Chlamydia pneumoniae is a frequent causative agent of acute respiratory disease. To assess whether C. pneumoniae plays a role in persistent cough, the prevalence of C. pneumoniae infection in adult patients with persistent cough was investigated. Nasopharyngeal swabs and serology samples from 366 adult patients with a persistent cough lasting in excess of 2 weeks and 106 control subjects were analysed for bacterial isolation and by PCR. C. pneumoniae was isolated from two patients and from none of the controls and was detected by PCR in 20 patients and one control. Serological evidence of acute C. pneumoniae infection was present in 24 patients but in none of the controls. Of these 20 patients who were positive by culture and/or PCR, three were still positive by PCR after 2 weeks of treatment with clarithromycin and symptoms either continued or relapsed. However, when patients were treated with clarithromycin for 5–6 weeks, their symptoms disappeared completely and the results of their cultures and/or PCR for C. pneumoniae became negative. These data suggest that C. pneumoniae infection may cause persistent cough in adults. Furthermore, these data also indicate that it may be necessary to eradicate the organism when C. pneumoniae is detected by culture and/or PCR in patients with persistent cough.
DowellS. F,
PeelingR. W,
BomanJ.11 other authors2001; Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). Clin Infect Dis 33:492–503[CrossRef]
EkmanM. R,
GraystonJ. T,
VisakorpiR,
KleemolaM,
KuoC. C,
SaikkuP.1993; An epidemic of infections due to Chlamydia pneumoniae in military conscripts. Clin Infect Dis 17:420–425[CrossRef]
FalckG,
GnarpeJ,
GnarpeH.1997; Prevalence of Chlamydia pneumoniae in healthy children and in children with respiratory tract infections. Pediatr Infect Dis J 16:549–554[CrossRef]
HammerschlagM. R,
RoblinP. M.2000a; Microbiologic efficacy of moxifloxacin for the treatment of community-acquired pneumonia due to Chlamydia pneumoniae . Int J Antimicrob Agents 15:149–152[CrossRef]
HammerschlagM. R,
RoblinP. M.2000b; Microbiological efficacy of levofloxacin for treatment of community-acquired pneumonia due to Chlamydia pneumoniae . Antimicrob Agents Chemother 44:1409[CrossRef]
MiyashitaN,
MatsumotoA,
KubotaY,
NakajimaM,
NikiY,
MatsushimaT.1996a; Continuous isolation and characterization of Chlamydia pneumoniae from a patient with diffuse panbronchiolitis. Microbiol Immunol 40:547–552[CrossRef]
MiyashitaN,
NikiY,
KishimotoT,
NakajimaM,
MatsushimaT.1997; In vitro and in vivo activities of AM-1155, a new fluoroquinolone, against Chlamydia spp. Antimicrob Agents Chemother 41:1331–1334
MiyashitaN,
FukanoH,
NikiY,
MatsushimaT.2001a; In vitro activity of telithromycin, a new ketolide, against Chlamydia pneumoniae . J Antimicrob Chemother 48:403–405[CrossRef]
MiyashitaN,
NikiY,
MatsushimaT.2001b; In vitro and in vivo activities of sitafloxacin against Chlamydia spp. Antimicrob Agents Chemother 45:3270–3272[CrossRef]
NennigM. E,
ShinefieldH. R,
EdwardsK. M,
BlackS. B,
FiremanB. H.1996; Prevalence and incidence of adult pertussis in an urban population. JAMA 275:1672–1674[CrossRef]
RobertsonP. W,
GoldbergH,
JarvieB. H,
SmithD. D,
WhybinL. R.1987; Bordetella pertussis infection: a cause of persistent cough in adults. Med J Aust 146:522–525
RoblinP. M,
HammerschlagM. R.1998; Microbiologic efficacy of azithromycin and susceptibilities to azithromycin of isolates of Chlamydia pneumoniae from adults and children with community-acquired pneumonia. Antimicrob Agents Chemother 42:194–196
SodaK,
KishimotoT,
KubotaY,
MatsushimaT,
IzutsuH,
MatsumotoA,
SoejimaR.1997; An outbreak of Chlamydia pneumoniae in a junior high school and its district: presence of asymptomatic oropharyngeal carriers in healthy subjects and in cases of pneumonia after a clinical cure. Amakusa Med J 11:17–28 (in Japanese
WrightS. W,
EdwardsK. M,
DeckerM. D,
GraystonJ. T,
WangS. P.1997; Prevalence of positive serology for acute Chlamydia pneumoniae infection in emergency department patients with persistent cough. Acad Emerg Med 4:179–183[CrossRef]