The importance of chlamydia and mycoplasmas in perinatology

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Chlamydia[edit | edit source]

  • obligatory intracellular small Gram-negative bacteria;
  • Chlamydia trachomatis
    • most common cause of sexually transmitted infections, mostly asymptomatic;
    • diagnosis: gold standard – culture on epithelial cells, PCR from smear;
    • infections during pregnancy: urethritis, cervititis, salpingitis → treatment: azithromycin or amoxicillin;
    • perinatal complications: increased risk of premature birth and premature outflow of amniotic fluid (PPROM); chronic salpingitis → infertility and increased risk ectopic pregnancy;
    • child infection: conjunctivitis, pneumonia; asymptomatic colonization of the nasopharynx, rectum or vagina;
      • pathogenesis: infection during childbirth, rarely during rupture of the fetal membranes (PROM) before caesarean section;
      • conjunctivitis of the newborn typically between the 5th and 14th day of life (between the 2nd and 5th day of life is the typical Neisseria gonorrhoeae conjunctivitis);
      • neonatal/infant pneumonia typically between 4 and 12 weeks of life; first, nasal obstruction/nasal secretions, cough, respiratory distress, X-ray of the lungs (atypical pneumonia – lung hyperinflation, bilateral diffuse interstitial or alveolar infiltrates), eosinophilia in the blood count;
      • treatment: p.o. erythromycin or azithromycin.[1][2]

Mycoplasma[edit | edit source]

  • the smallest free-living organisms; they have an extremely small genome;
  • do not have a cell wall → naturally resistant to beta-lactam antibiotics;
  • ID: PCR; demanding sample transport conditions (special transport media) → cultivation is not routinely performed;
  • Mycoplasma pneumoniae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Ureaplasma parvum
  • Ureaplasma urealyticum
    • pregnant infections: asymptomatic colonization of the lower genital tract (vulva, vagina, cervix);
    • perinatal complications: premature birth, premature ejaculation (PPROM), intra-amniotic infection, postpartum fever and endometritis;
    • child infection: congenital pneumonia, bacteremia, meningitis, bronchopulmonary dysplasia/chronic lung disease (controversial).
      • pathogenesis: ascending intrauterine infection, passage through the infected birth canal, hematogenous dissemination through the placenta → colonization of the skin, mucous membranes and respiratory tract; possibly dissemination to the bloodstream and CNS.[3][4]

Notes[edit | edit source]

Chlamydia pneumoniae and Mycoplasma spp. are common causes of atypical pneumonia in school-age children and young adults, but have not been described in neonates.[4]


References[edit | edit source]

Related Articles[edit | edit source]

External links[edit | edit source]

References[edit | edit source]

  1. ↑ GOMELLA, TL, et al. Neonatology : Management, Procedures, On-Call Problems, Diseases, and Drugs. 7. edition. Lange, 2013. pp. 581. ISBN 978-0-07-176801-6.
  2. ↑ POLIN, Richard – SPITZER, Alan. Fetal and Neonatal Secrets. 3. edition. Elsevier Health Sciences, 2013. pp. 345-346. ISBN 9780323091398.
  3. ↑ GOMELLA, TL, et al. Neonatology : Management, Procedures, On-Call Problems, Diseases, and Drugs. 7. edition. Lange, 2013. pp. 930. ISBN 978-0-07-176801-6.
  4. ↑ a b POLIN, Richard – SPITZER, Alan. Fetal and Neonatal Secrets. 3. edition. Elsevier Health Sciences, 2013. pp. 366. ISBN 9780323091398.
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