Abstract
As Chlamydia pneumoniae is an obligate intracellular parasite capable of causing prolonged, often subclinical infection, diagnosis of C. pneumoniae infection is somewhat complicated. Although isolation of the organism implies infection, it may not imply that the organism is causing pneumonia or other respiratory infection in the patient. It is also unclear whether colonization or asymptomatic infection without disease elicits an antibody response. Multiple diagnostic methods have been evaluated, but there is no “gold standard” for determining whether disease occurring in an individual is due to C. pneumoniae. Although it has been suggested that there are differences in the antibody response to primary infection, reinfection and reactivated infection, there are limited data correlating serology with culture. This is further complicated by the lack of standardized methods for serology and nonculture methods such as polymerase chain reaction (PCR).
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References
Grayston JT, Campbell LA, Kuo C-C, Modhorst CH, Saikku P, Thom DH, Wang S-P (1990) A new respiratory tract pathogen: Chlamydia pneumoniae strain TWAR. J Infect Dis 161: 618–625
Block S, Hedrick J, Hammerschlag MR, Cassell GH (1995) Mycoplasma pneumoniaeand Chlamydia pneumoniae in community-acquired pneumonia in children: comparative safety and efficacy of clarithromycin and erythromycin suspensions. Pediatr Infect Dis J 14: 471–477
Augenbraun MH, Roblin PM, Mandel LJ, Hammerschlag MR, Schachter J (1991) Chlamydia pneumoniae pneumonia with pleural effusion: diagnosis by culture. Am J Med 91: 437–438
Block S, Hammerschlag MR, Hedrick J, Tyler R, Smith A, Roblin PM, Gaydos C, Pham D, Quinn TC, Palmer R, McCarty J (1997) Chlamydia pneumoniae in acute otitis media. Pediatr Infect Dis J 16: 858–862
Cles L, Stamm WE (1990) Use of HL cells for improved isolation and passage of Chlamydia pneumoniae. J Clin Microbiol 28: 938–940
Wong KH, Skelton SK, Chan YK (1992) Efficient culture of Chlamydia pneumoniaewith cell lines derived from the human respiratory tract. J Clin Microbiol 30: 1625–1630
Roblin PM, Dumornay W, Hammerschlag MR (1992) Use of HEp-2 cells for improved isolation and passage of Chlamydia pneumoniae. J Clin Microbiol 30: 1968–1971
Montalban GS, Roblin PM, Hammerschlag MR (1994) Performance of three commercially available monoclonal reagents for confirmation of Chlamydia pneumoniae in cell culture. J Clin Microbiol 32: 1406–1407
Wang S-P, Grayston JT (1991) Chlamydia pneumoniae elementary body antigenic reactivity with fluorescent antibody is destroyed by methanol. J Clin Microbiol 29: 1539–1541
Grayston JT, 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
Grayston JT, Aldous MB, Easton A, Wang SP, Kuo C-C, Campbell LA, Altman J (1993) Evidence that Chlamydia pneumoniae causes pneumonia and bronchitis. J Infect Dis 168: 1231–1235
Emre U, Roblin PM, Gelling M, Dumornay W, Rao M, Hammerschlag MR, Schachter J (1994) The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med 148: 727–731
Harris JA, Kolokathis A, Campbell M, Cassell HG, Hammerschlag MR (1998) Safety and efficacy of azithromycin in the treatment of community-acquired pneumonia in children. Pediatr Infect Dis J 17: 865–871
Hammerschlag MR, Gregory W, Schwartz DB, Pistorious BJ, Inverso JA, Kolokathis A (1997) Azithromycin in the treatment of community-acquired pneumonia (CAP) due to Chlamydia pneumoniae. In: Abstracts of the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy, September 28–October 1, 1997. American Society for Microbiology, Washington, DC, abstr K-138, p 352
Kutlin A, Roblin P, Hammerschlag MR (1998) Antibody response to Chlamydia pneumoniae infection in children with respiratory illness. J Infect Dis 177: 720–724
Campbell LA, Kuo C-C, Wang S-P, Grayston JT (1990) Serologic response to Chlamydia pneumoniae infection. J Clin Microbiol 28: 1261–1264
Iijima Y, Miyashita N, Kishimoto T, Kanamoto Y, Soejima R (1994) Characterization of Chlamydia pneumoniae species-specific protein immunodominant in humans. J Clin Microbiol 32: 583–588
Black CM, Jonson JE, Farshy CE, Brown TM, Berdal BP (1991) Antigenic variation among strains of Chlamydia pneumoniae. J Clin Microbiol 29: 1312–1316
Jantos CA, Heck S, Roggendorf R, Sen-Gupta M, Hegemann J (1997) Antigenic and molecular analysis of different Chlamydia pneumoniae strains. J Clin Microbiol 35: 620–623
Glassick T, Gifard P, Timms P (1996) Outer membrane protein 2 gene sequences indicate that Chlamydia pecorum and Chlamydia pneumoniae cause infections in koalas. Syst Appl Microbiol 19: 457–464
Peterson EM, Cheng X, Qu Z, de la Maza LM (1996) Characterization of the murine antibody response to peptides representing the variable domains of the major outer membrane protein of Chlamydia pneumoniae. Infect Immun 64: 3354–3359
Hyman CL, Roblin PM, Gaydos CA, Quinn TC, Schachter J, Hammerschlag MR (1995) The prevalence of asymptomatic nasopharyngeal carriage of Chlamydia pneumoniaein subjectively healthy adults: assessment by polymerase chain reaction-enzyme immunoassay and culture. Clin Infect Dis 20: 1174–1178
Kern DG, Neill MA, Schachter J (1993) A seroepidemiologic study of Chlamydia pneumoniae in Rhode Island. Chest 104: 208–213
Verkooyen RP, Hazenberg MA, Van Haaren GH, van denBosch JM, Snijder RJ, Van Helden HP, Verbrugh HA (1992) Age-related interference with Chlamydia pneumoniae microimmunofluorescence serology due to circulating rheumatoid factor. J Clin Microbiol 30: 1287–1290
Carter MW, Al-Mahdwawi SAH, Giles IG, Treharne JD, Ward ME, Clarke IN (1991) Nucleotide sequence and taxonomic value of the major outer membrane protein gene of Chlamydia pneumoniae IOL-207. J Gen Microbiol 137: 465–475
Moss TR, Darougar S, Woodland RM et al (1993) Antibodies to Chlamydia species in patients attending a genitourinary clinic and the impact of antibodies to C. pneumoniae and C. psittaci on the sensitivity and the specificity of C. trachomatis serology tests. Sex Transm Dis 20: 61–65
Peeling RW, Wang SP, Grayston JT, Blasi F, Boman J, Clad A, Freidank H, Gaydos CA, Gnarpe J, Hagiwara T, Jones RB, Orfila J, Persson K, Poulakkainen M, Saikku P, Schachter J (1998) Chlamydia serology: inter-laboratory variation in microimmunofluorescence results. In: Stephens RS, Byrne GI, Christiansen G, Clarke IN, Grayston JT, Rank RG, Ridgway GL, Saikku P, Schachter J, Stamm WE (eds) Chlamydia infections. Proceedings of the 9th International Symposium on Human Chlamydia Infections, 21–28 June, 1998. University of California, San Francisco, pp 159–162
Gnarpe J, Gnarpe H, Sundelof B (1991) Endemic prevalence of Chlamydia pneumoniaein subjectively healthy persons. Scand J Infect Dis 23: 387–388
Hammerschlag MR, Chirgwin K, Roblin PM, Gelling M, Dumornay W, Mandel L, Smith P, Schachter J (1992) Persistent infection with Chlamydia pneumoniae following acute respiratory illness. Clin Infect Dis 14: 178–182
Dean D, Roblin P, Mandel L, Schachter J, Hammerschlag MR (1998) Molecular evaluation of serial isolates from patients with persistent Chlamydia pneumoniae infections. In: Stephens RS, Byrne GI, Christiansen G, Clarke IN, Grayston JT, Rank RG, Ridgway GL, Saikku P, Schachter J, Stamm WE (eds) Chlamydia infections. In: Proceedings of the 9th International Symposium on Human Chlamydial Infections, 21–28 June, 1998. University of California, San Francisco, pp 219–222
Bartlett JG, Breiman RF, Mandell LA, File TM (1998) Community-acquired pneumonia in adults: guidelines for management. Clin Infect Dis 26: 811–838
Plouffe JF, Herbert MT, File TM, Baird I, Parsons JN, Kahn JB, Reilly-Gauvin KT, The Pneumonia Study Group (1996) Ofloxacin versus standard therapy in treatment of community-acquired pneumonia requiring hospitalization. Antimicrob Agents Chemother 40: 1175–1179
File TM, Segreti J, Dunbar L, Player R, Kohler R, Williams RR, 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 the treatment of adults with community-acquired pneumonia. Antimicrob Agents Chemother 41: 1965–1972
Roblin PM, Hammerschlag MR (1998) Microbiologic efficacy of azithromycin and susceptibility to azithromycin of isolates of Chlamydia pneumoniae from adults and children with community-acquired pneumonia. Antimicrob Agents Chemother 42: 194–196
Roblin PM, Montalban G, Hammerschlag MR (1994) Susceptibility to clarithromycin and erythromycin of isolates of Chlamydia pneumoniae from children with pneumonia. Antimicrob Agents Chemother 38: 1588–1589
Mourad AM, Sweet RC, Sugg N, Schachter J (1980) Relative resistance to erythromycin in Chlamydia trachomatis. Antimicrob Agents Chemother 18: 696–698
Jones, RB, Van derPol B, Martin DH, Shepard MK (1990) Partial characterization of Chlamydia trachomatis isolates resistant to multiple antibiotics. J Infect Dis 162: 1309–1315
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© 1999 Springer-Verlag Italia, Milano
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Hammerschlag, M.R. (1999). Chlamydia pneumoniae: How to Document Respiratory Infection. In: Allegra, L., Blasi, F. (eds) Chlamydia pneumoniae. Springer, Milano. https://doi.org/10.1007/978-88-470-2280-5_6
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DOI: https://doi.org/10.1007/978-88-470-2280-5_6
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