Published ahead of print on February 25, 2005, doi:10.1164/rccm.200407-917OC Am. J. Respir. Crit. Care Med., Volume 171, Number 10, May 2005, 1083-1088 A more recent version of this article appeared on May 15, 2005
Submitted on July 15, 2004 The Bronchial Lavage of Pediatric Patients with Asthma contain Infectious ChlamydiaWilmore C Webley1*,1 Department of Microbiology, University of Massachusetts, Amherst, MA, USA, 2 Department of Pediatric Pulmonology, Baystate Medical Center, Springfield, MA, USA, 3 Department of Pathology, Baystate Medical Center, Springfield, MA, USA * To whom correspondence should be addressed. E-mail: wilmore{at}microbio.umass.edu.
There has been a worldwide increase in the incidence of asthma and the disease has greatly impacted the public health care system. Chlamydia pneumoniae has been reported as a possible contributing factor in asthma. The organism has been detected by PCR in bronchial tissue but there has been no direct evidence of viability. To determine the frequency of viable Chlamydia in children, blood and bronchoalveolar lavage were collected from 70 pediatric patients undergoing flexible fibreoptic bronchoscopy. Forty-two of these patients had asthma while the remaining patients had various respiratory disorders. Fifty-four percent [38] of the bronchoalveolar lavage samples were PCR positive for Chlamydia and 31% [22] of the PCR positive samples were positive when cultured on macrophages. Twenty-eight [40%] and 14 [20%] of the PCR and culture-positives respectively, were from asthma patients. Culture of the blood samples revealed that 24 [34.3%] of 70 were positive for Chlamydia compared to 8 [11%] of 70 matched non-respiratory controls [P<0.01]; 17 [24%] of the positive blood cultures from the respiratory group were from asthma patients. Elevation of total IgE was strongly associated with lavage culture positivity for Chlamydia . We therefore conclude that viable Chlamydia pneumoniae organisms are frequently present in the lung lavage fluid from this cohort of predominantly asthmatic pediatric patients. Key words: Chlamydia pneumoniae, Asthma, Bronchial Lavage, Culture
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