zithromax and Chlamydiaceae-Infections

Topics: Adult; Aged; Anti-Bacterial Agents; Azithromycin; Chlamydia trachomatis; Chlamydiaceae Infections; Diagnosis, Differential; DNA, Bacterial; Fluorescent Antibody Technique, Direct; Humans; Male; Middle Aged; Prospective Studies; Prostatitis; Urinalysis; Urine

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Chlamydiaceae Infections; Female; Humans; Treatment Outcome; Uterine Cervicitis

Simkania negevensis (Sn) is an intracellular microorganism belonging to the family Simkaniaceae in the order Chlamydiales and has been associated with respiratory tract infections in infants and adults. The aim of this study was to analyze the outcome of Sn infection in different cell types.. The results of Sn infection were examined by infectivity assays, PCR and EM. The cellular response to infection was evaluated by following the synthesis of mRNA for inflammatory cytokines and cytokine secretion.. Infections could be active, with production of progeny and cytopathic effects (CPE); persistent, induced by iron depletion or in minimally permissive cell types, with small numbers of infectious progeny; or cryptic, with no CPE or infectious progeny, but with Sn DNA detected. EM showed an abundance of EB and multiplying RB in active infection, small inclusions with mainly single RB particles in persistent infection, and aberrant inclusions in cryptic infection. We report reversion to active infection of iron-induced or spontaneous persistence; attempts to "cure" persistence with antibiotic treatment resulted in the absence of infectivity but not in the eradication of Sn DNA.. Sn infections are versatile and induce a host cell inflammatory response, which may be relevant to potential Sn pathologies in vivo.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Cells, Cultured; Chlamydiaceae Infections; Chlamydiales; Cytokines; Humans; In Vitro Techniques

The cost-effectiveness of different STD diagnosis and treatment approaches has not been evaluated previously.. The goals of the study were to compare the cost-effectiveness of "gold standard" care (GS), syndromic management (SM), and mass treatment (MT) protocols for the treatment of cervical gonococcal and chlamydial infections in a hypothetical model of 1 million women in Africa.. A decision tree model was constructed for each of the protocols. Sensitivity analyses were conducted and 10,000 Monte Carlo simulations were run to test the robustness of the cost-effectiveness estimates to changes in underlying assumptions.. MT with doxycycline for chlamydia was the most cost-effective protocol in terms of cost per cure. SM protocol had the lowest total programmatic costs. For the GS protocol, using azithromycin for chlamydial infections was found to be more cost-effective than using doxycycline. For both the GS and SM protocols, the total cost of the program was most sensitive to the percentage of women seeking STD treatment and the prevalence of non-STD vaginal discharge, whereas the cost of MT was almost exclusively determined by coverage rates.. No single protocol carries with it all the desired conditions of an optimal cost-effective program. The treatment-seeking behavior, STD prevalence, and coverage of each locale must be evaluated to determine the most cost-effective and highest impact program. MT was found to be the most cost-effective protocol in terms of cost per woman treated when compared with the SM and GS protocols for STDs in women.

Topics: Adolescent; Adult; Africa; Anti-Bacterial Agents; Azithromycin; Chlamydiaceae Infections; Clinical Protocols; Cost-Benefit Analysis; Decision Trees; Doxycycline; Female; Gonorrhea; Humans; Multivariate Analysis; Uterine Cervicitis

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Child; Chlamydiaceae Infections; Chlamydophila pneumoniae; Enzyme-Linked Immunosorbent Assay; Humans; Infant; Latex Fixation Tests; Legionella; Mycoplasma pneumoniae; Pneumonia, Bacterial; Pneumonia, Mycoplasma; Polymerase Chain Reaction