Cook, Peter Jorn;
(1998)
The pathogenic significance of Chlamydia pneumoniae infection.
Doctoral thesis (M.D), UCL (University College London).
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Abstract
This study tested the associations of Chlamydia pneumoniae infection with ethnic origin, steroid medication, asthma, chronic obstructive pulmonary disease, unstable angina, myocardial infarction, stroke syndromes and hypertension. Adjustments were made by logistic regression for potential confounding variables, including age, sex, smoking, diabetes mellitus and social deprivation. C. pneumoniae antibodies were measured by micro-immunofluorescence in 2,675 hospital patients from a multi-ethnic population. Acute C. pneumoniae infection or reinfection was defined by an IgG titre of =512, a fourfold rise in IgG or IgM =8, and previous infection by IgG 64-256 or IgA =8. Among patients without active respiratory or cardiovascular disease, Afro- Caribbeans showed significantly more acute infection (odds ratio 5.5, 95% confidence intervals 2.0-15.0) and previous infection (1.9, 1.0-3.7) than Caucasians. Patients on steroids had previous infection more frequently (2.1, 1.4-3.8) than non-steroid users. Severe chronic asthmatics had more previous infection than controls (4.0, 1.6-10.0), this difference being independent of steroid use, but there was no significant difference between patients with acute asthma and controls. Patients with exacerbations of chronic obstructive pulmonary disease more often had acute (2.8,1.3-6.1) and previous infection (2.0,1.2-3.4) than controls. In patients with unstable angina, there were more acute (2.4, 1.5-3.9) and previous infections (3.1, 2.2-4.4) than in controls, and in myocardial infarction, the corresponding odds ratios were 2.7 (1.7-4.5) and 3.1 (2.1-4.5). Both acute (4.2, 2.5-7.1) and previous infection (4.4, 3.0-6.5) were found more commonly in patients with strokes than in controls. In patients with chronic hypertension, previous infection was found more commonly (2.5, 1.3-4.7) than in controls. Serological diagnosis of C. pneumoniae infection presents problems in performance and interpretation, and the organism is difficult to culture. The development and validation of a polymerase chain reaction assay are also described.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | M.D |
| Title: | The pathogenic significance of Chlamydia pneumoniae infection |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. |
| Keywords: | Health and environmental sciences; Asthma; Ethnic origin; Hypertension; Pulmonary disease; Steroids |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10105002 |
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