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Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma
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1991
Year
AsthmaRespiratory DiseasesMycoplasma PneumoniaeClinical EpidemiologyRespiratory InfectionAsthmatic BronchitisInfectious Respiratory DiseasePulmonary MedicineInfection ControlStrain TwarPublic HealthMedicineChlamydia PneumoniaeClinical MicrobiologyChlamydial InfectionEpidemiologyRespiratory Tract Illness
<h3>Objective.</h3> —To study the clinical characteristics of respiratory tract illness caused by<i>Chlamydia pneumoniae</i>. <h3>Design.</h3> —Prospective clinical, bacteriologic, and serologic study. Secondarily, a matched comparison of patients with and without evidence of<i>C pneumoniae</i>infection (serologic titers ≥1:64 and <1:16, respectively). <h3>Setting.</h3> —Four primary care (family practice) clinics in Madison, Wis, and nearby towns. <h3>Patients.</h3> —The study included 365 white males and females (mean age, 34.2 years). <h3>Main Outcome Measures.</h3> —Association of acute<i>C pneumoniae</i>infection with signs and symptoms of respiratory illness and the relationship of<i>C pneumoniae</i>antibody titer with wheezing at the time of enrollment in the study, and with the diagnosis of asthmatic bronchitis. <h3>Results.</h3> —Nine (47%) of 19 patients with acute<i>C pneumoniae</i>infection had bronchospasm during respiratory illness, and there was a strong quantitative association of<i>C pneumoniae</i>titer with wheezing at the time of enrollment in the study (<i>P</i>=.01). In the matched study,<i>C pneumoniae</i>antibody was significantly associated with asthmatic bronchitis after, but not before, respiratory illness (odds ratio, 7.2; 95% confidence interval, 2.2 to 23.4). Four infected patients had newly diagnosed asthma after illness, and four others had exacerbation of previously diagnosed asthma. There was no serologic evidence of coexisting<i>Mycoplasma pneumoniae, Chlamydia trachomatis</i>, or respiratory viral infection in 96% of patients with asthmatic bronchitis and asthma. <h3>Conclusions.</h3> —Some<i>Cpneumoniae</i>antibody titers, although not diagnostic of chlamydial infection by present criteria, probably represent acute reinfection or ongoing chronic infection. Repeated or prolonged exposure to<i>C pneumoniae</i>may have a causal association with wheezing, asthmatic bronchitis, and asthma. (<i>JAMA</i>. 1991;266:225-230)