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

Marcadores inflamatórios e anticorpos anti-chlamydia em pacientes com síndrome metabólica / Inflammatory markers and antichlamydial antibodies in patients with metabolic syndrome / Marcadores inflamatorios y anticuerpos anti-chlamydia en pacientes con síndrome metabólico

FUNDAMENTO: A síndrome metabólica está associada ao aumento de risco de eventos cardiovasculares. Marcadores inflamatórios e anticorpos anti-Chlamydia têm sido relacionados ao desenvolvimento e à progressão da aterosclerose e dos eventos cardiovasculares. OBJETIVO: Avaliar os marcadores inflamatórios interleucina-6 (IL-6) e fator de necrose tumoral-alfa (TNF-α) e os anticorpos anti-Chlamydia pneumoniae em pacientes com síndrome metabólica (SM), com e sem eventos cardiovasculares. MÉTODOS: Estudo transversal constituído por 147 indivíduos. Desses, 100 (68 por cento) com SM e sem eventos cardiovasculares; e 47 (32 por cento) com SM e com eventos cardiovasculares. Dos indivíduos que sofreram eventos cardiovasculares, 13 (6,11 por cento) apresentam infarto agudo do miocárdio (IAM), e dez (4,7 por cento), acidente vascular cerebral (AVC). O diagnóstico da SM foi determinado pelos critérios do NCEP-ATPIII. RESULTADOS: A média de idade dos sujeitos com eventos cardiovasculares foi de 61,26 ± 8,5 e de 59,32 ± 9,9 nos indivíduos sem esses eventos (p=0,279), havendo predomínio do sexo feminino. O grupo com SM e sem evento apresentou maior peso, altura, IMC e circunferência abdominal. Para os indivíduos com eventos cardiovasculares (p=0,001), os marcadores inflamatórios IL-6 e TNF-α e a doença vascular periférica foram significativamente maiores. Obtiveram-se níveis elevados de anticorpos IgG para Chlamydia pneumoniae no grupo SM, sem eventos e de IgA no grupo com eventos quando comparados os dois grupos. Com relação ao IAM e ao AVC, os anticorpos anti-Chlamydia pneumoniae não demonstraram significância estatística, comparados ao grupo sem eventos cardiovasculares. Associação foi observada com o uso de estatinas, hipoglicemiantes orais, injetáveis e anti-inflamatórios não esteroidais no grupo com esses eventos. CONCLUSÃO: Marcadores inflamatórios encontram-se significativamente elevados em pacientes com SM, com IAM e AVC. Anticorpos anti-Chlamydia não mostraram diferença significativa em pacientes com SM, com e sem eventos.

BACKGROUND: The metabolic syndrome is associated with increased risk of cardiovascular events. Inflammatory markers and antichlamydial antibodies have been linked to the development and progression of atherosclerosis and cardiovascular events. OBJECTIVE: To evaluate the inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), as well as anti-chlamydia pneumoniae antibodies, in patients with metabolic syndrome (MS), with and without cardiovascular events. METHODS: Cross sectional study consisting of 147 individuals. Out of these, 100 (68 percent) with MS and without cardiovascular events; and 47 (32 percent) with MS and with cardiovascular events. Among the individuals who had had cardiovascular events, 13 (6.11 percent) had acute myocardial infarction (AMI) and ten (4.7 percent) had cerebrovascular accident (CVA). The diagnosis of MS was determined by the criteria of NCEP-ATPIII. RESULTS: The mean age of subjects with cardiovascular events was 61.26 ± 8.5 and 59.32 ± 9.9 in subjects without such events (p = 0.279), with a predominance of females. The weight, height, BMI and waist circumference of the group with MS and without event was greater. Among individuals with cardiovascular events (p = 0.001), the inflammatory markers IL-6 and TNF-α and the peripheral vascular disease were significantly greater. There were high levels of IgG antibodies to C. pneumoniae in the SM group, without events, and of IgA antibodies in the group with events, when the two groups were compared. With respect to AMI and stroke, the anti-chlamydia pneumoniae antibodies showed no statistical significance, compared to the group without cardiovascular events. An association was observed with the use of statins, nonsteroidal anti-inflammatory drugs and injectable, oral hypoglycemic agents, in the group with these events. CONCLUSION: The inflammatory markers were significantly elevated in patients with MS, with acute myocardial infarction and stroke. There was no significant difference in anti-chlamydial antibodies in patients with MS, with and without events.

FUNDAMENTO: El síndrome metabólico está asociado al aumento de riesgo de eventos cardiovasculares. Marcadores inflamatorios y anticuerpos anti-Chlamydia han sido relacionados al desarrollo y a la progresión de la aterosclerosis y de los eventos cardiovasculares. OBJETIVO: Evaluar los marcadores inflamatorios interleucina-6 (IL-6) y factor de necrosis tumoral-alfa (TNF-α) y los anticuerpos anti-Chlamydia pneumoniae en pacientes con síndrome metabólico (SM), con y sin eventos cardiovasculares. MÉTODOS: Estudio transversal constituido por 147 individuos. De estos, 100 (68 por ciento) con SM y sin eventos cardiovasculares; y 47 (32 por ciento) con SM y con eventos cardiovasculares. De los individuos que habían sufrido eventos cardiovasculares, 13 (6,11 por ciento) presentan infarto agudo de miocardio (IAM), y diez (4,7 por ciento), accidente cerebro vascular (ACV). El diagnóstico del SM fue determinado por los criterios del NCEP-ATPIII. RESULTADOS: La media de edad de los sujetos con eventos cardiovasculares fue de 61,26 ± 8,5 y de 59,32 ± 9,9 en los individuos sin esos eventos (p=0,279), habiendo predominio del sexo femenino. El grupo con SM y sin evento presentó mayor peso, altura, IMC y circunferencia abdominal. Para los individuos con eventos cardiovasculares (p=0,001), los marcadores inflamatorios IL-6 y TNF-α y la enfermedad vascular periférica fueron significativamente mayores. Se obtuvieron niveles elevados de anticuerpos IgG para Chlamydia pneumoniae en el grupo SM, sin eventos y de IgA en el grupo con eventos cuando fueron comparados los dos grupos. Con relación al IAM y al ACV, los anticuerpos anti-Chlamydia pneumoniae no demostraron significación estadística, comparados al grupo sin eventos cardiovasculares. Asociación fue observada con el uso de estatinas, hipoglicemiantes orales, inyectables y antiinflamatorios no esteroides en el grupo con esos eventos. CONCLUSIÓN: Marcadores inflamatorios se encuentran significativamente elevados en pacientes con SM, con IAM y ACV. Anticuerpos anti-Chlamydia no mostraron diferencia significativa en pacientes con SM, con y sin eventos.

Prevalência de Chlamydia Pneumoniae e Mycoplasma Pneumoniae em diferentes formas da doença coronariana / Prevalencia de Chlamydia Pneumoniae y Mycoplasma Pneumoniae en diferentes formas de la enfermedad coronaria / Prevalence of Chlamydia Pneumoniae and Mycoplasma Pneumoniae in different forms of coronary disease

FUNDAMENTO: Vários agentes infecciosos foram investigados desde que se demonstrou a associação entre infecção e aterosclerose, porém os resultados desses estudos são conflitantes. OBJETIVO: Testar a associação entre títulos séricos de anticorpos anti-Chlamydia e anti-Mycoplasma em diferentes formas de síndromes coronarianas agudas (SCA). MÉTODOS: Cento e vinte e seis pacientes foram divididos em quatro grupos: SCA com elevação do segmento ST (32 pacientes), SCA sem elevação do segmento ST (30 pacientes), doença arterial coronariana crônica (30 pacientes) e doadores de sangue sem doença coronariana conhecida (34 pacientes - grupo-controle). Nos primeiros dois grupos, amostras de soro foram coletadas na admissão (primeiras 24 horas de hospitalização) e após 6 meses de seguimento. Nos outros dois grupos, colheu-se apenas uma amostra basal. Em todas as amostras, anticorpos IgG anti-Chlamydia e anti-Mycoplasma foram dosados por imunofluorescência indireta. RESULTADOS: Diferenças significativas foram observadas entre a medida basal e após 6 meses de seguimento nos pacientes com infarto do miocárdio com elevação do segmento ST, tanto para Chlamydia (650±115,7 vs. 307±47,5, p = 0,0001) quanto para Mycoplasma (36,5±5,0 vs. 21,5±3,5, p = 0,0004). Os grupos com SCA tiveram níveis séricos de anticorpos anti-Chlamydia e anti-Mycoplasma mais altos na dosagem basal, em relação aos pacientes com doença arterial coronariana crônica e grupo-controle, mas as diferenças obtidas não tiveram significância estatística. CONCLUSÃO: O presente estudo mostrou associação entre os títulos de anticorpos anti-Chlamydia e anti-Mycoplasma na fase aguda dos pacientes com angina instável ou infarto do miocárdio.

BACKGROUND: Several infectious agents have been investigated since the association between atherosclerosis and infection was demonstrated; however, the results of these studies are contradictory. OBJECTIVE: To test the association between serum titers of anti-Chlamydia and anti-Mycoplasma antibodies in different forms of acute coronary syndromes (ACS). METHODS: One hundred and twenty-six patients were divided in 4 groups: ACS with ST- segment elevation (32 patients), ACS without ST-segment elevation (30 patients), chronic coronary artery disease (30 patients) and blood donors without known coronary disease (34 patients - control group). In the two first groups, serum samples were collected at hospital admission (first 24 hours of hospitalization) and after a 6-month follow-up. In the other two groups, only a basal sample was collected. Anti-Chlamydia and anti-Mycoplasma antibodies were measured by indirect immunofluorescence in all samples. RESULTS: Significant differences were observed between the basal sample and the one measured after a 6-month follow-up in patients with myocardial infarction with ST-segment elevation for Chlamydia (650±115.7 versus 307±47.5, p=0.0001) as well as Mycoplasma (36.5±5.0 versus 21.5±3.5, p=0.0004). The groups with ACS had higher anti-Chlamydia and anti-Mycoplasma serum antibody levels in the basal measurement, when compared to the patients with chronic coronary disease and the control group, but the differences were not statistically significant. CONCLUSION: The present study showed an association between the serum titers of anti-Chlamydia and anti-Mycoplasma antibodies in the acute phase of patients with unstable angina or myocardial infarction.

FUNDAMENTO: Se han investigado diversos agentes infecciosos desde que se evidenció la asociación entre infección y aterosclerosis, sin embargo esos estudios ofrecen resultados conflictivos. OBJETIVO: Probar la asociación entre títulos séricos de anticuerpos anti-Chlamydia y anti-Mycoplasma en diferentes formas de síndromes coronarios agudos (SCA). MÉTODOS: Se dividieron a 126 pacientes en 4 grupos: SCA con elevación del segmento ST (32 pacientes), SCA sin elevación del segmento ST (30 pacientes), enfermedad arterial coronaria crónica (30 pacientes) y donadores de sangre sin enfermedad coronaria conocida (34 pacientes - grupo-control). En los primeros dos grupos, muestras de suero se colectaron al ingreso (primeras 24 horas de hospitalización) y tras 6 meses de seguimiento. En los otros dos grupos, se colectó solamente una muestra basal. En todas las muestras, se dosificaron anticuerpos IgG anti-Chlamydia y anti-Mycoplasma por inmunofluorescencia indirecta. RESULTADOS: Se observaron diferencias significativas entre la medida basal y tras 6 meses de seguimiento en los pacientes con infarto de miocardio con elevación del segmento ST, tanto para Chlamydia (650±115,7 vs 307±47,5, p = 0,0001) como para Mycoplasma (36,5±5,0 vs 21,5±3,5, p = 0,0004). Los grupos con SCA tuvieron niveles séricos de anticuerpos anti-Chlamydia y anti-Mycoplasma más altos en la dosificación basal, con relación a los pacientes con enfermedad arterial coronaria crónica y grupo-control, sin embargo las diferencias obtenidas no tuvieron significancia estadística. CONCLUSIÓN: El presente estudio reveló asociación entre los títulos de anticuerpos anti-Chlamydia y anti-Mycoplasma en la fase aguda de los pacientes con angina inestable o infarto de miocardio.

Chronic Chlamydia pneumoniae infection and bronchial asthma: is there a link?

PURPOSE: Besides well-defined environmental causes, accumulating evidence suggests that respiratory tract infections play an important role in the pathogenesis of asthma. Among these Chlamydia pneumoniae infection has been discussed as possibly inducing the development of asthma. METHODS: This study was designed to investigate the presence of anti chlamydial IgG, IgA, and IgM antibodies by ELISA in serum samples of 60 adults with a clinical history of asthma and 100 healthy age and sex matched controls. All the samples positive for Chlamydial genus specific IgG antibodies were then subjected to Chlamydia pneumoniae species specific IgG antibody ELISA. RESULTS: The IgG anti chlamydial antibody-positivity rate in the patients with bronchial asthma (80%) was significantly higher in all age groups than that in the healthy age and sex matched controls (59%). No significant association was observed for IgA and IgM anti chlamydial antibodies. C. pneumoniae species specific IgG antibody seroprevalence was also found to be significantly higher in all age groups in comparison to controls (61.66% vs 38%). CONCLUSIONS: Serological evidence of chronic infection with C. pneumoniae was more frequent in patients with asthma compared with control subjects. Our results support the correlation of bronchial asthma and chronic infection with C. pneumoniae in Indian population.

Seroprevalence of Chlamydia pneumoniae in asthmatic children from Northern India.

Serum from children with chronic persistent asthma was subjected to C. pneumoniae IgG antibody determination. C. pneumoniae IgG serology suggestive of persistent infection was significantly higher in chronic persistent asthma group than in the control group. Seropositivity was significantly more in moderate and severe persistent groups than in the control subjects. There was no evidence of acute C. pneumoniae infection (IgM serology done in duplicate) in acute exacerbations.

Association of common chronic infections with coronary artery disease in patients without any conventional risk factors.

BACKGROUND & OBJECTIVES: Report from the west suggest an association of infections and inflammation with atherosclerotic coronary artery disease (CAD). Entire microbial burden from several simultaneous chronic infections could be more important than a single infection in promoting atherosclerosis. No study has been done in Indian population, investigating the association of various chronic infections with CAD. We therefore evaluated the presence of markers of chronic infections in CAD patients having no conventional risk factors and healthy individuals in a tertiary care hospital in north India. METHODS: Seropositivity to IgG antibodies was investigated for Chlamydia pneumoniae, Mycoplasma pneumoniae, and Helicobacter pylori in 30 CAD patients with no conventional risk factors scheduled for coronary artery bypass surgery and in healthy blood donors. Periodontal pathogens were isolated by aerobic and anaerobic culture. RESULTS: All patients except one were < 55 yr of age and six were younger than 40 yr. Seropositivity to C. pneumoniae was significantly higher in CAD patients than healthy controls (63.3 vs. 23.3%, P<0.01). Combined seropositivity to both C. pneumoniae and M. pneumoniae was significantly higher in CAD patients with myocardial infarction (MI) than those without MI (61.5 vs. 11.8%, P<0.05). Aerobic and anaerobic cultures for the isolation of periodontal pathogens were positive in seven patients and five healthy blood donors. INTERPRETATION & CONCLUSION: C. pneumoniae seropositivity was significantly higher (P<0.001) in CAD patients without any of the conventional risk factors for CAD. Combined seropositivity to C. pneumoniae and M. pneumoniae was significantly higher (P<0.05) in CAD patients with MI than in those without MI. Possibly CAD in young is not (or less) governed by conventional risk factors, and infectious agents can be potential risk factors for the development of atherosclerosis and CAD in this subset of patients.

Community-acquired pneumonia by Chlamydophila pneumoniae: a clinical and incidence study in Brazil

As there was not any data on Chlamydia pneumoniae (TWAR) infections in Brazil so far, a prospective cohort study of adult patients hospitalized due to CAP was carried out for one year in a Brazilian university general hospital to detect the incidence of CAP by Chlamydophila pneumoniae (TWAR) for one year. During a whole year 645 consecutive patients hospitalized due to an initial presumptive diagnosis of respiratory diseases by ICD-10 (J00-J99), excluding upper respiratory diseases, were screened; 59 consecutive patients with CAP were diagnosed. They had determinations of serum antibodies to C. pneumoniae by microimmunofluorescence at the Infectious Diseases Laboratory of University of Louisville (KY, USA); 37 patients (63.8 percent) had seroreactivity to TWAR antigens, from which 23 (39.6 percent) had previous infection; 3 patients (5.2 percent) were diagnosed with CAP by TWAR and got cured. The incidence of TWAR CAP in our hospital by seroconversion was 5.2 percent. Our incidence of 5.2 percent is probably underestimated since TWAR culture was not available; we suggest that Real-Time PCR be used along with other diagnostic methods in future studies to detect the actual incidence of TWAR CAP. We propose that the serological criterion of IgM >1:16 alone to the diagnosis of acute infection by TWAR are discontinued due a lack of specificity.

Titration of specific antibodies to mycoplasma pneuomoniae, Chlamydia pneumoniae and Legionella pneumophila among Iranian pilgrims' sera during Hajj season in 2004

Respiratory tract infection is the most common diseases among Iranian pilgrims during Hajj season. To understand the possibility of bacterial involvement in such infections, we screened the pilgrims' sera to determine the titer of antibodies against Mycoplasma pneuomoniae [MP], Chlamydia pneumoniae [CP] and Legionella pneumophila [LP]. Serum samples from 128 pilgrims were collected, before the trip and one month after returning home. Antibodies to MP, CP, LP were assayed using Immunoflourecent and ELISA methods. IgM antibody titre to CP did not elevated, but IgG antibody titer was increased in 34.58% [n=48] and 15.82% [n=22] of cases, indicating of recent infection. The specific antibodies to MP and LP were not increased. In pilgrims infected with an atypical respiratory pathogen, C. pneumoniae should be considered as an important causative. The true prevalence of this pathogen should be investigated since it relies on the sensitivity and specificity of currently available diagnostic methods

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.

Anticuerpos contra Chlamydophilaen pacientes con infarto agudo del miocardio y riesgo coronario, y su relación con la muerte / Antibodies against Chlamydophila in patients with acute myocardial infarction and coronary risk and their association with mortality

OBJETIVO: Determinar si los anticuerpos contra Chlamydophila pneumoniae en pacientes con infarto agudo del miocardio y factores de riesgo coronario se asocian con la muerte. MATERIAL Y MÉTODOS: Se hizo un estudio observacional, prospectivo, transversal y comparativo. Se incluyeron en el estudio 100 sujetos que, entre 1999 y 2000, estuvieron hospitalizados en la Unidad Coronaria del Hospital de Especialidades del Centro Médico La Raza, del Instituto Mexicano del Seguro Social. Se trataba de una muestra constituida por pacientes de ambos sexos, mayores de 18 años, con infarto agudo del miocardio y riesgo coronario. Mediante microinmunofluorescencia indirecta se identificaron anticuerpos contra Chlamydophila pneumoniae, Chlamydophila psitacii y Chlamydia trachomatis. De entre los 100 sujetos, se eligieron al azar 33, a quienes se les determinaron anticuerpos contra Chlamydophila, no sólo durante su estancia en el hospital, sino también al salir de éste y a los tres meses de haber sufrido el infarto agudo del miocardio. Se calcularon las medias y las desviaciones geométricas estándares para los títulos de anticuerpos contra Chlamydophila, y se determinó la razón de momios y el intervalo de confianza al 95 por ciento entre los factores de riesgo coronario y la muerte. RESULTADOS: Setenta por ciento de los pacientes de la muestra inicial presentaron anticuerpos contra Chlamydophila pneumoniae; no se identificaron anticuerpos contra Chlamydophila psitacii y Chlamydia trachomatis. No se observó una fuerza de asociación estadísticamente significativa con la muerte en pacientes con infarto agudo del miocardio y factores de riesgo coronario. De los 33 individuos de la submuestra, 25 presentaron anticuerpos contra Chlamydophila pneumoniae, y en 83 por ciento de estos últimos casos, se registró un descenso de dichos anticuerpos a los tres meses de haberse presentado el infarto agudo del miocardio. CONCLUSIONES: A pesar de que en pacientes con infarto agudo del miocardio y riesgo coronario se presentó un incremento en la frecuencia de seropositividad a Chlamydophila pneumoniae, no se observó una fuerza de asociación estadísticamente significativa de ello con la muerte.

Immunocomb Chlamydia bivalent assay to study Chlamydia species-specific antibodies in patients with coronary heart disease.

BACKGROUND & OBJECTIVE: Serological evidences suggested an association between Chlamydia pneumoniae infection and coronary heart disease (CHD). Efficacy of available serological tests for detection of C. pneumoniae antibody has been debated. The present study was carried-out to assess the efficacy of Immunocomb Chlamydia bivalent IgG assay vis-à-vis micro immunofluorescence (MIF) test in detecting C. pneumoniae and C. trachomatis--specific antibodies in patients with CHD. METHODS: Serum samples collected from clinically confirmed cases of CHD (n=114) were subjected to Immunocomb Chlamydia bivalent assay and the standard MIF test. Antibodies specific to C. pneumoniae and C. trachomatis were detected quantitatively. RESULTS: Though Immunocomb Chlamydia bivalent test yielded 73.7 per cent positivity for C. pneumoniae- specific IgG antibody (compared to 50.8% by MIF), the specificity of Immunocomb was found only 32.14 per cent. Positive and negative predictive values of Immunocomb assay were 54.8 and 60.0 per cent respectively. INTERPRETATION & CONCLUSION: The findings of the present study indicated that though Immunocomb assay was inferior to MIF, it can be used as a method for presumptive serology due to its rapidity and ease of performance. Wherever possible, one or more additional tests should also be performed to increase the specificity of such studies.

Prevalence and clinical features of Chlamydia pneumoniae pneumonia at Srinagarind Hospital, Khon Kaen, Thailand.

Between October 2000 and December 2002, a prospective study was conducted among hospitalized community acquired pneumonia (CAP) patients admitted to Srinagarind Hospital, Khon Kaen, Thailand. The diagnosis of Chlamydia pneumoniae infection was based on serologic testing. The prevalence of C. pneumoniae among patients hospitalized with CAP was 8.7%; 24 cases of 276 hospitalized CAP patients. The mean age was 42.7 (range, 17-79) years and the male to female ratio was 1:2.4. More than half (54.2%) of them were without underlying disease. The mean duration of symptoms prior to admission was 5.5 (SD 3.7) days. Leukocytosis was found in 62.5% of patients. Localized patchy alveolar infiltration was the most common radiographic finding, followed by bilateral interstitial infiltration. Over half (52.4%) of the patients had a non-productive cough. Gram-positive diplococci or no organisms predominated in cases where adequate sputum was obtained. Dual infection was found in 45.8% of cases, mostly with Streptococcus spp or Klebsiella pneumoniae. Four patients (16.7%) had an initial clinical presentation of severe CAP; 3 of 4 had a dual infection. Ten patients (41.7%) received macrolides or a macrolide plus a third generation beta-lactam at the beginning of management. Two patients (8.3%) did not improve clinically and were transferred home. The average hospital stay was 11 .5 (range, 1-45) days. Parapneumonic effusions complicated 20.8% of the cases. Other complications included acute respiratory failure (16.7%), shock (8.3%), hospital-acquired pneumonia (8.3%), and acute renal failure (4.2%). We concluded that C. pneumoniae caused a wide variation of clinical presentations ranging from mild disease to severe CAP. Co-infection with other bacterial pathogens was a common finding. Use of macrolides or new fluoroquinolones as part of an initial therapeutic regimen should be considered to cover this organism.

Etiologies and treatment outcomes in patients hospitalized with community-acquired pneumonia (CAP) at Srinagarind Hospital, Khon Kaen, Thailand.

Local epidemiological data on the etiologies of in-patients who are hospitalized with CAP is needed to develop guidelines for clinical practice. This study was conducted to determine the pattern of microorganisms causing community-acquired pneumonia (CAP) in adult patients admitted to Srinagarind Hospital, Khon Kaen, Thailand, between January 2001 and December 2002. Altogether, 254 patients (124 males, 130 females) averaging 56.4 (SD 19.8) years were included. Eighty-six of them (33.8%) presented with severe CAP on initial clinical presentation. The etiologies for the CAP cases were discovered by isolating the organisms from the blood, sputum, pleural fluid, and other sterile sites. Serology for Chlamydia pneunmoniae and Mycoplasma pneumoniae were performed to diagnose current infection. The causative organisms were identified in 145 patients (57.1%). Streptococcus pneumoniae was the commonest pathogen, identified in 11.4% of the cases, followed by Burkholderia pseudomallei (11.0%) and Klebsiella pneumoniae (10.2%). The atypical pathogens, C. pneumoniae and M. pneumoniae, accounted for 8.7% and 3.9% of the isolates, respectively. Sixteen patients (6.3%) had dual infections; C. pneumoniae was the most frequent coinfecting pathogen. The average length of hospital stay was 12.9 (SD 14.0) days, with 27.9% staying more than 2 weeks. Overall, 83.9% of the patients improved with treatment, 10.2% did not improve and 5.9% died. The most common complications were acute respiratory failure (31.1%) and septic shock (20.9%). We conclude that initial antibiotic use should cover the atypical pathogens, C. pneumoniae and M. pneumoniae, in hospitalized CAP patients. B. pseudomallei is an endemic pathogen in Northeast Thailand, and should be considered in cases of severe CAP.

Seroprevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in Stable Asthma and Chronic Obstructive Pulmonary Disease

Mycoplasma pneumoniae and Chlamydia pneumoniae have been suggested to take part in the acute exacerbation of bronchial asthma and chronic obstructive pulmonary disease (COPD). Several studies have questioned whether they may play pathogenic roles in connection with bronchial asthma and COPD. This study was designed to evaluate the seroprevalences of M. pneumoniae and C. pneumoniae in stable asthma and COPD patients, and to compare with control patients. The medical records of one hundred forty patients who underwent M. pneumoniae and C. pneumoniae serology were retrospectively reviewed. Seroprevalences of M. pneumoniae and C. pneumoniae in the asthma group (11.1% and 8.3%, respectively) were higher than in the control group (4.4% and 2.2%, respectively) without statistical significance. The seroprevalence of M. pneumoniae in the COPD group (16.9%) was significantly higher than in the control group, and the seroprevalence of C. pneumoniae in the COPD group (3.4%) was higher than in the control group without statistical significance. This study raises important questions about the relation of M. pneumoniae and C. pneumoniae infection with stable asthma or COPD.

Follicular cervicitis: a case report.

Chronic follicular cervicitis (CFC) is a benign inflammatory condition which can be easily diagnosed with a fair degree of assurance on pap stained cervical smears, thus preventing the need for cervical biopsy. We report a case of CFC in a postmenopausal woman.

Prevalence and incidence of Chlamydia pneumoniae antibodies among the healthy elderly and patients with chronic obstructive pulmonary diseases.

Chlamydia pneumoniae is an obligatory intracellular bacteria which can cause both acute and chronic respiratory tract infection. The significance of chronic and recurrent respiratory infection may be of prime importance in chronic obstructive pulmonary diseases (COPD). The purpose of this study was to determine the prevalence and incidence of C. pneumoniae antibodies in elderly COPD patients compared to a healthy elderly control group. C. pneumoniae antibodies were detected by an enzyme-linked immunosorbent assay in serum samples obtained from 127 elderly COPD patients and a 131 healthy elderly control group. The results showed that the seroprevalence of C. pneumoniae infection as determined by the existence of specific IgG or IgA or IgM antibodies was 96.1% in the COPD patients and 75.6% in the control group (p < 0.01). The prevalence of individual C. pneumoniae IgG, IgA and IgM in elderly COPD vs healthy control was 85.8% vs 66.4%, 85.0% vs 51.1% and 3.9% vs 0%, respectively. The incidence or seroconversion rate of C. pneumoniae antibodies after one year follow-up was found to be 33% in the COPD patients and 67.9% in the control group. High prevalence and incidence of C. pneumoniae antibodies indicates that both acute and chronic C. pneumoniae infection play a role in elderly COPD patients. Therefore, antibiotics of choice for C. pneumoniae infection should probably be considered.

Análise da associação de esclerose múltipla e infecção por Chlamydia pneumoniae / Analysis of association between multiple sclerosis and Chlamydia pneumoniae infection

A Esclerose Múltipla (EM) é uma doença crônica do sistema nervoso central de etiologia desconhecida. Nos últimos anos as pesquisas sobre a associação entre a Chlamydia pneumoniae e EM tem revelado resultados não convergentes. Assim, realizamos um estudo caso-controle pesquisando a presença de anticorpos IgG e IgM em sangue e líquor, pelo método de microimunofluorescência em 40 casos e 40 controles. Entre os casos, 30 foram positivos no estudo laboratorial, e entre controles 31(OR 1.15 - IC 0.36-3.67) ( p 0.79). Conclui-se, nesta amostra, que a Chlamydia pneumoniae não constitui explicação etiológica para a EM. / Multiple Sclerois (MS) is a central nervous system chronic disease of unknoun etiology. Over the last five years studies about the association between MS and Chlamydia pneumoniae have shown disagreeing results . We have carried out a case-control study looking for IgG and IgM antibodies through the micro-immunoflurescent antibody test in 40 cases and 40 controls. Among the cases, 30 have come out positive in the laboratory study and 31 among the controls ( OR 1.15-CI 0.36 - 3.67) ( p 0.79). In this sample we come to the conclusion that Chlamydia pneumoniae is not an etiological explanation for MS...