Chlamydia trachomatis infections in the newborn
- Mohan Pammi, MD, PhD
Mohan Pammi, MD, PhD
- Associate Professor
- Baylor College of Medicine
- Margaret R Hammerschlag, MD
Margaret R Hammerschlag, MD
- Professor of Pediatrics and Medicine
- SUNY Downstate Medical Center
- Section Editors
- Leonard E Weisman, MD
Leonard E Weisman, MD
- Section Editor — Neonatology
- Professor of Pediatrics
- Baylor College of Medicine
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
Chlamydia trachomatis (C. trachomatis) is the most common cause of sexually transmitted genital infections in the United States. Infants born vaginally to infected mothers with genital disease are at risk for acquiring C. trachomatis, which usually presents as conjunctivitis and/or pneumonia.
The clinical features, diagnosis, and treatment of C. trachomatis conjunctivitis and pneumonia in the newborn and young infant are reviewed here.
Pneumonia in older children, other disorders caused by Chlamydia, and the possible role of infection in preterm delivery are discussed elsewhere. (See "Pneumonia caused by Chlamydia species in children" and "Acute otitis media in children: Epidemiology, microbiology, clinical manifestations, and complications" and "Preterm birth: Risk factors and interventions for risk reduction".)
EPIDEMIOLOGY AND TRANSMISSION
C. trachomatis is primarily transmitted to newborns via exposure to an infected mother's genital flora during vaginal birth . There are case reports documenting chlamydial infection in infants born after cesarean delivery with ruptured membranes and, more rarely, intact membranes [2-5]. The latter condition indicates either a transmembrane or a transplacental transmission of the infection.
There are 15 serovariants of C. trachomatis. Neonatal infection is usually caused by C. trachomatis serovariants D through K, which are the primary serotypes causing genital disease in adults .
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- EPIDEMIOLOGY AND TRANSMISSION
- Prevalence in pregnancy
- Risk of transmission
- CLINICAL MANIFESTATIONS
- - Laboratory features
- Indications for testing
- Diagnostic methods
- - Culture
- - Nucleic acid amplification tests
- - Antigen detection methods
- - Other tests
- Choice of antibiotic
- - Risk of pyloric stenosis
- Treatment of the mother
- Maternal screening
- Prophylaxis against conjunctivitis
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS