Meijer A, Dagnelie C F, De Jong J C, De Vries A, Bestebroer T M, Van Loon A M, Bartelds A I, Ossewaarde J M
Research Laboratory for Infectious Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
Eur J Epidemiol. 2000;16(12):1099-106. doi: 10.1023/a:1010912012932.
Acute respiratory disease is one of the most common reasons to consult a general practitioner. A substantial part of these diseases cannot be explained by an infection with a virus or a common pathogenic bacterium. To study this diagnostic deficit, the prevalence of Chlamydia pneumoniae and Mycoplasma pneumoniae infections was determined in two groups of patients consulting a general practitioner. DNA of C. pneumoniae and M. pneumoniae was detected by a polymerase chain reaction (PCR) in nose/throat swabs from six (1.1%), and from seven (1.3%) patients, respectively, of 557 patients consulting a general practitioner for complaints suggestive for a virus infection during the 1994/1995 respiratory infections season. Two patients remained C. pneumoniae PCR-positive for at least 4 weeks. All others were negative within 3 weeks. Double infections of C. pneumoniae and influenza virus (3/6), and of M. pneumoniae and respiratory syncytial virus (1/7) or rhinovirus (1/7) were diagnosed. During the 1992/1993 season, attempts to isolate C. pneumoniae in cell culture or to detect C. pneumoniae DNA by PCR using throat swabs were all negative for 80 patients with a sore throat, although serological data suggested a C. pneumoniae infection in 13 (16%) patients. A specimen from another patient of this group was M. pneumoniae PCR-positive and the corresponding serum specimens showed a persistent high antibody titre. In summary, the prevalence of acute C. pneumoniae and M. pneumoniae infections was less than 2% in patients consulting a general practitioner.
急性呼吸道疾病是患者咨询全科医生的最常见原因之一。这些疾病中有很大一部分无法用病毒或常见病原菌感染来解释。为研究这一诊断不足问题，对两组咨询全科医生的患者进行了肺炎衣原体和肺炎支原体感染患病率的测定。在1994/1995呼吸道感染季节，因疑似病毒感染症状而咨询全科医生的557例患者中，分别从6例（1.1%）和7例（1.3%）患者的鼻/咽拭子中通过聚合酶链反应（PCR）检测到肺炎衣原体和肺炎支原体的DNA。有2例患者的肺炎衣原体PCR检测至少4周呈阳性。其他所有患者在3周内检测结果均为阴性。诊断出3例肺炎衣原体与流感病毒双重感染（6例中的3例），以及1例肺炎支原体与呼吸道合胞病毒双重感染（7例中的1例）和1例肺炎支原体与鼻病毒双重感染（7例中的1例）。在1992/1993季节，对80例咽痛患者进行了细胞培养分离肺炎衣原体或用咽拭子通过PCR检测肺炎衣原体DNA的尝试，结果均为阴性，不过血清学数据显示13例（16%）患者存在肺炎衣原体感染。该组另1例患者的标本肺炎支原体PCR检测呈阳性，相应血清标本显示抗体滴度持续较高。总之，咨询全科医生的患者中急性肺炎衣原体和肺炎支原体感染的患病率低于2%。
