The aim of this study was to evaluate the incidence and morbidities of Chlamydia trachomatis
infections in newborn infants. Tissue culture and direct immunofluorescence (DIF) tests were used to detect the presence of nasopharyngeal C. trachomatis
infection in 35 preterm and 21 healthy term neonates. All infants were followed up clinically for 3 months, and
enzyme-linked
immunosorbent assay analysis for serum antichlamydial
IgG and
IgM was performed on day 15 and week 6. Tissue culture and/or DIF studies showed that 10 of the preterm infants (28.57%), but none of the term infants, were C. trachomatis-positive. The sensitivities of DIF and tissue culture were 40% and 70%, respectively, demonstrating the diagnostic superiority of tissue culture tests for detecting C. trachomatis. Only one asymptomatic preterm infant was found to be positive for antichlamydial
antibodies at the 6th week. All C. trachomatis-positive infants were given
macrolide antibiotics for 14 days. The study showed that male infants were more frequently infected, but types of delivery, mean gestational ages, mean
birth weights, and the need for
mechanical ventilation were similar in C. trachomatis-infected and uninfected preterm infants. However, the duration of
oxygen treatment was longer in infected preterm infants. Clinical
conjunctivitis was more frequent in C. trachomatis-infected infants (60%) than in uninfected infants (24%). C. trachomatis-positive infants had
pneumonia more frequently; however, all patients with
pneumonia were negative for antichlamydial
IgM and
IgG antibodies.
Macrolide treatment for 2 weeks for nasopharyngeal C. trachomatis positivity may have prevented C. trachomatis related
pneumonia, but it may not have significantly influenced the risk of
pneumonia caused by other agents. Chlamydial
infections may lead to early and late respiratory problems in preterm infants. Nasopharyngeal screening may help physicians detect C. trachomatis
infections and provide a means of early diagnosis in this vulnerable patient group.