Chlamydia pneumoniae in coronary bypass grafts of redo patients. The concept of the 'adventitial baseline infection'.
The pathogenic role of Chlamydia pneumoniae in late coronary bypass graft failure has not yet been extensively investigated. We examined failed and new arterial/venous bypass grafts using immunohistochemistry, polymerase chain reaction (PCR), and serology. Thirty-four long-term failed grafts and 28 new grafts were examined in 21 patients undergoing redo coronary artery bypass grafting (CABG). Immunohistochemically, 28 (82%) failed grafts were positive in the intimal-medial compartment, and 33 grafts (97%) were positive for C. pneumoniae in the adventitia. Thirteen (46%) and 27 (96%) new grafts showed infection in the intima-media and in the adventitia, respectively (p < 0.05). Immunohistochemically, the overall presence of C. pneumoniae in all vessels examined was 66% in the intima-media and 97% in the adventitia (p < 0.05). C. pneumoniae was detected by PCR in 19 (31%) of all the vessels examined. C. pneumoniae seems to be frequently present in grafts of patients considered for redo CABG in Hungary. The adventitia of both failed, and new grafts particularly often contained C. pneumoniae. The results suggest that there exists an adventitial baseline infection from which infection of the inner wall layers develops, depending on local microenvironmental conditions. This is the first study to evaluate chlamydial infection in arterial/venous coronary grafts by immunohistochemistry, PCR, and serology.
Glasz
Tibor
T
2nd Department of Pathology, Semmelweis University, Ulloi ut 93, 1091 Budapest, Hungary. gt@korb2.sote.hu
Hortoványi
Eszter
E
Mózes
Géza
G
Kiss
András
A
Lotz
Gábor
G
Nagy
Pál Kaposi
PK
Szik
Agnes
A
Kardos
Magdolna
M
Sziller
István
I
Nagy
Bálint
B
Bán
Zoltán
Z
Tóth
András
A
Kassai
Imre
I
Horkay
Ferenc
F
Dudás
Gábor
G
Kádár
Anna
A
D002690:Chlamydia Infections / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification / Q000472:pathogenicity*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000473:pathology* / Q000601:surgery; D005260:Female; D006083:Graft Occlusion, Vascular / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012086:Reoperation; D019737:Transplants / Q000382:microbiology*