Can acute Chlamydia pneumoniae respiratory tract infection initiate chronic asthma?
Can acute Chlamydia pneumoniae respiratory tract infection initiate chronic asthma?
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DOI：
10.1016/s1081-1206(10)63126-2
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发表时间：
1998-10-01
影响因子：
5.9
通讯作者：
McDonald, R
中科院分区：
文献类型：
--
作者：
Hahn, DL;McDonald, R
背景：肺炎衣原体感染可引起急性呼吸道疾病（包括鼻窦炎、支气管炎和肺炎），有时伴有喘息。对于以前未暴露的非哮喘个体的急性感染是否会产生持续的喘息导致慢性哮喘的诊断，我们知之甚少。目的：我们试图确定急性肺炎支原体呼吸道感染患者是否会发展为慢性哮喘。方法：通过血清学检测对163例患有急性喘息性疾病或慢性哮喘的初级保健门诊青少年和成人（平均年龄43岁，男性45%）进行肺炎原体感染评估。这些患者中的一个亚组还进行了肺炎原体的鼻咽培养。结果：20例（12%）患者经血清学诊断为肺炎原体感染（15例），培养分离诊断为肺炎原体感染（3例），或两者均诊断为肺炎原体感染（2例）。在这20名患者中，10名患者首次喘息，其中6名患者随后发展为慢性哮喘(5)或慢性支气管炎(1)，并伴有血清学特征提示慢性感染。另外10名被诊断为肺炎原体感染的患者已经被诊断为慢性哮喘。在这些患者中，最初的血清学结果提示慢性感染而非急性感染。结论：急性肺炎支原体呼吸道感染在以前未暴露的非哮喘个体中可导致慢性哮喘。既往诊断为慢性哮喘的患者应评估是否有可能感染慢性肺炎支原体。
Background: Chlamydia pneumoniae infection can cause acute respiratory illnesses (including sinusitis, bronchitis, and pneumonia) that are sometimes associated with wheezing. Little is known about whether acute infection in a previously unexposed, nonasthmatic individual can produce persistent wheezing leading to a diagnosis of chronic asthma.Objective: We sought to determine whether patients with acute C. pneumoniae respiratory tract infections would develop chronic asthma.Methods: A consecutive series of 163 primary care outpatient adolescents and adults (average age 43, 45% male) who had acute wheezing illnesses or chronic asthma were evaluated for C. pneumoniae infection by serologic testing. A subgroup of these patients also had nasopharyngeal cultures for C. pneumoniae.Results: Twenty patients (12%) were diagnosed with C. pneumoniae infection defined by serology (15), culture isolation (3), or both (2). Of these 20, 10 patients wheezed for the first time and 6 of them subsequently developed chronic asthma (5) or chronic bronchitis (1) along with a serologic profile suggesting chronic infection. The other 10 patients diagnosed with C. pneumoniae infection already had a diagnosis of chronic asthma. In these patients initial serologic findings suggested chronic rather than acute infection.Conclusions: Acute C. pneumoniae respiratory tract infections in previously unexposed, nonasthmatic individuals can result in chronic asthma. Patients previously diagnosed with chronic asthma should be evaluated for possible chronic C. pneumoniae infection.