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      A retrospective survey of Chlamydia pneumoniae infection rates in paediatric patients from a single centre in Wuxi, China

      research-article
      ,
      The Journal of International Medical Research
      SAGE Publications
      Chlamydia pneumonia, children, respiratory infections

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          Abstract

          Objective

          To provide some epidemiological data on Chlamydia pneumoniae infection rates in paediatric patients at a single centre in Wuxi, China.

          Methods

          This was a retrospective analysis of serum samples from paediatric patients (<12 years) with a respiratory tract infection (RTI) and who had been admitted to the Department of Paediatrics, Wuxi No.2 People’s Hospital, China, from 01 January 2015 to 31 December 2016. C. pneumoniae IgM antibodies had been analysed using enzyme-linked immunosorbent assay (ELISA).

          Results

          Of the 3866 children (2073 boys, 1793 girls) with a RTI that provided serum samples, 19% were positive for C. pneumoniae IgM antibodies. Among these children, 56% were positive for other infections.

          Conclusions

          Children over 6 years of age with a RTI had a higher C.pneumoniae infection rate than younger children and the infection rate was more common in winter months compared with other times of the year.

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          Most cited references14

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          Role of persistent infection in the control and severity of asthma: focus on Chlamydia pneumoniae.

          Conventional risk factors have been unable to explain most of the substantial increase in the prevalence of asthma observed in many countries during the last few decades. Much attention has been directed at the "hygiene hypothesis", the apparent inverse relationship between intense systemic childhood infections and the subsequent development of asthma and atopy. However, it is not only the absence or scarcity of infections, but the prolonged presence of certain microorganisms in the lungs that may be involved in the development of asthma. Accumulating evidence suggests that Chlamydia pneumoniae, an intracellular ubiquitous pathogen with an innate propensity to persist and cause chronic infections, may be associated with asthma. This microorganism can achieve a state of "latency" in which it is viable but dormant and does not multiply. During this state, however, chlamydia continues to synthesize the "stress" protein, a 60-kDa heat shock protein (hsp60). This protein is able to elicit a strong host inflammatory response at sites of its production and appears to be involved in tissue injury and scarring processes. As inflammation has been found to be present in almost all asthmatics, whatever the severity and aetiology of the disease, inhaled glucocorticoids now have an established position in the treatment of early stages. However, corticosteroids negatively affect many aspects of cell-mediated immunity and favour the shift from a T-helper-1-type response towards a T-helper-2-type response. Corticosteroids may thus severely deteriorate the host's ability to eradicate an intracellular pathogen, such as Chlamydia pneumoniae, which requires a properly functioning cell-mediated (T-helper-1-type) immune response to be cleared. These drugs are also able to reactivate persistent Chlamydia to an active growth phase, which, by increasing the production of pro-inflammatory cytokines at the site of infection, can further amplify inflammation in the airways of patients with asthma.
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            Infection-related asthma.

            The role of infection in asthma is varied in that it may exacerbate established asthma or contribute to the initial development of the clinical onset of asthma. Mounting evidence implicates both roles with particular viral pathogens, namely human rhinovirus and respiratory syncytial virus, among the most likely culprits in asthma inception. Once asthma is present, infection, particularly viral infection, is a common precipitant of asthma exacerbations. Bacterial infections and colonization also have been associated with exacerbation and recurrent wheeze, an effect that may be independent or a cofactor with viruses. Atypical bacterial infections such as Mycoplasma pneumoniae and Chlamydia pneumoniae and fungi in the case of allergic bronchopulmonary aspergillosis, also play a potential role in inducing and exacerbating this disease. In addition, certain individuals may have a genetic predisposition toward viral-induced wheezing and the development of asthma. This article will discuss host and environmental factors, common pathogens, clinical characteristic, and genetic influences associated with infection-related asthma.
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              Occurrence of Chlamydia trachomatis and Chlamydia pneumoniae in paediatric respiratory infections.

              An emerging body of evidence suggests that half of asthma in both children and adults is associated with chronic lung infection. The aim of the present study was to determine the frequency of viable Chlamydia pneumoniae (Cp) and C. trachomatis (Ct) in the respiratory tracts of paediatric patients with chronic respiratory diseases. Bronchoalveolar lavage fluid (BALF) samples obtained from 182 children undergoing bronchoscopy for clinical reasons were assayed using PCR analysis, in vitro tissue culture and immunofluorescence staining for the presence of Cp and Ct. Chlamydia-specific DNA was detected by PCR in 124 (68%) out of 182 patients; 79 were positive for Cp, 77 positive for Ct and 32 for both organisms; 75 patients had cultivable Chlamydia. Ct DNA prevalence decreased, whereas Cp positivity generally increased with age. A total of 59 out of 128 asthma patients and 16 out of 54 nonasthmatics were Chlamydia culture positive. When the patients were divided into inflammatory versus noninflammatory airway disease, there were 69 (46%) out of 150 and six (18%) out of 32 BALF samples with cultivable Chlamydia, respectively. Viable Chlamydia pneumoniae and Chlamydia trachomatis occur frequently in children with chronic respiratory diseases and may be more prevalent in asthma patients. To the current authors' knowledge, this is the first report of viable Chlamydia trachomatis in the lungs of children.
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                Author and article information

                Journal
                J Int Med Res
                J Int Med Res
                IMR
                spimr
                The Journal of International Medical Research
                SAGE Publications (Sage UK: London, England )
                0300-0605
                1473-2300
                28 October 2020
                October 2020
                : 48
                : 10
                : 0300060520961720
                Affiliations
                [1-0300060520961720]Department of Pediatrics, Wuxi No.2 People’s Hospital, Wuxi, China
                Author notes
                [*]Xiao-Fei Zhou, Department of Paediatrics, Wuxi No.2 People’s Hospital, No. 68 of Zhongshan road, Liangxi district, Wuxi, 214002, China. Email: zhouxiaofei0923@ 123456163.com
                Author information
                https://orcid.org/0000-0002-9415-2827
                Article
                10.1177_0300060520961720
                10.1177/0300060520961720
                7645430
                33115294
                4ab852f0-e9c4-44ff-856d-064b9e7d7473
                © The Author(s) 2020

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 31 March 2020
                : 4 September 2020
                Categories
                Retrospective Clinical Research Report
                Custom metadata
                ts2

                chlamydia pneumonia,children,respiratory infections
                chlamydia pneumonia, children, respiratory infections

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