Clinical Microbiology Department, Hospital Universitario de Móstoles, C/Río Júcar, s/n, 28935 Móstoles, Madrid, Spain.
Infect Dis Clin North Am. 2010 Mar;24(1):61-71. doi: 10.1016/j.idc.2009.10.002.
Chlamydophila pneumoniae is estimated to cause about 10% of community-acquired pneumonia (CAP) cases and 5% of bronchitis cases, although most patients with C pneumoniae infection are asymptomatic, and the course of respiratory illness is relatively mild. The incubation period of C pneumoniae infection is around 21 days, and such symptoms as cough and malaise show a gradual onset, yet may persist for several weeks or months despite appropriate antibiotic therapy. Diagnosis by nasopharyngeal specimen culture, serum antibody titers, or molecular techniques is usually delayed with respect to the onset of symptoms, antibiotic treatment, or disease resolution and there is no accurate, standardized, commercial US Food and Drug Administration-cleared diagnostic method available. Erythromycin, tetracycline, and doxycycline are used as first-line therapy, although some investigators report no clinical or survival benefits from treating CAP caused by atypical pathogens. Meanwhile, adequate prospective studies have met with ethical and logistic barriers. Despite these limitations, North American guidelines recommend the antimicrobial treatment of patients with acute C pneumoniae respiratory infection.
肺炎衣原体估计可引起约 10%的社区获得性肺炎 (CAP) 病例和 5%的支气管炎病例,尽管大多数肺炎衣原体感染患者无症状,且呼吸道疾病的病程相对较轻。肺炎衣原体感染的潜伏期约为 21 天,咳嗽和不适等症状逐渐出现,但即使在适当的抗生素治疗后,也可能持续数周或数月。鼻咽标本培养、血清抗体滴度或分子技术的诊断通常滞后于症状出现、抗生素治疗或疾病缓解,并且目前尚无准确、标准化、经美国食品和药物管理局批准的商业诊断方法。红霉素、四环素和强力霉素被用作一线治疗药物,尽管一些研究人员报告称,治疗非典型病原体引起的 CAP 并无临床或生存获益。同时,充分的前瞻性研究也遇到了伦理和后勤方面的障碍。尽管存在这些局限性,北美指南仍建议对急性肺炎衣原体呼吸道感染患者进行抗菌治疗。