Community epidemiology of Chlamydia and Mycoplasma pneumoniae in LRTI in France over 29 months.
BACKGROUND
The role of Chlamydia pneumoniae (CP) and Mycoplasma pneumoniae (MP) in lower respiratory tract infections (LRTI) is still little known in community settings.


METHODS
In all, 3207 adult cases of LRTI (871 with pneumonia, and 2336 with acute bronchitis) were prospectively included in the ETIIC1 ETIIC : ETude de l'Incidence des Infections respiratoires basses d'origine Communautaire dues A Chlamydia pneumoniae et Mycoplasma pneumoniae (Incidence of CP and MP in LRTI in community settings) program by 303 general practitioners and 24 hospital physicians in France between September 1997 and February 2000. The polymerase chain reaction and immunoassays were used to detect CP or MP in 3198 pharyngeal specimens obtained by gargling.


RESULTS
Of these 3198 patients, 232 (7.3%), were PCR-positive for CP and/or MP. Immunoassays were far less sensitive than PCRs (Se = 2 and 13% for MP and CP). Among the 2336 patients with acute bronchitis, PCR was positive for CP in 95 (4.1%), and for MP, in 54 (2.3%). Among the 671 patients with radiologically confirmed pneumonia, PCR was positive for CP in 23 (3.4%), and for MP in 49 (7.3%). CP and MP displayed significant geographic heterogeneity. Independent clinical determinants of positive PCR for CP and/or MP were age below 45 years, previous antimicrobial therapy (especially betalactams). Clinical signs were not of practical use in distinguishing accurately between etiologic diagnoses.


CONCLUSIONS
CP or MP diagnosed by PCR were found in more than 7% of patients with LRTI in community settings with a significant geographical heterogeneity and significant temporal trends in the incidence.
Gaillat
Jacques
J
The Infectious Diseases Unit, Hôpital d'Annecy, France. smi.jgaillat@ch-annecy.fr
Flahault
Antoine
A
deBarbeyrac
Bertille
B
Orfila
Jeanne
J
Portier
Henri
H
Ducroix
Jean-Pierre
JP
Bébéar
Christiane
C
Mayaud
Charles
C
D000328:Adult; D017677:Age Distribution; D001991:Bronchitis / Q000453:epidemiology / Q000382:microbiology*; D023521:Chlamydophila Infections / Q000453:epidemiology / Q000382:microbiology*; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D011859:Radiography; D012141:Respiratory Tract Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D018571:Sentinel Surveillance; D011795:Surveys and Questionnaires