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Chlamydia pneumoniae community-acquired pneumonia: A review of 62 hospitalized adult patients

Ambulant erworbene Pneumonien durchChlamydia pneumoniae: Übersicht über 62 stationär behandelte erwachsene Patienten

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Summary

In a prospective study,Chlamydia pneumoniae was identified as the etiological agent in 62 (17.9%) of 346 adult patients hospitalized over the course of one year for community-acquired pneumonia at the Soroka Medical Center in Beer-Sheva, Israel. The diagnosis ofC. pneumoniae infection was based on serological testing of antibodies by the MIF technique. In 43 of these patients (69.4%), at least one other etiological agent, in addition toC. pneumoniae for community-acquired pneumonia was identified.Streptococcus pneumoniae was identified in 34 patients withC. pneumoniae (54.8%), as an additional causative factor in infection. Community-acquired pneumonia patients withC. pneumoniae were significantly older than non-C. pneumoniae patients (p=0.03), had a higher APACHE II score on admission (p<0.05), a higher rate of positive blood cultures (p=0.02), and longer periods of hospitalization (p=0.022). Seven patients with pureC. pneumoniae infection recovered, despite treatment which is not considered to be specific forC. pneumoniae. It was concluded thatC. pneumoniae is a common etiological agent for community-acquired pneumonia in our region, particularly in the elderly, and is characterized by a high rate of concomitant infections with other pulmonary pathogens. No specific clinical or radiological pattern was discerned that could distinguish betweenC. pneumoniae community-acquired pneumonia and non-C. pneumoniae community-acquired pneumonia.

Zusammenfassung

Unter 346 im Rahmen einer prospektiven Studie erfaßten Patienten mit ambulant erworbener Pneumonie fanden sich 62 Fälle (17,9%), bei denenChlamydia pneumoniae als der verantwortliche Erreger identifiziert wurde. Die Studie lief über einen Zeitraum von einem Jahr am Soroka Medical Center in Beer-Sheva, Israel. Die Diagnose basierte auf dem serologischen Nachweis von anti-C. pneumoniae Antikörpern mit der MIF-Technik. Bei 43 dieser Patienten fand sich mindestens noch ein zusätzlicher Erreger (69,4%). Bei 34 Patienten wurdeStreptococcus pneumoniae isoliert (54,8%). Patienten mit einerC. pneumoniae-Infektion waren signifikant älter als Patienten, bei denenC. pneumoniae nicht der Erreger war (p=0,03), diese Patienten hatten außerdem bei Einweisung einen höheren APACHE Score (p<0,05), häufiger positive Blutkulturen (p=0,02) und mußten länger stationär behandelt werden (p=0,022). Obwohl keine erregerspezifische Behandlung vorgenommen worden war, erholten sich 7 Patienten, die an einerC. pneumoniae Pneumonie erkrankt waren. Wir schließen aus den Daten, daßC. pneumoniae in unserer Region ein häufiger Pneumonieerreger ist, der vorwiegend ältere Personen befällt. Typischerweise besteht eine hohe Rate an Begleitinfektionen mit anderen Pneumonieerregern. Wir fanden kein spezifisches radiologisches Muster oder klinische Konstellationen, die eine Unterscheidung zwischenC. pneumoniae-Pneumonie und Pneumonien anderer Ätiologie ermöglichen würden.

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References

  1. Jalonen, E., Taira, S., Paton, J. C., Kerttula, Y., Suomalainen, P., Leinonen, M. Pneumolysin produced inBacillus subtilis as antigen for measurement of pneumococcal antibodies by enzyme immunoassay. Serodiag. Immunother. Inf. Dis. 4 (1990) 451–458.

    Google Scholar 

  2. Jalonen, E., Paton, J. C., Koskela, M., Kerttula, Y., Leinonen, M. Measurement of antibody responses to pneumolysin — a promising method for the presumptive aetiological diagnosis of pneumococcal pneumonia. J. Infect. 19 (1989) 127–134.

    Google Scholar 

  3. Leinonen, M., Syrjala, H., Jalonen, E., Kujala, P., Herva, E. Demonstration of pneumolysin antibodies in dissociated immune complexes — a new method for etiological diagnosis of pneumococcal pneumonia. Serodiag. Immunother. Inf. Dis. 4 (1990) 459–468.

    Google Scholar 

  4. Holloway, Y., Snijder, J. A., Boersma, W. G. Demonstration of circulating pneumococcal immunoglobulin G immune complexes in patients with community-acquired pneumonia by means of an enzymelinked immunosorbent assay. J. Clin. Microbiol. 31 (1993) 3247–3254.

    Google Scholar 

  5. Burman, L. A., Leinonen, M., Trollfors, B. Use of serological methods to diagnose pneumonia caused by noncapsulatedHaemophilus influenzae andMoraxella catarrhalis. J. Infect. Dis. 170 (1994) 220–222.

    Google Scholar 

  6. Leinonen, M., Luotonen, J., Herva, E., Valkonen, K., Mäkelä, P. H. Preliminary serologic evidence for a pathogenic role ofBranhamella catarrhalis. J. Infect. Dis. 144 (1981) 570–574.

    Google Scholar 

  7. Claesson, B., Leinonen, M. Moraxella (Branhamella) catarrhalis — an uncommon cause of community-acquired pneumonia in Swedish children. Scand. J. Infect. Dis. 26 (1994) 399–402.

    Google Scholar 

  8. Echevarria, J. M., Leon, P., Balfagon, P., Lopez, J. A., Fernandez, M. V. Diagnosis ofMycoplasma pneumoniae infection by microparticle agglutination and antibody-capture enzyme-immunoassay. Eur. J. Clin. Microbiol. Infect. Dis. 9 (1990) 217–220.

    Google Scholar 

  9. Grayston, J. T. Chlamydia pneumoniae, strain TWAR pneumonia. Ann. Rev. Med. 43 (1992) 317–323.

    Google Scholar 

  10. Fang, G., Fine, M., Orloff, J., Arisumi, D., Yu, V. L., Kappor, W., Grayston, T., Wang, S. P., Kohler, R., Muder, R. R., Yee, Y. C., Rihs, J. D., Vickers, R. M. New and emerging etiologies for community-acquired pneumonia with implications for therapy. Medicine 69 (1990) 307–316.

    Google Scholar 

  11. Marrie, T. J., Grayston, T., Wang, S., Kuo, C. Pneumonia associated with the TWAR strain ofChlamydia. Ann. Intern. Med. 106 (1987) 507–511.

    Google Scholar 

  12. Blasi, F., Consenti, R., Legnani, D., Denti, F., Allegra, L. Incidence of community-acquired pneumonia caused byChlamydia pneumoniae in Italian patients. Eur. J. Clin. Microbiol. Infect. Dis. 12 (1993) 696–699.

    Google Scholar 

  13. Jantos, C., Artelt, P., Schiefer, H. G. Acute lower respiratory tract infection associated withChlamydia pneumoniae in Germany. Eur. J. Clin. Microbiol. Infect. Dis. 12 (1993) 33–35.

    Google Scholar 

  14. Almirall, J., Morato, I., Riera, F., Verdaguer, A., Priv, R., Coll, P., Vidal, J., Murgui, L., Valls, F., Catalan, F., Balanzo, X. Incidence of community-acquired pneumonia andChlamydia pneumoniae infection: a prospective multicenter study. Eur. Respir. J. 6 (1993) 14–18.

    Google Scholar 

  15. Kragsbjerg, P., Persson, K., Holmberg, H. Regional differences ofChlamydia pneumoniae as causative agent of pneumonia in Sweden. Scand. J. Infect. Dis. 24 (1992) 113–114.

    Google Scholar 

  16. Sundelof, B., Gnarpe, J., Gnarpe, H., Orillner, L., Darovgar, S. Chlamydia pneumoniae in Swedish patients. Scand. J. Infect. Dis. 25 (1993) 429–433.

    Google Scholar 

  17. Saikku, P. The epidemiology and significance ofChlamydia pneumoniae. J. Infect. 25, Suppl. 1 (1992) 27–34.

    Google Scholar 

  18. Grayston, J. T. Chlamydia pneumoniae, strain TWAR. Chlamydial Infections, Proceedings of the Seventh International Symposium on Human Chlamydial Infections. Cambridge University Press, Cambridge 1990, pp. 389–401.

    Google Scholar 

  19. Torres, A., El-Ebiary, M. Relevance ofChlamydia pneumoniae in community-acquired respiratory infections. Eur. Respir. J. 6 (1993) 7–8.

    Google Scholar 

  20. Shemer-Avni, Y., Lieberman, D. Chlamydia pneumoniae induced ciliostasis in ciliated bronchial epithelial cells. J. Infect. Dis. 171 (1995) 1274–1278.

    Google Scholar 

  21. Grayston, J. T. Infections caused byChlamydia pneumoniae strain TWAR. Clin. Infect. Dis. 15 (1992) 757–763.

    Google Scholar 

  22. Marrie, T. J., Durant, H., Yates, L. Community-acquired pneumonia requiring hospitalization: 5-year prospective study. Rev. Infect. Dis. 11 (1989) 586–599.

    Google Scholar 

  23. McConnell, C. T., Plouffe, J. F., File, T. M., Mueller, C. F., Wong, K., Skelton, S. K., Marston, B. J., Breiman, R. F. CBPIS Study Group. Radiologic appearance ofChlamydia pneumoniae (TWAR strain) respiratory infections. Radiology 192 (1994) 819–824.

    Google Scholar 

  24. Kuo, C. C., Grayston, J. T. In vitro drug susceptibility ofChlamydia sp. strain TWAR. Antimicrob. Agents Chemother. 32 (1988) 257–258.

    Google Scholar 

  25. Thom, D. H., Grayston, J. T. Infections withChlamydia pneumoniae strain TWAR. Clin. Chest Med. 12 (1991) 245–256.

    Google Scholar 

  26. Lipsky, B. A., Tack, K. J., Kuo, C. C., Wang, S., Grayston, J. T. Ofloxacin treatment ofChlamydia pneumoniae (strain TWAR) lower respiratory tract infections. Am. J. Med. 89 (1990) 722–724.

    Google Scholar 

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Authors and Affiliations

  1. Div. of Internal Medicine, Soroka Medical Center of Kupat Holim, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101, Beer-Sheva, Israel

    D. Lieberman M. D., A. Porath M. D., F. Schlaeffer M. D. & Devora Lieberman M. D.

  2. Dept. of Microbiology, Assaf Harofe Medical Center, Zerifin

    Miriam Ben-Yaakov Ph. D., Zilia Lazarovich M. Sc. & Ida Boldur Ph. D.

  3. Savyon Diagnostics Laboratories, Ashdod, Israel

    Ora Horovitz Ph. D.

  4. National Public Health Institute, Oulu

    Maija Leinonen Ph. D.

  5. Dept. of Medical Microbiology, University of Oulu, Oulu, Finland

    P. Saikku Ph. D.

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  1. D. Lieberman M. D.
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  2. A. Porath M. D.
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  3. F. Schlaeffer M. D.
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  4. Devora Lieberman M. D.
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  5. Miriam Ben-Yaakov Ph. D.
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  6. Zilia Lazarovich M. Sc.
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  7. Ida Boldur Ph. D.
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  8. Ora Horovitz Ph. D.
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  9. Maija Leinonen Ph. D.
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  10. P. Saikku Ph. D.
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Lieberman, D., Porath, A., Schlaeffer, F. et al. Chlamydia pneumoniae community-acquired pneumonia: A review of 62 hospitalized adult patients. Infection 24, 109–114 (1996). https://doi.org/10.1007/BF01713313

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  • DOI: https://doi.org/10.1007/BF01713313

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