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    Chlamydia trachomatis ist das in Industrieländern am häufigsten sexuell übertragene Bakterium.1 Bei jedem zehnten bis zwanzigsten jungen, sexuell aktiven Erwachsenen lassen sich die Keime nachweisen. Mit über 300.000 Infektionen pro Jahr rechnet man hierzulande.2 KLINISCHES BILD: Chlamydien-Infektionen verlaufen typischerweise chronisch-schleichend. Wegen fehlender oder geringer Krankheitszeichen kommt die Diagnose häufig spät, oder die Infektion bleibt unentdeckt.2 Bei Männern verursachen die Serotypen D bis K des sich obligat intrazellulär vermehrenden Bakteriums bis zu 50% aller akuten nicht-gonorrhoischen Harnröhrenentzündungen, die mit schmerzhaftem Wasserlassen und Ausfluß aus der Urethra einhergehen können, und mindestens ein Drittel aller akuten Nebenhodenentzündungen.3 Bei Frauen löst die aufsteigende Infektion Entzündungen des Gebärmutterhalses, des Endometriums sowie der Eileiter aus.4 Infekt-Arthritiden bei Männern und Frauen können auf C.-trachomatis-Infektionen zurückgehen.3 Frauen stecken sich bei ungeschütztem Verkehr mit einem infizierten Partner leichter an als Männer (40%iges vs. Die Infektion verläuft bei Frauen häufiger asymptomatisch (bis 75% vs. 20%), sie tragen aber ein höheres Risiko schwerwiegender Folgeschäden.5 Eileiterentzündungen können Sterilität oder eine Extrauterin-Schwangerschaft nach sich ziehen. Nach einer durchgemachten Infektion sind über 10% der Betroffenen unfruchtbar, nach drei Infektionsepisoden mehr als die Hälfte. DIAGNOSE: Der Enzym-Immunoassay deckt den Keim im infizierten Urethra- bzw. Zervixabstrich zu 80% bis 90% auf.6 Empfindlicher, aber aufwendiger sind Fluoreszenztest oder Kultur.6,4 SCREENING: Neugeborene infizierter Mütter können sich unter der Geburt anstecken, mit der häufigen Folge von Einschlußkonjunktivitis oder Pneumonie.6 Ein Screening möglichst aller schwangeren Frauen auf Chlamydienantigen wird daher empfohlen.2 In Schweden ließ sich die Infektionshäufigkeit seit Einführung eines umfassenden allgemeinen Screening-Programms in den frühen 80er Jahren halbieren.6 BEHANDLUNG: Mittel der Wahl ist Doxycyclin (VIBRAMYCIN u.a.): zweimal 100 mg täglich für mindestens sieben4 bis zehn2 Tage (vgl. Alternativ können zweimal täglich 500 mg Erythromycin (ERYTHROCIN u.a.) eingenommen werden. Traitement Contre la Chlamydia - Traitements Zithromax Tablets - NPS MedicineWise ZITHROMAX 500 mg Filmtabletten PZN 2481966 - Beipackzettel.
     
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