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Original Articles
Importance of Chlamydia pneumoniae (TWAR) as a Cause of Community-Acquired Pneumonia in Korea
Myoung-don Oh, Seon Ju Kim*, Seong Min Kim, Eui Chong Kim**, Kang Won Choe
Department of Internal Medicine and Clinical Pathology**, Seoul National University College of Medicine, Seoul, KoreaDepartment of Clinical Pathology*, Kyungsang University College of Medicine, Jinju, Korea
Vol.27 Num.1 (p45~49)
Background : Chlamydia pneumoniae strain TWAR causes acute infections of the respiratory tract. Previous study showed that prevalence of TWAR antibody in adults from different areas of the world ranged from 25% to 50%. In korea, positive rate of poly-IgG antibodies against TWAR was reported to be about 50% among healthy adults. These suggest that infections caused by TWAR may be quite prevalent in Korea. We tried to determine whether TWAR is an important pathogen of community-acquired pneumonia.
Methods : We studied 108 healthy persons and 79 military recruits with pneumonia who were evacuated from the training camp to the military hospital from February to April 1993. IgG and IgM antibodies to TWAR were measured using the microimmunofluorescence method. Elementary body antigen from TWAR antigen from TWAR was provided by the Washington Research Foundation. Serologic evidence of current infection was defined as a four-fold rise in antibody titer. In addition, a titer of 16 or greater in the IgM fraction and of 512 or greater in the IgG fraction were considered presumptive evidence of current or recent infection.
Results : Of the 108 healthy subjects, none had IgM TWAR antibody, while 67(62%) had IgG antibody at a titer of 16 or greater. Of the 79 military recruits with pneumonia, cough and sputum developed in 100%, fever in 87%, and crackles in 78%. Chest X-ray infiltration was noticed in 87%. Duration of symptoms before admission was less than 7 days in 27%, 8~13 days in 27%, 14~20 days in 27%, 21 days or longer in 20%.
Of the military recruits with pneumonia, 15%(12/79) showed evidence of acuteTWAR infection: 11 showed a four-fold antibody titer rise, and 1 had IgG antibody titer greater than 512.
Conclusion : These results suggest that TWAR infections are quite prevalent and TWAR may be one of the important pathogens of community-acquired pneumonia in Korea.
Keywords : Chlamydia pneumoniae(TWAR), Community-acquired pneumonia, Seroepidemiology