title: Chlamydophila pneumoniae respiratory tract infection aggravates therapy refractory bronchitis or pneumonia in childhood.
abstract: BACKGROUND
  Chlamydophila pneumoniae was frequently found in bronchial secretions of children with therapy-refractory bronchitis or pneumonia. It was studied, how the agent modifies the course of disease and what findings are associated with the infection.
  
  
  METHODS
  Bronchial secretions obtained at bronchoscopy of 428 children were studied for C. pneumoniae infection using polymerase chain reaction with enzyme immunoassay detection. Children tested negative and positive were compared for their clinical findings.
  
  
  RESULTS
  C. pneumoniae was found in 143 children (33 %). A C. pneumoniae infection has been found to be associated with a purulent bronchial inflammation (90/143 vs. 144/285, p = 0.02), a Streptococcus pneumoniae co-infection (13/143 vs. 6/285, p = 0.002) and a restrictive disturbance (11/51 vs. 8/93, p = 0.04). Purulent inflammation (Odds ratio 7.9; 95 % confidence interval [CI] 1.6-39.3), 2 co-infections (Odds ratio 14.3; 95 % CI 1.4-144.4) and co-infection with M. pneumoniae (4/4 versus 9/26, p = 0.03; Mantel Haentzel 3.0; 95 % CI 1.1-8.0) were identified as factors more often associated with a restrictive disturbance in children with bronchial C. pneumoniae infection. An adequate antibiotic therapy improved pulmonary function. No association was found for wheezing, eosinophil inflammation of the nasal mucosa, alpha-1 antitrypsin or immunoglobulin deficiency in serum, level of secretory IgA in bronchial mucus, pathological lung scintigram, gastro-esophageal reflux disease, sweat test and other co-infections.
  
  
  CONCLUSIONS
  In children with therapy-refractory bronchitis or pneumonia bronchial C. pneumoniae infection was associated with a more severe disease in case of several, mostly bacterial co-infections. Adequate antibiotic therapy for C. pneumoniae infection has been demonstrated to improve pulmonary function.
authors.affiliation: Children's and Youth Hospital, Department of Infectious, Bronchopulmonary and Allergic Diseases, Greiswald. schmidt3@uni-greifswald.de
authors.forename: S M
authors.initials: SM
authors.lastname: Schmidt
authors.forename: C E
authors.initials: CE
authors.lastname: Müller
authors.forename: L
authors.initials: L
authors.lastname: Gürtler
authors.forename: R
authors.initials: R
authors.lastname: Bruns
authors.forename: E H
authors.initials: EH
authors.lastname: Ballke
authors.forename: H
authors.initials: H
authors.lastname: Wiersbitzky
authors.forename: M
authors.initials: M
authors.lastname: Ehlers
authors.forename: H J
authors.initials: HJ
authors.lastname: Rose
authors.forename: S K
authors.initials: SK
authors.lastname: Wiersbitzky
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D029481:Bronchitis, Chronic / Q000175:diagnosis* / Q000188:drug therapy; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy; D023521:Chlamydophila Infections / Q000175:diagnosis* / Q000188:drug therapy; D016993:Chlamydophila pneumoniae; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D008176:Lung Volume Measurements; D008297:Male; D008826:Microbial Sensitivity Tests; D018410:Pneumonia, Bacterial / Q000175:diagnosis*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000188:drug therapy; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000188:drug therapy; D016133:Polymerase Chain Reaction; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors; D015163:Superinfection / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents