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1.  Is one swab enough to detect chlamydial infection of the cervix? 
Three swabs were taken from the cervix of each of 104 women for the detection of Chlamydia trachomatis. The processing of three swabs instead of one increased the isolation rate by only 2%, and later swabs did not result in the production of more chlamydial inclusions than first swabs. In most clinics, therefore, a single cervical swab is adequate to detect chlamydial infection.
PMCID: PMC1046386  PMID: 6518349
2.  Interaction between Trichomonas vaginalis and other pathogenic micro-organisms of the human genital tract. 
Trichomonas vaginalis organisms were mixed with suspensions of Neisseria gonorrhoeae, Mycoplasma hominis or Chlamydia trachomatis to allow ingestion of these micro-organisms by the trichomonads. Culture studies indicated that gonococci and mycoplasmas were ingested and that the number of intracellular viable organisms decreased rapidly, most gonococci being killed within six hours and all mycoplasmas within three hours. Electron microscopy revealed phagocytic uptake and destruction of these two micro-organisms within the trichomonads, gonococcal degradation being associated with lysosomal enzyme activity. There was no evidence from cultural or electron microscopy studies that C trachomatis organisms persisted in mixed culture with T vaginalis.
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PMCID: PMC1046266  PMID: 6421451
3.  A study of inactivation of Chlamydia trachomatis by normal human serum. 
To assess the effect of human serum on the viability of Chlamydia trachomatis, organisms were mixed with unheated and heat inactivated homologous serum, and the numbers surviving after incubation at 37 degrees C for 1 hour were compared. With a pool of sera obtained from 12 donors, the number of chlamydiae surviving incubation in unheated serum was less than 1% of that surviving incubation in heat inactivated serum. The antichlamydial activity of the unheated pooled serum samples could be noticeably reduced by treatment with Mg-EGTA (ethyleneglycolbis (beta-amino ethyl ether)-N,N'-tetra-acetic acid). This indicated a requirement for calcium ions and showed that the alternative pathway of complement activation played only a minor role, if any, in the inactivation process. When 12 serum samples were tested individually it was found that four inactivated chlamydiae to an extent comparable with that seen with the pooled serum. The other eight samples showed only moderate (or slight) antichlamydial activity, with survival rates in unheated serum of 20-60% (or more than 60%) of those in heat inactivated serum. There was no correlation between the titres of antichlamydial antibodies and antichlamydial activity, all serum samples having undetectable or low concentrations of antibody on measurement by micro-immunofluorescence. The antichlamydial activity destroyed by heating was restored, however, when heat inactivated serum was mixed with an equal volume of an unheated serum that was not inhibitory to chlamydiae. When the latter serum was heated before addition antichlamydial activity was not restored, indicating the requirement of both a heat stable and a heat labile factor. This observation and the need for calcium ions for inactivation of chlamydiae are compatable with killing mediated by antibody and complement. Thus serum samples from individuals with no clinical or serological evidence of infection with chlamydiae vary in their ability to inactivate the organism, some having antichlamydial activity which is possibly mediated by antibody and complement.
PMCID: PMC1046239  PMID: 6416608
4.  Infection of female squirrel monkeys (Saimiri sciureus) with trichomonas vaginalis as a model of trichomoniasis in women. 
Marmosets, tamarins, owl monkeys, and squirrel monkeys were inoculated intravaginally with Trichomonas vaginalis. The latter animal species was most susceptible, trichomonads being recovered from four of six monkeys for periods ranging usually up to one month. Vaginal discharge was seen in most infected animals but polymorphonuclear leucocytes were rare. Infected animals developed serum IgG antibody responses and also local IgG and IgA responses, the latter occurring sometimes on reinoculation in the absence of organism recovery. Antibody responses were, however, of short duration and, overall, immunity was weak because two animals were reinfected on a second or subsequent challenge. Some of the observations are relevant to vaginal trichomoniasis in women.
PMCID: PMC1046194  PMID: 6409346
5.  Prevalence of chlamydial infection in promiscuous women. 
Chlamydia trachomatis was isolated from the cervix of 18 (33%) of 55 women who admitted to two or more casual sexual contacts to one (3%) of 32 women who admitted to one casual contact in the preceding month. The chlamydial infections did not produce characteristic clinical features. Since promiscuous women are at high risk of acquiring chlamydial infection, they should be regarded as a priority group when resources for chlamydial isolation are limited.
PMCID: PMC1046148  PMID: 6831188
6.  Evaluation of an enzyme-linked immunosorbent assay for the detection of antibody to Trichomonas vaginalis in sera and vaginal secretions. 
Using a whole-cell antigen antibody to Trichomonas vaginalis was measured by an enzyme-linked immunosorbent assay (ELISA). IgG antibody was found in sera from only three of 99 children under 12 years of age. In contrast, serum IgG or IgM antibody or both were detected in 80.4% of women who had vaginal trichomoniasis and in 13.7% of uninfected women. Although antibody was found in cervical and vaginal secretions, the correlation between current infection and the presence of antibody was poorer than found between circulating antibody and infection. IgG or IgA antibody or both was detected in the secretions of 73.2% and 41% of infected and uninfected women respectively. This may be accounted for, at least partly, by previous infections since antibody, circulating or local, was found most often in women who had a history of trichomoniasis. There was no indication that some other vaginal micro-organism stimulated antibody directed against T vaginalis.
PMCID: PMC1046087  PMID: 6982095
7.  Anaerobes in men with urethritis 
Sixty-four men with non-gonococcal urethritis (NGU), seven with gonococcal urethritis (GU), and 30 who had no symptoms or signs of urethritis were studied. Chlamydia trachomatis was isolated from urethral specimens taken from 22% of the men with NGU, and 18% with GU, but not from those who did not have urethritis even though 20 (67%) of them had a history of NGU, GU, or both. The chlamydial isolation rate for men having NGU for the first time was 30%. Ureaplasma urealyticum was isolated from 42% of the men with NGU, 43% of men with GU, and 27% of those without urethritis.
In addition to aerobes anaerobes were isolated frequently from men whether or not they had urethritis, the most common being anaerobic Corynebacteria, peptococci, and micro-organisms of the Bacteroides-Fusobacteria group. There was no appreciable difference in the overall isolation of anaerobes from men with NGU (89%) or from those without disease (80%). The rate of isolation of a Gram-negative anaerobic bacillus from men with NGU (50%) was, however, strikingly different to that from men with GU (14%) or from those without disease (13%). Furthermore, this bacillus was recovered from 28 (56%) of 50 men with NGU who were considered chlamydia-negative and from 19 (61%) of 31 men who were both chlamydia-negative and ureaplasma-negative. The effect of antibiotic treatment was evaluated in a few patients only, so that although those from whom the Gram-negative bacillus was eliminated by tetracycline recovered clinically there is a need for a prospective therapeutic trial to evaluate further the importance of the bacillus.
PMCID: PMC1046085  PMID: 7127057
8.  Urinary abnormalities in non gonococcal urethritis. 
The association between urinary abnormalities detected by the two-glass urine test and objective urethritis was investigated in a study of 221 male patients with non-gonococcal urethritis. A strong correlation existed between urinary threads and urethritis, but use of the test for diagnosis and in the assessment of cure is limited by its poor predictive value in both treated and untreated patients.
PMCID: PMC1045981  PMID: 7326552
9.  Taking cell cultures to the patient in an attempt to improve chlamydial isolation. 
McCoy cell cultures were inoculated with 121 urethral and cervical specimens taken from patients attending one of two sexually transmitted disease clinics. The mean number of Chlamydia trachomatis inclusions was greater when the cultures were inoculated with the specimens and centrifuged in the clinic than when the specimens were first stored in liquid nitrogen. Furthermore, 18 of the 29 chlamydia-positive specimens produced larger numbers of of inclusions when inoculated immediately. Despite this, the isolation rate from specimens inoculated directly (22%) was about the same as from specimens which had been frozen (21%). Of the 30 occasions on which the cell monolayers were disrupted, 29 followed immediate inoculation. This may possibly have been due to some toxic factor in some of the specimens.
PMCID: PMC1045866  PMID: 7008897
10.  Microbiological, serological, and histopathological features of experimental Chlamydia trachomatis urethritis in chimpanzees. 
A laboratory-passaged genital strain of Chlamydia trachomatis and two unpassaged genital strains from patients with nongonococcal urethritis were inoculated intraurethrally into three young male chimpanzees. Chlamydia were recovered from the urethra of two animals and specific antibody responses were detected in all of them. Furthermore, a urethral polymorphonuclear leucocyte response, but not an overt discharge, occurred in all the chimpanzees about 1-2 weeks after inoculation. None of these events occurred in a chimpanzee inoculated with medium only. At necropsy three months after inoculation the submucosa of the urethra of one chimpanzee was densely infiltrated with small round cells. This suggests that a similar chronic lymphocytic response may occur in human chlamydial infection of the urethra.
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PMCID: PMC1045864  PMID: 7470833
11.  One-step staining of Neisseria gonorrhoeae in urethral discharge by methyl green-pyronin. 
Methyl green-pyronin (MGP) was used in a one-step procedure to stain smears of urethral discharge from 169 men. Duplicate smears were stained by Gram's method and discharge was cultured for Neisseria gonorrhoeae. The organisms were isolated from 67 specimens and intracellular diplococci were seen in 74 smears after Gram staining and in 77 after staining by MGP. Furthermore, more extracellular and intracellular diplococci were seen in smears stained by MGP than by Gram's method and the proportion of polymorphonuclear leucocytes found to contain the organisms was greater after staining with MGP. Staining with MGP is simple, rapid, inexpensive, and easily automated.
PMCID: PMC1045783  PMID: 6159054
19.  Non-specific urethritis. A placebo-controlled trial of minocycline in conjunction with laboratory investigations. 
The results of a double-blind therapeutic trial on 81 men suffering from non-specific urethritis (NSU) show that minocycline was more effective than a placebo. Before treatment Chlamydia trachomatis was isolated from 31 per cent. of the men, ureaplasmas from 58 per cent., and Mycoplasma hominis from 7-5 per cent. There is evidence that chlamydiae are a cause of urethritis. However, after minocycline therapy improvement in the clinical response of patients from whom only ureaplasmas were isolated was less significant, so that the evidence that these organisms are pathogenic is less convincing. Possible reasons for this are discussed, as are the implications of finding minocycline-resistant ureaplasmas in at least 6 per cent. of the patients who harboured these organisms. The symptoms and signs of patients from whom micro-organisms were not isolated also improved after minocycline therapy, implying that the aetiological agents in this group of patients are antibiotic-sensitive. However, the results do not exclude the possibility that a minocycline-resistant agent is the cause of urethritis in a minority of patients.
PMCID: PMC1045279  PMID: 786440
21.  Ureaplasma urealyticum and Mycoplasma hominis in chlamydial and non-chlamydial nongonococcal urethritis. 
Urethral specimens from 726 patients with nongonococcal urethritis (NGU) were examined for Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis. Chlamydiae were isolated from 35.9% of ureaplasma-positive patients and from 36.5% of ureaplasma-negative patients. Ureaplasmas were isolated from 52.5% of chlamydia-positive patients and from 53.1% of chlamydia-negative patients, an observation which contrasts with that of some workers who have suggested that ureaplasmas are significantly associated with chlamydia-negative NGU. Furthermore, the numbers of ureaplasmas isolated from patients who did or did not harbour chlamydiae were not significantly different nor was there a particular association of ureaplasmas with chlamydia-negative NGU in patients experiencing their first episode of disease. In addition, M. hominis was not isolated more frequently from those from whom chlamydiae were or were not isolated. The only significant associations were the isolation of M. hominis from patients who were ureaplasma-positive and of ureaplasmas from those who were M. hominis-positive. These findings do not necessarily mitigate against ureaplasmas being responsible for some cases of chlamydia-negative NGU.
PMCID: PMC1045578  PMID: 427513
22.  Urethritis due to Chlamydia trachomatis. 
Ninety-five men suffering from gonococcal urethritis were treated and observed. Forty-nine developed postgonococcal non-specific urethritis (PGU). Seventeen men were demonstrated to be free from PGU after careful observation; these formed a control group. Chlamydia trachomatis was isolated from urethral material from 26 (53%) of the PGU group but from none of the controls. This difference was highly significant (P less than 0-001). It confirms that C. tachomatis is a pathogen in the urethra. The presence of specific IgM antibody to C. trachomatis in serum from some men developing PGU, from whom that organism was isolated, suggests that the infection was recent in those cases. Ureaplasma urealyticum (T strain mycoplasma) was isolated from urethral material taken from 22 (45%) of the 49 men in the PGU group, and from 12 (71%) of the 17 in the control group. Mycoplasma hominis was isolated from 10 (20%) of the 49 men in the PGU group, and from four (24%) of the 17 men in the control group. Thus, no evidence was obtained that mycoplasmas (U. urealyticum, M. hominis) are patogenic in the urethra.
PMCID: PMC1045386  PMID: 871894
23.  Pneumonia in mice produced by Neisseria gonorrhoeae. 
Gonococci of colony type 1 were introduced by intranasal inoculation into the lungs of mice in an attempt to produce infection. The organisms were eliminated from the three strains of mice used within 24 hours of challenge. Cyclophosphamide treatment of mice failed to render them susceptible although the organisms disappeared more slowly. The lungs of immunologically normal animals that had received either viable or heat-killed gonococci were acutely inflamed with infiltration of bronchioles and alveoli by polymorphonuclear and mononuclear leucocytes. Most of the changes had resolved after about four days. In cyclophosphamide-treated mice pulmonary infiltration by polymorphonuclear leucocytes was not evident, suggesting that these cells were not primarily responsible for the clearance of the gonococci. Despite the failure to produce a sustained infection, this model may be valuable for studying the local inflammatory effect of gonococcal endotoxin.
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PMCID: PMC1045338  PMID: 843896
24.  Prolonged eradication of urogenital mycoplasmas after administration of tetracycline to men in the Antarctic. 
Meatal swabs were obtained at intervals over 1 year from 23 men in the Antarctic. A 5-day course of tetracycline was given to twelve of them. In retrospect it was found that the antibiotic had been received by two men who were harbouring ureaplasmas, one of whom also had M. hominis. After treatment, these organisms were not found in any of the swabs taken over the next year, except in a swab from one of the men following sexual contact after this time. One of the twelve men developed N.S.U. just before arriving in the Antarctic. He responded clinically to a shorter course of tetracycline and ureplasmas were not recovered from a meatal swab immediately thereafter. However, without further sexual contact, ureaplasmas and disease recurred about a month later. This time, after a 5-day course of tetracycline, disease was not seen, and ureaplasmas were not isolated, over the next year. In contrast, ureaplasmas were isolated consistently over a year from two men who were not given the antibiotic. The evidence strongly suggests that, under natural conditions, the most likely cause of mycoplasmas, particularly ureaplasmas, recurring in the genital tract after apparently adequate tetracycline therapy, is re-infection as a result of sexual re-exposure.
PMCID: PMC1045296  PMID: 1036463

Results 1-24 (24)