The Prostatitis Foundation

From: jdimitrakov@my-deja.com

 

Antibiotic resistance of Chlamydia trachomatis

There are several points worth mentioning:
1.
As I mentioned in a recent discussion with Prof. Julius Schachter from UCSF - the man who has written or collaborated in virtually every study on Chlamydia in the past 20 years - he pointed out that in his opinion Chlamydia trachomatis does not by itself infect the prostate but the part of the prostate that goes through it - the so-called "Pars prostatica urethrae" or "Membranous urethra" (which is situated a little bit further down from the prostate at the place where the pelvic floor muscles cross from both sides and form a very thin place which is very frequently injured during cystoscopies and gives rise to strictures. That's why this place was called "membranous" (meaning thinner, and hence, more prone to injury). So, in Schachter's opinion expressed by him years ago in an editorial in the Journal of Urology, Chlamydial prostatitis is actually chronic posterior urethritis.
2.
Present very sensitive techniques tend to be over "user-friendly". They might sometimes give a positive result when only DNA fragments are present (not live bacteria) and so the test is, in the microbiological sense True Positive but in the clinical sense, for the urologist, False Positive, meaning practically:
1. The patient gets a positive lab result
2. The clinician, if unaware of the technique, administers numerous antibiotics and the patient is not cured (since antibiotics cannot kill DNA)
 
If we have to be exact, there are tests which should supplement PCR and LCR for Chlamydia trachomatis and these are the tests which test for Chlamydia RNA - a marker of viability and division of Chlamydia (therefore, of the possibility that it could be affected by antibiotics). My suspicion, confirmed by everyday experience, is (since I have patients whom I have tested for 30 days every day) and the results oscillate - negative - positive - negative - is that in some patients Chlamydia is shed intermittently and so only during this time should antibiotics be administered.
3.
In my opinion, long-term Chlamydial infection (and any infection long-term) should not be approached from the point of view of :KILL THE BUG but instead: HELP THE BODY FIGHT OFF THE INFLAMMATION. For all who believe they have a Chlamydial infection I always recommend to have their samples tested at best in three independent labs. Besides, remember that there are techniques for Chlamydia antibiotic sensitivity testing provided...there is Chlamydia.

Multiple drug-resistant Chlamydia trachomatis associated with clinical treatment failure

[In Process Citation]
AUTHORS: Somani J; Bhullar VB; Workowski KA; Farshy CE; Black CM
AUTHOR AFFILIATION: Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.
SOURCE: J Infect Dis 2000 Apr;181(4):1421-7 [MEDLINE record in process]
CITATION IDS: PMID: 10762573 UI: 20227766
ABSTRACT: In vitro susceptibility testing and genotyping were done on urogenital isolates of Chlamydia trachomatis from 3 patients, 2 of whom showed evidence of clinical treatment failure with azithromycin and one of whom was the wife of a patient. All 3 isolates demonstrated multidrug resistance to doxycycline, azithromycin, and ofloxacin at concentrations >4.0 &mgr;g/mL. Recurrent disease due to relapsing infection with the same resistant isolate was documented on the basis of identical genotypes of both organisms. This first report of clinically significant multidrug-resistant C. trachomatis causing relapsing or persistent infection may portend an emerging problem to clinicians and public health officials.
-- Best regards, Jordan Dimitrakov, MD

 

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