Verkooyen R P, Van Lent N A, Mousavi Joulandan S A, Snijder R J, van den Bosch J M, Van Helden H P, Verbrugh H A
Department of Clinical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, The Netherlands.
J Med Microbiol. 1997 Nov;46(11):959-64. doi: 10.1099/00222615-46-11-959.
The incidence of Chlamydia pneumoniae infection was determined in patients with chronic obstructive pulmonary diseases (COPD) by prospective serial serology. Chlamydia-specific IgG, IgM and IgA antibodies were detected with a recombinant DNA lipopolysaccharide (LPS) ELISA as well as with a micro-immunofluorescence (MIF) assay with C. pneumoniae elementary bodies. From 271 consecutive COPD patients who visited the outpatient clinic of the department of pulmonary diseases (211 males, 60 females, age range 34-88 years, mean age 66 SD 10 years), blood samples (n = 1058) were taken every 2-7 months; the observation period ranged from 3 to 19 months (mean 15 SD 4). The prevalence of chlamydial IgG was 72% with the MIF and 53% with the rDNA LPS ELISA. More than 90% of the COPD patients had no significant changes in their chlamydia-specific IgG, IgA and IgM titres in either test during the observation period. Seven (3%) patients had MIF results indicating acute C. pneumoniae infection during their surveillance period, of whom five were confirmed by rDNA LPS ELISA. Eleven (4%) additional patients were infected during observation, as determined by rDNA LPS ELISA only. These patients had significantly elevated C. pneumoniae-specific IgG and IgA MIF titres, as compared with the patients without infection. All 18 patients with serological evidence of acute infection during their surveillance period were re-tested in a commercial MIF test that can distinguish between C. pneumoniae, C. trachomatis and C. psittaci LPS-specific antibodies, but no evidence of C. trachomatis or C. psittaci infection was found. The incidence of chlamydial infection was 2.2 and 5.3/100 person-years, when diagnosed by MIF and rDNA LPS ELISA, respectively. It is concluded that the rDNA LPS chlamydia assay may currently be the most sensitive serological tool for diagnosing recent respiratory chlamydia infections and that C. pneumoniae infection occurs frequently in COPD patients.
通过前瞻性系列血清学方法测定慢性阻塞性肺疾病（COPD）患者肺炎衣原体感染的发生率。采用重组DNA脂多糖（LPS）酶联免疫吸附测定（ELISA）以及用肺炎衣原体原体进行的微量免疫荧光（MIF）测定法检测衣原体特异性IgG、IgM和IgA抗体。从连续271例到肺病科门诊就诊的COPD患者（211例男性，60例女性，年龄范围34 - 88岁，平均年龄66±10岁）中，每2 - 7个月采集血样（n = 1058）；观察期为3至19个月（平均15±4个月）。采用MIF法时衣原体IgG的患病率为72%，采用rDNA LPS ELISA法时为53%。超过90%的COPD患者在观察期内两种检测方法中衣原体特异性IgG、IgA和IgM滴度均无显著变化。7例（3%）患者在监测期内MIF结果提示急性肺炎衣原体感染，其中5例经rDNA LPS ELISA证实。另外11例（4%）患者仅经rDNA LPS ELISA测定在观察期内被感染。与未感染患者相比，这些患者肺炎衣原体特异性IgG和IgA MIF滴度显著升高。在监测期内所有18例有急性感染血清学证据的患者均在可区分肺炎衣原体、沙眼衣原体和鹦鹉热衣原体LPS特异性抗体的商业MIF检测中重新检测，但未发现沙眼衣原体或鹦鹉热衣原体感染的证据。采用MIF和rDNA LPS ELISA诊断时，衣原体感染的发生率分别为2.2和5.3/100人年。结论是rDNA LPS衣原体检测目前可能是诊断近期呼吸道衣原体感染最敏感的血清学工具，且肺炎衣原体感染在COPD患者中频繁发生。
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