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The aim of our study was to determine the incidence of Chlamydia trachomatis (C. trachomatis) infections and its role in the etiopathogenesis of urinary tract infections in women. We studied 68 women, who where divided into two groups (I-with urethral syndrome, II-with other urologic diseases). With the use of direct diagnostic methods (immunofluorescence method, tissue culture) C. trachomatis infection was found in 25/68 (36.8%) women. In the group of women with urethral syndrome the percentage of positive results was higher in comparison to the second group, 53.8% and 26.2%, respectively. Specific antichlamydial antibodies of IgG class using direct immunoenzymatic method were found in 10/26 (38.5%) women with urethral syndrome. In the first group the infection was found more often in the urethra (urethra-85.7%, uterine cervix-50%) as in comparison to the second group. In the second group infection was found more often in the uterine cervix (urethra-45.5%, uterine cervix-72.7%). The incidence of C. trachomatis infection in women with urethral syndrome was in direct correlation with a larger number of polynuclear leukocytes in urine sediment (more than 3 in the viewing field). C. trachomatis infection was found in 76.5% of women with leukocyturia and 12.5% of women in which the number of leukocytes in urine sediment was less than 3 in the viewing field. The incidence of Ureaplasma urealyticum and Mycoplasma hominis infections between both study groups did not differ significantly. However, the incidence of yeast-like fungi infections in the group of women with other urologic diseases was double. The clinical sign most often found in women infected with C. trachomatis and with urethral syndrome was dysuria, which was present in all 14 women. In the group of women with other urologic diseases the clinical sign found most often was pollakisuria (72.7%).

The increased number of the genitourinary system infection caused by Chlamydia trachomatis (Ch. Tr.), increased number of patients with dysuria or sterile leukocyturia gave stimulus to studies of 615 patients from Department of Nephrology and District Outpatient Nephrological Care Unit with regard to infections with that microbes. Material for investigations derived from urethra. Diagnostic examinations were performed using the Mc Coy cell culture and the immunofluorescence method. The infection was noted in 176 patients (119 women and 57 men) that is in 28.6% of cases studied. The mean age of patients was 42.7 +/- 12 years. Clinical symptoms such as dysuria or frequency were typical for that kind of infection. The most frequent abnormality was leukocyturia or leukocyturia accompanied by erythrocyturia noted in 66% of patients. Isolated erythrocyturia was observed in 24.4% of cases. It has been stated that anamnesis or routine laboratory examinations were not able to the identification of infection. In face of poorly characteristics of clinical picture of infection the infection with Ch.Tr. could be the cause of unsuccessful therapy in patients with signs of genitourinary tract infections.

102 Chlamydia trachomatis isolates obtained from pregnant women and 42 isolates from man-consorts of women with chlamydial infection of cervix were immunotyped using a microimmunofluorescence (micro IF) with monoclonal antibodies kit (Washington Research Foundation, Seattle, USA). In both groups of patients the most common serovars were: E (37.3%) and D (24.6%) belonging to B-complex. Additional serovars noted were: F (11.3%), J (11.3%), I' (4.5%), I (3.5%, K (3.5%), G (2.8%) and H. Ba (both 0.2%). N. gonorrhoeae and/or T. vaginalis infections were more frequent from patients with B-complex Ch. trachomatis serovars (28/75 that is 37%) than C-complex Ch. trachomatis serovars (3/25 that is 12%).

From urethra of 40 men with CTU, 190 bacterial strains were isolated, 110 before and 80 after treatment with OFX (400 mg daily for 5 days). Among the strains coexisting with Chlamydia trachomatis, Staphylococcus epidermidis (30.9%), Micrococcus (13.6%), Streptococcus group D (10.9%) and Staphylococcus aureus (10.9%) were isolated more frequently than others. The in vitro susceptibility testing showed that, in comparison to erythromycin, doxycycline, oxytetracycline and co-trimoxazole, OFX was the most active antimicrobial agent against the majority of bacteria (except streptococci) isolated from urethra in CTU cases in men. The OFX treatment was found to reduce the total number of isolated strains, including Staphylococcus aureus and Staphylococcus saprophyticus, without disturbing normal urethral flora.

The Chlamydiazyme Test was used in the laboratory examination of 1139 patients (716 women, 368 men, 55 children) hospitalized in the departments of urology, nephrology and gynaecology. Urethral and cervical smears were examined. In comparison with the culture method for C. trachomatis on McCoy cells the Chlamydiazyme test had a 91.6% agreement of the positive and negative results. The disagreeing results, that is only Chlamydiazyme test positive or only culture positive, accounted respectively for 2.1% and 6.2% of the results. The sensitivity of the Chlamydiazyme test was 74.6% and its specificity was 97.2%.

In the group of 150 men with urological diseases simultaneous examinations of urethra swabs and sperm specimens were done. By culture method on McCoy cells Chlamydia trachomatis was found more frequently in semen (46.7%) than in urethra (35.3%); in 103 patients with urethritis the results were 43.6% and 33.0% respectively. Consistently positive results were obtained in 33 (26.0%) and consistently negative ones in 66 (44.05) of all examined men. In 31 (20.7%) patients, 22 with urethritis including Chlamydia trachomatis was cultured from semen alone and in 14 (9.3%) from urethra alone. The above findings suggest that human semen constitutes a valuable diagnostic material in cases suspected of infection due to Chlamydia trachomatis.