Chlamydia trachomatis infection in infants: a prospective study

Area of Science:

• Neonatal infections
• Ophthalmology
• Pediatric respiratory diseases

Background:

• Chlamydia trachomatis (C. trachomatis) is a common sexually transmitted bacterium.
• Vertical transmission from mother to infant can occur during childbirth.
• The clinical manifestations of C. trachomatis infection in neonates include conjunctivitis and pneumonia.

Purpose of the Study:

• To prospectively evaluate the incidence and clinical outcomes of C. trachomatis infection in infants born to infected mothers.
• To determine the association between C. trachomatis infection and neonatal conjunctivitis and lower respiratory tract infections.
• To assess the utility of prenatal screening for C. trachomatis.

Main Methods:

• Prospective study involving 198 pregnant mothers positive for chlamydial antigen.
• Infant follow-up for up to six months with C. trachomatis detection via cell culture.
• Clinical assessment for conjunctivitis and lower respiratory tract infections.
• Chlamydial antigen enzyme-linked immunosorbent assay (ELISA) used for screening.

Main Results:

• C. trachomatis was recovered from 25% of infants (43/174).
• Neonatal conjunctivitis was significantly more common in infants with C. trachomatis (47%) compared to those without (14%).
• Lower respiratory tract infections were also more frequent in infected infants (14% vs 2%).
• ELISA showed a high rate of false positives, often associated with Staphylococcus aureus.
• The incidence of C. trachomatis infection was 8.2 per 1000 live births.

Conclusions:

• C. trachomatis is a significant cause of neonatal conjunctivitis and respiratory infections.
• Infant infections are often asymptomatic or present with mild symptoms.
• Effective treatment with oral erythromycin is available.
• Routine prenatal screening for C. trachomatis is not warranted given the availability of treatment and potential for false positives with screening tests.