This article will focus on a sexually transmitted infection that occurs in patients of venereal 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 is about the disease urogenital chlamydia. The often asymptomatic course, difficulties in diagnosis, and the uniqueness of the pathogen result in 15 to 20% of the sexually active population being infected or carriers. In our age of sexual emancipation and openness in matters of sexual relations, knowledge about urogenital chlamydia, ways of infection, complications and prevention methods become a necessity.
Not a virus, not a bacterium, not a protozoan
The causative agent of urogenital chlamydia is Chlamydia trachomatis, a unicellular organism that belongs to cocci bacteria. But unlike them, chlamydia have 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 toextracellular 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 functions. Outside of living cells, they behave like bacteria, and when they penetrate 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 be viable in the external environment for a long time.
But the elemental form of chlamydia has no resource for division, so it tends to get inside the host cell. Having penetrated into it, chlamydia turns into a reticular body - they are large (up to 1 thousand nanometers), they do not have a nucleus and there is no permanent 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, up to 1 thousand new ones are formed from one pathogen. And it is in this form inside the epithelial cell of chlamydia that they are almost invulnerable. The life cycle of the pathogen consists of 6 stages and is shown 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 unfavorable environmental conditions (for example, exposure to antibiotics), chlamydia are able to pass 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 also 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 (chlamydia die in boiling water in a minute), under the action of high concentration disinfectants.
How chlamydia harms the body
The pathogenic action of the pathogen manifests itself in three forms:
- During the division of the parasite in the cells of the epithelium, it secretes special proteins - endotoxins, which cause inflammation in the human body. It is endotoxins that lead to fever, subfebrile temperature, 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 periodintracellular parasitism of chlamydia activate surface proteins to resist the defense mechanisms of the host cell. These proteins affect the overall resistance of neighboring cells and lead to the spread of infection.
Sexual 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 manifests itself in women and men (and with different symptoms), it is also possible to detect in children. Chlamydia, genital herpes and human papillomavirus are among the three most common sexually transmitted infections. Although the incidence ratio in women and men is 1 to 1, urogenital chlamydia is recorded in women 2 times more often than in men, which is most likely due to more frequent examinations of women by gynecologists.
Ways of infection into the body
As already emphasized, this is an infection that is primarily transmitted sexually (genital-genital, genital-oral, genital-anal). Women are more susceptible to infection and infection from a partner through unprotected contact will occur in 1 out of 4 cases.
Infection can enter the body through the household route through bed linen, towels andother items (for example, benches in the bathhouse).
Infection of newborns is possible antenatally - in the intrauterine period (through the placenta or contaminated 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 are relentless: every year up to 1 billion infected people are registered in the world, in Russia this sexual infection is diagnosed in 33% of women and 45% of men. And such a widespread occurrence of chlamydia is associated with the characteristics and stages of the disease:
- Latent, incubation or hidden period can last from 1 week to several years. At this time, the infection proceeds without symptoms and does not bother the person. It is possible to detect infection only with the help of laboratory diagnostics of urogenital chlamydia.
- The acute period of the disease lasts up to 2 weeks. Symptoms of urogenital chlamydia at this stage are discomfort, slight itching and mucous discharge from the vagina or urethra. The symptoms are not so acute, and at the end of this phase they often disappear, and the disease moves on to the next stage.
- Chronic urogenital chlamydia. Accompanied by exacerbation of thrush, there are pulling pains in the lower abdomen in the weaker sex. Urogenital chlamydia in men at this stage causespain in the perineum.
The asymptomatic course of the disease leads to the fact that those infected for a long time may be unaware of the existing threat and infect others with it. Complications of chlamydia will force them to see a doctor.
How dangerous is this infection
If urogenital chlamydia has not been treated, chronic infection can lead to the following complications:
- Inflammation of the urethra (urethritis) in men.
- Inflammatory process on the cervix in women (cervitis).
- Loss of the lining of the uterus (endometritis).
- Inflammation of the prostate (prostatitis).
- When the infection enters the blood through damaged blood vessels, it leads to Reiter's disease, when the urethra, joints and conjunctiva of the eyes 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 start treatment of urogenital chlamydia in the early stages of its detection. The insidiousness of this silent infection should not weaken attention to he alth andpatients' well-being.
Chlamydia in an "interesting position"
In the early stages of pregnancy, infection with chlamydia in the expectant mother can lead to the development of placental insufficiency. And this is hypoxia (oxygen starvation) of the fetus. At best, this is an increased muscle tone in a child. At the worst, it is intrauterine fetal growth arrest or miscarriage. In addition, the child may experience hydrocephalus, liver and kidney damage, beriberi, and iron deficiency anemia.
But don't panic right away. Modern medicine has sufficient tools to cure the expectant mother without harming the child. And yet, when planning a pregnancy, you should not take risks, but undergo an examination by a gynecologist.
Methods for diagnosing urogenital chlamydia
Often the symptoms of this disease do 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). The results are ready on the 2nd day, confirmation is not required. Mucous scrapings are taken for analysis.
- Immunoassay - 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%.
- Cultural method - inoculation of your material on the medium with the determination of sensitivity to antibiotics. Long, expensive, but highly accurate analysis (up to90%). In addition, such a culture will reveal which antibiotics your chlamydia is sensitive to, and not your husband or neighbor.
- Common smear (microscopy with staining) - the accuracy of this method is up to 15%. For analysis, a smear of mucous membranes is taken, it only gives reason to suspect the presence of chlamydia.
- Immunofluorescent analysis - stained with a special composition of chlamydia glow when examined using a fluorescent microscope. Accuracy - up to 50%, the entire analysis will take no more than an hour.
- Mini tests sold in pharmacies. Simple and cheap, but only up to 20% accurate.
Kill in the bud
Chlamydia should be treated immediately after detection! The effectiveness of treatment is directly related to the stage of infection detection. 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 is Azithromycin (single dose) or Doxycycline (course 7 days). In addition to antibiotics, the treatment regimen includes antifungal ("Flucanazole"), immunostimulating ("Interferon") drugs and topical agents.
It is obligatory to carry out control tests for urogenital chlamydia. Clinical recommendations are abstinence from sexual intercourse, exclusion of alcohol and restriction of dairy products. In addition, it is desirable to undergo an examination and sexual partner.
Prevention
In the dispensary treatment of infection, the prevention of urogenital chlamydia is a measure that is standard for all sexual infections, namely:
- Control of persons who have been in contact with the infected.
- Monitoring compliance with prescriptions and thoroughness of treatment.
- Preventive examination of the decreed contingent.
All women are subject to mandatory control when they are referred for termination of pregnancy, childbirth and all couples who apply to family planning centers.
What will aggravate the course of chlamydia
During the treatment of the disease, it is necessary to stop taking oral contraceptives and switch to mechanical methods of protection (condoms). This is how you can avoid reinfection.
Intrauterine contraceptives should also be removed. Except that 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 tumors of the prostate, increased inflammation of the female genital organs.
Imidazole drugs and non-specific antibiotics can lead to microflora dysbacteriosis and even more difficult and prolonged treatment.
The combination of chlamydia and surgery is very dangerous. Starting from adhesions in the genital ducts of a woman and ending with the infection outside the genitourinary system. Before surgicaloperations, it is desirable to be screened for chlamydia.
What traditional medicine advises
If the diagnosis of chlamydia in Russia began in the 1990s, how did our grandmothers bear and give birth to children? Really there were no chlamydias? A reasonable question - of course, there were. And there were miscarriages, and terminations of pregnancy, and h alts in the development of the fetus. It's just that medicine has not diagnosed these cases as the consequences of chlamydia.
Traditional healers offer many ways of both local and restorative treatment for this infection. In particular, when treating a bacterial infection, it is advisable to add parsley, celery, basil, cumin, cloves, mint, and saffron to your diet. The strengthening and stimulating effect on the immune system of ginseng, magnolia vine, eleutherococcus, echinacea has not been canceled either.
And yet, having decided to use the recipes of our grandmothers, do not forget to consult your doctor: modern medicine has long been not as conservative as we used to think.
