Screening for Chlamydial Infection

Prepared by H. Dele Davies, MD, MSc, FRCPC, Assistant Professor of Microbiology, of Infectious Diseases and of Pediatrics, University of Calgary, Alberta

These recommendations were finalized by the Task Force in October 1992

1. Canadian Task Force on the Periodic Health Examination: The periodic health examination. Can Med Assoc J 1984; 130: 1278-1285

2. Gully P: Chlamydial infection in Canada. Can Med Assoc J 1992; 147(6): 893-896

3. Frommell GT, Rothenberg R, Wang S, et al: Chlamydial infection of mothers and their infants. J Pediatr 1979; 95: 28-32

4. Schachter J, Grossman M, Sweet RL, et al: Prospective study of perinatal transmission of Chlamydia trachomatis. JAMA 1986; 255(24): 3374-3377

5. Schachter J, Grossman M, Holt J, et al: Prospective study of chlamydial infections in neonates. Lancet 1979; 2(8139): 377-380

6. Hammerschlag MR, Anderka M, Semine D, et al: Prospective study of maternal and infantile infection with Chlamydia trachomatis. Pediatrics 1979; 64(2): 142-148

7. Forbes BA, Bartholoma N, McMillan J, et al: Evaluation of a monoclonal antibody test to detect chlamydia in cervical and urethral specimens. J Clin Microbiol 1986; 23(6): 1136-1137

8. Shafer M-A, Vaughan E, Lipkin ES, et al: Evaluation of fluorescein-conjugated monoclonal antibody test to detect Chlamydia trachomatis endocervical infections in adolescent girls. J Pediatr 1986; 108(5 Pt 1): 779-783

9. Stamm WE, Harrison HR, Alexander ER, et al: Diagnosis of Chlamydia trachomatis infections by direct immunofluorescence staining of genital secretions. Ann Intern Med 1984; 101(5): 638-641

10. Moncada J, Schachter J, Bolan G, et al: Confirmatory assay increases specificity of the chlamydiazyme test for Chlamydia trachomatis infection of the cervix. J Clin Microbiol 1990; 28: 1770-1773

11. Sellors J, Mahony J, Jang D, et al: Rapid, on site diagnosis of chlamydia urethritis in men by detection of antigens in urethral swabs and urine. J Clin Microbiol 1991; 29: 407-409

12. Chernesky M, Castriciano S, Sellors J, et al: Detection of Chlamydia trachomatis antigens in urine as an alternative to swabs and cultures. J Infect Dis 1990; 161: 124-126

13. Mahony JB, Luinstra KE, Sellors JW, et al: Confirmatory polymerase chain reaction testing for Chlamydia trachomatis in first - void urine from asymptomatic and symptomatic men. J Clin Microbiol 1992; 30(9): 2241-2245

14. Jaschek G, Gaydos CA, Welsh LE, et al: Direct detection of Chlamydia trachomatis in urine specimens from symptomatic and asymptomatic men by using a rapid polymerase chain reaction assay. J Clin Microbiol 1993; 31(5): 1209-1212

15. Health and Welfare Canada: Canadian guidelines for screening for Chlamydia trachomatis infection. Can Dis Wkly Rep 1989; 15(S5): 1-12

16. Centers for Disease Control: 1989 sexually transmitted diseases guidelines. MMWR 1989; 38(S-8): 1-43

17. Linnemann CC Jr, Heaton CL, Ritchey M: Treatment of Chlamydia trachomatis infections: comparison of 1- and 2-g doses of erythromycin daily for seven days. Sex Transm Dis 1987; 14(2): 102-106

18. Lassus A: Comparative studies of azithromycin in skin and soft-tissue infections and sexually transmitted infections by Neisseria and Chlamydia species. J Antimicrob Chemother 1990; 25(Suppl A): 115-121

19. Steingrimsson O, Olafsson JH, Thorarinsson H, et al: Azithromycin in the treatment of sexually transmitted disease. J Antimicrob Chemother 1990; 25(Suppl A): 109-114

20. Johnson RB: The role of azalide antibiotics in the treatment of Chlamydia. Am J Obstet Gynecol 1991; 164(6 Pt 2): 1794-1796

21. Martin DH, Mroczkowski TF, Dalu ZA, et al: A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. N Engl J Med 1992; 327: 921-925

22. Hooton TM, Batteiger BE, Judson FN, et al: Ofloxacin versus doxycycline for treatment of cervical infection with Chlamydia trachomatis. Antimicrob Agents Chemother 1992; 36(5): 1144-1146

 23. Cohen I, Veille J-C, Calkins BM: Improved pregnancy outcome following successful treatment of chlamydial infection. JAMA 1990; 263(23): 3160-3163

24. Ryan GJ, Abdella TN, McNeeley SG, et al: Chlamydia trachomatis infection in pregnancy and effect of treament on outcome. Am J Obstet Gynecol 1990; 162(1): 34-39

25. Black-Payne C, Ahrabi MM, Bocchini JA, et al: Treatment of Chlamydia trachomatis identified with Chlamydiazyme during pregnancy. Impact on perinatal complications and infants. J Reprod Med 1990; 35(4): 362-367

26. Schachter J, Sweet RL, Grossman M, et al: Experience with the routine use of erythromycin for chlamydial infections in pregnancy. N Engl J Med 1986; 314: 276-279

27. McMillan JA, Weiner LB, Lamberson HV, et al: Efficacy of maternal screening and therapy in the prevention of chlamydia infection of the newborn. Infection 1985; 13(6): 263-266

28. McCormack WM, Rosner B, Lee YH, et al: Effect of birth weight of erythromycin treatment of pregnant women. Obstet Gynecol 1987; 69: 202-207

29. Cates W, Wasserheit J: Genital chlamydial infections: epidemiology and reproductive sequelae. Am J Obstet Gynecol 1991; 164(6 Pt 2): 1771-1781

30. Stamm WE, Koutsky LA, Beneditti JK, et al: Chlamydia trachomatis urethral infections in men. Ann Intern Med 1984; 100: 47-51

31. Lycke E, Lowhagen GB, Hallhagen G, et al: The risk of transmission of genital Chlamydia trachomatis infection is less than that of genital Neisseria gonorrhoeae infection. Sex Transm Dis 1980; 7: 6-10

32. Leka T, Patrick K, Benenson AS: Chlamydia trachomatis urethritis in university men: risk factors and rates. J Am Board Fam Pract 1990; 3: 81-86

33. Fish AN, Fairweather DV, Oriel JD, et al: Chlamydia trachomatis infection in a gynecology clinic population: identification of high-risk groups and the value of contact tracing. Eur J Obstet Gynecol Reprod Biol 1989; 31: 67-74

34. Washington AE, Johnson RE, Sanders LL Jr: Chlamydia trachomatis infections in the United States. What are they costing us? JAMA 1987; 257(15): 2070-2072

35. Phillips RS, Aronson MD, Taylor WC, et al: Should tests for Chlamydia trachomatis cervical infection be done during routine gynecologic visits? An analysis of the costs of alternative strategies. Ann Intern Med 1987; 107(2): 188-194

36. Estany A, Todd M, Vasquez M, et al: Early detection of genital chlamydial infection in women: an economic evaluation. Sex Transm Dis 1989; 16(1): 21-27

37. Sellors JW, Pickard L, Gafni A, et al: Effectiveness and efficiency of selective vs universal screening for chlamydial infection in sexually active young women. Arch Intern Med 1992; 152: 1837-1844

38. Nettleman M, Bell T: Cost-effectiveness of prenatal testing for Chlamydia trachomatis. Am J Obstet Gynecol 1991; 164(5 Pt 1): 1289-1294

39. U.S. Preventive Services Task Force: Guide to Clinical Preventive Services: an Assessment of the Effectiveness of 169 Interventions. Williams & Wilkins, Baltimore, Md, 1989: 147-150

40. Centers for Disease Control: Recommendations for the prevention and management of Chlamydia trachomatis infections, 1993. MMWR 1993; 42(RR-12): 1-39