title: Community-acquired Chlamydia pneumoniae pneumonia in Japan: a prospective multicenter community-acquired pneumonia study.
abstract: OBJECTIVE
  To investigate the clinical features of Chlamydia pneumoniae pneumonia in Japan and to evaluate the newly created Japanese community-acquired pneumonia (CAP) guidelines.
  
  
  METHODS
  A multicenter CAP surveillance study was carried out in 20 hospitals between December 1999 and March 2000. The diagnosis of C. pneumoniae infection was based on isolation in cell culture, the polymerase chain reaction and serologic testing of antibodies by the microimmunofluorescence test.
  
  
  RESULTS
  Among 232 CAP cases, C. pneumoniae was identified as the etiologic agent in 15 cases (6.5%). C. pneumoniae was the only pathogen identified in nine of these cases, while one or more additional etiological agents were found in the other six cases. Of the present and previously reported single agent C. pneumoniae pneumonia cases, about 50% were more than 60 years old and had underlying diseases. A relatively slow pulse rate in relation to fever was not seen in these patients. The mean WBC count of all patients was normal. No patient required respiratory support or admission to an intensive care unit and no deaths occurred among these patients.
  
  
  CONCLUSIONS
  The clinical pictures of C. pneumoniae pneumonia as a single agent were mild to moderate and were remarkably different from those of cases of C. pneumoniae pneumonia concomitant with other bacteria. If the patient is less than 60 years old and some guideline headings are excluded, we think it would be possible to distinguish between C. pneumoniae and bacterial pneumonia.
authors.affiliation: Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Kurashiki, Okayama.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Miyashita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
authors.forename: Kotaro
authors.initials: K
authors.lastname: Oizumi
authors.forename: Keizo
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukano
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Niki
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Matsushima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023521:Chlamydophila Infections / Q000453:epidemiology*; D016993:Chlamydophila pneumoniae; D017714:Community-Acquired Infections / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology*; D011159:Population Surveillance; D011446:Prospective Studies