CLINICAL STUDIES OF UROGENITAL INFECTIONS WITH CHLAMYDIA TRACHOMA TIS Report 2. The Epidemiology of Chlamydial Infections in Okayama District in Japan and Detection of Antibodies to Chlamydiae in the Sera of Patients with Infertility by Means of the Microplate Immunofluorescence Antibody Technique (MFA) Masamichi Amano, Hiromichi Kiuchi, Manabu Suzuki and Hiroyoshi Tanaka Department of Urology, Kawasaki Medical School, Kurashiki, Japan (Director: Prof. H. Tanaka) Hiroko Bessho and Akira Matsumoto Department of Microbiology, Kawasaki Medical School, Kurashiki, Japan (Director: Prof. A. Matsumoto) To examine the epidemiology of Chlamydial infections in Okayama district in Japan and where Chlamydia trachomatis (C. trachomatis) infections were involved in the cause of male infertility, two antibodies (IgG and IgM) in the sera collected from 335 patients without chlamydial infections (control) who visited our hospital, as well as from 92 infertile patients, were measured by means of microplate immunofluorescence antibody technique (MFA), in which large inclusions of C. trachomatis L-2 and C. psittaci Izawa strains were used as antigen. The antibody titers to both antigens in each specimen were determined by the endpoint at which serum dilution gave specific inclusion staining. When the titer (1: 8 and more) to C. trachomatis was higher than that to C. psittaci, the serum was scored as positive, containing antibody to C. trachomatis. IgM titers over 1: 4 were scored as positive. The results were summarized as follows: 1. In the control group, the antibody (IgG) was detected in the sera from 25 males (14. 5%) and 32 females (19. 8%). The IgM positive cases were five in males and three in females. The antibody (IgG) to C. psittaci was detected in the sera from 11 males (6. 4%) and one female (0. 6%). In the pediatric group, two kind of antibodies to Chlamydiae were not detected in the sera from 37 patients. These results strongly suggested widespreading infection with C. trachomatis among Japanese adults. 2. In the infertile patients, the antibody (IgG) was detected in the sera from 9 males (12. 9%) and one female (4. 5%), respectively. The positive rates to IgG antibody of patients in the sterile group or patients with pus cell in semen (over 10 WBCIHPF) were higher than that of patients with the other
semen quality or those without WBC in semen. In the patients with azoospermia and normal FSH levels (normogonadotropic azzospermia), the antibody (IgG) was detected in the sera from three patients and two of them showed inflammatory occlusion of the reproductive tract. Possibility for obstruction of reproductive tract after urogenital infections with C. trachomatis was thought.
[Female]
(-): Female case, Positive rates: Male 12. 9%(9/70) Female 4. 5%(1/22)