Community-Acquired Pneumonia Due to Chlamydia pneumoniae

  • Julio A. Ramirez
  • James T. Summersgill


Polymerase Chain Reac Lactam Antibiotic Reticulate Body Chlamydia Psittaci Erythromycin Ethylsuccinate 
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  1. Aldous, M. B., Grayston, J. T., Wang, S. P., & Foy, H. M. (1992). Seroepidemiology of Chlamydia pneumoniae TWAR infection in Seattle families, 1966ȓ1979. J. Infect. Dis., 166, 646–649.PubMedGoogle Scholar
  2. Augenbraun, M. H., Roblin, P. M., Mandel, L. J., Hammerschlag, M. R., & Schachter, J. (1991). Chlamydia pneumoniae pneumonia with pleural effusion: diagnosis by culture. Am. J. Med., 91, 437–438.PubMedCrossRefGoogle Scholar
  3. Bates, J. H., Campbell, G. D., Barron, A. L., McCracken, G. A., Morgan, P. N., Moses, E. B., & Davis, C. M. (1992). Microbial etiology of acute pneumonia in hospitalized patients. Chest, 101, 1005–1012.PubMedGoogle Scholar
  4. Berlau, J., Groh, A., & Straube, E. (1996). Improved isolation of Chlamydia pneumoniae from synovial cell cultures by using polyethylene glycol. Med. Microbiol. Lett., 5, 167–172.Google Scholar
  5. Block, S., Hedrick, J., Hammerschlag, M. R., Cassell, G. H., & Craft, J. C. (1995). Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate. Pediatr. Infect. Dis. J., 14, 471–477.PubMedGoogle Scholar
  6. Boman, J., Allard, A., Persson, K., Lundborg, M., Juto, P., & Wadell, G. (1997). Rapid diagnosis of respiratory Chlamydia pneumoniae infection by nested touchdown polymerase chain reaction compared with culture and antigen detection by EIA. J. Infect. Dis., 175, 1523–1526.PubMedGoogle Scholar
  7. Boman, J., Soderberg, S., Forsberg, J., Birgander, L. S., Allard, A., Persson, K., Jidell, E., Kumlin, U., Juto, P., Waldenstrom, A., & Wadell, G. (1998). High prevalence of Chlamydia pneumoniae DNA in peripheral blood mononuclear cells in patients with cardiovascular disease and in middle-aged blood donors. J. Infect. Dis., 178, 274–277.PubMedGoogle Scholar
  8. Campbell, L. A., Perez-Melgosa, M., Hamilton, D. J., Kuo, C. C., & Grayston, J. T. (1992). Detection of Chlamydia pneumoniae by polymerase chain reaction. J. Clin. Microbiol., 30, 434–439.PubMedGoogle Scholar
  9. Chirgwin, K., Roblin, P. M., & Hammerschlag, M. R. (1989). In vitro susceptibilities of Chlamydia pneumoniae (Chlamydia sp. strain TWAR). Antimicrob. Agents Chemother., 33, 1634–1635.PubMedGoogle Scholar
  10. Comandini, U. V., Maggi, P., Santopadre, P., Monno, R., Angarano, G., & Vullo, V., (1997). Chlamydia pneumoniae respiratory infections among patients infected with the human immunodeficiency virus. Eur. J. Clin. Microbiol. Infect. Dis., 16, 720–726.PubMedCrossRefGoogle Scholar
  11. Cooper, M. A., Baldwin, D., Matthews, R. S., Andrews, J. M., & Wise, R. (1991). In vitro susceptibility of Chlamydia pneumoniae (TWAR) to seven antibiotics. J. Antimicrob. Chemother., 28, 407–413.PubMedGoogle Scholar
  12. Dalhoff, K., & Maass, M. (1996). Chlamydia pneumoniae pneumonia in hospitalized patients: clinical characteristics and diagnostic value of polymerase chain reaction detection in BAL. Chest, 110, 351–356, Aug.PubMedGoogle Scholar
  13. Ekman, M. R., Grayston, J. T., Visakorpi, R., Kleemola, M., Kuo, C. C., & Saikku, P. (1993). An epidemic of infections due to Chlamydia pneumoniae in military conscripts. Clin. Infect. Dis., 17, 420–425.PubMedGoogle Scholar
  14. Emre, U., Roblin, P. M., Gelling, M., Dumornay, W., Rao, M., Hammerschlag, M. R., & Schachter, J. (1994). The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch. Pediatr. Adolesc. Med., 148, 727–732.PubMedGoogle Scholar
  15. Emre, U., Bernius, M., Roblin, P. M., Gaerlan, P. F., Summersgill, J. T., Steiner, P., Schachter, J., & Hammerschlag, M. R. (1996). Chlamydia pneumoniae infection in patients with cystic fibrosis. Clin. Infect. Dis., 22, 819–823.PubMedGoogle Scholar
  16. Fang, G. D., Fine, M., Orloff, J., Arisumi, D., Yu, V. L., Kapoor, W., Grayston, J. T., Wang, S. P., Kohler, R., Muder, R. R., Yee, Y. C., Rihs, J. D., & Vickers, R. M. (1990). New and emerging etiologies for community-acquired pneumonia with implications for therapy: a prospective multicenter study of 359 cases. Medicine, 69, 307–316.PubMedGoogle Scholar
  17. File, T. M. Jr., Segreti, J., Dunbar, L., Player, R., Kohler, R., Williams, R. R., Kojak, C., & Rubin, A. (1997). A multicenter, randomized study comparing the efficacy and safety of intravenous and/or oral levofloxacin versus ceftriaxone and/or cefuroxime axetil in treatment of adults with community-acquired pneumonia. Antimicrob. Agents Chemother., 41, 1956–1972.Google Scholar
  18. Freidank, H. M., Bong, R., & Wiedmann-AL-Ahmad (1996). Use of trypinized buffalo green monkey cells for improved culture of Chlamydia pneumoniae. Med. Microbiol. Lett., 5, 173–181.Google Scholar
  19. Gaydos, C. A., Quinn, T. C., & Eiden, J. J. (1992). Identification of Chlamydia pneumoniae by DNA amplification of the 16S rRNA gene. J. Clin. Microbiol., 30, 796–800.PubMedGoogle Scholar
  20. Gaydos, C. A., Eiden, J. J., Oldach, D., Mundy, L. M., Auwaerter, P., Warner, M. L., Bance, E., Burton, A. A., & Quinn, T. C. (1993a). Diagnosis of Chlamydia pneumoniae infection in patients with community-acquired pneumonia by polymerase chain reaction enzyme immunoassay. Clin. Infect. Dis., 19, 157–160.Google Scholar
  21. Gaydos, C. A., Fowler, C. L., Gill, V. J., Eiden, J. J., & Quinn, T. C. (1993b). Detection of Chlamydia pneumoniae by polymerase chain reaction-enzyme immunoassay in an immunocompromised population. Clin. Infect. Dis., 17, 718–723.PubMedGoogle Scholar
  22. Gaydos, C. A., Roblin, P. M., Hammerschlag, M. R., Hyman, C. L., Eiden, J. J., Schachter, J., & Quinn, T. C. (1994). Diagnostic utility of PCR-enzyme immunoassay, culture, and serology for detection of Chlamydia pneumoniae in symptomatic and asymptomatic patients. J. Clin. Microbiol., 32, 903–905.PubMedGoogle Scholar
  23. Gaydos, C. A., Summersgill, J. T., Sahney, N. N., Ramirez, J. A., & Quinn, T. C. (1996). Replication of Chlamydia pneumoniae in vitro in human macrophages, endothelial cells and aortic artery smooth muscle cells. Infect. Immun., 64, 1614–1620.PubMedGoogle Scholar
  24. Gran, J. T., Hjetland, R., & Andreassen, A. H. (1993). Pneumonia, myocarditis and reactive arthritis due to Chlamydia pneumoniae. Scand. J. Rheumatol., 22, 43–44.PubMedGoogle Scholar
  25. Grayston, J. T. (1992). Infections caused by Chlamydia pneumoniae strain TWAR. Clin. Infect. Dis., 15, 757–763.PubMedGoogle Scholar
  26. Grayston, J. T., Kuo, C. C., Wang, S. P., & Altman, J. (1986). A new Chlamydia psittaci strain, TWAR, isolated in acute respiratory tract infections. N. Engl, J. Med., 315, 161–168.CrossRefGoogle Scholar
  27. Grayston, J. T., Diwan, V. K., Cooney, M., & Wang, S. P. (1989). Community-and hospital-acquired pneumonia associated with Chlamydia TWAR demonstrated serologically. Arch. Intern. Med., 149, 169–173.PubMedCrossRefGoogle Scholar
  28. Grayston, J. T., Campbell, L. A., Kuo, C. C., Mordhorst, C. H., Saikku, P., Thom, D. H., & Wang, S. P. (1990). A new respiratory tract pathogen: Chlamydia pneumoniae strain TWAR. J. Infect. Dis., 161, 618–625.PubMedGoogle Scholar
  29. Hahn, D. L., Dodge, R. W., & Golubjatnikov, J. (1991). Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA, 266, 225–230.PubMedCrossRefGoogle Scholar
  30. Haidl, S., Ivarsson, S., Bjerre, I., & Persson, K. (1992). Guillain-Barre syndrome after Chlamydia pneumoniae infection. N. Engl. J. Med., 326, 576–577.PubMedGoogle Scholar
  31. Hammerschlag, M. R., Chirgwin, M. R. K., Roblin, P. M., Gelling, M., Dumornay, W., Mandel, L., Smith, P., & Schachter, J. (1992a). Persistent infection with Chlamydia pneumoniae following acute respiratory illness. Clin. Infect. Dis., 14, 178–182.PubMedGoogle Scholar
  32. Hammerschlag, M. R., Qumi, K. K., & Roblin, P. M. (1992b). In vitro activities of azithromycin, clarithromycin, L-Ofloxacin, and other antibiotics against Chlamydia pneumoniae. Antimicrob. Agents. Chemother., 36, 1573–1574.PubMedGoogle Scholar
  33. Jackson, L. A., Campbell, L. A., Kuo, C. C., Rodriguez, D. I., Lee, A., & Grayston, J. T. (1997). Isolation of Chlamydia pneumoniae from a carotid endarterectomy specimen. J. Infect. Dis., 176, 292–295.PubMedCrossRefGoogle Scholar
  34. Karalus, N. C., Cursons, R. T., Leng, R. A., Mahood, C. B., Rothwell, R. P. G., Hancock, B., Cepulis, S., Wawatai, M., & Coleman, L. (1991). Community-acquired pneumonia: aetiology and prognostic index evaluation. Thorax, 46, 413–418.PubMedGoogle Scholar
  35. Kauppinen, M. T., Herva, E., Kujala, P., Leinonen, M., Saikku, P., & Syrjala, H. (1995). The etiology of community-acquired pneumonia among hospitalized patients during a Chlamydia pneumoniae epidemic in Finland. J, Infect. Dis., 172, 1330–1335.Google Scholar
  36. Kauppinen, M. T, Lahde, S., & Syrjala, H. (1996a). Roentgenographic findings of pneumonia caused by Chlamydia pneumoniae. A comparison with streptococcus pneumonia. Arch. Intern. Med., 156, 1851–1856.PubMedCrossRefGoogle Scholar
  37. Kauppinen, M. T, Saikku, P., Kujala, P., Herva, E., & Syrjala, H. (1996b). Clinical picture of community-acquired Chlamydia pneumoniae pneumonia requiring hospital treatment: a comparison between chlamydial and pneumococcal pneumonia. Thorax, 51, 185–189.PubMedCrossRefGoogle Scholar
  38. Kazuyama, U., Lee, S. M., Amamiya, K., & Taguchi, F. (1997). A novel method for isolation of Chlamydia pneumoniae by treatment with trypsin and EDTA. J. Clin. Microbiol., 35, 1624–1626.PubMedGoogle Scholar
  39. Kleemola, M., Saikku, P., Visakorpi, R., Wang, S. P., & Grayston, J. T. (1988). Epidemics of pneumonia caused by TWAR, a new Chlamydia organism, in military trainees in Finland. J. Infect. Dis., 157, 230–236.PubMedGoogle Scholar
  40. Kuo, C. C, & Grayston, J. T. (1988). In vitro drug susceptibility of Chlamydia sp. Strain TWAR. Antimicrob. Agents Chemother., 32, 257–258.PubMedGoogle Scholar
  41. Kuo, C. C., & Grayston, J. T. (1990). A sensitive cell line, HL cells, for isolation and propagation of Chlamydia pneumoniae strain TWAR. J. Infect. Dis., 162, 755–758.PubMedGoogle Scholar
  42. Kuo, C. C., Jackson, L. A., Campbell, L. A., & Grayston, J. T. (1995). Chlamydia pneumoniae (TWAR). Clin. Microbiol. Rev., 8, 451–461.PubMedGoogle Scholar
  43. Lipsky, B. A., Tack, K. J., Kuo, C. C., Wang, S. P., & Grayston, J. T. (1990). Ofloxacin treatment of Chlamydia pneumoniae (strain TWAR) lower respiratory tract infections. Am. J. Med., 89, 722–724.PubMedCrossRefGoogle Scholar
  44. Maass, M., Essig, A., Marre, R., & Henkel, W. (1993). Growth in serum-free medium improves isolation of Chlamydia pneumoniae. J. Clin. Microbiol., 31, 3050–3052.PubMedGoogle Scholar
  45. Malinverni, R., Kuo, C.-C., Campbell, L. A., Lee, A., & Grayston, J. T. (1995). Experimental Chlamydia pneumoniae (TWAR) pneumonitis: effect of two antibiotic regimens on the course and persistence of infection. Antimicrob. Agents Chemother., 39, 45–49.PubMedGoogle Scholar
  46. Marik, P. E., & Iglesias, J. (1997). Severe community-acquired pneumonia, shock and multiorgan dysfunction syndrome caused by Chlamydia pneumoniae. J. Intern. Med., 241, 441–444, May.PubMedGoogle Scholar
  47. Marrie, T. J., Grayston, J. T, Wang, S. P., & Kuo, C. C. (1987). Pneumonia associated with TWAR strain of Chlamydia. Ann. Intern. Med., 106, 507–511.PubMedGoogle Scholar
  48. McClarty, G. (1994). Chlamydiae and the biochemistry of intracellular parasitism. Trends Microbiol., 2, 157–164.PubMedCrossRefGoogle Scholar
  49. McConnell, C. T, Plouffe, J. F, File, T. M., Mueller, C. F., Wong, K.-H., Skelton, S. K., Marston, B. J., Breiman, R. F., & CBPIS Study Group. (1994). Radiographic appearance of Chlamydia pneumoniae (TWAR strain) respiratory infections. Radiology, 192, 819–824.PubMedGoogle Scholar
  50. Moazed, T. C., Kuo, C.-C., Grayston, J. T, & Campbell, L. (1998). Systemic dissemination of C. pneumoniae infection via macrophages. J. Infect. Dis., 177, 132–135.CrossRefGoogle Scholar
  51. Molestina, R. E., Dean, D., Ramirez, J. A., & Summersgill, J. T. (1998). Characterization of a strain Chlamydia pneumoniae isolated from a coronary atheroma by analysis of the omp 1 gene and biological activity in human endothelial cells. Infect. Immun., 66, 1360–1376.Google Scholar
  52. Montalban, G. S., Roblin, P. M., & Hammerschlag, M. R. (1994). Performance of three commercially available monoclonal reagents for confirmation of Chlamydia pneumoniae in cell culture. J. Clin. Microbiol., 32, 1406–1407.PubMedGoogle Scholar
  53. Norton, R., Schepetiuk, S., & Kok, T. W. (1995). Chlamydia pneumoniae pneumonia with endocarditis. Lancet, 345, 1376–1377, May 27.PubMedCrossRefGoogle Scholar
  54. Örtqvist, Å. (1996). Oral empiric treatment of community-acquired pneumonia. Chest, 110, 1499–1506.PubMedGoogle Scholar
  55. Pham, D. G., Madico, G. E., Quinn, T. C., Enzler, M. J., Smith, T. F., & Gaydos, C. A. (1998). Use of lambda phage DNA as a hybrid internal control in a PCR-Enzyme Immunoassay to detect Chlamydia pneumoniae. J. Clin. Microbiol., 34, 1919–1922.Google Scholar
  56. Ramirez, J. A. (1995). Switch therapy in adult patients with pneumonia. Clin. Pulm. Med., 2, 327–333.Google Scholar
  57. Ramirez, J. A., & Ahkee, S. (1997). Early switch from IV antimicrobials to oral clarithromycin in patients with CAP. Infect. Med., April, 319–323.Google Scholar
  58. Ramirez, J. A., Ahkee, S., Summersgill, J. T, Ganzel, B. L., Ogden, L. L., Quinn, T. C., Gaydos, C. A., Bobo, L. L., Hammerschlag, M. R., Roblin, P. M., LeBar, W., Grayston, J. T., Kuo, C. C., Campbell, L. A., Patton, D. L., Dean, D., & Schachter, J. (1996a). Isolation of Chlamydia pneumoniae from the coronary artery of a patient with coronary atherosclerosis. Ann. Intern. Med., 125, 979–982.PubMedGoogle Scholar
  59. Ramirez, J. A., Ahkee, S., Tolentino, A., Miller, R. D., & Summersgill, J. T. (1996b). Diagnosis of Legionella pneumophila, Mycoplasma pneumoniae or Chlamydia pneumoniae lower respiratory infection using the polymerase chain reaction on a single throat swab specimen. Diagn. Microbiol. Infect. Dis., 24, 7–14.PubMedCrossRefGoogle Scholar
  60. Roblin, R. M., & Hammerschlag, M. R. (1998). Microbiologic efficacy of azithromycin and susceptibilities to azithromycin of isolates of Chlamydia pneumoniae from adults and children with community-acquired pneumonia. Antimicrobial, Agents Chemother., 42, 194–196.Google Scholar
  61. Roblin, P. M., Dumornay, W., & Hammerschlag, M. R. (1992). Use of HEp-2 cells for improved isolation and passage of Chlamydia pneumoniae. J. Clin. Microbiol., 30, 1968–1971.PubMedGoogle Scholar
  62. Saikku, P., Wang, S. P., Kleemola, M., Brander, E., Rusanen, E., & Grayston, J. T. (1985). An epidemic of mild pneumonia due to an unusual strain of Chlamydia psittaci. J. Infect. Dis., 151, 832–839.PubMedGoogle Scholar
  63. Saikku, P., Leinonen, M., Mattila, K. J., Ekman, M. R., Nieminen, M. S., Makela, P. H., Huttunen, J. K., & Valtonen, V. (1988). Serologic evidence of an association of a novel Chlamydia, TWAR, with chronic coronary heart disease and acute myocardial infarction. Lancet, 2, 983–985.PubMedGoogle Scholar
  64. Shemer-Avni, Y., & Lieberman, D. (1995). Chlamydia pneumoniae-induced ciliostasís in cilíated bronchial epithelial cells. J. Infect. Dis., 171, 1274–1278.Google Scholar
  65. Steinhoff, D., Lode, H., Ruckdeschel, G., Heidrich, B., Rolfs, A., Fehrenbach, F. J., Mauch, H., Hoffken, G., & Wagner, J. (1996). Chlamydia pneumoniae as a cause of community-acquired pneumonia in hospitalized patients in Berlin, Clin. Infect. Dis., 22, 958–964, June.PubMedGoogle Scholar
  66. Sundelöf, B., Gnarpe, J., Gnare, H., Grillner, L., & Darougar, S. (1993). Chlamydia pneumoniae in Swedish patients. Scand. J. Infect. Dis., 25, 429–433.PubMedGoogle Scholar
  67. Thom, D. M., Grayston, J. T., Wang, S. P., Kuo, C. C., & Altman, J. (1990). Chlamydia pneumoniae, strain TWAR, Mycoplasma pneumoniae and viral infections in acute respiratory disease in a university student health clinic population. Am. J. Epidemiol., 132, 248–256.PubMedGoogle Scholar
  68. Tjhie, J. H., Roosendaal, R., MacLaren, D. M., & Vanden-broucke-Grauls, C. M. J. E. (1997). Improvement of growth of Chlamydia pneumoniae on HEp-2 cells by pretreatment with polyethylene glycol in combination with additionally centrifugation and extension of culture time. J. Clin. Microbiol., 35, 1883–1884.PubMedGoogle Scholar
  69. Verkooyen, R. P., Hazenberg, M. A., Van Haaren, G. H., Van Den Bosch, J. M., Snijder, R. J., Van Helden, H. P., & Verbrugh, H. A. (1992). Age-related interference with Chlamydia pneumoniae micro-immunofluorescence serology due to circulating rheumatoid factor, J. Clin. Microbiol., 30, 1287–1290.PubMedGoogle Scholar
  70. Wang, S. P., Kuo, C. C., & Grayston, J. T. (1979). Formalinized Chlamydia trachomatis organisms as antigen in the micro-immunofluorescence test. J. Clin. Microbiol., 10, 259–261.PubMedGoogle Scholar
  71. Yang, Z. P., Cummings, P. K., Patton, D. L., & Kuo, C. C. (1994). Ultra structural lung pathology of experimental Chlamydia pneumoniae pneumonitis in mice. J. Infect. Dis., 170, 464–467.PubMedGoogle Scholar

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© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Julio A. Ramirez
    • 1
  • James T. Summersgill
    • 1
  1. 1.Division of Infectious Diseases, Department of Medicine, School of MedicineUniversity of LouisvilleLouisville

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