D. Karnak et al., Chlamydia pneumoniae infection and acute exacerbation of chronic obstructive pulmonary disease (COPD), RESP MED, 95(10), 2001, pp. 811-816
The objective of the study was to investigate the possible association of C
hlamydia pneumoniae (Cpn) in acute exacerbations of chronic obstructive pul
monary disease (COPD) patients. Thirty-eight acutely exacerbated COPD patie
nts and 17 healthy smokers were enrolled in the study, as the study and con
trol groups respectively. Nasopharyngeal swabs and paired serum samples for
antibody testing of Cpn (microimmunofluorescence-MIF) were obtained from a
ll subjects. Sputum cultures of COPD patients were also performed. No patho
genic bacteria were isolated from nasopharyngeal swabs in any subject. Sero
logic evidence of recent Cpn infection was observed in 13 (34%) COPD patien
ts and in one (5%) control subject. The prevalence of Cpn IgG and IgM antib
odies representing acute infection were significantly higher in COPD patien
ts than in control subjects (P < 0.05 and P < 0.01 respectively). Prevalenc
e of IgA antibodies and IgG pre-existing antibodies did not show any differ
ence (P > 0.05). Microbiologic culture of the sputa yielded potentially pat
hogenic micro-organisms in 23 of 38 (60%) COPD patients. Alpha-haemolytic s
treptococcus (35%), Niesseria spp. (31%) and Candida spp. (9.5%) were most
prominent micro-organisms in positive cultures, Although a high prevalence
of IgG antibodies against Cpn was detected, it was the sole causative agent
in only four (10%) patients. We conclude that a remarkable number of COPD
patients (34%) are acutely infected with Cpn and it may either be the sole
causative agent or frequently a co-agent in acute exacerbations. (C) 2001 H
arcourt Publishers Ltd.