Mycoplasma pneumoniae and Chlamydia pneumoniae community-acquired pneumonia in young adults from a family medicine practice.

Abstract

Introduction: A major area of pathology in primary care practice is represented by respiratory infections, from common colds to severe lower respiratory tract illness. Our aim was to evaluate the incidence of Mycoplasma pneumoniae and Chlamydia pneumoniae pneumonia among the patients with suspected atypical pneumonia from a family medicine urban setting in Iaşi, Romania, to study serological retrospective diagnosis, the therapeutic outcome and the modified immunologic parameters in a subgroup of patients.

Methods: We enrolled 93 patients with suspected atypical community-acquired pneumonia (CAP); enzyme-linked immunosorbent assay (ELISA) testing for Mycoplasma pneumoniae and Chlamydia pneumoniae was performed, both immunoglobulins M and G being determined. Considering the systemic inflammation associated to atypical germs infections, in a subgroup of 13 patients, with positive results for Mycoplasma and Chlamydia pneumoniae, interleukin 5, interleukin 8, tumor necrosis factor α and interferon γ levels were determined, using chemiluminescence method (EI-CLA).

Results: Positive IgM serology for atypical germs was recorded in 25.8% of patients. Mycoplasma pneumoniae infection was confirmed in 10.8% of patients, Chlamydia pneumoniae infection in 6.5% of patients, and co-infection (both Mycoplasma pneumoniae and Chlamydia pneumoniae) in 8.6% of patients. A number of 41 patients (44.0%) presented chronic cough/bronchial hyperreactivity despite the treatment. Modified values were recorded for all immunological parameters tested, confirming the role in chronic airway inflammation.

Conclusions: Mycoplasma and Chlamydia pneumoniae CAP, frequent among young adults, is successfully treated with macrolides, still, the residual symptoms and the modified immunologic parameters need further studies regarding chronic inflammation.