Evidencia molecular de la infección por Chlamydophila pneumoniae en reptiles de Argentina / Molecular evidence of Chlamydophila pneumoniae infection in reptiles in Argentina

En la región central de Argentina, las características epidemiológicas y moleculares de las infecciones por Chlamydophila pneumoniae en reptiles son desconocidas. Para detectar C. pneumoniae, se usó la reacción en cadena de la polimerasa anidada que amplifica el gen rpoB en muestras de hisopado cloacal de 19 reptiles. Once (57,89 %) reptiles resultaron positivos. La secuenciación y el análisis filogenético corroboraron la presencia de esta bacteria. No se detectó ADN de C. pneumoniae en la faringe ni IgM anti-C. pneumoniae en el suero de los cuidadores; sin embargo, ellos presentaron títulos muy elevados de IgG anti-C. pneumoniae. La detección de ADN de C. pneumoniae en los reptiles demostró la circulación de este agente en el centro recreativo donde se realizó este estudio, lo que podría explicar la exacerbada respuesta inmunitaria en los cuidadores; este hallazgo sugiere la presencia de un potencial ciclo zoonótico. Se reporta aquí por primera vez la detección de C. pneumoniae en reptiles en Argentina

In the central area of Argentina, the epidemiological and molecular characteristics of Chlamydophila pneumoniae infections in reptiles are still unknown. A nested polymerase chain reaction of the rpoB gene was used to detect C. pneumoniae in cloacal swab samples from 19 reptiles at a recreational area. Eleven (57.89%) reptiles were positive; the sequencing and phylogenetic analysis confirmed the presence of this bacterium. Neither C. pneumoniae DNA in the caregivers'pharynges nor IgM antibodies anti-C. pneumoniae in their serum samples were detected; however, caregivers presented very high titers of IgG anti-C. pneumoniae. The detection of C. pneumoniae DNA in reptiles demonstrated the circulation of this agent in the recreational area and could be responsible for the exacerbated immune response of the personnel handling the reptiles, which suggests a potential zoonotic cycle. This is the first report of the detection of C. pneumoniae in reptiles in Argentina

Application of three uniplex polymerase chain reaction assays for the detection of atypical bacteria in asthmatic patients in Kuwait

Respiratory infections are known to exacerbate wheezing in many asthmatic patients. We aimed to use molecular methods for the fast detection of Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila in respiratory specimens from asthmatic patients in Kuwait. We used uniplex PCR assays to detect the three atypical bacteria in clinical specimens from 235 asthmatic and non-asthmatic patients in Kuwait. A regression analysis was used to identify the risk factors related to the bacterial type. Group comparisons for similarity were conducted and correlation coefficients were calculated using SPSS statistical software. The detection limits using uniplex PCR for C. pneumoniae, L. pneumophila and M. pneumoniae were approximately 1 pg, 2.4 fg and 12 pg of DNA, respectively. M. pneumoniae PCR positivity was more common in asthmatic patients [15%] than in non-asthmatic subjects [9%] [P < 0.05]. A marked difference was observed between patients with acute asthma exacerbation [11%] and patients with chronic [stable] asthma [7%] among Kuwaiti patients; these percentages were 16% for non-Kuwaiti acute asthma patients and 14% for non-Kuwaiti chronic asthma patients [P < 0.201]. There was a weak positive correlation between asthma severity and PCR positivity for M. pneumoniae. The PCR results for C. pneumoniae and L. pneumoniae were found to be statistically insignificant. The results of this study suggest that infection with M. pneumoniae may be related to the exacerbation of asthma symptoms and could possibly be a factor that induces wheezing

Inflamação sistêmica causada pela periodontite crônica em pacientes vítimas de ataque cardíaco isquêmico agudo / Systemic inflammation caused by chronic periodontite in patients victims of acute ischemic heart attack

OBJETIVO: Processos inflamatórios e infecciosos mediados por bactérias em sítios distantes têm sido descritos como fator de risco à doença coronariana isquêmica aguda (DCIA). MÉTODOS: Cento e oitenta e um pacientes com DCIA, com e sem periodontites crônicas, foram incluídos neste estudo. Os pacientes foram admitidos no HC da UNICAMP e estratificados em três grupos: grupo 1 - pacientes com periodontite crônica grave (31 homens e 19 mulheres; média de idade 55,1 ± 11,29 anos); grupo 2 - pacientes com periodontite crônica leve (40 homens e 28 mulheres; média de idade 54,8 ± 10,37 anos); grupo 3 - pacientes desdentados (43 homens e 20 mulheres; média de idade 67,5 ± 8,55 anos). Amostras sanguíneas foram coletadas para mensurar os perfis lipídico, hematológico e glicêmico. Além disso, biópsias de 17 artérias coronárias com aterosclerose e igual número de artérias mamárias internas sem degeneração aterosclerótica no grupo 1 foram investigadas. Para análise estatística utilizou-se a análise de variância (ANOVA) e o teste de Scheffé para comparações múltiplas. RESULTADOS: Triglicérides e LDL estavam elevados no grupo 1 em relação ao grupo 2. O HDL apresentou-se reduzido em 20 por cento dos pacientes do grupo 1, e em 8 por cento nos desdentados. A glicemia estava elevada no grupo 1. DNA de bactérias periodontais foram detectados em 58,8 por cento das artérias coronárias. CONCLUSÕES: Pacientes com DCIA e periodontite crônica grave podem apresentar perfil lipídico alterado, como também microorganismos associados com as periodontites crônicas graves podem permear dentro de vasos coronarianos.

OBJECTIVE: Infectious and inflammatory processes mediated by bacteria in distant sites have been described as a risk factor for acute ischemic heart disease (AIHD). METHODS: One hundred one patients with AIHD with and without chronic periodontitis (CP) were included in this study. Patients were admitted to the HC UNICAMP and stratified into three groups: in group 1, we selected patients with severe chronic periodontitis (31 men and 19 women, mean age 55.1 ± 11.29 years old); the group 2 with mild chronic periodontitis (40 men and 28 women, mean age 54.8 ± 10.37 years old) and group 3 represented by the toothless (43 men and 20 women, mean age 67.5 ± 8.55 years old). Blood samples were collected to measure the lipid profiles, hematological and blood glucose levels. In addition, biopsies of seventeen coronary arteries with atherosclerosis and an equal number of internal mammary arteries without atherosclerotic degeneration in group 1 were investigated. Statistical analysis by analysis of variance (ANOVA) and Scheffé test for multiple comparisons was performed. RESULTS: Triglyceride and LDL levels were elevated in group 1 than in group 2. HDL were reduced by 20 percent in group 1 and remained reduced by 8 percent in toothless. Blood glucose was higher in group 1. DNA of periodontal bacteria was detected in 58.8 percent of the coronary arteries. CONCLUSIONS: Patients with (AIHD) and severe chronic periodontitis may have altered lipid profile, as well as microorganisms associated with CP can permeate into coronary vessels.

Detection of Chlamydia pneumonia in multiple sclerosis patients

Multiple Sclerosis [MS] is a demyelinating disease. Although it is considered an autoimmune, the exact etiology of MS has yet to be identified. MS is hypothesized to be caused by infectious agents that initiate an autoimmune reaction and /or death of oligodendrocytes. These latter events result in gradual disappearance of the myelin sheath of nerve fibers causing multiple symptoms and, ultimately, neurological deficit. Among the infectious agents linked to MS in Chlamydia pneumonia. This agent has been found in various studies to be prevalent in MS patients compared to control individuals. In this study, we investigated the presence of C. pneumonia in sera and cerebrospinal fluids [CSF] of MS patients. Serum and CSF were obtained form 36 MS patients and 37 control donors, including healthy donors and patients with other neurological diseases. In order to increase the sensitivity of detection, nested polymerase chain reaction [PCR] was utilized. Although multiple protocols of DNA extraction and PCR procedures were utilized, C. pneumonia DNA was not evident in all samples of MS patients. On the other hand, amplified DNA of C. pneumonia was inconsistently detected in serum samples in only three control individuals. These results suggest lack of apparent association of C. pneumonia to MS

Chlamydia pneumoniae and stroke: is there a direct relationship? / Chlamydia pneumoniae e acidente vascular cerebral aterotrombótico: existe relação direta?

OBJECTIVE: To investigate the possible relationship between atherothrombotic stroke and Chlamydia pneumoniae. METHOD: 150 patients with carotid atherothrombosis were enrolled. The casuistic was divided in three groups: ischemic stroke (IS): 65 patients; transient ischemic attack (TIA): 26 patients; and control: 59. The IS or TIA onset was up to 30 days from the beginning of the study. Carotid atheromatoses was diagnosed by Doppler-ultrasonography. Patients with cardioembolic risk or non-atherothrombotic origin were excluded. Comparisons were done between the three groups, and within each group according to the different age sub-groups, to the main arteries affected, and to the atherogenic risk factors. Bacteria detection was done using polimerase chain reaction. RESULTS: Only one patient tested positive for C. pneumoniae belonging to the control group. CONCLUSION: These results do not suggest that C. pneumoniae participated in the onset of IS or TIA or that it has a role in carotid plaque destabilization.

OBJETIVO: Investigar a possível relação entre Chlamydia pneumoniae e acidente vascular cerebral aterotrombótico (AVC). MÉTODO: 150 pacientes com aterotrombose carotídea foram estudados. A casuística foi dividida em 3 grupos: AVC: 65 pacientes; ataque isquêmico transitório (AIT): 26 pacientes e controles: 59. O início do AVC ou AIT era até 30 dias da inclusão no estudo. A ateromatose carotídea foi diagnosticada por ultrassonografia com Doppler. Os pacientes com risco cárdio-embólico ou sem evidência de aterotrombose foram excluídos. Foram estabelecidas comparações entre os 3 grupos e dentro de cada grupo, formado sub-grupos de acordo com diferentes idades, território arterial comprometido e fatores de risco. A detecção da bactéria foi feita por reação de polimerização em cadeia. RESULTADOS: Somente um paciente, pertencente ao grupo controle, teve resultado positivo. CONCLUSÃO: Estes achados não sugerem que a C. pneumoniae participe no desencadeamento do AVC ou AIT ou que tenha papel na desestabilização da placa.

Do Archaea and bacteria co-infection have a role in the pathogenesis of chronic chagasic cardiopathy?

Chronic cardiopathy (CC) in Chagas disease is a fibrotic myocarditis with C5b-9 complement deposition. Mycoplasma and Chlamydia may interfere with the complement response. Proteolytic enzymes and archaeal genes that have been described in Trypanosoma cruzi may increase its virulence. Here we tested the hypothesis that different ratios of Mycoplasma, Chlamydia and archaeal organisms, which are frequent symbionts, may be associated with chagasic clinical forms. MATERIALS AND METHODS: eight indeterminate form (IF) and 20 CC chagasic endomyocardial biopsies were submitted to in situ hybridization, electron and immunoelectron microscopy and PCR techniques for detection of Mycoplasma pneumoniae (MP), Chlamydia pneumoniae(CP), C5b-9 and archaeal-like bodies. RESULTS: MP and CP-DNA were always present at lower levels in CC than in IF (p < 0.001) and were correlated with each other only in CC. Electron microscopy revealed Mycoplasma, Chlamydia and two types of archaeal-like bodies. One had electron dense lipid content (EDL) and was mainly present in IF. The other had electron lucent content (ELC) and was mainly present in CC. In this group, ELC correlated negatively with the other microbes and EDL and positively with C5b-9. The CC group was positive for Archaea and T. cruzi DNA. In conclusion, different amounts of Mycoplasma, Chlamydia and archaeal organisms may be implicated in complement activation and may have a role in Chagas disease outcome.

Detection of Chlamydophila pneumoniae (Chlamydia pneumoniae) in endarteroctomy specimens of coronary heart diseases patients.

BACKGROUND & OBJECTIVE: Association of Chlamydia pneumoniae with atherosclerosis and coronary artery disease is debated. Increased antibody levels against C. pneumoniae in patients with coronary artery disease is widely reported. Direct evidence would be demonstration of C. pneumoniae, its antigen or genome in the diseased arterial tissue. This study was thus conducted to look for antigen or genome of C. pneumoniae in coronary artery specimens from patients with coronary artery disease along with serology. METHODS: Sixty two end arteriotomy specimens of discarded coronary arteries from patients of coronary heart disease were tested for presence of C.pnuemoniae genome using 2 nested PCR assays and antigen detection by immuno-fluorescence assay. Presence of species specific antibodies were also tested in the patients. RESULTS: C. pneumoniae could not be detected by PCR or immunofluorescence assay in any specimen. C. pnuemoniae Ig G antibody was detected in 42 of the 62 (67.7%) patients studied, compared to 10 of the 23 (43.47%) of controls. Moreover 18 of 62 (29%) patients compared to 4 of 23 (17.39%) controls possessed IgA antibodies. INTERPRETATION & CONCLUSION: Association of C.pneumoniae and coronary artery disease would not be established by genome or antigen detection. However, C. pneumoniae antibodies were detected in more number of patients than controls. More studies are required to reach to a conclusion.

Evaluation of direct immunofluorescence test for diagnosis of upper respiratory tract infection by Chlamydia pneumoniae.

BACKGROUND: Chlamydia pneumoniae causes a variety of respiratory infections and is involved in cardiovascular diseases. Diagnosis of C. pneumoniae infection currently relies on antibody detection by microimmunofluorescence (MIF), which has limited use, and is the retrospective diagnosis for acute infection. OBJECTIVE: Find an effective early diagnosis of acute upper respiratory infection, or use in combination with MIF to accurately diagnose the infection by C. pneumoniae. MATERIAL AND METHOD: Direct immunofluorescence (DIF) was developed to detect C. pneumoniae in nasopharyngeal specimens obtained from patients with upper respiratory tract infection, and normal individuals. IgM and IgG antibodies against C. pneumoniae by MIF were determined for evaluation of the detected C. pneumoniae and seroconversion. RESULTS: DIF gave positive results in 29 of 37 (78.4%) samples from 31 patients. Fifteen samples positive by DIF illustrated antibody titers interpreted as acute C. pneumoniae infection, and eight DIF positive samples showed antibody titers of chronic infection. Negative results by both DIF and MIF were found in two patients and 23 of 25 by DIF but 20 of 25 by MIF in normal subjects. Five paired sera subsequently collected from three of the 31 patients illustrated seroconversion 2-4 months after the primary specimen collection, which gave positive results by DIF but negative for antibodies. Significant association was found between C. pneumoniae detection by DIF and antibodies by MIF when analysis was done in the group of patients and normal subjects (p < 0.001; Pearson chi-square test). CONCLUSION: DIF could be an alternative assay for early diagnosis of C. pneumoniae infection, and may be used in combination with MIF for accurate diagnosis of acute C. pneumoniae infection.

Role of Chlamydia pneumoniae infection in Egyptian asthmatic patients

The role of respiratory infections in asthma is poorly understood. Chlamydia pneumoniae [C.pneumoniae] infection is claimed to be of importance for the development of asthma. This study was designed to investigate the role of Chlamydia pneumoniae infection in asthmatic patients in an attempt to understand its role in respiratory tract allergy. Forty adults and forty children with acute attack of asthma were included in our study in addition to ten healthy adults and ten healthy children as control group. Nasopharyngeal aspirates were taken from patients and controls and tested for the presence of Chlamydia pneumoniae by tissue culture and PCR. Six [15%] adult patients were positive by culture as well as PCR while two [5%] patients were positive by culture alone, in children, four [10%] patients were positive by both culture and PCR, only one [2.5%] patient was positive by culture alone. None of the control group gave positive result with culture or PCR. Taking chlamydia tissue culture as the reference method, the PCR sensitivity in adult group was 75% and in children 80% while the specificity in both groups was 100%. There is no statistically significant difference regarding the chlamydia positivity by culture and PCR between the patient group and the control group suggesting that C.pneumoniae may not play a significant role in the pathogenesis of asthma

A study on immunopathogenetic mechanisms of atherosclerotic process caused by chronic infection of Chlamydia pneumoniae in rats (Ratus novergicus).

AIM: this study was aimed to determine the correlations between duration of Chlamydia pneumoniae infection and the development of atherosclerotic process in white-rats' (Ratus novergicus) aorta. METHODS: this is an experimental study which examined the expression of TNFa, IL-1b, IL-8, adhesion molecule of VCAM-1 and the development of foam cells associated with atherosclerotic process in white-rats' aorta. There were 32 male rats, +/- 6 weeks of age, divided into 4 groups: control group (K) without infection, and 3 groups with infection through nasal and oral inoculation of Chlamydia pneumoniae by single dose of 5 x 105 in amount of 35 microl. The first group (P1) was preserved for 5(1/2) months period, the second group (P2) was preserved for 7(1/2) months and the third group (P3) was preserved for 9(1/2) months. At the end of study, histological slides were made from aortic tissues in order to study the development of atherosclerotic process by examining foam cells and cytokines expression of TNFa, IL-1b, IL-8 and VCAM-1. Foam cells examination was performed by Hematoxcillin-eosin staining, while indirect immunohistochemistry staining was used to examine the expression of TNFa, IL-1b, IL-8 and VCAM-1. Afterward, the amount of foam cells and cytokines expression was measured. The study result was analyzed by ANOVA. RESULTS: there was increased expression of TNFa, IL-1b, IL-8, VCAM-1and increased foam cells formation (extended atherosclerosis area) in the aortic tissues infected by Chlamydia pneumoniae (5(1/2) months, 7(1/2) months and 9(1/2) months), which was significantly different compared to the control group. The result of ANOVA revealed that the most important factor in tissue injury is foam cells development induced by VCAM-1 and IL-8 in all of phases (characterized by most abundant neutrophil infiltration). It indicated the infection caused by extracellular pathogenic agent, which established the fatty streak (acute phase) in 5(1/2) months period. In the group with 7(1/2) months infection period, TNFa also had important roles (characterized by increased monocytes and lymphocytes infiltration), indicating that there was negative-gram pathogenic agent with intracellular infection, which caused a progressive atherosclerotic process, and development of fibrosis / atherosclerotic plaque (sub acute phase). In 9(1/2) months infection period, there was large thrombus containing a lot of leukocytes in the aorta (chronic phase). CONCLUSION: based on the result of this study, it may be concluded that Chlamydia pneumoniae may cause atherosclerotic process in aorta. Extracellular infection of Chlamydia pneumoniae occurs in all of phases and intracellular infection begins in sub-acute phase. On 5(1/2) months period, fatty streak is developed (acute phase); on 7(1/2) months period, there is atherosclerotic plaque (sub acute phase); and on 9(1/2) period, there is large thrombus containing a lot of leukocytes (a progressive chronic phase).

A role for archaeal organisms in development of atherosclerotic vulnerable plaques and myxoid matrices

PURPOSE: Vulnerable plaques are characterized by a myxoid matrix, necrotic lipidic core, reactive oxygen species, and high levels of microorganisms. Aerobic microbes such as Chlamydophila pneumoniae and Mycoplasma pneumoniae usually do not survive in oxidative stress media. Archaea are anaerobic microbes with powerful anti-oxidative enzymes that allow detoxification of free radicals whose presence might favor the survival of aerobic microorganisms. We searched for archaeal organisms in vulnerable plaques, and possible associations with myxoid matrix, chlamydia, and mycoplasma bodies. METHODS: Twenty-nine tissue samples from 13 coronary artherectomies from large excentric ostial or bifurcational lesions were studied using optical and electron microscopy. Infectious agents compatible with archaea, chlamydia, and mycoplasma were semiquantified using electron micrographs and correlated with the amounts of fibromuscular tissue, myxoid matrix, and foam cells, as determined from semi-thin sections. Six of the cases were also submitted to polymerase chain reaction with archaeal primers. RESULTS: All 13 specimens showed archaeal-compatible structures and chlamydial and mycoplasmal bodies in at least 1 sample. There was a positive correlation between extent of the of myxoid matrix and archaeal bodies (r = 0.44, P = 0.02); between archaeal and mycoplasmal bodies (r = 0.41, P = 0.03), and between chlamydial bodies and foam cells (r = 0.42; P = 0.03). The PCR test was positive for archaeal DNA in 4 of the 6 fragments. DISCUSSION: DNA and forms suggestive of archaea are present in vulnerable plaques and may have a fundamental role in the proliferation of mycoplasma and chlamydia. This seems to be the first description of apparently pathogenic archaea in human internal organ lesions.

PROPOSTA: Placas vulneráveis são caracterizadas por matriz mixomatosa, centro lipídico necrótico, espécies reativas de oxigênio e alto níveis de microorganismos. Micróbios aeróbicos como Chlamydophila pneumoniae e Mycoplasma pneumoniae usualmente não sobrevivem em meio de estresse oxidativo. Arquéias são microorganismos anaeróbicos com poderosas enzimas anti-oxidantes que permitem detoxificação de radicais livres e a presença delas poderia favorecer a sobrevivência de micróbios aeróbicos. Pesquisamos por elementos de arquéia em placas vulneráveis e sua possível associação com degeneração mixomatosa da matriz e aumento do número de clamídias e micoplasmas. MÉTODOS: Vinte e nove amostras de 13 produtos de aterotomia de lesões grandes e excêntricas de óstio ou bifurcação de coronárias foram estudadas pela microscopia óptica e eletrônica. Agentes compatíveis com arquéia, clamídia e micoplasma foram semiquantificados pela microscopia eletrônica e correlacionados com quantidade de tecido fibromuscular, matriz mixomatosa e células xantomatosas. Seis casos foram também submetidos à reação em cadeia da polimerase com oligonucleotídeos de arquéia. RESULTADOS: Os 13 casos foram positivos para estruturas sugestivas de arquéia, micoplasma ou clamídia, em pelo menos uma amostra. Houve correlação positiva entre intensidade de matriz mixomatosa versus arquéia (r=0.44, p=0.02); arquéia versus micoplasma (r=0.41, p=0.03) e clamídia versus células xantomatosas r=0,42; 0.03). PCR foi positiva para DNA de arqueia em 4 dos 6 fragmentos. DISCUSSÃO: DNA e formas compatíveis com arquéia estão presentes em placas vulneráveis e podem ter papel fundamental na proliferação de micoplasma e clamídia. Este parece ser o primeiro relato de arquéia aparentemente patogênica em lesões de órgãos internos humanos.

Etiology of community - acquired pneumonia in hospitalized patients in Jordan

To ascertain the causative organisms of community acquired pneumonia [CAP] in Jordanian patients requiring hospital admission. A prospective study of both adults and children admitted to Princess Basma and Princess Rahma Teaching Hospitals in Irbid, Jordan with a diagnosis of CAP over a 6-month period from April to October 2002. A total of 35 adult patients were admitted with a mean age of 47 years, and 63 children with a mean age of 3 years. A pathogen was isolated from 25 [71%] adults, and from 17 [27%] children, and sputum cultures gave the best diagnostic yield. In adults Streptococcus pneumoniae was the most common isolate [26%], followed by Chlamydia pneumoniae [23%], Haemophilus influenzae [17%], Mycoplasma pneumoniae [9%], and Legionella pneumophila and Klebsiella pneumoniae [6%] each. Seven of the 9 gram negative isolates were from patients with some co morbid illness. While in children, Chlamydia pneumoniae was the most common [14%], followed by Mycoplasma pneumoniae [6%], and Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa [3%] each. Streptococcus pneumoniae and atypical microorganisms are the most common cause of CAP in previously healthy adults; while in those with associated co morbid illness, gram negative organisms are the likely cause. In children, the overall detection rate of causative organisms was low with atypical microorganisms being the most common

Detección de Chlamydia pneumoniae en tejido aórtico humano: amplificación del gen kdtA e hibridación in vitro / Detection of Chlamydia pneumoniae in human aortic tissue: kdtA gene amplification and in vitro hybridization

Introducción. La ateroesclerosis es la principal causa de enfermedad coronaria y cerebrovascular, las cuales, a su vez, son las causas más comunes de mortalidad y morbilidad n el mundo occidental. Publicaciones recientes sugieren que ciertos microorganismos infecciosos podrían jugar un papel importante en la génesis y progresión de la aterosclerosis. De acuerdo con reportes seroepidemiológicos y de detección directa, Chlamydia pneumoniae podría ser el candidato más plausible. No obstante, no se ha determinado su papel específico en el proceso aterogénico, por lo cual en los últimos años ha surgido la necesidad de explorar diversas técnicas de detección de C. pneumoniae en arterias. Objetivo. El propósito de este estudio fue investigar la presencia de C. pneumoniae en muestras de tejido aórtico de catorce pacientes sometidos a cirugía de reemplazo aórtico, utilizando la amplificación del gen kdtA por PCR acoplada a un ensayo de hibridación in vitro. Materiales y métodos. De cada uno de catorce segmentos de aorta se obtuvo una muestra al azar para la extracción de ADN y la detección de C. pneumoniae por PCR-hibridación in vitro. Resultados. Doce (85,7 por ciento) de catorce muestras de tejido de aorta resultaron positivas para C. pneumoniae. Conclusión. Los resultados encontrados en este estudio sugieren que la presencia de C. pneumoniae es frecuente en el tipo de muestras analizado. En estudios posteriores resultaría importante examinar si esta proporción se mantiene en una muestra poblacional mayor

Chlamydia pneumoniae e Mycoplasma pneumoniae nos nódulos de calcificacão da estenose da valva aórtica / Chlamydia pneumoniae and Mycoplasma pneumoniae in calcified nodes of stenosed aortic valves

OBJETIVO: Investigar se chlamydia pneumoniae (CP) ou mycoplasma pneumoniae (MP) estão presentes na estenose da valva aórtica (EA). MÉTODOS: Imuno-histoquímica foi utilizada para identificar os antígenos de CP (Ag-CP), a hibridizacão in situ para identificar o DNA de MP, e microscopia eletrônica para avaliacão dos dois agentes, nos grupos: normal - 11 valvas normais de autópsia; aterosclerose - 10 valvas de pacientes com aterosclerose sistêmica de autópsia e sem EA; e EA - 14 espécimes cirúrgicos provenientes de pacientes com EA analisados em 3 sub-regiões: EA-preservada - regiões mais preservadas na periferia da valva; EA-fibrose - tecido fibrótico peri-calcificacão; e EA-calcificacão - nódulos calcificados. RESULTADOS: As medianas da fracão de área positiva para Ag-CP foram 0,09; 0,30; 0,18; 1,33; e 3,3 nos grupos acima descritos, respectivamente. A densidade de CP foi significativamente maior nos grupos aterosclerose e EA-calcificacão em relacão ao normal (p<0,05). Dentro do grupo EA, a quantidade de CP foi maior nas regiões de fibrose e calcificacão (p<0,05). As fracões de área positivas para MP-DNA (medianas) foram 0,12; 0,44; 0,07; 0,36; e 1,52 nos grupos acima descritos, respectivamente. A quantidade de MP-DNA foi maior na EA-calcificacão em relacão ao normal (p<0,05). Dentro do grupo EA, maior quantidade de MP-DNA foi encontrada nas regiões de calcificacão e fibrose (p<0,05). CONCLUSAO: Os nódulos de calcificacão da EA tinham maior concentracão de CP e MP sugerindo que essas bactérias possam estar associadas ao desenvolvimento de calcificacão e inflamacão, apontando novas semelhancas entre os processos de EA e aterosclerose, que podem ter mecanismos infecciosos envolvidos.

Presencia de Chlamydia pneumoniae en placas ateroscleróticas / Chlamydia pneumoniae presence in atherosclerotic plaques

Chlamydia pneumoniae es un patógeno mundialmente reconocido como causante de infecciones del tracto respiratorio en humanos, se caracteriza por ser un microorganismo intracelular obligado. Al presente, se ha comprobado su presencia en placas ateromatosas por múltiples técnicas como la inmunohistoquímica, la microscopía electrónica y la reacción en cadena de la polimerasa (PCR). La enfermedad aterosclerótica, es responsable de muchos de los accidentes cerebrovasculares y cardiovasculares. Sin embargo el papel patogénico de este microorganismo en dicha enfermedad aun no es claro. En este estudio, por medio de ka reacción en cadena de la polimerasa (PCR) se logró comprobar la presencia de C. pneumoniae en el 28 por ciento de 93 muestras de tejido vascular provenientes de pacientes que fueron sometidos a cirugía de revascularización quirúrgica. La presencia de este microorganismo en tejido vascular de pacientes con enfermedad coronaria podría considerarse como un factor de riesgo cardiovascular para el desarrollo de aterosclerosis y enfermedades cerebrovasculares

Seroprevalence of IgG antibodies to Chlamydia pneumoniae and Helicobacter pylori among coronary heart disease patients and normal individuals in South Indian population.

In recent years, the role of infectious agents in the aetiology of atherosclerotic disease has come to the forefront. In the present study, seroprevalence (IgG) of chlamydia pneumoniae and helicobacter pylori in patients with atherosclerotic coronary heart disease was compared to normal healthy adults. Out of a total of 117 patients 101 had unstable angina (UA) and 16 had chronic stable angina (CSA). C. pneumoniae seropositivity was found in 66% of patients with UA and 94% of CSA patients. The corresponding figures for H. pylori were 58% and 56% respectively. In comparison, 81% of healthy adults were seropositive for C. pneumoniae and 53% for H.pylori. No significant association was found between CHD and the infectious agents. However, this study has revealed a high infection by C. pneumoniae as well as H.pylori in this part of India.

Neumonía adquirida en la comunidad que se hospitaliza: estudio etiológico / Community acquired pneumonia in a hospitalized community: etiological study

BACKGROUND: Community-acquired pneumonia (CAP) that requires hospitalization, is a common and serious disease. A permanent assessment in specialized centers, to define therapeutic guidelines according to local epidemiological factors, is mandatory. AIM: To study the etiology of CAP requiring hospital admission. PATIENTS AND METHODS: Adult patients with CAP, admitted to the Clinical Hospital of the University of Chile between 1999 and 2001 were studied. A clinical, radiological and microbiological assessment was done in all patients. Blood and sputum cultures and serology for Chlamydia and Mycoplasma pneumoniae were performed. RESULTS: Thirty one patients aged 62 +/- 18 years, 12 female, met inclusion criteria. An etiologic diagnosis was made in 74 per cent of cases, (52 per cent definitive, 22 per cent probable). Frequency of definitive diagnosis was: 25 per cent Mycoplasma pneumoniae, 19 per cent Chlamydia pneumoniae and 13 per cent Streptococcus pneumoniae. Mixed etiology was found in 16 per cent and a final diagnosis was not obtained in 26 per cent of the cases. No correlation was found between clinical and radiological patterns, and the etiologic agent. C reactive protein and erythrosedimentation rate were significantly higher in CAP due to Chlamydia and Streptococcus pneumoniae. CONCLUSIONS: The higher frequency of Mycoplasma and Chlamydia pneumoniae, than previously reported, suggests that atypical agents should be considered in the initial antimicrobial therapy prescribed to these patients.

Etiology of acute lower respiratory tract infection.

OBJECTIVE: To identify pathogens responsible for acute severe lower respiratory tract infection (ALRTI) in under five children by non-invasive methods. METHOD: 95 children hospitalized with acute severe lower respiratory tract infection were investigated for identification of viruses, bacteria, chlamydia or mycoplasma by nasopharyngeal aspirates, blood culture and serology. RESULT: Etiological agents could be identified in 94% of the patients. Viruses from NP aspirate could be isolated in 36 (38%), bacterial isolates from blood cultures in 15 (16%); mycoplasma was identified in 23 (24%) and chlamydia in 10 (11%) by serological tests; mixed infections were present in 8 (8%) patients. CONCLUSION: Noninvasive methods can be useful in identifying etiological agents in severe ALRTI.

Chlamydia pneumoniae, Mycoplasma pneumoniae, fatores de crescimento e células inflamatórias nas lesões ateroscleróticas iniciais da aorta ascendente, em portadores de doença arterial coronária / Chlamydia pneumoniae, Mycoplasma pneumoniae, growth factors and inflammatory cells in the early atherosclerotic lesions of ascending aorta in patients with coronary artery disease

Chlamydia pneumoniae (CP), Mycoplasma pneumoniae (MP), linfócitos, macrófagos e fatores de crescimento (FC) foram pesquisados na íntima de lesões iniciais ateroscleróticas da aorta ascendente de 30 pacientes submetidos a cirurgia de coronária. Analisou a correlação entre: quantidade de macrófagos, CP e MP, linfócitos e o espessamento intimal (EI). CP esteve presente e em correlação com número de linfócitos T (CD4, CD8) e B (CD20), macrófagos (CD68) e MP se correlacionou quantidade de CP. Não houve correlação entre os FC e EI ou com o número de macrófagos CD68. Em conclusão, o estudo fala a favor de que CP está relacionada ao desenvolvimento da aterosclerose e da inflamação na íntima / Presence of Chlamydia pneumoniae(CP), Mycoplasma pneumoniae(MP), lymphocytes, macrophages and growth factors(GF) from the intima fragments of acending aorta from 30 patients submited to CABG. Analized correlation between: macrophages, CP and MP, lymphocytes and the intimal thickness (IT). The study showed that CP and MP are present in initial atherosclerotic lesions; Strong correlation of T (CD4, CD8) and B (CD20), macrophages (CD68) and MP with the mean numbers of CP positive cells suggest that CP is related with the development of atherosclerosis and with its inflamation. There was no correlation between growth factors and intimal thickness or with the mean number of CD68 macrophages...

Interleukin-8 [IL-8] in acute myocardial infarction: correlation with chlamydia pneumonia antibody seropositivity

This study was conducted to determine the relation between the chlamydia pneumoniae [CP] seropositivity and the serum levels of interleulcin-8 [IL-8] in patients with acute myocardial infarction [AMI]. The study included 77 Egyptian patients having AMI and 13 control healthy subjects of matched age and sex. CP antibody testing [IgM and IgG] was performed using indirect immunofluorescence test, together with IL-8 immunoassay in both patients and control. High titers of CP IgG antibodies were found in 55.8% of AMI patients [43 patients], while only one positive case [7.69%] was found in control group. Higher concentrations of IL-8 were found in AMI patients when compared with the control group. Also, the levels of IL-8 were higher among CP positive AMI patients when compared with negative cases. It was concluded that a high prevalence of anti-Chlamydia IgG antibodies was found among a group of AMI patients and also higher levels of IL-8 among CP positive cases was found. It can be suggested that CP chronic infection is implicated in these cases and it could be considered as a contributing factor for the persistence of elevated levels of the chemokine IL-8 in some of those patients