Chlamydia pneumoniae infection associated with uncontrolled asthma: a hospital based cross sectional study.
OBJECTIVE
To evaluate the proportion of anti- Chlamydia pneumoniae (Cp) IgM positivity in patients with uncontrolled asthma and partly controlled childhood asthma and their clinical correlates.


METHODS
This was a hospital based cross sectional study. Children aged 1 to 12 y suffering from asthma were included after written informed parental consent. For diagnosis and classification of uncontrolled and partly controlled asthma, GINA guidelines 2009 were used. Anti-Cp IgM was tested by using an enzyme linked immunosorbent assay (ELISA) and value of antibody index ≥ 0.90 was considered positive. Data was collected on demographic, clinical and investigative variables including chest radiograph posterior-anterior view.


RESULTS
From August 2010 through August 2011 44 patients hospitalized with uncontrolled asthma in exacerbation and 45 patients with partly controlled asthma from ambulatory care settings were included. Anti-Cp IgM was positive in 25 % (n = 11/44) and 6.7 % (n = 3/45) patients with uncontrolled and partly controlled asthma, respectively (Odds ratio = 4.67, χ (2) = 5.64, 95 % CI 1.20-18.10, p 0.0 17). Among the patients of uncontrolled asthma, duration of hospital stay was longer in anti-Cp IgM positive patients (9 ± 2.19 vs. 7.19 ± 2.10 d, p 0.02).


CONCLUSIONS
Since anti-Cp IgM positivity was associated with age >5 y and radiological consolidation in uncontrolled asthma in exacerbation, specific treatment of Chlamydia pneumoniae must be actively considered.
Department of Pediatrics, Chhatrapati Shahuji Maharaj Medical University (CSMMU), Lucknow 226003, India. shallya@rediffmail.com
Shally
S
Awasthi
Krishna Kumar
KK
Yadav
Jyotsna
J
Agarwal
D000888:Antibodies, Anti-Idiotypic; D001249:Asthma / Q000150:complications* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000150:complications* / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007902:Length of Stay; D008297:Male
D000888:Antibodies, Anti-Idiotypic; C044203:anti-IgM