Quantitative aspects of chlamydial infection of the cervix.

In 580 women with Chlamydia trachonmatis infection of the cervix, the degree of the infection was assessed by counting the number of chlamydial inclusions which developed in McCoy cell monolayers inoculated with cervical swab material under standardised conditions. In 34% of these women inclusion counts were <100 per monolayer whereas in 36% the counts were greater than or equal to 1000. Clinical features in each of these groups were compared to see if certain factors could be identified as the cause, or the result, of high-grade rather than low-grade infection. A significant association was found between high inclusion counts and the presence of cervical mucopus or cervical ectopy. Oral contraceptives acted additively with ectopy but had no significant effect alone. Concurrent gonorrhoea did not affect the degree of chlamydial infection. High inclusion counts were more common in women under 20 years of age than in older women.

Chlamydial infection of the cervix in contacts of men with nongonococcal urethritis.

An investigation of chlamydial infection in sexual contacts of patients with nongonococcal urethritis (NGU) was carried out to determine the clinical signs of infection in the cervix, and their response to chemotherapy, and the incidence of cervical infection in the presence of ectopy and oral contraception. In 202 consecutive female contacts of NGU the isolation rate of Chlamydia trachomatis was 35%. Hypertrophic ectopy and endocervical mucopus were present in 19% and 37% of chlamydia-positive patients respectively and, in all but one, resolved after treatment. Only 14% of those followed up after treatment developed yeast infections. The chlamydial isolation rate was significantly higher in patients with hypertrophic ectopy and endocervical mucopus. Cervical ectopy and oral contraceptives acted additively, each producing a significant effect on the chlamydial isolation rate in the presence of the other but not when present alone.

Neonatal conjunctivitis caused by Neisseria gonorrhoeae and Chlamydia trachomatis.

In a selected group of 103 babies referred with neonatal conjunctivitis Neisseria gonorrhoeae was isolated from 11 and Chlamydia trachomatis from 33. Concurrent infection was present in three. On toddler sibling developed chlamydial conjunctivitis. After treatment C. trachomatis was re-isolated from six babies during the follow-up period. The discharge started one to three days after delivery in only three babies with gonococcal conjunctivitis and at five to eight days in eight babies. One baby was delivered by caesarean section. N. gonorrhoeae was isolated from four asymptomatic fathers, all of whom had urethritis. The mean onset of discharge in the 33 babies from whom Chlamydia was isolated was 7-1 days. One baby was delivered by caesarean section. Chlamydial conjunctivitis was associated with a high incidence of prematurity and of postpartum infection in the mother. Ten fathers of Chlamydia-positive babies were examined. C. tachomatis was isolated from four, all of whom were asymptomatic but had low-grade urethritis. These findings confirm the pathogenic role of C. trachomatis in the cervix and indicate the importance to the family of an adequate microbiological investigation of neonatal conjunctivitis.