DETECTION OF CHLAMYDIA-PNEUMONIAE BY POLYMERASE CHAIN REACTION-ENZYMEIMMUNOASSAY IN AN IMMUNOCOMPROMISED POPULATION

Chlamydia pneumoniae has now been associated with pneumonia, bronchiti s, pharyngitis, acute chest syndrome of sickle cell disease, and asthm a. Because of the difficulty of primary isolation and tissue-culture a daptation of this organism, we used a previously developed polymerase chain reaction-enzyme immunoassay (PCR-EIA) to screen 132 culture-nega tive bronchoalveolar lavage (BAL) specimens from 108 immunocompromised patients (34% of whom were positive for human immunodeficiency virus) and 7 healthy volunteers. Thirteen specimens (9.8%) from 12 immunocom promised patients (11.1%) gave a positive result; one patient had two positive specimens obtained 3 days apart. No healthy volunteer had a P CR-EIA-positive BAL specimen. Twelve (11.1%) of the immunocompromised patients also had diagnostic levels of antibody. Four patients had pos itive results in both PCR-EIA and serological tests. Thus 20 (18.5%) o f the 108 patients had laboratory evidence of C. pneumoniae infection. These data indicate that diagnosis of acute infection with C. pneumon iae can be established more rapidly and reliably by PCR-EIA than by cu lture or serology, particularly among immunocompromised patients, in w hom serological changes in response to infection are relatively undepe ndable. With an infection rate of 11.1% according to PCR-EIA, C. pneum oniae should be considered in the evaluation and treatment of pneumoni a in immunocompromised patients.