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Chlamydia trachomatis lower respiratory tract infection in infants
H J Zar1, A Van Dyk, J K Yeats
1Department of Paediatrics and Child Health, University of Cape Town, South Africa.
Insights
Chlamydia trachomatis is a significant cause of lower respiratory tract infections in infants. Early diagnosis and treatment are crucial, as many cases are initially misdiagnosed.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Chlamydia trachomatis is a potential cause of lower respiratory tract infections (LRTI) in infants, particularly when maternal sexually transmitted disease prevalence is high.
- Infant LRTI diagnosis can be challenging, with potential for misdiagnosis and delayed appropriate treatment.
Purpose of the Study:
- To investigate the prevalence and clinical characteristics of Chlamydia trachomatis infection in infants presenting with lower respiratory tract infections in South Africa.
Main Methods:
- A study was conducted on 100 ambulatory infants with signs of LRTI.
- Diagnostic methods included culturing for C. trachomatis and other common respiratory pathogens.
- Clinical data, including age, symptoms, and treatment history, were collected and analyzed.
Main Results:
- 6% of infants with LRTI tested positive for C. trachomatis.
- Infected infants were significantly younger than uninfected infants (mean age 3.8 weeks vs 8.7 weeks).
- Clinical signs associated with C. trachomatis infection included eye discharge and conjunctivitis; rhinorrhoea and wheeze were more common in uninfected infants. Co-infections with other bacteria were observed.
Conclusions:
- Chlamydia trachomatis is an important pathogen to consider in infant LRTI, especially in high-risk populations.
- Misdiagnosis is common, highlighting the need for increased awareness and specific diagnostic testing.
- Most C. trachomatis infections in this cohort presented as mild disease manageable with outpatient antibiotic therapy.
Abstract:
Chlamydia trachomatis may be an important cause of lower respiratory tract infection (LRTI) in infants born to mothers amongst whom there is a high prevalence of sexually transmitted disease. A study of 100 ambulatory infants with signs of LRTI in South Africa showed that 6% had C. trachomatis infection. The majority of the infected infants had received chloramphenicol eye ointment as prophylaxis. Half had previously visited a health facility for the same illness but the infection has been misdiagnosed. Infants with C. trachomatis infection were According to the Centers for Disease Control (CDC) guidelines, 85% were younger than uninfected infants (mean (SD) age of 3.8 weeks (3.2) vs 8.7 weeks (5.4); p=0.03). Clinical signs significantly associated with chlamydial infection were the presence of eye discharge (p = 0.02) or conjunctivitis (p = 0.01). There was a greater rate of rhinorrhoea (p = 0.06) and wheeze (p = 0.03) amongst patients without chlamydial infection. H. influenzae, M. catarrhalis, S. pneumoniae, S. aureus and N. gonorrhoeae were cultured from five different patients infected with chlamydia. The majority of infants with chlamydial infection had mild disease requiring only outpatient anti- biotic therapy.