Evaluated 278 pregnant women and 79 infants for CT. Vertical transmission of CT was 55% (11/22).
Neonatal conjunctivitis (45% versus 18.3%) and pneumonia (30% versus 8.3%) were more common in infants of CT-infected women compared to CT-uninfected women (). DNA sequencing of CT isolated from mothers and infants was identical
300 pregnant women were evaluated for CT and 11% found to have CT. Vertical transmission of CT was 24% and was higher for vaginal delivery 66.7% versus cesarean 8.3%
Evaluated 182 pregnant women at >37 weeks’ gestation and followed up their infants for 2 months after delivery. None of the newborn infants had CT, and none had CT at the 2-month follow-up
Evaluated infants for CT and NG ophthalmia neonatorum and found rates of 23.2 per 100 live births of ON; 8.1 per 100 live births or 31% of 181 cases of neonatal conjunctivitis were from CT. For 201 CT-exposed infants, CT was recovered from the eye in 31% and throat in 2% of infants. NG transmission to infants was more likely in infants whose mothers had both CT and NG
Evaluated CT-exposed and CT-unexposed infants for CT, ophthalmia neonatorum or conjunctivitis, and pneumonia. CT-exposed infants were more likely to have CT positive cultures (37% (18/49) versus 0% (0/40)), develop ophthalmia neonatorum or conjunctivitis (37% versus 15%, ), or have pneumonia (12% versus 0%, ). One CT-exposed infant death was also noted
CT and conjunctivitis/neonatal ophthalmia (studies = 11)
Evaluated 54 cases of acute eye infections of children (6 DOL to 16 yo) presenting to an ophthalmology clinic. Of the 10 cases of ophthalmia neonatorum, 60% were from CT
Evaluated 192 infants with neonatal conjunctivitis for CT. CT was isolated from 12.5% () of cases and NP colonization with CT was also found in 62.5% () of these cases. CT conjunctivitis incidence was estimated at 4 per 1000 live births. Only one infant had treatment failure after being treated with oral erythromycin
Evaluated 98 newborn infants with conjunctival secretions along with 122 children with respiratory tract disease in the hospital for CT. CT was recovered from 12.2% (12) of infants’ eyes and 26.2% (32) of respiratory secretions
17 cases of neonatal conjunctivitis were evaluated for an etiology. CT was recovered in 29.4% () of cases and a statistically significant association with CT was noted
449 newborn infants were examined for 1 mo to evaluate for ophthalmia neonatorum. Ophthalmia neonatorum (ON) occurred in 19.4% of cases with CT ON diagnosed in 1.8% (8) of infants, which were more severe
Evaluated infants for ophthalmia neonatorum over a 7 mo period, and CT was isolated from 2.7% (17) infants. Conjunctivitis from CT was usually unilateral as opposed to bilateral
112 infants with ophthalmia neonatorum were evaluated for CT and NG; CT was detected in 33% (37). Also followed 335 neonates and found 16% (55) developed ophthalmia neonatorum with 16% of cases due to CT
Evaluated 38 infants with ophthalmia neonatorum and 277 children with trachoma in a trachoma endemic region. CT was isolated in 8-9% of infants with ophthalmia neonatorum, and chlamydia was isolated from 31% of children with trachoma with 92% belonging to classic trachoma serovars. The study did not support that perinatal CT ophthalmic infections played a major role in trachoma epidemiology
149 infants with ophthalmia neonatorum were evaluated for CT, NG, and other infections. CT was isolated from 13% of infants, and 3/5 were trachoma serovars
Donders et al., 1991 [59], Paul et al., 1999 [38], and Christian et al., 2005 [43]—see Table 1 on adverse pregnancy outcomes for other information relevant to conjunctivitis/neonatal ophthalmia. Laga et al., 1986 [13]—see vertical transmission section above in this table.
87 children (ages 2 mo to 3 yrs) admitted to a hospital were evaluated for the etiology of their lower respiratory tract infection (LRTI). CT was uncommon and only recovered in 1.2% of patients and in only 1 patient under 6 mo (5.9%)
76 infants < 6 mo of age presenting to hospitals were evaluated for CT and viruses. CT was isolated in 16.7% of infants in one hospital and 21.7% of infants in another; overall CT was recovered in 18.5% of all infants with LRTI from both sites
74 children < 5 yrs admitted to the hospital for LRTI were evaluated for infectious etiologies. For infants < 1 yr, 10% had CT recovered from nasopharyngeal aspirates and were diagnosed with CT pneumonia
170 children (1 mo to 2 yrs) admitted to the hospital for acute bronchiolitis were evaluated for CT, respiratory viruses, and other etiologies. 2.4% had CT, and all of these children also had RSV
Evaluated 405 infants < 3 mo of age presenting to a hospital as part of multicenter WHO study on pneumonia, sepsis, and meningitis. In 203 infants that had nasopharyngeal aspirates done, 15.8% had CT isolated whereas 28% had RSV isolated
90 infants < 1 yo with pneumonia and 43 controls were evaluated for viral and other infectious etiologies. CT was also isolated from 2 infants with lower respiratory tract infection and one control patient, whereas RSV was found in 37% of patients
Evaluated 52 infants between 7 and 30 days of life to determine prevalence of CT-associated pneumonia and found 63.5% (33/52) had CT isolated from their upper airways and 51% (24/47) had CT-associated pneumonia based on findings of both CT-colonization and interstitial pneumonia on X-rays
Evaluated 100 ambulatory infants with signs of lower respiratory tract infection and found 6% had CT infection. Infants with CT were younger (mean age: 3.8 weeks versus 8.7 weeks, ) and were more likely to have eye discharge () or conjunctivitis () than uninfected infants
Datta et al., 1988 [61], Shen et al., 1995 [33], and Wu et al., 1999 [34], also discuss rates of pneumonia in CT-exposed infants in the CT vertical transmission section of this table.
Secondary analysis of a multicenter perinatal HIV transmission study testing pregnant women midpregnancy for CT and NG. HIV MTCT was similar for women with and without CT (24.1% versus 23.2%, )
A secondary analysis of a large, randomized, multicenter trial of HIV-infected pregnant women evaluating different antiretroviral prophylaxis regimens to prevent intrapartum HIV MTCT. Infants of women coinfected with CT and NG had higher rates of adverse outcomes (sepsis, pneumonia, congenital syphilis, septic arthritis, conjunctivitis, LBW, preterm birth, or death) compared to infants of women uninfected with these STIs (65.7% versus 37%, ) and were especially at risk for death, LBW, and preterm delivery. Death (11.4% versus 3%, ), low birth weight (42.9% versus 16.9%, ), and preterm delivery (28.6% versus 10.2%, ) were higher among infants of CT and/or NG coinfected women compared to STI unexposed infants. These infants born to mothers with CT and/or NG were 1.4 times more likely to have at least one of these adverse outcomes (OR 1.35, 95% CI 1.03–1.8)
Additional secondary analysis of the RCT noted above. Among the 117 cases of HIV MTCT, higher rates of HIV MTCT were noted among women with CT (10.7%) or with both CT and NG (14.3%) compared to those uninfected 8.1% (); findings suggested a possible association of CT with increased HIV MTCT (OR 1.47, 95% CI 0.9–2.3, and )
Adachi et al. [24, 60]—30% of cohort from South Africa. STI = sexually transmitted infection, CT = Chlamydia trachomatis, NG = Neisseria gonorrhoeae, and RSV = respiratory syncytial virus. yo = year(s) old, yrs = years, mo = month(s), DOL = days of life, MTCT = mother-to-child transmission, and LBW = low birth weight. LRTI = lower respiratory tract infection, RCT = randomized clinical trial, NP = nasopharyngeal, and ON = ophthalmia neonatorum.
