Lack of association between Kawasaki syndrome and Chlamydia pneumoniae infection: an investigation of a Kawasaki syndrome cluster in San Diego County.
BACKGROUND
The etiology of Kawasaki syndrome (KS), the leading cause of acquired coronary artery disease in children, is unknown. Recent studies have suggested that Chlamydia pneumoniae, a common respiratory pathogen associated with an increased risk of heart disease, might lead to KS.


OBJECTIVE
To assess whether KS was associated with an elevated risk of having a current or antecedent infection with C. pneumoniae.


METHODS
Blood, urine and pharyngeal specimens from KS patients in San Diego County, CA, during a period of high KS incidence were analyzed for evidence of recent C. pneumoniae infection by culture, PCR and serology. Specimens collected from two control groups, family members of KS patients and age-matched children attending outpatient clinics for well child visits, were similarly analyzed.


RESULTS
Thirteen cases were identified. Forty-five outpatient controls and an average of three family members per patient were enrolled in the study. All specimens tested negative for the presence of C. pneumoniae by PCR and culture except for one blood specimen from the mother of a case-patient. Serologic analysis of patients and a subset of outpatient and family controls revealed no evidence of current C. pneumoniae infection; 4 of 13 adult family controls had IgG titers consistent with past exposure to C. pneumoniae. Case patients were no more likely than outpatient controls to have had a respiratory illness in the preceding 2 months (11 of 13 patients vs. 35 of 45 controls; odds ratio, 1.57; 95% confidence interval, 0.3 to 11.9).


CONCLUSIONS
We found no evidence that C. pneumoniae infection was associated with KS.
Schrag
S J
SJ
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. zha6@cdc.gov
Besser
R E
RE
Olson
C
C
Burns
J C
JC
Arguin
P M
PM
Gimenez-Sanchez
F
F
Stevens
V A
VA
Pruckler
J M
JM
Fields
B S
BS
Belay
E D
ED
Ginsberg
M
M
Dowell
S F
SF
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D016000:Cluster Analysis; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution