Pneumonia due to Chlamydia pneumoniae in children: Epidemiology, diagnosis, and treatment

Abstract

The term "atypical" pneumonia has been used to differentiate infections caused by Chlamydia pneumoniae, Mycoplasma pneumoniae, Legionella, and other related organisms from pneumonia caused by classic bacteria, the prototype being Streptococcus pneumoniae. However, recent studies demonstrated that the clinical presentation of pneumonia due to atypical pathogens cannot readily be differentiated from those caused by "typical" bacteria. This is further complicated by the observation that coinfections with atypical pathogens and other bacteria are frequent. Nonetheless, the term "atypical" can be useful, as these organisms share a number of characteristics that separate them from "typical" bacteria. They are either obligate or facultative intracellular parasites that cannot be isolated using routine microbiologic methods. The most commonly used method of diagnosis of these infections is serology, which has significant limitations. Although C. pneumoniae is now recognized worldwide as a common cause of respiratory infections in adults and children, major gaps remain in our knowledge of the biology of this organism and how it causes disease, in major part due to the lack of readily available, standardized diagnostic methods.

Comparison of NxTAG Respiratory Pathogen Panel and Anyplex II RV16 Tests for Multiplex Detection of Respiratory Pathogens in Hospitalized Children

“…In addition to the targets common to the two panels, the new technique was able to yield positive results for Mycoplasma pneumoniae and Chlamydophila pneumoniae, which are bacterial agents frequently associated with pediatric respiratory infections (22,23). Conversely, the fact that we did not detect any Legionella pneumophila infection in our study could be explained by the unusual incidence of this bacterium in children.…”

“…In this regard, there were minor differences in the number of positive results by NxTAG RPP RUO (n ϭ 204) and Anyplex II RV16 (n ϭ 194) compared to the number of positives confirmed after discrepancy analysis (n ϭ 198). Of note, the important proportion of coinfected specimens that we detected (14.2%) could otherwise have been missed by traditional methods.In addition to the targets common to the two panels, the new technique was able to yield positive results for Mycoplasma pneumoniae and Chlamydophila pneumoniae, which are bacterial agents frequently associated with pediatric respiratory infections (22,23). Conversely, the fact that we did not detect any Legionella pneumophila infection in our study could be explained by the unusual incidence of this bacterium in children.…”

Atypical bacterial pathogen infection in children with acute bronchiolitis in northeast Thailand

“…8 Chlamydia and mycoplasma are fastidious and difficult to grow in culture, so they require either specialized cell culture techniques or a long period of incubation before their presence can be confirmed or excluded. The interpretation of serological tests used for C pneumoniae, C trachomatis, and M pneumoniae diagnoses is also problematic because a large proportion of the population has preexisting IgG antibodies from prior exposure(s) 9 ; therefore, diagnosis of infections caused by these organisms is usually confirmed with the polymerase chain reaction (PCR) technique.…”

The validity of the criteria for primary infection of Chlamydophila pneumoniae in children by measuring ELISA IgM antibodies

“…Chlamydophila pneumoniae (C. pn) is an important causative pathogen of airway infection [1] that has been suggested to be associated with asthma and arteriosclerosis. Diagnostic methods include detection of the pathogen, i.e., isolation culture and polymerase chain reaction (PCR) test, and measurement of the serum specific antibody titer [2].…”