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Thomas A. Bell, MD, MPH; Walter E. Stamm, MD; San pin Wang, MD; Cho chou Kuo, MD, PhD; King K. Holmes, MD, PhD; J. Thomas Grayston, MD

JAMA. 1992;267(3):400-402.

Abstract
Objective.
—To study the natural history of Chlamydia trachomatis infections in infants.

Design.
—Bacteriologic and serologic study of an inception cohort.

Setting.
—University of Washington Medical Center, Seattle.

Participants.
—Twenty-two infants with C trachomatis infections either not treated early in life or recurring after antimicrobial treatment.

Main Outcome Measures.
—Persistence of infection in various anatomic sites, antibody responses to specific serovars (serologic variants) of C trachomatis, and serovars of isolates from mothers and infants.

Results.
—The cumulative proportion of infants still infected at the age of 1 year was 35%. Infection persisted in the conjunctiva, nasopharynx, and oropharynx in one child for as long as 866 days (28.5 months), when she was cured by treatment. In none of the infants did serologic tests suggest acquisition of infection other than at birth. Isolates of C trachomatis from mothers and their respective infants were always of the same serovar.

Conclusions.
—Many infants infected with C trachomatis at birth remain infected for months or years in the absence of specific antimicrobial therapy. Such infections may be confused with those acquired by sexual abuse.

(JAMA. 1992;267:400-402)

Author Affiliations
From the Departments of Pediatrics (Dr Bell), Medicine (Drs Stamm and Holmes), Pathobiology (Drs Wang and Kuo), and Epidemiology (Drs Bell and Grayston), University of Washington, Seattle.

Footnotes
Presented, in part, at the Sixth International Symposium on Human Chlamydial Infections, Sanderstead, Surrey, England, June 17,1986; and the Second International Congress on Sexually Transmitted Diseases, Paris, France, June 27, 1986.

Reprint requests to SC-36, Department of Epidemiology, University of Washington, Seattle, WA 98195 (Dr Bell).

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