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[Acute respiratory Chlamydia pneumoniae infections in adults. Value of direct gene amplification diagnosis] Infections respiratoires aigues de l'adulte a Chlamydia pneumoniae. Interet du diagnostic direct par amplification
genique.
Vincent F, Petitjean J, Filmont JE, Le Moel G, Fontaine V, Vabret A Freymuth F, Brun J
Rev Mal Respir (1999 Dec) 16(6):1131-7 ISSN:
0761-8425
Chlamydia pneumoniae
Chlamydia Infections
Polymerase Chain Reaction
Respiratory Tract Infections
Acute Disease
Adult
Aged
Aged, 80 and over
Antibodies, Bacterial
Asthma
Community-Acquired Infections
Comparative Study
DNA, Bacterial
English Abstract
Enzyme-Linked Immunosorbent Assay
Female
Human
Lung Diseases
Lung Diseases, Obstructive
Male
Middle Age
Medline Database
Healthstar Database
Published in French
Abstract
Chlamydia pneumoniae has been established recently as an important human respiratory pathogen. The aim of this study was to define the incidence of Chlamydia pneumoniae in acute respiratory infections by evaluating its presence in posterior nasopharyngeal aspirates or broncho-alveolar lavage specimens by polymerase chain reaction- hybridization (PCR-EIA) as well as the titres of specific antibodies in serum by a rELISA test and a micro-immunofluorescence (MIF) test. 68 adults patients were investigated. Eight patients (11.8%) were positive by either rELISA or PCR-EIA or both, with an infection rate of 5 patients with community-acquired pneumonia, 2 asthmatic patients and 1 patients with an exacerbation of chronic obstructive pulmonary disease. Serological evidence of acute
infection was found in four of these patients with rELISA test and in three others with MIF test. PCR-EIA detected Chlamydia pneumoniae DNA in four patients, but there were concordant results with rELISA and PCR-EIA in only one patient. In conclusion, Chlamydia pneumoniae appears to be a common etiologic agent of acute respiratory infections in adults. The discrepancy between serological test and PCR-EIA results reflects the difficulties in routine laboratory diagnosis of Chlamydia pneumoniae. The ambiguous results of serological tests from a single serum sample assess the utility of PCR for prompt diagnosis. When PCR is negative or no feasible, a second serology to 15/21 days of interval is necessary. Further studies with optimised techniques must be developed.
Service de Pneumologie
Hopital Cote de Nacre
CHRU de Caen. bellini@club-internet.fr
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