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European Journal of Pediatrics

, Volume 177, Issue 8, pp 1255–1260 | Cite as

Influence of different delivery modes on the clinical characteristics of Chlamydia trachomatis pneumonia

  • Jiejing Xu
  • Lili Yu
  • Baidi Fu
  • Deyu Zhao
  • Feng Liu
Original Article

Abstract

We analyzed the effects of delivery methods on Chlamydia trachomatis pneumonia in infants. Three hundred forty-four children hospitalized with Chlamydia trachomatis pneumonia were enrolled. They were divided into the vaginal delivery group and the cesarean delivery group. We compared and analyzed their age of onset, peripheral blood white blood cell count, liver enzymes, chlamydia trachomatis titers, and chest radiograph scores. Seventy-eight (22.7%) were delivered by a cesarean, and 266 (77.3%) were delivered vaginally. There were no statistically significant differences between groups when compared by sex and age (P > 0.05). Copy numbers and white blood cell counts in the peripheral blood of children with Chlamydia trachomatis in respiratory secretions of the vaginal delivery group were significantly higher than those of the cesarean delivery group (P < 0.05). The alanine aminotransferase and aspartate aminotransferase levels between groups were not statistically significant. Comparisons of admission chest radiography scores, discharge radiography scores, and score differences showed no statistical differences (P > 0.05).

Conclusion: Infants delivered by cesarean comprise approximately one-fifth of those affected. The Chlamydia trachomatis titers and peripheral blood leukocyte counts of the vaginal delivery group were higher than those of the cesarean delivery group. Age of onset, liver enzymes, pulmonary inflammation, and pneumonia absorption were not different between groups.

What is Known:

Chlamydia trachomatis is an important pathogen that causes lower respiratory tract infections in infants.

C. trachomatis is primarily transmitted to infants through the infected mother, resulting in Chlamydia trachomatis pneumonia subsequently.

What is New:

Vaginal delivery and cesarean delivery can result in Chlamydia trachomatis pneumonia transmission; however, cesarean delivery accounts for ~ 20% of cases.

C. trachomatis volume in the respiratory tract and the number of peripheral blood leukocytes in infants delivered vaginally were higher than those in infants delivered by cesarean.

Keywords

Chlamydia trachomatis Delivery modes Childhood pneumonia Clinical characteristics 

Abbreviations

ALT

Alanine aminotransferase

AST

Aspartate aminotransferase

WHO

World Health Organization

Notes

Authors’ contributions

Jiejing Xu and Lili Yu are joint principal authors who contributed to the conception and design of the study and conducted the data analysis and wrote the paper; Baidi Fu helped to collect the clinical data. Deyu Zhao and Feng Liu are joint corresponding authors who supervised the study, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Funding

This study was supported by grants from the Nanjing Medical Science and Technique Development Foundation, Nanjing, China (JQX15008), and Jiangsu Youth Medical Talent Foundation, Nanjing, China (QNRC2016087). This study was supported by the project which is correlation analysis between the genotypes of Mycoplasma pneumoniae V district and the clinical prognosis (No. 201723003). Project was also supported by the National Science Foundation for Young Scientists of China (Grant No. 81700035).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

References

  1. 1.
    Airenne S, Surcel H-M, Alakärppä H, Laitinen K, Paavonen J, Saikku P, Laurila A (1999) Chlamydia pneumoniae infection in human monocytes. Infect Immun 67(3):1445–1449PubMedPubMedCentralGoogle Scholar
  2. 2.
    Moazed TC, Kuo CC, Crrayston JT, Campbell LA (1998) Evidence of systemic dissemination of Chlamydia pneumoniae via macrophages in the mouse. J Infect Dis 177(5):1322–1325CrossRefPubMedGoogle Scholar
  3. 3.
    Choroszy-Król IC, Frej-Mądrzak M, Jama-Kmiecik A, Bober T, Jolanta Sarowska J (2012) Characteristics of the chlamydia trachomatis species—immunopathology and infections. Adv Clin Exp Med 21(6):799–808PubMedGoogle Scholar
  4. 4.
    Brunham RC, Zhang DJ, Yang X, McClarty GM (2000) The potential for vaccine development against chlamydial infection and disease. J Infect Dis 181(3):538–543CrossRefGoogle Scholar
  5. 5.
    Igietseme JU, Black CM, Caldwell HD (2002) Chlamydia vaccines: strategies and status. BioDrugs 16(1):19–35CrossRefPubMedGoogle Scholar
  6. 6.
    Honkila M, Wikström E, Renko M, Surcel H-M, Pokka T, Ikäheimo I, Uhari M, Tapiainen T (2017) Probability of vertical transmission of Chlamydia trachomatis estimated from national registry data. Sex Transm Infect 93(6):416–420CrossRefPubMedGoogle Scholar
  7. 7.
    Reisvuo S (2004) World authority of the medical translation of the translation-female genital tract infectious diseases. 4 version. Science and Technology Press, Shandong, pp 56–87Google Scholar
  8. 8.
    Yu J, Wu S, Li F, Hu L (2009) Vertical transmission of Chlamydia trachomatis in Chongqing China. Curr Microbiol 58(4):315–320CrossRefPubMedGoogle Scholar
  9. 9.
    Chen CJ, Wu KG, Tang RB, Yuan HC, Soong WJ, Hwang BT (2007) Characteristics of Chlamydia trachomatis infection in hospitalized infants with lower respiratory tract infection. J Microbiol Immunol Infect 40(3):255–259CrossRefPubMedGoogle Scholar
  10. 10.
    Zifang J, Shen K, Shen Y (2015) Zhu Fu Tang practical pediatrics, 8th edn. People’s Medical Publishing House, Beijing, pp 1063–1065Google Scholar
  11. 11.
    Deng H, Rui J, Zhao D, Liu F (2018) Mycoplasma pneumoniae 23S rRNA A2063G mutation does not influence chest radiography features in children with pneumonia. J Int Med Res 46(1):150–157CrossRefPubMedGoogle Scholar
  12. 12.
    Toni Darville MD (2005) Chlamydia trachomatis infections in neonates and young children. Semin Pediatr Infect Dis 16(4):235–244CrossRefPubMedGoogle Scholar
  13. 13.
    Gaydos CA, Summersgill JT, Sahney NN, Ramirez JA, Quinn TC (1996) Replication of Chlamydia pneumonia in vitro in human macrophages, endothelial cells and aortic smooth muscle cells. Infect Immun 64(5):1614–1620PubMedPubMedCentralGoogle Scholar
  14. 14.
    Cates W, Wasserheit JN (1991) Genital chlamydial infections: epidemiology and reproductive sequelae. Am Jobstet Gynecol 164:1771–1781CrossRefGoogle Scholar
  15. 15.
    Norman J (2002) Epidemiology of female genital Chlamydia trachomatis infections. Best Pract Ros Clin Obstet Gynaecol 16(6):775–787CrossRefGoogle Scholar
  16. 16.
    K.L. Hon, A.K. Leung (2013) Chlamydial pneumonitis: a creepy neonatal disease. Case Rep Pediatr, p. 549–649Google Scholar
  17. 17.
    Bellulo S, Bosdure E, David M, Rolain JM, Gorincour G, Dubus JC (2012) Chlamydia trachomatis pneumonia: two atypical case reports. Arch Pediatr 19:142–145CrossRefPubMedGoogle Scholar
  18. 18.
    Herieka E, Dhar J (2001) Acute neonatal respiratory failure and Chlamydia trachomatis. Sex Transm Infect 77(2):135–136CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Webley WC, Tilahun Y, Lay K et al (2009) Occurrence of Chlamydia trachomatis and Chlamydia pneumonia in paediatric respiratory infections. Eur Respir J 33:360–367CrossRefPubMedGoogle Scholar
  20. 20.
    Duijts L (2012) Fetal and infant origins of asthma. Eur J Epidemiol 27(1):5–14CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Bisgaard H, Hermansen MN, Buchvald F, Loland L, Halkjaer LB, Bønnelykke K, Brasholt M, Heltberg A, Vissing NH, Thorsen SV, Stage M, Pipper CB (2007) Childhood asthma after bacterial colonization of the airway in neonates. N Engl J Med 357(15):1487–1495CrossRefPubMedGoogle Scholar
  22. 22.
    Silva MJ, Florêncio GL, Gabiatti JR, Amaral RL, Eleutério Júnior J, Gonçalves AK (2011) Perinatal morbidity and mortality associated with chlamydial infection: a meta-analysis study. Braz J Infect Dis 15(6):533–539CrossRefPubMedGoogle Scholar
  23. 23.
    Wise Michelle R, Sadler L, Alec E (2015) Chlamydia trachomatis screening in pregnancy in New Zealand: translation of national guidelines into practice. J Prim Health Care 7(1):65–70PubMedGoogle Scholar
  24. 24.
    Yanhua H, Deng Z, Cheng M (2005) Ureaplasma urealyticum infection on pregnancy. Guangdong Medicine 2(2):229–230Google Scholar
  25. 25.
    Zhang C, Zhu D, Guo X (2002) A study on ways of intrauterine infection of chlamydia trachomatis. Zhonghua Fu Chan Ke Za Zhi 37(3):149–151PubMedGoogle Scholar
  26. 26.
    Mishra KN, Bhardwaj P, Mishra A, Kaushik A (2011) Acute chlamydia trachomatis respiratory infection in infants. J Glob Infect Dis 3(3):216–220CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Ipple MA, Beem MO, Saxon EM (1979) Clinical characteristics of the afebrile pneumonia associated with Chlamydia trachomatis infection in infants less than 6 months of age. Pediatrics 63(2):192–197Google Scholar
  28. 28.
    Salaria M, Singh M (2002) A typical pneumonia in children. Indian Pediatr 39:259–266PubMedGoogle Scholar
  29. 29.
    Matsukawa A, Lukacs NW, Standiford TJ, Chensue SW, Kunkel SL (2000) Adenoviral-mediated overexpression of monocyte chemoattractant Protein-1 differentially alters the development of Th1 and Th2 type responses in vivo. J Immunol 164(4):1699–1704CrossRefPubMedGoogle Scholar
  30. 30.
    Zhao Y, De Trez C, Flynn R, Ware CF, Croft M, Salek-Ardakani S (2009) The adaptor molecule MyD88 directly promotes CD8 T cell response to vaccinia virus. J Immunol 182(10):6278–6286CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Xia M, Bumgarner RE, Lampe MF, Stamm WE (2003) Chlamydia trachomatis infection alters host cell transcription in diverse cellular pathways. Infect Dis 187(9):424–434CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Children’s Hospital of Nanjing Medical UniversityNanjingChina
  2. 2.Department of Respiration, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical CollegeHuazhong University of Science & TechnologyWuhanChina

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