Chlamydia trachomatis and lower respiratory tract infection during infancy in Assiut

ABSTRACT

The study included 330 cases with lower acute respiratory tract infection [LARI] as well as 100 controls. Their ages ranged from 0 to 12 months [median 5 -months]. The cases were subjected to full clinical and radiological examination. The cases and controls were subjected to laboratory investigations which included determination of antichlamydial antibodies of IgG fraction in the serum, as well as gastric aspirate direct smear for determination of polymorphonuclear leucocytic proportion in relation to other cells and for bacterial and fungal detection. Cultures from gastric aspirate were done for bacterial and fungal isolation. The frequency of chlamydia trachomatis LARI was present in 15.2% of our cases. 29% of our cases with LARI between 1-6 months of age were due to chlamydia infection. The commonest presenting clinical picture of chlamydia LARI was that of bronchiolitis. The frequency of chlamydia bronchiolitis in our cases with LARI was significantly higher in low socio-economic state than the rest of the cases, in rural than urban cases, among artificially fed infants than breast fed ones and during spring and summer than autumn and winter. The frequencies of both acute otitis media and gastroenteritis were significantly higher among chlamydia LARI than other causes of LARI. The prognosis of chlamydia bronchiolitis was good except when associated with other bacterial infection. Gastric aspirate study proved to be as the sensitivity for direct gastric aspirate smear in detecting pathogenic micro-organisms In relation to culture was 84.6% for Candida, 81.3% for single bacterial infection and 69.7% for mixed bacterial infection useful tool in the diagnosis bacterial and fungal LARI in infancy, Chlamydial LARI should be considered in infants below 6 months of age with bronchiolitis