Perinatally acquired Chlamydia trachomatis associated morbidity in young infants.

OBJECTIVE This study was designed to evaluate the spectrum of morbidity associated with perinatally acquired Chlamydia trachomatis in infants < or =12 weeks of age, and to determine its relationship to maternal Chlamydia trachomatis status. METHODS DESIGN Retrospective review of maternal and infant records. SETTING Large inner city teaching hospital. PATIENTS A cohort of 530 symptomatic infants < or =12 weeks of age who were tested for Chlamydia trachomatis infection in the upper respiratory tract during a 2-year period from January 1993 to December 1994. RESULTS During the study period, 70/530 (13.2%) patients tested positive for Chlamydia trachomatis from the conjunctiva and/or the nasopharynx. Complete medical records of 66 of these infants were available for review. Forty-eight of 66 (73%) infants had conjunctivitis, 13/66 (20%) had pneumonia, 5/66 (7%) had both conjunctivitis and pneumonia. Thirteen of 66 (20%) infants were hospitalized, 7 for pneumonia and 6 for ophthalmia, accounting for 68 hospital days. In 55/66 (83%), maternal records were available for review. Nineteen of 55 (35%) mothers had documented Chlamydia trachomatis infection at delivery or during pregnancy that had not been treated; 16/55 (29%) mothers tested negative for Chlamydia trachomatis sometime during pregnancy but were not retested at delivery, 8/55 (14%) were treated for Chlamydia trachomatis during pregnancy but status at delivery regarding reinfection was not evaluated. In 12/55 (22%) mothers, no prenatal testing was documented. CONCLUSIONS This study demonstrates significant morbidity in early infancy associated with perinatally acquired Chlamydia trachomatis infection. There is need for studies evaluating the importance of adequate maternal testing and treatment to reduce perinatal transmission.

[1]  M. Hammerschlag,et al.  Use of polymerase chain reaction for the detection of Chlamydia trachomatis in ocular and nasopharyngeal specimens from infants with conjunctivitis. , 1997, The Pediatric infectious disease journal.

[2]  R. Peeling,et al.  Serologic evidence of Chlamydia trachomatis infection and risk of preterm birth. , 1995, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[3]  S. Yeh,et al.  Prevalence of Chlamydia trachomatis infection in pregnant patients. , 1991, Public health reports (1974).

[4]  J. French,et al.  Chlamydia trachomatis infection during pregnancy , 1991, American journal of obstetrics and gynecology.

[5]  T. N. Abdella,et al.  Chlamydia trachomatis infection in pregnancy and effect of treatment on outcome. , 1990, American journal of obstetrics and gynecology.

[6]  L. Howard,et al.  Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants , 1987, Journal of clinical microbiology.

[7]  K. Holmes,et al.  Delayed appearance of Chlamydia trachomatis infections acquired at birth. , 1987, The Pediatric infectious disease journal.

[8]  A. Washington,et al.  Chlamydia trachomatis infections in the United States. What are they costing us? , 1987, JAMA.

[9]  R. Sweet,et al.  Chlamydia trachomatis infection and pregnancy outcome. , 1987, American journal of obstetrics and gynecology.

[10]  K. Holmes,et al.  Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. , 1986, JAMA.

[11]  R. Sweet,et al.  Prospective study of perinatal transmission of Chlamydia trachomatis. , 1986, JAMA.

[12]  M. Grossman,et al.  Experience with the routine use of erythromycin for chlamydial infections in pregnancy , 1986, The New England journal of medicine.

[13]  K. Holmes,et al.  Microbial causes of neonatal conjunctivitis , 1984 .

[14]  E. Alexander,et al.  Role of Chlamydia trachomatis in perinatal infection. , 1983, Reviews of infectious diseases.

[15]  K. Holmes,et al.  Prematurity and perinatal mortality in pregnancies complicated by maternal Chlamydia trachomatis infections. , 1982, JAMA.

[16]  A. D. Heggie,et al.  Chlamydia trachomatis infection in mothers and infants. A prospective study. , 1981, American journal of diseases of children.

[17]  M. Anderka,et al.  Prospective study of maternal and infantile infection with Chlamydia trachomatis. , 1979, Pediatrics.

[18]  R. Rothenberg,et al.  Chlamydial infection of mothers and their infants. , 1979, The Journal of pediatrics.

[19]  K. Holmes,et al.  Ophthalmia neonatorum associated with maternal chlamydial infections. , 1977, Transactions. Section on Ophthalmology. American Academy of Ophthalmology and Otolaryngology.