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Chlamydial antibodies in children with lower respiratory disease
G Carballal1, J B Mahony, C Videla
1Departmento de Microbiologia, Facultad de Medicina, Universidade de Buenos Aires, Argentina.
Insights
Recent Chlamydia trachomatis infection was found in nearly 20% of Argentinean infants with lower respiratory distress. This bacterial infection may be linked to bronchiolitis and pneumonia in young children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Acute lower respiratory infections are a significant cause of morbidity in infants.
- Bacterial pathogens, such as Chlamydia trachomatis, are increasingly recognized as potential contributors to respiratory illness in young children.
- Understanding the prevalence and impact of Chlamydia trachomatis in this age group is crucial for diagnosis and treatment.
Purpose of the Study:
- To investigate the serologic evidence of recent Chlamydia trachomatis infection in Argentinean children aged 1-18 months presenting with acute lower respiratory distress.
- To determine the association between Chlamydia trachomatis infection and specific respiratory conditions like bronchiolitis and pneumonia.
- To explore potential transmission routes, including horizontal transmission, of Chlamydia trachomatis in this population.
Main Methods:
- Serologic testing (IgM, seroconversion, enzyme immunoassay, microimmunofluorescence) was used to detect recent Chlamydia trachomatis infection.
- Study included 255 children aged 1-18 months with clinical and radiologic evidence of acute lower respiratory distress, excluding viral or bacterial infections.
- Prevalence was compared between children in an orphanage and those in pediatric hospitals, and across different age groups.
Main Results:
- Chlamydia trachomatis infection was detected in 19.2% (49/255) of the children studied.
- Infection rates were 16.9% for bronchiolitis and 20.2% for pneumonia.
- A significantly higher prevalence (35.1%) was observed in children from a La Plata orphanage compared to those in Buenos Aires pediatric hospitals (12.7%).
- Infections were found across all age groups up to 18 months, with a notable proportion in children over 3 and 6 months of age.
Conclusions:
- Chlamydia trachomatis infection is associated with acute lower respiratory distress, including bronchiolitis and pneumonia, in Argentinean children aged 1-18 months.
- The findings suggest that Chlamydia trachomatis may be a significant, yet potentially underdiagnosed, cause of respiratory illness in this pediatric population.
- Evidence points towards horizontal transmission as a possible route for Chlamydia trachomatis infection in young children.
Abstract:
Forty-nine of 255 (19.2%) Argentinean children between the ages of 1 and 18 months without evidence of viral or bacterial infections, but with clinical and radiologic evidence of acute lower respiratory distress, had serologic evidence of recent Chlamydia trachomatis infection by the demonstration of specific IgM, seroconversion or 4-fold rise in titer or elevated titers by enzyme immunoassay and the microimmunofluorescence test. Recent C. trachomatis infection was detected in 28 of 166 (16.9%) of children with bronchiolitis and 18 of 89 (20.2%) with pneumonia. Three additional children with bronchiolitis had Chlamydia pneumoniae-specific antibody. There was a significantly higher prevalence of C. trachomatis infection in children living in La Plata city orphanage (26 of 74, 35.1%) than in those attending 2 pediatric hospitals in Buenos Aires (23 of 181, 12.7%) (P less than 0.001). C. trachomatis infection was detected in all age groups up to 18 months. Thirty of 49 infections were in children older than 3 months of age and 16 were in children older than 6 months. These results suggest that C. trachomatis infection may be associated with bronchiolitis and pneumonia in children between the ages of 1 and 18 months of age in Argentina and that a proportion may be horizontally transmitted.