis D-L-serovars.

Azitromicin (Sumamed®, PLIVA) antibiotik je proizveden u Plivinu Istraživačkom institutu. Zahvaljujući svojim iznimnim svojstvima, postao je danas najprodavaniji antibiotik u svijetu i svakako najpropisivaniji antibiotik za liječenje najčešćih bakterijskih spolno prenosivih i urogenitalnih infekcija, jednokratno u dozi od 1 g po. Lijek je izbora za liječenje akutne infekcije Chlamydijom trachomatis, Ureaplasmom urealyticum i Mycoplasmom genitalium. Kliničkom primjenom azitromicina postignut je u svjetskim razmjerima bitan napredak u liječenju SPI. Danas je međutim jasno da u SPI postoje indikacije u kojima je jednokratna primjena 1 g azitromicina nedostatna te se doze i duljina primjene moraju mijenjati. Tako se u liječenju perzistentne klamidijske infekcije primjenjuje u dozi 1x1 g na tjedan tijekom 3 tjedna. I u liječenju zdjelične upalne bolesti preporučuje se terapija tijekom 3 tjedna, najčešće 1x1 g na tjedan tijekom 3 tjedna ili 1x500 mg u iv. infuziji tijekom 1-2 dana, a zatim 250 mg po. do ukupno 7 dana liječenja. U produljenoj primjeni 1x1 g na tjedan tijekom 3 tjedna primjenjuje se i kod postveneričnoga reaktivnog artritisa i Reiterova sindroma., A zithromycin (Sumamed, PLIVA) is an antibiotic discovered in PLIVA’s Research Institute. Thanks to its exceptional properties, it has become the best-selling antibiotic worldwide and the most prescribed antibiotic for the treatment of the most common bacterial sexually transmitted and urogenital infections. Administered in a single 1 g oral dose, azithromycin is a drug of choice for acute infections due to Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma genitalium. At the global level, considerable progress has been made in the treatment of sexually transmitted infections thanks to the clinical use of azithromycin. However, it is clear today that there are some indications where a single 1 g dose is insufficient and that azithromycin strengths and the duration of treatment should be changed. Therefore, azithromycin is administered in a dose of 1 g/week over three weeks in persistent chlamydial infection. A three-week therapy is also recommended in pelvic inflammatory disease, most often 1 g/week over three weeks or 500 mg/day IV over 1 – 2 days, followed by oral 250 mg doses up to 7 days. The long-term administration of 1 g/week over three weeks is also indicated in postvenereal reactive arthritis and Reiter’s syndrome.

1)男子尿路性器感染症のクラミジア陽性率29.0%で, 疾患別には淋疾を含む尿道炎30.5%, 副睾丸炎27.%, 前立腺炎21.1%であった.2)非淋菌性尿道炎のクラミジア陽性率は33.0%で, また淋菌性尿道炎の23.3%にクラミジア感染症を合併していた.3)年齢分布は21歳～40歳までの間に91.1%が集中しており, 平均31歳であった.4)感染経路は77.8%が性交によるもので, そのうちprostituteからの感染が62.1%と1番多かった.5)潜伏期間は2～3週間前後のものが多く, 1ヵ月以上と長いものも認められた.また, 感染の機会から症状発現の時期が明らかでない症例が多かった.6)細胞培養法と直接塗抹法の陽性一致率は37.5%で, 陰性一致率は100%であった.7) IgM抗体陽性例を1例も認めなかった, Between January, 1984 and August 1986, we examined 151 male patients with urogenital infections including 114 cases of urethritis, 18 cases of epididymitis, 19 cases of prostatitis at the outpatient clinic of the department of urology, Toho University's Ohmori Hospital. The positive rate for Chlamydia trachomatis from the urethra based on cell cultures was 29.0%, (30.5% for urethritis, 27.8% for epididymitis, and 21.1% for prostatitis). The positive rate for non-gonorrheal urethritis was 33.0% and chlamydia infections were complicated by gonorrheal urethritis in 23.3% of the cases. The mean age of the patients with positive Chlamydia trachomatis was 31.9 years. The route of infection in 77.8% of the cases was sexual intercourse the most common cause of which was infection from a prostitute in 62.1% of the cases. The latent period was in most cases from 2-3 weeks.