ARTICLESARS-CoV-2 and Chlamydia pneumoniae co-infection:A review of the literature / Coinfección por Chlamydia pneumoniae y SARS-CoV-2: Una revisión de la literatura

Abstract Bacterial co-pathogens are commonly identified in viral respiratory infections and are important causes of morbid-mortality. The prevalence of Chlamydia (C.) pneumoniae infection in patients infected with SARS-CoV-2 has not been sufficiently studied. The objective of the present review was to describe the prevalence of C. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A search in MEDLINE and Google Scholar databases for English language literature published between January 2020 and August 2021 was performed. Studies evaluating patients with confirmed COVID-19 and reporting the simultaneous detection of C. pneumoniae were included. Eleven articles were included in the systematic review (5 case cross-sectional studies and 6 retrospective studies). A total of 18450 patients were included in the eleven studies. The detection of laboratory-confirmed C. pneumoniae infection varied between 1.78 and 71.4% of the total number of co-infections. The median age of patients ranged from 35 to 71 years old and 65% were male. Most of the studies reported one or more pre-existing comorbidities and the majority of the patients presented with fever, cough and dyspnea. Lymphopenia and eosinopenia were described in COVID-19 co-infected patients. The main chest CT scan showed a ground glass density shadow, consolidation and bilateral pneumonia. Most patients received empirical antibiotics. Bacterial co-infection was not associated with increased ICU admission and mortality. Despite frequent prescription of broad-spectrum empirical antimicrobials in patients with coronavirus 2-associated respiratory infections, there is a paucity of data to support the association with respiratory bacterial co-infection. Prospective evidence generation to support the development of an antimicrobial policy and appropriate stewardship interventions specific for the COVID-19 pandemic are urgently required.

Resumen Los patógenos bacterianos pueden detectarse en las infecciones respiratorias virales y son una causa importante de morbimortalidad. La prevalencia de Chlamydia pneumoniae en pacientes infectados con SARS-CoV-2 ha sido poco estudiada. El objetivo de la presente revisión fue describir la prevalencia de C. pneumoniae en pacientes con enfermedad por coronavirus 2019 (COVID-19). Para ello se realizó una búsqueda bibliográfica en Medline y Google Académico, entre enero de 2020 y agosto de 2021. De la revisión surgieron 11 artículos (cinco estudios de casos transversales y seis estudios retrospectivos), que incluyeron un total de 18.450 pacientes. La detección de C. pneumoniae varió entre el 1,78 y 71,4% del total de las coinfecciones. La media de edad de los pacientes osciló entre los 35 y 71 años y el 65% fueron hombres. En la mayoría de los estudios se informaron comorbilidades preexistentes y la mayor parte de los pacientes presentó fiebre, tos y disnea. Además, se describió linfopenia y eosinofilopenia en pacientes con COVID-19 coinfectados. La principal manifestación en la tomografía computarizada fue densidad de vidrio esmerilado, consolidación y neumonía bilateral. La mayoría de los pacientes recibió antibióticos de manera empírica. La coinfección bacteriana no se asoció con un aumento de ingresos en cuidados intensivos ni mortalidad. A pesar de la prescripción de antimicrobianos empíricos en pacientes con infecciones respiratorias asociadas a coronavirus existen pocos reportes de detección de coinfección bacteriana. Es necesario generar evidencia para el desarrollo de políticas antimicrobianas e intervenciones de administración apropiadas y específicas en la pandemia de COVID-19.

Detección atípica de Chlamydia pneumoniae no humana en una muestra endocervical. Reporte de caso / Atypical detection of non-human Chlamydia pneumoniae in an endocervical sample. Case Report

Resumen ANTECEDENTES: Chlamydia trachomatis es uno de los principales microorganismos de trasmisión sexual asociado de manera importante con infertilidad femenina. La detección de genotipos y nuevas variantes de Chlamydia trachomatis permite conocer su prevalencia, distribución geográfica, identificar la aparición de resistencia antimicrobiana y las asociaciones clínicas o comportamientos sexuales y desarrollar vacunas. Este caso clínico es el primer informe de infección endocervical por una cepa diferente a C trachomatis. CASO CLÍNICO: Paciente de 25 años, con diagnóstico de infertilidad primaria de 2 años de evolución por factor endocrino-ovárico (sobrepeso e hipotiroidismo subclínico) y por factor masculino de hipospermia y teratozoospermia. El cultivo microbiológico endocervical detectó la infección por Ureaplasma spp y Chlamydia spp. La identificación de la cepa de Chlamydia mediante secuenciación del gen 16S del ARNr informó que era Chlamydia pneumoniae. La existencia de un plásmido en esta cepa de C pneumoniae confirmó que la infección endocervical fue por una cepa de Chlamydia pneumoniae no humana. CONCLUSIÓN: Este caso clínico sugiere la posibilidad de que una cepa de C pneumoniae no humana sea capaz de trasmitirse sexualmente a los humanos, estar circulando en la población mexicana y causar infertilidad, aunque aún se desconocen el origen y la dirección de la trasmisión.

Abstract BACKGROUND: Chlamydia trachomatis is one of the leading sexually transmitted microorganisms that is significantly associated with the development of female infertility. The detection of genotypes and new variants ofChlamydia trachomatisallows us to know their prevalence and geographic distribution, identify the appearance of antimicrobial resistance, clinical associations, or sexual behaviors, and develop vaccines. This clinical case reports for the first time endocervical infection by a strain other thanC. trachomatis. CLINICAL CASE: A 25-year-old woman with primary infertility of 2 years of evolution due to endocrine-ovarian factor (overweight and subclinical hypothyroidism) and male factor characterized by hypospermia and teratozoospermia. Endocervical microbiological culture detected infection byUreaplasma urealyticumandChlamydiaspp. Identification of theChlamydiastrain by sequencing the 16S rRNA gene reported that it wasChlamydia pneumoniae. The presence of plasmid in this strain ofC. pneumoniaeconfirmed that the endocervical infection was by a non-humanChlamydia pneumoniaestrain. CONCLUSION: This clinical case suggests that a non-human strain ofC. pneumoniaecan be sexually transmitted to humans, circulating in the Mexican population, and causing infertility, although the origin and direction of transmission are still unknown.

Evaluación de la prevalencia de infección por gérmenes atípicos en pacientes con neumonía adquirida en la comunidad en un hospital de referencia peruano / Evaluation of the prevalence of infection by atypical germs in patients with community acquired pneumonia in a peruvian reference hospital

Objetivo: Determinar la prevalencia de infección por gérmenes atípicos evaluada mediante la determinación de anticuerpos IgM en casos de neumonía adquirida en la comunidad en pacientes adultos inmunocompetentes atendidos en el Hospital Nacional Hipólito Unanue. Métodos: Se evaluaron a aquellos pacientes adultos inmunocompetentes que acudieron a la emergencia del Hospital Hipólito Unanue con neumonía adquirida en la comunidad entre setiembre del 2008 y enero del 2009. Se tomaron muestras de sangre para realizar serología para Mycoplasma pneumoniae y Chlamydia pneumoniae mediante la detección de niveles de inmunoglobulina M determinados por prueba de ELISA. Resultados:Se reclutaron 85 pacientes. La edad promedio fue de 65,33 ± 21,43 años. Se encontraron 3 casos de pacientes con serología positiva a IgM frente a M. pneumoniae y 1 caso positivo a C. pneumoniae. Los títulos de anticuerpos contra M. pneumoniae tuvieron una correlación altamente significativa con la edad (r=-0,28; p<0,01). se encontró una correlación estadísticamente significativa entre los índices de anticuerpos IgM frente a M. pneumoniae y C. pneumoniae (r=0,29; p<0,01). Conclusión: La infección por gérmenes atípicos no parece ser una condición frecuente en pacientes hospitalizados con diagnóstico de neumonía adquirida en la comunidad. Se deben realizar estudios en poblaciones mayores utilizando serología pareada o estudios moleculares, incluyendo pacientes ambulatorios a fin de definir el rol de patógenos atípicos en casos de neumonía a nivel nacional.

Objective: To determine the prevalence of infection due to atypical microorganisms in cases of community-acquired pneumonia in adult inmunocompetent patients seeking attention in the Hospital Nacional Hipolito Unanue. Methods: Adult inmunocompetent patients seeking medical attention in the emergency ward of Hospital Hipolito Unanue with diagnosis of community-acquired pneumonia were evaluated between september 2008 and january 2009. Blood samples were drawn for Mycoplasma pneumoniae and Chlamydia pneumoniae serology, by the detection of M Inmunoglobulin by ELISA technique. Results: We recruited 85 patients. The average age was 65.33 ± 21.43 years. We found 3 cases with positive IgM serology against M. pneumoniae and 1 case positive against C. pneumoniae. The antibody titers against M. pneumoniae had a highly significant correlation with the age (r=-0.28; p<0.01). We also found a statistically significant difference between the titers of antibodies against M. pneumoniae and those correspondent to C. pneumoniae (r=0.29; p<0.01). Conclusion: Infection due to atypical microorganisms doesn't seem to be a frequent condition in inpatients with diagnosis of community-acquired pneumonia. Research in larger populations, including outpatients should be done, in order to define the role of atypical pathogens in cases of pneumonia at a national level.

Study on correlation between serum vitamin E level and community acquired pneumonia / 国际检验医学杂志

Objective To investigate the correlation between vitamin E and community acquired pneumonia (CAP) .Methods A total of 128 cases of CAP(CAP group) and 135 people undergoing the healthy physical examination (excluding CAP ,control group) in our hospital from Jan .2016 to Dec .2016 were chosen .Each group was divided into the age subgroups of 0-17 years old ,18-40 years old and 41-65 years old .Vitamin E ,Chlamydia pneumoniae(CPn) and mycoplasma pneumoniae(MP) were detected in all the subjects .Then the obtained data were statistically analyzed .Results The average vitamin E was (15 .43 ± 4 .37)mg/L in the control group and (6 .37 ± 3 .24)mg/L in the CAP group ,the difference between the two group was statistically significant(P<0 .05) .In the control group ,there were 7 cases of MP positive and 6 cases of CPn positive .In the CAP group ,there were 32 cases of MP posi‐tive and 25 cases of CPn positive .The differences of MA and CPn positive between the two groups were statistically significant(P<0 .05) .The vitamin E levels in the 0 -17 years old ,18 -40 years old and 41 -65 years old subgroups of the control group were (14 .75 ± 4 .12) ,(16 .42 ± 4 .35) ,(16 .42 ± 4 .35)mg/L respectively ,while which in the various subgroups of the CAP group were (5 .43 ± 3 .18) ,(7 .74 ± 3 .65) ,(7 .74 ± 3 .65)mg/L respectively ,the difference in different age groups between the two groups was statistically significant(P<0 .05) .Conclusion Maintaining a high level of serum vitamin E level could effectively prevent CAP .

120 cases of non gonococcal urethritis mycoplasma and chlamydia infection and drug resistance status / 中国基层医药

Objective To investigate non gonococcal urethritis mycoplasma and chlamydia infection and drug sensitivity status.Methods From June 2014 to December 2014,120 cases of non gonococcal urethritis patients in our hospital were given chlamydia trachomatis,ureaplasma,mycoplasma detection and mycoplasma culture and drug sensitivity test of mycoplasma.Mycoplasma and chlamydia test results were compared between male and female patients.Positive drug sensitivity test results of ureaplasma urealyticum (Uu) and mycoplasma hominis (Mh) were observed.Results Among the 120 patients with positive detection,the proportion of Uu was the highest,up to 41.67％ (50/120);the second was Mh,accounting for 31.67％ (38/120).The detection rate of Uu in women (57.14％)was significantly higher than that in males (28.13％),and the difference was statistically significant (x2 =10.35,P ＜ 0.05).The susceptibility of mycoplasma to pristinamycin susceptible rate highest,Uu and type mycoplasma reached 100.00％;followed by doxycycline,the susceptibility of Uu reached 98.00％ and the susceptibility of Mh to 100.00％;sensitive rates of Uu and Mh to josamycin were 96.00％ and 90.48％.The sensitive rates of Uu and Mh to tetracycline were 92.00％ and 90.48％ respectively.Conclusion The mycoplasma infection was mainly caused by Uu.Clinical treatment of mycoplasma infection can be based on the drug sensitivity test results to reasonably choose antibiotics,and sensitive rates of pristinamycin,doxycycline were higher.

A meta‑analysis of the association between Chlamydia pneumoniae infection and lung cancer risk.

OBJECTIVE: The association between Chlamydia pneumoniae infection and lung cancer risk was not clear with small number of cases in each study. The aim of this meta‑analysis was to evaluate the correlation between pneumonia infection and lung cancer risk by pooling the open published papers. MATERIALS AND METHODS: We searched the electronic databases of Medline, EMBASE, Web of Science, and China National Knowledge Infrastructure databases for publications related to the association between pneumonia infection and lung cancer risk. Odds ratio (OR) and its 95% confidence interval (95% CI) was used to assess the correlation. The data were pooled by Stata11.0 software (Stata Corporation, College Station, TX, USA). RESULTS:Thirteen publications, involving 2549 lung cancer patients and 2764 controls were included in this meta‑analysis. The pooled results indicated that the C. pneumoniae infection significant increased the risk of lung cancer OR = 2.07 (95% CI: 1.43–2.99) by random effect model. And for serum IgG, 12 publications reported the IgG positive rate in lung cancer patients and relative healthy controls. The pooled OR was 2.22 (95% CI: 1.41–3.50) by using the random effects model which indicated that the IgG positive rate was significantly higher in lung cancer patients than that of healthy controls. The sensitivity analysis indicated the pooled OR was not sensitive to a single study. However, Begger’s funnel plot and Egger’s line regression analysis indicated significant publications bias for this meta‑analysis. CONCLUSIONS: According to the present published data, C. pneumoniae infection may increase the risk of lung cancer. However, for its significant publications and heterogeneity among the included studies, the conclusion should be interpreted cautiously.

Eco-epidemiología de las Chlamydia psittaci, Chlamydia pneumoniae y Chlamydia pecorum: impacto en la salud pública / Eco Epidemiology of Chlamydia psittaci, Chlamydia pneumoniae and Chlamydia pecorum: impact on public healthpneumoniae by in vitro neutralization and microimmunofluorescence assays. Zentralbl Bakteriol 1996; 284(1):52-57.20. Phoon MC, Yee GW, Koh WP, Chow VT. Comparative Seroepidemiologic Analysis of Chlamydophila pneumoniae Infection using Microimmunofluorescence, Enzyme Immunoassay and Neutr

ntroducción: Las infecciones zoonóticas son una creciente amenaza para la salud mundial. Varias especies de Chlamydia y sus implicancias son poco conocidas. Objetivo: Profundizar el conocimiento eco-epidemiológico de Chla-mydia en Córdoba.Materiales y métodos: Se implementaron técnicas serológicas y mo-leculares para la detección de Chlamydia en 314 individuos sanos, 44 con nexo epidemiológico asociado a Psitacosis, 505 aves silvestres, 288 aves cautivas, 30 reptiles y 30 equinos. Resultados: En humanos se detectó C. pneumoniae, C. pecorum, C. psittaci, y co-infecciones asociadas a mayor cuantificación bac-teriana. La prevalencia de anticuerpos en indivi-duos sanos fue de 14,3 % y en pacientes 68,2 %. Se evidenció una respuesta inmune exacerbada en trabajadores en contacto con reptiles infectados con C. pneumoniae. En aves cautivas se identificó C. pneumoniae, C. psittaci, C. pecorum, C. galliná-cea y co-infecciones con mayor concentración de ADN. Las aves silvestres no excretaban Chlamydia. En equinos se halló C. pneumoniae, también en Su-ricata suricatta y Atelerix albiventris. El genotipo A se halló en humanos, reptiles, aves, mamíferos no humanos y B en equinos. Conclusiones: C. psittaci genotipo WC se detectó en aves y humanos; en menor frecuencia los genotipos E/B y A. Este hallazgo sugiere que los animales pueden representar una fuente subestimada de C. psittaci. El hallazgo de C. pneumoniae y C. pecorum en pacientes y en animales, plantea posibles ciclos zoonóticos y la necesidad de diagnóstico diferencial. Estos resultados avalaron el decreto de ley provincial de tenencia y comercialización de animales, promovido por la Secretaría de Am-biente de Córdoba

Introduction: Zoonotic infections are a growing threat to global health. Chlamydia and its implications are not well known.The aim of this study was to further the eco-epidemiological knowledge of Chlamydia in Cordoba.Materials and methods: Serological and molecular techniques was implemented for detection of Chlamydia in 314 healthy individuals, 44 individuals associated with Psittacosis, 505 wild birds, 288 captive birds, 30 reptiles and 30 equine.Results: In humans were detected C. pneumoniae, C. pecorum, C. psittaci and co-infections associated with increased bacterial quantification.The prevalence of antibodies in healthy individuals was 14.3% and 68.2% patients. Exacerbated immune response was detected in workers with contact infected with C. pneumoniae evidenced reptiles.In captive birds we detected C. pneumoniae, C. psittaci, C. pecorum, C. gallinácea and co-infections with the highest concentration of DNA. Wild birds did not excrete Chlamydia.In horses we found C. pneumoniae, also in Suricata suricatta and Atelerix albiventris. The genotype was found in humans, reptiles, birds, mammals and non-human equine B.Conclusions: C. psittaci WC genotype was detected in birds and humans; less frequently genotypes E/B and A. This finding suggests that animals can be a source of C. psittaci underestimated.The discovery of C. pneumoniae and C. pecorum in patients and animals raises potential zoonotic cycles and the need for differential diagnosis.These results endorsed the decree of provincial law to possess and marketing of animals, promoted by Secretaría de Ambiente de Córdoba

Chlamydia pneumoniae-related hemophagocytic lymphohistiocytosis in an adult patient with clonal karyotype abnormality.

Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease characterized by a severe hyperinflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages. Herein, we report a 58-year-old male who had Chlamydia pneumoniae-related pneumonia, followed by aggressive HLH. An abnormal cytogenetic profi le was also detected. To our knowledge, this is the fi rst report of an adult patient with C. pneumoniaassociated HLH.

Neumonía por bacterias atípicas: mycoplasma y Chlamydia pneumoniae ¿qué elementos tenemos para hacer un diagnóstico adecuado y decidir cuándo tratar? / Atypical pneumonia: mycoplasma and chlamydia pneumoniae: making an accurate diagnosis and deciding when to treat

Atypical Pneumonia has been studied for many years. Most clinically relevant atypical organisms involved in pneumonia in children are Mycoplasma pneumoniae and Chlamydia pneumoniae. Although great progress has been reached in new techniques, still there is no good tool, neither standardized nor accurate for a definitive diagnosis. In other hand, antibiotic therapy is under review due to contradictory evidence to support their use. We present a critical view of actual knowledge and propose an algorithm to proceed in clinical ground.

La neumonía por bacterias atípicas es sujeto de estudio desde hace años. Dentro de las bacterias atípicas más frecuentes y clínicamente relevantes en niños se reconocen Mycoplasma pneumoniae y Chlamydia pneumoniae. A pesar del aumento en el conocimiento de estas infecciones y avance en las técnicas diagnósticas, aun no contamos con una herramienta estandarizada y confiable que permita realizar un adecuado diagnóstico. Por otra parte, la necesidad real de efectuar un tratamiento antibiótico sigue siendo tema de discusión. Se presenta a continuación una revisión crítica del conocimiento actual y una propuesta de su enfrentamiento clínico.

Association of Chlamydia pneumoniae IgG and IgA antibody in coronary artery disease.

Background: Cardiovascular disease, resulting from atherosclerosis, is a leading cause of global morbidity and mortality. Classical risk factors explain much of the attributable risk for cardiovascular events, but other risk factors for the development and progression of atherosclerosis, which can be identified, may be important therapeutic targets. Infectious agents, such as Chlamydia pneumoniae, have been proposed as contributory factors in the pathogenesis of atherosclerosis. The present study was conducted to determine the seroprevalence of C. pneumoniae antibodies and to study the association of chronic C. pneumoniae infection with Coronary Artery Disease (CAD). Methods: The study group included 90 angiographically proven CAD patients and age and sex matched 90 normal coronaries as control group. With total aseptic precaution 3 ml blood was collected. Enzyme linked immunosorbant assay was performed for all subjects to detect the presence of IgG and IgA antibodies to Chlamydia pneumoniae (Cp). Results: IgG and IgA Cp antibodies were detected in 67.8% and 58.9% CAD patients compared to 45.6% and 11.1% controls. IgG + IgA Cp antibodies were detected in 88.9% CAD patients when compared to 50.0% controls. Seroprevalence of IgG and IgA Cp antibodies were high among CAD patients compared to controls and was found statistically significant. A significant presence of Chlamydia pneumoniae antibodies was detected in smokers, diabetes mellitus, hypertension, and dyslipidemia. Conclusion: In the present study, the seroprevalence of IgG and IgA Cp antibodies was found to be higher in CAD patients compared to controls. The present study supports the association between Chlamydia pneumoniae infection and Coronary artery disease.

Clinical presentations of Chlamydia pneumoniae in children hospitalized for acute respiratory infections: a comparison to Mycoplasma pneumonia

PURPOSE: Chlamydia pneumoniae is a common intracellular bacterial pathogen and plays an important role in acute respiratory infections. The purpose of this study was to investigate clinical presentations of C. pneumoniae in children with acute respiratory infections. METHODS: We examined the medical records of pediatric patients (age<18 years) admitted with acute respiratory infections of C. pneumoniae to Gachon University Gil Medical Center between March 1, 2011 and August 31, 2014. We compared the clinical features of C. pneumoniae infection with that of Mycoplasma pneumoniae infection. RESULTS: We confirmed acute respiratory infections of C. pneumoniae in 110 patients out of 2,156 patients (5.1%) admitted with acute respiratory infections. The mean age was 37.2+/-30.1 months. More than half of them (54.5%) had coinfection. C. pneumoniae infection had mild and subacute courses. The mean duration of symptoms prior to admission was 8.5+/-13.8 days. There were remarkable seasonal variations and prevalence was higher in December and April (P=0.03 and P=0.02, respectively). Although rhinorrhea and pharyngeal injection were more common in C. pneumoniae infection (P<0.05), clinical signs and symptoms were similar between C. pneumoniae and M. pneumoniae. Extrapulmonary manifestations such as skin lesion, Gastrointestinal symptoms, hepatitis, and neurologic symptoms were common (41.0%) in C. pneumoniae infection and, had similar incidence in M. pneumoniae infection. CONCLUSION: C. pneumoniae is an important infectious agent of acute respiratory infections in children. Clinical pictures of C. pneumoniae are similar to M. pneumoniae, even in extrapulmonary manifestations. C. pneumoniae should be taken into consideration in differential diagnosis of acute respiratory infection in children.

Actualización en la fisiopatología de la preeclampsia: update

La preeclampsia constituye una de las complicaciones más frecuentes y a la vez más serias de la gestación y contribuye de manera significativa a la mortalidad materna y perinatal. No obstante los avances en el estudio de la preeclampsia, aún no está del todo esclarecido su mecanismo fisiopatológico. En este capítulo, intentamos revisar nuevas teorías propuestas acerca de su fisiopatología. Los aspectos genéticos y angiogénicos serán revisados en otros capítulos de este simposio.

Preeclampsia is one of the most frequent and serious disorders of pregnancy. It is a significant contributor of maternal and perinatal mortality worldwide. An important amount of research has been devoted in the research of preeclampsia in the recent years; nonetheless, its pathophysiology is yet to be completely understood. In this review, we will discuss new proposed theories on the pathophysiology of preeclampsia. Genetic and angiogenic aspects of preeclampsia will be reviewed elsewhere in this issue.

A Case of Childhood Paroxysmal Cold Hemoglobinuria Related with Suspicious Chlamydia Infection / 임상소아혈액종양

Paroxysmal cold hemoglobinuria (PCH) is a rare diagnosis of acquired hemolytic anemia in children, which is caused by a specific cold antibody named Donath-Landsteiner hemolysin. Although various bacteria or viruses were reported as triggering factor of PCH, childhood PCH related to Chlamydia pneumoniae infection is uncommon. The authors report a case of childhood PCH which is related with suspicious Chlamydia pneumoniae infection, with a review of pertinent literature.

A Case of Childhood Paroxysmal Cold Hemoglobinuria Related with Suspicious Chlamydia Infection / 임상소아혈액종양

Paroxysmal cold hemoglobinuria (PCH) is a rare diagnosis of acquired hemolytic anemia in children, which is caused by a specific cold antibody named Donath-Landsteiner hemolysin. Although various bacteria or viruses were reported as triggering factor of PCH, childhood PCH related to Chlamydia pneumoniae infection is uncommon. The authors report a case of childhood PCH which is related with suspicious Chlamydia pneumoniae infection, with a review of pertinent literature.

Detection of Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila in children with acute respiratory infection / 中华实用儿科临床杂志

Objective To analyze the characteristics of Mycoplasma pneumo-niae (MP),Chlamydia pneumoniae (CP),Legionella pneumophila (LP) in hospitalized children with acute respiratory tract infection.Methods Serum and urine were collected from 5275 children (aged from 3 days to 16 years old) admitted with acute respiratory tract infection from Jan.to Dce.2012.The levels of MP-IgM,CP-IgM in serum,and LP antigen in urine were detected by passive agglutination,enzyme-linked immunosorbent assay,and immunochromatographic assay respectively.The epidemiology of positive cases were analyzed.Results 1.Among 5275 children with acute respiratory tract infection,1537 cases (29.1％) were detected with at least 1 type of the pathogens:MP infection was 20.1％ (1060 cases),CP infection was 8.7％ (45 cases),and LP positive rate was 0.3％ (18 cases),mix infection rate was 2.56％ (135 cases).2.The prevalence of MP,CP and LP infections in the different months and quarters were significantly different(all P ＜0.01).The positive rate of MP was highest in November while it was lowest in May.The positive rate of CP was highest in November while it was lowest in July.The positive rate of LP was highest in December,no infection case was found in February,May and the time during July to November.3.In all,the occurrence of positive results of MP,CP,and LP in children were higher in winter than that in other seasons.The infection of December was more than that in the other month.Meanwhile,infection of MP,CP and LP were mostly occured in children over age of 5.In addition,the positive rates were higher in male than that in female.Furthermore,children with bronchial pneumonia had higher positive rates of infection compared to children with acute respiratory tract infection.Conclusion Pathogen detection is an important basis for the diagnosis of children with the infection of MP,CP,LP.

Efficiency of Chlamydia Pneumoniae Culture in the Upper Airway Epithelial Cell Lines: AMC-HN-4, AMC-HN-7, and AMC-HN-8 / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Chlamydia pneumoniae (C. pneumoniae) is a well-known pathogen of upper and lower respiratory tract infection. For a more efficient and practical cell culture system, we studied the growth of two clinical isolates of C. pneumoniae in selected cell lines derived from the human respiratory tract. MATERIALS AND METHOD: HeLa 229, HEp-2, which are well-known cell lines for the culture of C. pneumoniae, and AMC-HN-4, AMC-HN-7, AMC-HN-8, which are the newly developed cell lines in Korea were examined. Strains of C. pneumoniae used in this study were TW-183 and LKK-1 (the first Korean strain). Chlamydia was inoculated on each confluent cell line and incubated for 48 hrs. After staining with anti-Chlamydial lipopolysaccharide monoclonal antibody, we compared the efficiency of the C. pneumoniae infection on each cell line by counting the inclusion bodies. RESULTS: In culturing C. pneumoniae LKK-1, AMC-HN-4 cells consistently yielded higher inclusion body counts than HeLa 229 cells did, whereas inclusion body counts by AMC-HN-7 cells was low. AMC-HN-7, AMC HN-8 cells yielded lower inclusion body counts than HEp-2 cells. In culturing C. pneumoniae TW-183, AMC-HN-4, AMC-HN-7, and AMC-HN-8 cells did not yield lower inclusion body counts than HeLa 229 cells did. AMC-HN-7 cells yielded lower inclusion body counts than HEp-2 cells. CONCLUSION: The newly established upper airway epithelial cell lines, AMC HN-4 and AMC HN-8, had similar culture efficiency as HeLa 229 and HEp-2 cells for Chlamydial infection; therefore, these two cell lines could be used for the future studies of C. pneumoniae.

Chronic infections & coronary artery disease with special reference to Chalmydia pneumoniae.

Background & objectives: Studies on cardiovascular diseases (CVD) in India have shown about 10-20 per cent of cases with no obvious risk factors, raising a suspicion of infections as a cause. There is a paucity of data on this possible role of infections. This study was, therefore, undertaken to find out the association between infection due to Chlamydia pneumoniae and other organisms and coronary artery disease (CAD). Methods: Patients with CAD were selected in group I (acute myocardial infarction, AMI) and group III (patients undergoing coronary artery bypass graft (CABG) surgery), and normal controls in group II. Routine biochemical, haematological and inflammatory tests [C-reactive protein (CRP), total leucocyte count (TLC), fibrinogen, ESR], serodiagnostic tests for IgA and IgG antibodies to C. pneumoniae, Helicobacter pylori, cytomegalovirus (CMV), Mycoplasma pneumoniae and Parvovirus B-19 by ELISA kits, C. pneumoniae antigen by microimmunofluorescence and PCR from endothelial tissue obtained at CABG were carried out. Aortic punch biopsies were done in patients who underwent CABG. Results: Acute MI patients had a significantly higher association with accepted cardiac risk factors, lipid profile, inflammatory and thrombogenic tests. IgG and IgA antibodies levels against C. pneumoniae were not significantly different in the controls as against the AMI group. However, C. pneumoniae antigen seropositive group had significant association with HDL cholesterol, lipid tetrad index (P<0.001) and with triglycerides. Parvovirus B antigen was detected in 8.3 per cent of tissue specimens by PCR and of 44 patients with AMI (6.8%) were also positive for parvovirus B-19 IgG antibodies. Interpretation & conclusions: There was no direct evidence of the involvement of C. pneumoniae and other infective agents and viruses in CAD. It is possible that such infections produce an indirect adverse effect on the lipid profile.

Correlation between Chlamydia pneumoniae infection and chronic obstructive pulmonary disease / 中华流行病学杂志

Objective To investigate the correlation between Chlamydia pneumonia (Cpn)infection and chronic obstructive pulmonary disease (COPD).Methods 82 patients with acute exacerbation COPD (AE-COPD) or stabilized COPD patients at outpatient visits,in the People' s Hospital of Jiangyin city from Aug.2010 to May 2012,together with 46 cases having stationary phase COPD and 38 healthy volunteers as control group,were involved in this study.Patients were bled 2 ml,on the next day of hospitalization while patients at emergency room were bled 2 ml immediately,but bled again on the 15th day.Serum was separated through cryopreservation and the Cpn antibodies (IgG,IgM and IgA antibodies) were detected,under micro-immunofluorescence.Results In terms of IgG in the three groups,the positive rates did not show significant differences (P＞0.05) but the GMT of the IgG in the AE-COPD group was significantly higher (P＜0.01) than that in the control group.IgA positive rate among the three groups; AE-COPD appeared the highest.There was no significant difference between the AE-COPD group and stationary phase COPD group (P＞0.05),however,there were significant differences between the AE-COPD group,the stationary phase COPD group and the control group (P＜0.01).In terms of GMT of IgA in the three groups,there was significant difference between the AE-COPD group and stationary phase COPD group (P＞0.05),but with significant difference between the AE-COPD group and the control group (P＞0.01).There was significant difference between stationary phase COPD group and the control group (P＞0.05).When comparing both the rates of acute infection and chronic infection on the AE-COPD groups with the control group,there appeared significant differences (P＜0.05,P＜0.01).When comparing the acute and chronic infection between the stationary phase COPD group and the control group,the rate of acute infection did not show significant difference (P＞0.05) while the chronic infection rate appear to have had significant difference (P＜0.01).Conclusion Cpn infection seemed to be closely related to the development of COPD.

Association between Intracellular Infectious Agents and Schizophrenia

OBJECTIVE: A number of studies have reported association between Toxoplasma gondii (T. gondii) and Chlamydia infection and the risk of schizophrenia. The aim of the present study was to compare the prevalence of T. gondii and Chlamydia infection between the schizophrenia and normal control subjects and to compare the clinical features between seropositive and seronegative schizophrenia patients. METHODS: The rate of serum reactivity to T. gondii, Chlamydia trachomatis (C. trachomatis), Chlamydia pneumonia in 96 schizophrenia and 50 control subjects was investigated using enzyme-linked immunosorbent assay and indirect fluorescent antibody technique. The clinical symptoms of the schizophrenia patients were scored with Positive and Negative Syndrome Scale and a comparative analysis was carried out. RESULTS: A significant positive association between immunoglobulin G (IgG) antibodies to T. gondii and C. trachomatis in schizophrenia was found, and the odds ratio of schizophrenia associated with IgG antibody was found to be 3.22 and 2.86, respectively. The Toxoplasma-seropositive schizophrenia patient had higher score on the negative subscale N1 and N7 and general psychopathology subscale G13, while C. trachomatis-seropositive schizophrenia patient had higher score on the general psychopathology subscale G10. CONCLUSION: The results from the present study suggest significant association between T. gondii, C. trachomatis infection and schizophrenia. In future, further studies are needed to elucidate the correlation between the two types of infection and schizophrenia.

Chlamydia pneumoniae as a causative factor of ankylosing spondylitis / 中华临床感染病杂志

Objective To investigate the association of chlamydia pneumoniae infection with ankylosing spondylitis (AS).MethodsSerum samples were obtained from 33 AS patients and 22 healthy controls.Enzyme-linked immunosorbent assay (ELISA) was applied to mearsure serum anti-Chlamydia pneumoniae antibodies (IgM/IgG),while immunofluorescence assay (IFA) was used to detect Chlamydia pneumoniae LPS antigen,and polymerase chain reaction (PCR) was used to amplify Chlamydia pneumoniae DNA in peripheral blood cells. Immunohistochemistical technique was applied to examine Chlamydia pneumoniae LPS antigen in synovial tissue from another 9 AS patients who received total hip replacement and 13 patients with comminuted femoral fractures.ResultsThe positive rates of Chlamydia pneumoniae IgM,LPS antigen and chlamydia pneumoniae DNA were higher in AS patients than those in healthy controls (78.8％ vs 22.7％,x2 =16.867,P =0.000; 66.7％ vs 31.8％,x2 =6.431,P =0.011; 33.3％ vs 9.1％,x2 =4.298,P =0.038).Chlamydia pneumoniae DNA positive rate was correlated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels (Z =-2.774 and -2.829,P =0.004).In synovial tissues,chlamydial LPS-containing inflammatory cells were observed in 77.8％(7/9) AS patients,while those in fracture patients was 30.8％ ( 4/13 ) ( P =0.08 ).Conclusion Chlamydia pneumoniae infection is common in blood circulation and joint cavity of AS patients and may be associated with the pathogenesis of AS.