Prevalence, rate of persistence and respiratory tract symptoms of Chlamydia pneumoniae infection in 1211 kindergarten and school age children

Schmidt, Sebastian; Müller, Cornelia; Mahner, B; Wiersbitzky, S

doi:10.1097/00006454-200208000-00012

Cited by 35 publications

(34 citation statements)

References 24 publications

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“…In our study, the median duration of positivity was about five months, and long-term positivity and reversion to positivity were observed in only a few cases. Very few cases showed significant elevation of IgG and IgA antibody titers, and this may be due to low antibody productivity in childhood [22], suggesting that IgM antibody measurement is essential for the diagnosis of C. pn infection by ELISA in children. The presence of false positive cases is possible even though the cut-off value of the ELISA C.pn IgM antibody titer is elevated, but it may be appropriate to regard HITAZYME ELISA C. pn IgM ID C2.0 as positive for the primary diagnosis of C. pn infection.…”

Section: Discussionmentioning

confidence: 99%

The validity of the criteria for primary infection of Chlamydophila pneumoniae in children by measuring ELISA IgM antibodies

Kamata

Obinata

Niizuma

et al. 2012

Journal of Infection and Chemotherapy

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Section: Discussionmentioning

confidence: 99%

The validity of the criteria for primary infection of Chlamydophila pneumoniae in children by measuring ELISA IgM antibodies

Kamata

Obinata

Niizuma

et al. 2012

Journal of Infection and Chemotherapy

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“…When elevated, IgM antibodies for C. pneumoniae and M. pneumoniae are considered indicative of acute infection, although they may not be elevated early in the disease course or with reinfection. We cannot verify that the two specimens that were culture negative and PCR positive for C. pneumoniae represented true disease or colonization given that C. pneumoniae is known to asymptomatically colonize the respiratory tract (2,9). Considering the high quantity of DNA target present, it is likely to represent true disease, but data correlating organism load and disease are lacking.…”

mentioning

confidence: 99%

Limited Utility of Culture for Mycoplasma pneumoniae and Chlamydophila pneumoniae for Diagnosis of Respiratory Tract Infections

et al. 2010

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We assessed the utility of culture for Mycoplasma pneumoniae and Chlamydophila pneumoniae to diagnose respiratory tract infections. Compared to PCR and IgM serology, culture was less sensitive and had extremely low yield. Culture is not recommended for these pathogens, and this method should be eliminated from routine practice.The etiology of respiratory tract infections can be difficult to diagnose by health care practitioners because clinical history and symptoms are usually nonspecific for most communityacquired pathogens. Mycoplasma pneumoniae and Chlamydophila pneumoniae cause up to 22% of community-acquired pneumonias and 5 to 10% of cases of tracheobronchitis, pharyngitis, laryngitis, and sinusitis (3-4, 7, 10, 12). Historically, culture has been the gold standard for diagnosis. However, cultivation of these microorganisms can prove challenging because they are fastidious and may require weeks for growth. Serology is more convenient and sensitive than culture, but results are often delayed, and false-negative test results often occur early in the course of illness. Although not standardized, nucleic acid-based tests, such as PCR, provide fast and sensitive results. While such tests are not always available on site in many medical centers, the 24-to 48-h delay in transit time may still be acceptable given the higher diagnostic yield of PCR.Despite the obvious limitations of culture, physicians continue to order this test frequently. In recent years, ARUP Laboratories has received large numbers of requests, including more than 3,000/year for M. pneumoniae and more than 1,500/ year for C. pneumoniae culture. Studies focusing on the value of culture either have been small in scale or have used type strains or patient isolates rather than direct patient specimens (8,13). An accurate and reliable diagnosis of M. pneumoniae and C. pneumoniae is important to differentiate them from other common respiratory pathogens because their treatments differ (1). Being aware of the poor sensitivity of culture for these pathogens, we found the high numbers of test requests for M. pneumoniae and C. pneumoniae culture from respiratory tract specimens to be concerning and to require further investigation. To examine more closely the utility of culture for diagnosing respiratory syndromes, we compared its performance to those of nucleic acid testing and serology for detection of M. pneumoniae and C. pneumoniae.From 2003 to 2008, microbiology results of culture, PCR, and serology performed at ARUP Laboratories for M. pneumoniae and C. pneumoniae were retrospectively reviewed with a specific focus on respiratory specimens (e.g., nasal wash, nasopharyngeal swab, bronchoalveolar lavage, tracheal aspirate, sputum, and pleural fluid) for PCR and culture. Respiratory specimens were transported either refrigerated or frozen, except for C. pneumoniae culture, for which only refrigerated specimens were transported. Additional data were collected for M. pneumoniae culture (1995 to 2003). C. pneumoniae enzyme-linked immunosorbent assay (ELI...

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“…Nevertheless, an IgG antibody prevalence rate of about 23% in the first age class is consistent with an early exposure to C pneumoniae infection in the community. 21 We found that the seroprevalence was not related to crèche attendance, family crowding, social status, or external tobacco smoke. Collectively, our data show that several social and environmental conditions are not related to the burden of C pneumoniae infection in this area, and that only strong differences in exposure could translate into substantial differences in seroprevalence.…”

Section: Discussionmentioning

confidence: 59%

A population based seroepidemiological survey ofChlamydia pneumoniaeinfections in schoolchildren

et al. 2005

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Aim: A serosurvey was carried out in schoolchildren from a northeastern area of Italy to define the burden of Chlamydia pneumoniae infection. Methods: A sample of 649 schoolchildren underwent a simplified version of the International Study of Asthma and Allergies in Childhood questionnaire and IgG and IgA antibodies were investigated using an enzyme immunoassay, followed by a microimmunofluorescence assay in reactive sera. Results: Of the children examined, 29% and 19.7% had IgG and IgA antibodies, respectively. The IgG prevalence increased with age. No other sociodemographical variable was related to C pneumoniae infection. An association was established between IgA prevalence and previous otitis media. Conclusions: A mesoendemic (intermediate between high and low endemic level) pattern of C pneumoniae infection is present in schoolchildren from this area and the prevalence rate is related to age. Moreover, this is the first epidemiological evidence of the role of C pneumoniae in otitis.

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Prevalence, rate of persistence and respiratory tract symptoms of Chlamydia pneumoniae infection in 1211 kindergarten and school age children

Abstract: We conclude that infection is common in the childhood population studied with seasonal variations in prevalence and epidemic-like occurrence. Asymptomatic infection occurs, especially in teenagers, but persistent infection is rare.

Cited by 35 publications

References 24 publications

The validity of the criteria for primary infection of Chlamydophila pneumoniae in children by measuring ELISA IgM antibodies

The validity of the criteria for primary infection of Chlamydophila pneumoniae in children by measuring ELISA IgM antibodies

Limited Utility of Culture for Mycoplasma pneumoniae and Chlamydophila pneumoniae for Diagnosis of Respiratory Tract Infections

A population based seroepidemiological survey ofChlamydia pneumoniaeinfections in schoolchildren

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