Incidence of community-acquired pneumonia caused byChlamydia pneumoniae in Italian patients

Blasi, Francesco; Cosentini, Roberto; Legnani, D.; Denti, F.; Allegra, L.

doi:10.1007/bf02009382

Cited by 43 publications

(23 citation statements)

References 15 publications

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“…C. pneumoniae was identified in 18.5% of the patients with community-acquired pneumonia, 9% of the asthmatic patients and 5% of the patients with acute exacerbations of COPD. These results are similar to those found in previous studies [5,11,13,[22][23][24][25][26]. However, poor correlation was found between PCR-EIA and rELISA serology.…”

Section: Discussionsupporting

confidence: 92%

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Petitjean

Vincent

Fretigny

et al. 1998

Journal of Medical Microbiology

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Chlamydia pneumoniae is a common respiratory tract pathogen. Serological methods currently used for the diagnosis of C. pneumoniae infection lack specificity, give ambiguous results from a single serum sample and often provide only a retrospective diagnosis. A prospective study was undertaken to assess whether PCR could be a useful addition to the serological techniques routinely practised for diagnosis. This study investigated 68 adult patients with a diagnosis of acute respiratory infection. Acute and convalescent serological determination of antibodies to C. pneumoniae were performed by means of an rELISA test and a micro-immunofluorescence (MIF) test. Nasopharyngeal aspirates or bronchoalveolar lavage specimens and bronchial aspirates obtained from the 68 patients were evaluated by PCR-enzyme immunoassay (PCR-EIA) for the presence of C. pneumoniae and by immunofluorescence assay and cell culture for virus identification. Mycoplasma pneumoniae serology was also performed. Eight patients (11.8%) were positive by either rELISA or PCR-EIA, or both, with an infection rate of 5 (18.5%) of 27 in patients with community-acquired pneumonia, 2 (9%) of 22 in asthmatic patients and 1 (5%) of 19 in patients with an exacerbation of chronic obstructive pulmonary disease. Serological evidence of acute infection was found in four of these patients with the rELISA test and in three others with the MIF test. PCR-EIA detected C. pneumoniae DNA in four specimens, but there were concordant results with both rELISA and PCR-EIA in only one patient. A positive PCR-EIA was also obtained in a patient who did not show an antibody response in acute serum. The discrepancy between serological and PCR-EIA results reflects the difficulties in routine laboratory diagnosis of C. pneumoniae infection and the necessity for further studies with optimised techniques.

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Section: Discussionsupporting

confidence: 92%

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Petitjean

Vincent

Fretigny

et al. 1998

Journal of Medical Microbiology

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“…pneumoniae is a worldwide respiratory pathogen involved in about 13% of community-acquired pneumonias and 5% of acute exacerbations of chronic bronchitis in our area [10,13]. Our preliminary data represent the first evidence of association between C. pneumoniae infection and asthma attacks in our country.…”

Section: Discussionmentioning

confidence: 63%

Acute exacerbations of asthma in adults: role of Chlamydia pneumoniae infection

Allegra¹,

Blasi²,

Centanni³

et al. 1994

Eur Respir J

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115

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A Ac cu ut te e e ex xa ac ce er rb ba at ti io on ns s o of f a as st th hm ma a i in n a ad du ul lt ts s: : r ro ol le e o of f C Ch hl la am my yd di ia a P Pn ne eu um mo on ni ia ae e i in nf fe ec ct ti io on n L. Allegra*, F. Blasi*, S. Centanni*, R. Cosentini**, F. Denti*, R. Raccanelli*, P. Tarsia*, V. Valenti* Seventy four adult out-patients with a diagnosis of acute exacerbation of asthma were studied. Acute and convalescent (≥3 weeks) serological determination of antibodies to cytomegalovirus, respiratory syncytial virus, adenovirus, influenza A and B, parainfluenza 1 and 3, Mycoplasma pneumoniae and Legionella pneumophila were performed by means of immunofluorescence tests. C. pneumoniae specific antibodies were detected by two microimmunofluorescence tests using a specific antigen (TW-183) and a kit with three chlamydial antigens. Pharyngeal swab specimens were also obtained for C. pneumoniae identification. Samples for bacterial culture were obtained in patients with productive cough (15 out of 74 patients).Fifteen patients (20%) presented seroconversion to at least one of the studied pathogens. Seven were found to be infected by virus, six by C. pneumoniae alone, and one by M. pneumoniae. One more patient showed seroconversion to C. pneumoniae and cytomegalovirus. In one out of 15 patients with productive cough, sputum culture yielded H. influenzae 10 5 colony forming units (cfu)·ml -1 .In conclusion, viruses were involved in about 9% of asthma attacks, while acute infection with intracellular bacteria was detected in 11% of cases. Notably, most of the latter (7 out of 8 cases) were due to C. pneumoniae infection. Further studies are needed in order to elucidate whether C. pneumoniae plays a role only as precipitant of asthma symptoms or is actually one of the causes of asthma.

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“…The diagnostic criteria for pneumonia caused by C. pneumoniae are a four-fold or greater increase in the titer for any Ig class of antibodies to C. pneumoniae between paired serum samples or an IgG titer of^1:512, orthe presence ofIgM (^1:16) antibodies for any serum sample examined by the MIF test (1,2). The diagnosis of C. pneumoniae pneumonia in previous reports (22)(23)(24)(25)(26)(27)(28)(29) was also based on these criteria. In addition, Kauppinen et al (26), Lieberman et al (27) and Suttithawil et al (29) included a high IgA titer as one of the diagnostic criterion of acute C. pneumoniaepneumonia.…”

Section: Discussionmentioning

confidence: 99%

Community-acquired Chlamydia pneumoniae Pneumonia in Japan: A Prospective Multicenter Community-acquired Pneumonia Study.

et al. 2002

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Objective To investigate the clinical features of Chlamydia pneumoniaepneumoniain Japan and to evaluate the newly created Japanese community-acquired pneumonia (CAP) guidelines. Patients and Methods A multicenter CAPsurveillance study was carried out in 20 hospitals between December 1999 and March 2000. The diagnosis of C. pneumoniae infection was based on isolation in cell culture, the polymerase chain reaction and serologic testing of antibodies by the microimmunofluorescence test. Results Among232 CAPcases, C. pneumoniae was identified as the etiologic agent in 15 cases (6.5 % ). C. pneumoniae was the only pathogen identified in nine of these cases, while one or moreadditional etiological agents were found in the other six cases. Of the present and previously reported single agent C. pneumoniae pneumonia cases, about 50%were more than 60 years old and had underlying diseases. A relatively slow pulse rate in relation to fever was not seen in these patients. The mean WBCcount of all patients was normal. No patient required respiratory support or admission to an intensive care unit and no deaths occurred among these patients. Conclusion The clinical pictures of C. pneumoniae pneumonia as a single agent were mild to moderate and were remarkably different from those of cases of C. pneumoniae pneumonia concomitant with other bacteria. If the patient is less than 60 years old and some guideline headings are excluded, we think it would be possible to distinguish between C. pneumoniae and bacterial pneumonia. (Internal Medicine 41: 943-949, 2002)

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Incidence of community-acquired pneumonia caused byChlamydia pneumoniae in Italian patients

Cited by 43 publications

References 15 publications

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Acute exacerbations of asthma in adults: role of Chlamydia pneumoniae infection

Community-acquired Chlamydia pneumoniae Pneumonia in Japan: A Prospective Multicenter Community-acquired Pneumonia Study.

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