Family Chlamydiaceae of the Gracilicutes division includes one genus Chlamydia (from the Greek chlamydos, cloak; the name arose from the similarity of the reticular cell to the membrane surrounding the ETs that mature in it]. Currently, the genus includes three species: C. trachomatis, C. psittaci and C. pneumoniae.

Everything types of chlamydia pathogenic for humans and many animals. The diseases they cause are ubiquitous and known as chlamydia.

Table 23-1. Classification of representatives of the genus Chlamydia

Chlamydia they are labile to the action of high temperatures (they die at 60 "C in 10 minutes), but persist for a long time at low temperatures.

Rice. 23-1. Chlamydia life cycle... 1 - attachment of an elementary body (ET) to an epithelial cell; 2 - penetration of ET into the cell through pinocytosis; 3 - blockade of phagosomal-lysosomal fusion; 4 - transformation of ET into a reticular body (RT); 5 - binary fission RT; 6 - maturation of ET within the RT; 7 - release of ET from the cell.

Chlamydia reproduce by binary fission. Chlamydia life cycle includes the formation of two basic forms (Fig. 23-1).

Elementary body of chlamydia(ET) is a small (0.2-0.5 μm) spherical extracellular structure with a three-layer cell wall. Metabolically inactive and adapted for extracellular survival. Elementary bodies of chlamydia- infectious units that infect cells. According to Romanovsky-Giemsa, ETs are colored purple.

Chlamydia reticular body(RT) - reproductive intracellular form. It is represented by a larger formation (up to 1 micron) with a reticular structure with a thin cell wall. It develops within 5-6 hours from ET, which has penetrated into the cytoplasm and underwent structural changes. Initially, an initial body (vegetative form) is formed from ET, which turns blue according to Romanovsky-Giemsa. Then the initial body turns into RT.

After the formation of the Republic of Tatarstan chlamydial cell begins to divide binary, forming inclusion bodies in the form of vacuoles in the cytoplasm of the infected cell. Chlamydial inclusion bodies usually located near-nuclear, according to Romanovsky-Giemsa they turn purple; they can be detected by light microscopy. In the bodies of inclusions, there are fissile RT. C. psittaci and C. pneumoniae form many small inclusion bodies surrounding the nucleus. C. trachomatis forms one large body. Due to the condensation of RT, an intermediate body is formed, resembling a bull's eye.

Intermediate bodies of chlamydia are transformed into ETs, ready to leave the cage. The release of ET is accompanied by the death of the infected cell.

Lecture
“Rickettsia. Chlamydia »

Lecturer: Ph.D. E.I. KOROTKOVA

Lecture plan:

Rickettsia.
Chlamydia.

Rickettsioses - This is a large group of vector-borne acute febrile infectious diseases caused by rickettsiae with common pathogenesis and clinical manifestations of the disease.

1909: H.T. Ricketts - the causative agent of Rocky Mountain fever;
1913: C. Inline - the causative agent of typhus;
1916: E. da Roja-Lima (the founder of the doctrine of rickettsia and rickettsia) - the term "rickettsia";
1953: P.F.Zdrodovsky – independent branch of medicine "Rickettsology" .

Taxonomy

Order: Rickettsiales
Family: Rickettsiaceae
Genus: Rickettsia Coxiella Rochalimаea Erlichia
Species: R. prowazekii C. burnetii R. quintana E. canis
R. sibirica
R. tsutsugamushi

Morphology

Dimensions - 0.3-0.6 × 0.8-3 microns;
Polymorphism (rod-shaped, coccoid and filamentous forms);
Immobile (exception - R. conorii, R. sibirica);
Do not form a dispute (exception - C. burnetii);
Have a microcapsule;
Gram negative.

Morphology

Romanovoky-Giemsa method (coccoid forms - pink, rod-shaped - blue);
The Machiavello-Zdrodovsky method (rickettsia - pink, protoplasm of cells - blue, nuclei - blue);
Silver plating according to Morozov (rickettsiae are dark brown on a light background).

In cell culture.

Biochemically not active.

Group specific antigens - thermostable LPS KS (separated during treatment with ether).
OX2, 19, K antigens - similarity with antigens Proteus vulgaris (Weil-Felix reaction).
Species specific antigens - at R. prowazekii deeper located thermolabile protein-polysaccharide complex (does not dissolve in ether).

Antigenic structure

Toxins:
Endotoxin;
Exotoxin is a heat-labile protein in a capsule-like layer.
factors of adhesion and invasion.

Resistance

Unstable in the external environment (exception -
C. burnetii);
560C - 10-30 minutes, 800C - 1 minute, boiling - instant;
0.5% formalin solution - 30 minutes;
R. prowazekii in dried lice feces at low temperatures - 2-3 months;
are sensitive to antibiotics (tetracycline).

Role in pathology

6 groups of rickettsioses:
I group - typhus:
- epidemic typhus - R. prowazekii;
- Recurrent typhus (Brill's disease) -
R. prowazekii;
- endemic (rat, flea) rash
typhoid - R. typhi;
II group – spotted fevers (tick-borne
rickettsioses):
- Marseilles fever - R. conorii;
- North Asian rickettsiosis - R. sibirica;
- vesicular rickettsiosis - R. acari;
III group – paraxysmal rickettsioses:
- Volyn (five-day fever) -
R. quintana;

Role in pathology

6 groups of rickettsioses:
IV group –Qu-rickettsioses (pneumorickettsioses):
- Q fever - C. burnetii;
V group –tsutsugamushi:
- tsutsugamushi fever -
R. tsutsugamushi;
VI group – rickettsioses of animals:
- Ehrlichia fever - E. canis.

In epidemiology - 2 groups of rickettsioses:
Epidemic anthroponoses (epidemic typhus, Volyn fever).
Source of infection - a sick person or carrier.
Carrier - a body louse or head louse.
Endemic zoonoses (endemic typhus, tsutsugamushi fever, North Asian tick-borne rickettsiosis and Q-fever).
Source and reservoir of infection - small mammals.
Carriers - ticks, fleas.

Epidemic typhus
(synonyms: lousy, military) –
This is an acute infectious disease caused by Provacek's rickettsiae, characterized by a cyclical course with fever, acute intoxication, predominant damage to the vascular and nervous systems, and a roseola-papular rash.

Anthroponosis.

Anthroponosis.
Source of infection - a patient with typhus or Brill's disease.
Infection transmission mechanisms:

transmissive (pathway - contamination);
aerogenic (path -
air-dust).

Carriers –
wages and
head lice.

Epidemiology

Development mechanism:
The introduction into the body of adhesion to cholesterol
containing cell receptors of vascular endothelium endocytosis reproduction.
Rickettsiemia and toxemia.
Lesion of small vessels in all organs with the formation of blood clots and specific granulomas.

Activation of protective
forces of the body.

Clinical periods

incubation (7-14 days);
elementary (4-5 days) - before rash appears;
the height of (4-10 days) - from the moment the rash appears until the temperature returns to normal;
convalescence (2-3 weeks).

Immunity
Antimicrobial and anti-toxic, resistant, long lasting, but unsterile: persists for a long time in the form of resting forms - after 10-20 years relapse(Brill's disease).

Brill's disease (synonyms: Brill-Zinsser disease, recurrent typhus) Is an acute cyclic infectious disease, which is an endogenous relapse of epidemic typhus, which often manifests itself after many years, and is characterized by a sporadic disease in the absence of lice, a source of infection and foci, a course lighter than epidemic typhus, but with a typical symptom complex.

Study material - blood, carriers.
Bacterioscopic method .
Bacteriological method .
Serological (main) - RSK, indirect RIF, RA, RNGA, IFA.
Allergic .
Molecular biological - PCR.

To differentiate primary typhus from Brill's disease, blood serum is treated with 2-mercaptoethanol or cysteine, destroying Jg M.
At primary typhus – titer reduction antibodies in processed whey;
At Brill's disease – antibody titer in both sera same.

Specific prophylaxis
Vaccination according to epidemiological indications:
Weigl's vaccine (cultivated in lice infected with microclysters);
Vaccine A.V. Pshenichnova - B.I. Reicher (cultivated by the epidermomembrane method);
Chemical typhus vaccine ;
Live combined typhus vaccine E (ZhKSVE) - strain "Madrid-E" grown in the yolk sacs of a chicken embryo.

Chlamydia - a group of widespread infectious diseases of humans and animals, characterized by a predominant lesion of the mucous membranes of the respiratory tract, eyes and genitals, as well as a tendency to chronic course.

1907: S. Provacek and L. Halberstedter –Chlamydia in scraping from the conjunctiva of a patient with trachoma.
1930: S. Bedson - the causative agent of psittacosis.
1935: Y. Miyagawa - the causative agent of lymphogranuloma venereum.

Taxonomy

Order - Chlamydiales
Family - Chlamydiaceae
Genus - Chlamydia;
View - C. trachomatis;
C. psittaci;
C. pneumoniae

Morphology

Spherical shape;
Diameter - 0.2-1.5 microns;
Gram-negative;
The cell wall is devoid of peptidoglycan;
According to Romanovsky-Giemsa - blue;
Intracellular - inclusions wrapped in a mantle (from the Greek. сhlamydos- cloak);
They multiply by binary fission.

Elementary bodies (ET) - mature extracellular form:

size - 0.2-0.4 microns;
according to Romanovsky-Giemsa - pink color.

Reticular bodies (RT) - intracellular reproductive
form:

size - 0.8-1.5 microns;
according to Romanovsky
Giemsa - blue
color.

Intermediate
calves .

Chlamydia life cycle

Absorption ET on a sensitive cell.
Penetration ET into the cell by endocytosis (7-10 hours).
Reorganization ET in RT (6-8 hours).
Division RT (18-24 hours).
Maturation RT to ET
through the transitional form
(36-42 hours).
Exit ET from the cage,
cell death.
Full cycle - 48-72 hours.

Development cycle

Biochemically not active.

Antigenic structure

Genus specific antigen - surface LPS KS, thermostable.
Species specific antigens - KS protein, heat-labile.
Type-specific antigens - proteins:
C. trachomatis - 15 serovars

pathogens of trachoma (A, B, Ba, C);
causative agents of urogenital chlamydia
(D, E, F, G, H, I, J, K);
the causative agent of lymphogranuloma venereum
(L1, L2, L3).

C. psittaci - 13 serovars.
C. pneumoniae - 4 serovars (TWAR, AR, KA, CWL).

Toxins:

Endotoxin;
Exotoxins - heat-labile protein substances .

Structural and chemical components of the cell: outer membrane proteins.

Resistance

Room temperature - 24-36 hours;
500C - 30 minutes;
700C - 10-15 minutes;
1000С - 1 minute.
Chlamydia sensitive to:
UVL;
working concentrations of disinfectants (2% chloramine solution - 1 min.);
antibiotics (tetracycline, macrolides);
fluoroquinolones.

Psittacosis (from the Greek. psittakos –
a parrot).
Ornithosis(from lat. ornitos- bird) -
it is an acute infectious
disease caused by
C. psittaci, characterized by
fever, intoxication,
primary lesion of the lungs, nervous
systems, increasing
liver and spleen.

Epidemiology.

Epidemiology.
Zoonosis.
Source and reservoir - wild and domestic birds.
Transmission mechanism - aerogenic (paths - airborne and airborne dust).
Entrance gate - upper respiratory tract.

C. trachomatis calls:
trachoma;
urogenital chlamydia;
lymphogranuloma venereum.
Trachoma (from the Greek. trachys- rough, uneven) is a chronic infectious eye disease characterized by keratoconjunctivitis with the formation of follicles (trachomatous grains), and in the late stage - scarring of the conjunctiva and cartilage of the eyelid.

Epidemiology.

Epidemiology.
Source of infection - sick person.
Transmission mechanism - contact (ways - direct contact, contact-household).

Urogenital chlamydia Is one of the most common sexually transmitted diseases in the world.
Epidemiology.
Source of infection - sick.
Transmission mechanism :

Contact (ways - sexual, contact-household);
Vertical (pathways - transplacental or in childbirth).

Entrance gate - genitourinary organs (tropism to the columnar epithelium).

Among women are amazed:
urethra;
uterus;
the fallopian tubes;
ovaries.
In men:
urethra;
prostate.
Complications:
female and male infertility.
Disease Reiter(classic triad) - urethritis, arthritis, conjunctivitis.

Pathogenesis and clinical features

Lymphogranuloma venereum (synonym: Dühring-Nicolas-Favre disease) Is a sexually transmitted disease characterized by the development of lymphadenitis.
Epidemiology.
Source of infection - sick.
Transmission mechanism - contact (way - sexual).

C. pneumoniae - bronchopneumonia.
Epidemiology.
Anthroponosis.
Source of infection - sick.
Transmission mechanism - aerogenic (way - airborne).
Immunity.
Cellular, unstable, short-lived
(the exception is lymphagranuloma).

Study material - scrapings from the conjunctiva, from the mucous membrane of the urethra, cervix, cervical canal, sputum, blood, synovial fluid.

Methods for laboratory diagnosis of chlamydia

Effective remedies specific prevention and treatment no chlamydia.

Mycoplasma

The pathogens of trachoma, conjunctivitis (blennorrhea with inclusions), inguinal lymphogranulomatosis (Nicola-Favre disease), ornithosis belong to the genus Chlamydia, the family Chlamydiaceae, the order Chlamydiales; they contain DNA and RNA, nucleoproteins, lipids, carbohydrates.

In the development cycle of chlamydia, three stages are observed: 1) small (0.2-0.4 microns) elementary bodies surrounded by a three-layer wall, which contain the genetic material of the nucleoid and ribosome in a compact state; 2) primary bodies, large (0.8-1.5 microns), have nucleoid fibrils and ribosomal elements, are covered with a thin wall, multiply by division; daughter cells are reorganized into elementary bodies, which can be extracellular and penetrate into other cells; 3) an intermediate (transient) stage between primary and elementary bodies. Small

(elementary) bodies have infectious properties, large (primary) bodies perform a vegetative function, the growth, reproduction and maturation of chlamydia are completed within 40 hours.

Monkeys are sensitive to the causative agent of trachoma, in which, when infected into the conjunctiva, experimental trachoma develops, similar to the disease in humans; some strains can multiply in the lungs of mice and guinea pigs infected intranasally, as well as during subcutaneous infection of guinea pigs and intracerebrally in mice. The reservoir of the pathogen is a person. The disease in humans is accompanied by blepharokeratoconjunctivitis. Patients develop chronic inflammation of the connective membrane of the eyes, tissue hyperplasia and hypertrophy of follicles that look like transparent grains. In severe cases, due to hypertrophy of the follicles, the conjunctiva looks like frog eggs. In the future, scarring of the follicles occurs.

Trachoma is transmitted by contact with patients through a towel, dirty hands, washing in a common basin, and also by flies.

Laboratory diagnostics is carried out by detecting inclusions in the cells of the epithelium of the conjunctiva.

Treatment is successfully carried out with antibiotics (tetracyclines, erythromycin) and sulfa drugs.

Prevention includes the timely identification and full treatment of patients, dispensary services for outbreaks, improvement of working and living conditions, and an increase in the material and cultural level of the population. A very high incidence of trachoma is noted in India and other Asian countries, in Africa. Trachoma affects 400-500 million people living in developing countries; it is the main cause of blindness.

Conjunctivitis of newborns, or blennorrhea with inclusions, is caused by Chl.trachomatis (Fig. 116.9), the disease proceeds with symptoms of infiltration of the conjunctiva, especially of the lower eyelid. The duration of the acute phase is 10-15 days, but noticeable infiltration persists for 2-3 months and longer. The source of infection is mothers in whom the pathogen persists in the genitourinary system and is transmitted during childbirth to newborn babies. Adults become infected by swimming in small ponds and non-chlorinated pools. Their disease manifests itself in the form of acute follicular conjunctivitis and lasts about a year. Treatment is carried out with sulfa drugs and antibiotics. The introduction of silver nitrate for the prevention of gonorrheal blennorrhea does not prevent conjunctivitis with inclusions.

The causative agent of venereal lymphogranulomatosis is Chl.trachomatis. The disease is sexually transmitted, occurs in hot subtropical countries. There are no cases of the disease in the USSR. This microorganism can also cause urethritis, proctitis, arthritis.

Laboratory diagnostics is carried out using microscopy with the processing of smears according to Romanovsky - Giemsa. The complement binding reaction and the allergic test are of diagnostic value. Intracerebral infection is used in white mice that develop fatal meningitis.

Treatment. Tetracyclines, penicillin and sulfanilamide preparations are used.

The causative agent of psittacosis - Chl.psittaci - causes diseases in many species of birds. The causative agent was discovered in 1933 by K. Maner.

The morphology and mode of reproduction are the same as in the entire genus Chyatusha. In smears-prints or sections from organs, microorganisms are located in the form of clusters surrounded by a vesicular membrane. They can be found when stained according to Romanovsky-Giemsa, in the cells of the lymphoid-macrophage system or extracellularly when they are ruptured (see Fig. 116.4). The G + C content in the nucleoid DNA is 39-45%. Chlamydia develops in the yolk sac of chicken embryos or the body of white mice, as well as in tissue culture and tumor cells at 39 ° C.

Chlamydiae have two antigens: thermostable, which is common to the group of ornithosis-psittacosis-lymphogranulomatosis, and thermolabile, degrading at 60 ° C and containing a protein substance.

The resistance is very high. Chlamydia remain alive for 2 years at a temperature of -70 ° C. Infected tissues at 4 ° C continue to be infectious for several weeks. Heating at a temperature of 60-70 ° C kills chlamydia within 10-15 minutes. Sensitive to common disinfectant solutions (chloramine).

More than 100 species of wild and domestic birds (parrots, pigeons, chickens, etc.), as well as white mice, rats, guinea pigs, rabbits, monkeys, are very susceptible to the causative agent of psittacosis. Various strains of Chl.psittaci cause psittacosis, psittacosis, pneumonia in calves, sheep, goats, pigs, horses; polyarthritis in sheep, calves, pigs; placentitis and abortion in calves and sheep; enteritis in calves; conjunctivitis in guinea pigs, calves and sheep; encephalitis in marsupial rats and encephalomyelitis in calves. In parrots, the disease is characterized by a runny nose, enteritis, debilitating diarrhea, and is usually fatal. Diseases are observed in South America, Australia and other countries.

The pathogen that has entered the human body enters the bloodstream and causes bacteremia, which continues into | for a week, and sometimes longer. In the tissues and organs of I, the pathogen goes through complex cycles that lead to a violation of cellular metabolism, the development of intoxication and allergies. Pneumonic lesion without shortness of breath, cough and pain in the chest is characteristic of psittacosis. At the height of the disease, X-ray examination reveals a picture of marginal lobular bronchopneumonia; resorption of exudate is slow.

Sources of infection are birds (sick or carriers), domestic and wild pigeons, ducks, chickens, turkeys. Adult birds recover, young birds die in a large percentage of cases. The pathogen is excreted in excrement, from which healthy birds and people are infected. Infection of animals is possible in utero, during sexual intercourse and a bite by blood-sucking insects.

A person usually becomes infected by aerogenic inhalation of infected dust or fluff, as well as when cutting birds, cleaning cages and caring for a bird, which is accompanied by contamination of the hands and contact of the pathogen on the mucous membranes. The possibility of infection from sick people by airborne droplets is not excluded.

Immunity after suffering an illness is relative and short-lived. Recurrent illnesses have been reported, especially among laboratory workers. The body's defense mechanism is associated with the presence of antibodies.

Laboratory diagnostics. The pathogen is found in the first days of the disease in sputum and blood. In the blood, it persists until the 5-7th day, in sputum, up to the 21st day of illness; marked the maximum duration of isolation of chlamydia with sputum for 8 years. When examining the autopsy material, the microorganism was isolated from lung tissue, spleen, exudate. To recognize ornithosis, microscopy is used, the complement binding reaction with paired sera (at the beginning and at the end of the disease).

Chlamydia can be isolated from the blood and sputum of sick people by intracerebral infection of white mice. The pathogen can be found in smears from the spleen, liver and in brain slices of experimental animals infected by the intraperitoneal method. Isolation of the pathogen is also possible when chick embryos are infected into the yolk sac. An allergic test with ornithine and a fluorescence method give a good result.

Treatment. Tetracyclines, streptomycin are prescribed; in chronic forms, vaccine therapy is recommended.

Prevention. It is achieved by successive measures: early diagnosis, isolation and hospitalization of patients in infectious diseases hospitals (in separate wards or boxes). Service personnel should wear masks, hands should be regularly disinfected with 0.5% chloramine solution.

Taking into account their characteristics, chlamydia occupies an independent (special) position among other microorganisms - prokaryotes. For humans, representatives of two genera are predominantly important - Chlamydia and Chlamydophila. Three types are of the greatest importance.

Chlamydia trachomatis , the various serotypes of which cause trachoma, lymphogranuloma venereum and the most common urogenital chlamydia.

Chlamydophila psittaci causes psittacosis and zoonotic chlamydia.

Chlamydophila pneumoniae causes anthroponous pneumonia, acute respiratory infections, the development of some forms of bronchial asthma, atherosclerosis is associated with this pathogen.

Morphological features.

The cell cycle of chlamydia development has two main forms - elementary bodies (ET) is an infectious form and reticular bodies (RT) - vegetative form. Spherical EBs are much smaller in size (less than 300 nm in diameter), have a more rigid electron-dense structure, are metabolically less active, and are adapted to short-term extracellular existence.

The cycle of development of chlamydia is carried out in the cytoplasmic inclusion - phagosome(vacuole), where ETs get by stimulating endocytosis. In the process of adsorption and endocytosis, thermolabile effector protein surface antigens of chlamydia are involved. ETs suppress phagosomal - lysosomal fusion and are converted with the participation of the main surface protein in RTs, which have an active metabolism, larger size and active binary fission. The reproduction cycle ends with the reverse transition of RT into ET, rupture of inclusion membranes and limiting membranes of the host cell, release of ET from the cells, and then ET infect new cells. Inclusion bodies are detected in cells using light and immunoluminescence microscopy.

In addition, chlamydiae are able to form L - forms, persistent forms.

Cultural properties.

Chlamydiae do not grow on nutrient media of the most complex composition (this makes them similar in properties to rickettsiae and especially to viruses), laboratory animals and chicken embryos (bioassay) and especially sensitive animal cell lines - more often McCoy cells (more often with treatment with cytostatics to increase sensitivity), which were considered the “gold standard” of diagnosis.

Biochemical properties.

Antigenic structure.

1. Allocate genus-specific surface antigen(LPS), localized on the outer membrane of the cell wall. LPS has two antigenic determinants, one of them is specific for the whole genus, the other cross-reacts with some other gram-negative bacteria (salmonella serovar minnesota), is thermostable.

2. MOMR - major outer membrane protein functions as a structural protein and porina... Includes thermolabile protein determinants with species, type and serovar specificity.

Determinants of pathogenicity.

1. Endotoxin (lipopolysaccharide), similar to the endotoxins of gram-negative bacteria.

2. Exotoxins are thermolabile substances.

3. Cell surface antigens that suppress defense reactions.

The pathogenicity factors of chlamydia prevent phagosomal - lysosomal fusion in phagocytes.

Brief description of distribution.

Urogenital chlamydia- the most common forms of chlamydia. In large countries (USA, Russia) several million cases are registered annually, in the world - from 50 to 90 million cases. The scarcity of the initial manifestations and the severe consequences of urogenital chlamydia, especially in women (reproductive disorders, infectious complications), impose special requirements on timely laboratory diagnosis. Chlamydia serovars D - K Chlamidia trachomatis, which cause urogenital chlamydia, are sexually transmitted from person to person. Asymptomatic carriage is observed in at least 5% of men and 10% of women. Certain serotypes of this pathogen cause such common diseases in the past as trachoma(accompanied by lesions of the conjunctiva and adjacent tissues of the eye, often leading to cataracts and blindness) and lymphogranuloma venereum (recorded mainly in the underdeveloped countries of Asia, Africa and Latin America with a warm climate).

Ornithosis- chlamydial infection caused by C.psittaci. A person becomes infected from birds - the main hosts of this pathogen by airborne dust and airborne droplets. In urban conditions, the main danger is represented by pigeons (from 20% to 100% are infected with this pathogen, children come into contact with them more often. At home, canaries and especially parrots can be a source (cause the most severe form - psittacosis). Psittacosis often proceeds as severe interstitial pneumonia In addition, serotypes of this pathogen cause zoonotic chlamydia(for example, the so-called viral abortion of sheep, chlamydia in cattle, etc.), in contact with sick animals, various forms of chlamydia in humans can develop. Clinical and epidemiological features of zoonotic chlamydia in humans have been insufficiently studied.

Bronchopneumonia caused by C. pneumoniae. These are anthroponotic infections transmitted from person to person, most of the cases are subclinical. There are lesions of the upper respiratory tract with the subsequent development of bronchopneumonia. These are common infections (antibodies to C. pneumoniae are detected in almost half of the adult population), but they are still poorly diagnosed. The development of certain forms of bronchial asthma and atherosclerosis is associated with this pathogen.

Given the variety of clinical manifestations and the need to differentiate various clinical forms of chlamydia (primarily genital and extragenital), laboratory diagnostics is of particular importance.

CHLAMIDIA ORNITOSIS

C. psittaci is the causative agent of psittacosis. SOURCE - birds (about 140 species). In most birds, psittacosis occurs as a latent infection. In poultry farms → contamination of service personnel.

Pathogenesis and immunity. They penetrate by airborne droplets, affect ## of the epithelium of the mucous membrane of the respiratory tract and regional lymph nodes. After the destruction of the infected ## → into the blood → into the parenchymal organs. ## lymphoid tissues can persist for a long time and cause relapses.

During the course of the disease, HRT develops. ATs are formed, but they do not provide immunity to recurrent disease. Lack of humoral protection and delayed-type allergies contribute to the occurrence of relapses.

Diagnostics. Isolation of the pathogen from the blood is possible in the first 2-3 weeks of the disease. The material is inoculated into the brain of white mice or chicken embryos into the yolk sac. In the ## of the brain or yolk sac, inclusions are detected, which are detected by immunofluorescent or enzyme-linked immunosorbent assay.

Serodiagnosis is carried out in RSK, RTGA, ELISA using the appropriate AGs from the pathogen. Allergic condition - intradermal tests with a specific allergen.

Prevention and Treatment. For treatment and emergency prevention - tetracycline antibodies.

OTHER CHLAMIDES

C. trachomatis is a species pathogenic for humans, it is divided into 15 serovars: L-1, L-2, L-3 are the causative agents of inguinal lymphogranulomatosis; A, Ba, B and C- trachoma; rest, from D to K- urethritis and eye diseases. The reservoir is a person. F !! in vivo are not susceptible. Transmission - by direct contact and through contaminated objects.

INGUINE LGM- venereal disease, common in countries with tropical and subtropical climates. X-Xia cyclical flow, there are 3 periods: Primary- 1.5-2 weeks after infection, a single vesicle appears at the injection site → erosion and ulcer. Secondary- generalization of the process, and tertiary- the fistula-adhesion process of the perineum is formed.

The disease is accompanied by allergies (detected by an intradermal reaction with an allergen from chlamydia). After an illness, a tense IMMUNITY is formed.

DIAGNOSTICS - microscopy of smears-prints of the contents of the lymph nodes. Isolation of the pathogen is carried out by sowing the material in cell cultures. For serodiagnostics, RSK and IF are used.

There is no specific prophylaxis.

TRACHOMA- hron infectious disease, x-Xia lesion ## of the conjunctiva of the eye. At the same time, inclusions are formed in the cytoplasm of chlamydia. The detection of these inclusions in conjunctival scrapings is of diagnostic value.

For treatment, AB of the tetracycline series is used. Without treatment → loss of vision.

CONJUNCTIVITIS OF NEWBORNS- infectious disease of newborns. The child becomes infected in the birth canal of a sick mother. In addition to conjunctivitis, pneumonia or gastroenteritis may occur. Chlamydial conjunctivitis can affect adults if they become infected while swimming in infected bodies of water.

URETHRITIS- a venereal disease, ranks second in frequency of occurrence after gonorrhea. With this disease, chlamydia affects the cylindrical epithelium of the urethra. M. b. cause of miscarriages, infertility.

RATER'S DISEASE- severe systemic chlamydia, which develops after an acute infection of the genitourinary organs or intestines in persons with defects in the immune system. Clinically manifested by the triad: urethritis, conjunctivitis, arthritis.

Laboratory diagnostics is carried out by microscopic examination of smears stained with Romanovsky-Giemsa paint. The presence of pink elementary bodies in ##, bluish-blue reticular bodies is a positive diagnosis. An immunofluorescent method with monoclonal antibodies is also used.

For serodiagnostics, the ELISA reaction, RSK is used. A 4-fold increase in the antibody titer in the 2nd blood serum sample is reliable. Isolation of chlamydia is rare. For this, cell cultures are infected with pathological material.