Chlamydia

CHLAMYDIA
Chlamydia trachomatis
>is a common sexually transmitted infection (STI) in
humans caused by the bacterium Chlamydia trachomatis.
 infection caused by any species belonging to the
bacterial family Chlamydiaceae. C. trachomatis is found
only in humans.
 Chlamydia is a major infectious cause of
human genital and eye disease. Chlamydia infection is
one of the most common sexually transmitted infections
worldwide; it is estimated that about 1 million individuals
in the United States are infected with chlamydia.
 small bacterium that
cannot grow outside a
living cell.
 an obligate intracellular
human pathogen,
 a Gram-negative
bacteria, therefore its cell
wall components retain
the counter-stain safranin
and appear pink under a
light microscope
Life Cycle
 2 forms:
 1. Elementary body= small (350 nn in
diameter) with an electro dense center,
adapted to the extracellular environment
 2. Reticular body= larger, 1 micrometer in
diameter, cant survive outside the host.
Diagnostic Exams
Cell Tissue Culture
 Tissue culture is the growth
of tissues and/or cells separ
ate from the organism.
 This is typically facilitated
via use of a liquid, semi-
solid, or solid growth
medium, such as broth or
agar.
 This is the primary
diagnostic tool
ELISA
 Enzyme- linked
immunosorbent
assay
 is
a biochemical techni
que used mainly
inimmunology to
detect the presence
of an antigen
Procedure
1. Performing an ELISA involves at least one

antibody with specificity for a particular antigen.
2. The sample with an unknown amount of antigen
is immobilized on a solid support
3. After the antigen is immobilized, the detection
antibody is added, forming a complex with the
antigen. The detection antibody can be
covalently linked to an enzyme, or can itself be
detected by asecondary antibody that is linked
to an enzyme through bioconjugation.
4. Between each step, the plate is typically
washed with a mild detergent solution
5.After the final wash step, the plate is
developed by adding an
enzymatic substrate to produce a
visible signal, which indicates the quantity of
antigen in the sample.
Direct fluorescent Antibody Test
 is a laboratory test that uses antibodies

tagged with fluorescent dye that can be used
to detect the presence of microorganisms.
 This method offers straight-forward

detection of antigens using fluorescently
labeled antigen-specific antibodies.
 Fluorescent chemicals are attached to the constant region
of an antibody. If the antigen is present, the antibody binds
to generate a very specific, very sensitive protein tag.
Procedure
 First you must prepare a fluorescein-labeled antibody. This
antibody must be specific for the organism or protein you
are trying to detect.
 Prepare your sample by fixing it to the slide.
 Add the fluorescein-labeled antibody. Give them time to
bind,
 Rinse off unbound antibody and observe the slide under a
fluorescent microscope. If the sample contains the
antigen of interest, it will emit light.
Advantages
 is both sensitive and specific (need mono-
clonal antibodies)
 can use on microbes that can't be easily
cultured
 can label single cells
 can view cells in natural environment
 can use different types of fluorescent-labeled
antibodies, each with different dye, to see
multiple cell types in one sample.
Disadvantages
 cross reactivity may be a problem-- often
difficult to develop the monoclonal antibody
that works well.
 must run careful controls to assure no false
positives or negatives
Treatment
 DRUG THERAPY- The first line of treatment
1. Oral doxycycLine to be taken for 7 days
MOA= Bacteriostatic effect, binds to the 30S

and 50S ribosomal subunits of MO, inhibiting
protein synthesis
NURSING CONSIDERATIONS:
>Obtain culture and sensitivity before giving 1st
dose
>give drug with milk or food to prevent GI
discomfort.
>stress good oral hygiene
>instruct client to avoid direct sunlight and
ultraviolet light, wear protective clothing and
use sunscreen
>advise pt. To increase fluid intake, and to avoid
taking oral tablets or capsules within 1 hour of
bedtime bec. Of possible esophageal irritation
or ulceration
2. Azithromycin (single 1 g- dose)
- Treatment of choice for pregnant women with
chlamydial infection
MOA: binds to the 50S subunit of bacterial

ribosomes, blocking protein synthesis;
bacteriostatic or bactericidal depending on
the concetration.
NURSING RESPONSIBILITIES
 Obtain for culture and sensitivity before

initiating therapy
 This may be taken with or without food
 Advise patient to avoid excessive sunlight and
to wear protective clothing and use sunscreen
when outside.
 Tell patient to take drug as prescribed even
after he/she feels better.
3. Erythromycin
MOA: binds to the 50S subunit of bacterial

ribosomes, blocking protein synthesis;
bacteriostatic or bactericidal depending on
the concetration.
NURSING RESPONSIBILITIES
>obtain urine specimen for culture and sensitivity tests

before giving 1st dose
>monitor hepatic function
>tell patient to take drug as prescribed even is he or
she already feels better,
>drug may be taken with food if GI upset occurs.
Tell patient not to take the drug with fruit juice or to
swallow whole chewable erythromycin tablets.
>instruct pt. To report adverse effects (N/V, fever,
vomiting, Abdominal pain.)
Special considerations
 Practice standard precautions when caring

for a patient with chlamydial infections.
 Make sure that the patient fully understands

the dosage requirements prescribed
medications for this infection.
• Stress the importance of completing the entire
course of drug therapy even after the symptoms
subside.
• Teach the client to follow meticulous personal

hygiene measures as recommended.
• To prevent eye contamination, instruct the patient

to avoid touching any discharge and to wash and
dry hiss hands thoroughly before touching his eyes
To prevent reinfection during treatment, urge
the patient to abstain from intercourse until
he and his partner are cured.
Urge the client to inform sexual contact of his

infection so that they can receive appropriate
treatment.
Tell the patient to return for follow op testing.

 Suggest that the patient and his partner
receive testing for the HIV.
 Check neonate of an infected mother for

sighs of chlamydial infections. Obtain
appropriate specimens for diagnostic testing.
Prevention
• The surest way to avoid transmission of STDs is to abstain from sexual
contact or be in a long-term mutually monogamous relationship with a
partner who has been tested and is not infected.
• Using latex condoms correctly and consistently during vaginal or rectal
sexual
• activity reduces the risk of getting chlamydia and developing
complications.
• Health care experts recommend all sexually active women 25 years of age
and
younger get chlamydia screening tests annually. They recommend an
annual
screening test for older women with risk factors for chlamydia (a new sex
partner or many sex partners). In addition, all pregnant women are advised
to
have a screening test for chlamydia. Nursing Diagnosis
Nursing Diagnosis
 Acute pain related to iriitation of mucosa and

effects of circulating toxins as evidenced by
verbal reports of genital irritation
Nursing interventions
Assess pt's signs and symptoms of pain and administer pain
meds as prescribed.
Plan activities with pt to provide distraction, such as reading,
crafts, television, and visits to help pt focus on non pain
related subjects
Perform comfort measures to promote relaxation, such as
massage, bathing, repositioning, and relaxation techniques.
Manipulate the environment to promote periods of
uninterrupted
Collaborate with pt in administering prescribed analgesics
when alternative methods of pain control are inadequate
 Impaired skin/tissue integrity related to
invasion of pathogenic organisms as
evidenced by inflammation of mucous
membrane
 assess the nutritional status monitor lab
values
 minimize the exposure of skin to moisture
 use careful sterile technique
 Ensure to increase protein for faster skin
healing
 teach skin & wound assessment to monitor
for infections & complications: teach proper
wound healing
Ineffective sexuality patterns, related to the
impaired relationship and fear of reinfection
 Situational low self-esteem, related to shame
and guilt becauseof having an STI
THE END

Chlamydia

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CHLAMYDIA

1. Performing an ELISA involves at least one

 is a laboratory test that uses antibodies

 This method offers straight-forward

1. Oral doxycycLine to be taken for 7 days

MOA= Bacteriostatic effect, binds to the 30S

MOA: binds to the 50S subunit of bacterial

 Obtain for culture and sensitivity before

MOA: binds to the 50S subunit of bacterial

>obtain urine specimen for culture and sensitivity tests

 Practice standard precautions when caring

 Make sure that the patient fully understands

• Teach the client to follow meticulous personal

• To prevent eye contamination, instruct the patient

Urge the client to inform sexual contact of his

Tell the patient to return for follow op testing.

 Check neonate of an infected mother for

 Acute pain related to iriitation of mucosa and

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