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Vol. 90. Issue 2.
Pages 182-189 (March - April 2014)
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Vol. 90. Issue 2.
Pages 182-189 (March - April 2014)
ARTIGO ORIGINAL
Open Access
Reporting detection of Chlamydia trachomatis DNA in tissues of neonatal death cases
Relato de detecção de DNA de Chlamydia trachomatis em tecidos de casos de óbito neonatal
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Maria Hernandez Trejoa,b, Norma E. Herrera Gonzalezb, Marcos R. Escobedo Guerrac, M. de Jesus de Haro Cruzc, Elsa R. Moreno-Verduzcod, Marcela Lopez-Hurtadoe, Fernando M. Guerra-Infantec,e,
Corresponding author
fguerra_96@yahoo.com

Corresponding author.
a Departamento de Neurobiologia do Desenvolvimento, Instituto Nacional de Perinatología, D.F., México
b Escola de Medicina, Instituto Politécnico Nacional, D.F., México
c Escola Nacional de Ciências Biológicas, Instituto Politécnico Nacional, D.F., México
d Departamento de Anatomia Patológica, Instituto Nacional de Perinatología, D.F., México
e Departamento de Infectologia, Instituto Nacional de Perinatología, D.F., México
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Article information
Abstract
Objective

to determine whether C. trachomatis was present in neonates with infection, but without an isolated pathogen, who died during the first week of life.

Methods

early neonatal death cases whose causes of death had been previously adjudicated by the institutional mortality committee were randomly selected. Endpoint and real-time poly-merase chain reaction of the C. trachomatis omp1 gene was used to blindly identify the presenceof chlamydial DNA in the paraffinized samples of five organs (from authorized autopsies) ofeach of the dead neonates. Additionally, differential diagnoses were conducted by amplifyinga fragment of the 16S rRNA of Mycoplasma spp.

Results

in five cases (35.7%), C. trachomatis DNA was found in one or more organs. Severe neonatal infection was present in three cases; one of them corresponded to genotype D of C. trachomatis. Interestingly, another case fulfilled the same criteria but had a positive polymerase chain reaction for Mycoplasma hominis, a pathogen known to produce sepsis in newborns.

Conclusion

the use of molecular biology techniques in these cases of early infant mortality demonstrated that C. trachomatis could play a role in the development of severe infection and in early neonatal death, similarly to that observed with Mycoplasma hominis. Further study is required to determine the pathogenesis of this perinatal infection.

Keywords:
Chlamydia trachomatis
Polymerase chain reaction
Newborn
Sepsis
Mortality
Resumo
Objetivo

determinar se a C. trachomatis está presente em neonatos com infecção, porém sem patógeno isolado, que morreram durante a primeira semana de vida.

Métodos

casos de óbito neonatal precoce cujas causas de óbito haviam sido anteriormente determinadas pelo Comitê de Mortalidade da instituição foram aleatoriamente selecionados. Foram utilizadas as reações em cadeia da polimerase convencional e em tempo real do gene omp1da C. trachomatis, para identificar, às cegas, a presença de DNA de clamídia nas amostras desparafinizadas de cinco órgãos (de autópsias autorizadas) de cada um dos neonatos mortos. Além disso, foram realizados diagnósticos diferenciais por amplificação de um fragmento do rRNA 16S de Mycoplasma ssp.

Resultados

em cinco casos (35,7%) a presença de DNA de C. trachomatis foi detectada em um ou mais órgãos. Havia infecção neonatal grave em três casos; um deles correspondente ao genótipo D de C. trachomatis. Curiosamente, outro caso preencheu os mesmos critérios, porém possuía uma reação em cadeia da polimerase positiva para Mycoplasma hominis, um patógeno conhecido por causar sepse em recém-nascidos.

Conclusão

a utilização de técnicas de biologia molecular nos casos de mortalidade infantil precoce mostrou que a C. trachomatis poderia desempenhar um papel no desenvolvimento de infecção grave e no óbito neonatal precoce semelhante ao observado com a Mycoplasma hominis. São necessários estudos adicionais para determinar a patogênese dessa infecção perinatal.

Palavras-chave:
Chlamydia trachomatis
Reação em cadeia da polimerase
Recém-nascido
Sepse
Mortalidade
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Como citar este artigo: Hernandez-Trejo M, Herrera-Gonzalez NE, Escobedo-Guerra MR, de Haro-Cruz MJ, Moreno-Verduzco ER, Lopez-Hurtado M, et al. Reporting detection of Chlamydia trachomatis DNA in tissues of neonatal death cases. J Pediatr (Rio J). 2014;90:182-9.

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