IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality... more IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality in children with nearly one million deaths occurring yearly worldwide. [1] Diagnosis of LRTI is generally made based on both clinical and laboratory findings. The main causes of LRTI in young children are viruses and bacteria. Although respiratory pathogens can be identified in about 25%-50% of cases of LRTI, [2-6] initial therapy is generally empiric. This is so because of the inability to determine the causative organisms in most of the patients by the time treatment is initiated. [7] One of the factors contributing to the unidentified etiology in LRTI is the difficulty in identifying atypical pathogens such as Mycoplasma pneumoniae, C. pneumoniae, Legionella spp. that do not respond to routinely used beta-lactam antibiotics for LRTI. The present study was done to determine the incidence of LRTI due to Chlamydia pneumoniae in young children. Introduction: Lower respiratory tract infections (LRTIs) continue to be a major health problem in children. Increasingly "atypical" agents such as Chlamydophila pneumoniae are being recognized as a significant cause of LRTI. The current study evaluated serological and molecular methods in detection of LRTI due to C. pneumoniae in young children. Materials and Methods: Serum and nasopharyngeal aspirate (NPA) were collected from 53 treatment-naïve children (6 months-6 years) with LRTI. Immunoglobulin M (IgM) and IgG antibodies to C. pneumoniae were detected in serum by enzyme-linked immunosorbent assay (ELISA) and microimmunofluorescence (MIF) test. Nonnested polymerase chain reaction (PCR) to detect a 183-bp fragment of the 60-kDa outer membrane protein 2 of C. pneumoniae was performed on DNA extracted from the NPA samples. Results: Of the 53 children tested, 14 (26.4%) children were diagnosed to have acute C. pneumoniae infection according to CDC guidelines. When compared with IgM MIF (reference test), PCR and IgM ELISA showed a sensitivity of 36% and 71%, respectively, and a specificity of 100%. IgG antibodies were positive in an additional 8 cases, by both MIF and ELISA, suggesting "possible" reinfection. Conclusion: This study despite its drawbacks provides evidence that C. pneumoniae is a significant cause of LRTI in young children.
IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality... more IntRoductIon Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality in children with nearly one million deaths occurring yearly worldwide. [1] Diagnosis of LRTI is generally made based on both clinical and laboratory findings. The main causes of LRTI in young children are viruses and bacteria. Although respiratory pathogens can be identified in about 25%-50% of cases of LRTI, [2-6] initial therapy is generally empiric. This is so because of the inability to determine the causative organisms in most of the patients by the time treatment is initiated. [7] One of the factors contributing to the unidentified etiology in LRTI is the difficulty in identifying atypical pathogens such as Mycoplasma pneumoniae, C. pneumoniae, Legionella spp. that do not respond to routinely used beta-lactam antibiotics for LRTI. The present study was done to determine the incidence of LRTI due to Chlamydia pneumoniae in young children. Introduction: Lower respiratory tract infections (LRTIs) continue to be a major health problem in children. Increasingly "atypical" agents such as Chlamydophila pneumoniae are being recognized as a significant cause of LRTI. The current study evaluated serological and molecular methods in detection of LRTI due to C. pneumoniae in young children. Materials and Methods: Serum and nasopharyngeal aspirate (NPA) were collected from 53 treatment-naïve children (6 months-6 years) with LRTI. Immunoglobulin M (IgM) and IgG antibodies to C. pneumoniae were detected in serum by enzyme-linked immunosorbent assay (ELISA) and microimmunofluorescence (MIF) test. Nonnested polymerase chain reaction (PCR) to detect a 183-bp fragment of the 60-kDa outer membrane protein 2 of C. pneumoniae was performed on DNA extracted from the NPA samples. Results: Of the 53 children tested, 14 (26.4%) children were diagnosed to have acute C. pneumoniae infection according to CDC guidelines. When compared with IgM MIF (reference test), PCR and IgM ELISA showed a sensitivity of 36% and 71%, respectively, and a specificity of 100%. IgG antibodies were positive in an additional 8 cases, by both MIF and ELISA, suggesting "possible" reinfection. Conclusion: This study despite its drawbacks provides evidence that C. pneumoniae is a significant cause of LRTI in young children.
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