POOR CORRELATION BETWEEN MICROIMMUNOFLUORESCENCE SEROLOGY AND POLYMERASE-CHAIN-REACTION FOR DETECTION OF VASCULAR CHLAMYDIA-PNEUMONIAE INFECTION IN CORONARY-ARTERY DISEASE PATIENTS

Chlamydia pneumoniae has been associated to coronary artery disease by various methods including recovery of viable bacteria from plaques. T he pathogenetical relevance of this is unclear but investigation of an tichlamydial therapy in coronary arteriosclerosis is already in progre ss. The microimmunofluorescence test (MIF), the only species-specific serological assay available, might be considered useful in identifying patients with vascular chlamydial infection. However, this has never been systematically examined. We compared levels of C. pneumoniae anti bodies in sera using MIF with direct detection of C. pneumoniae in cor onary artery segments from 158 patients undergoing myocardial revascul arization. A polymerase chain reaction (PCR) protocol, recently evalua ted for use with vascular materials, detected C. pneumoniae infection in 34 patients. Correlation of serology and PCR was poor: in relation to PCR, MIF-IgG analysis had 21% sensitivity, 90% specificity, 37% pos itive predictive value, and 81% negative predictive value for detectio n of chlamydial presence. Thus, the MIF test currently appears not sui table to predict individual vascular C. pneumoniae infection.