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Chlamydia pneumoniae and chronic lung diseases. 肺炎衣原体与慢性肺部疾病。
A L Laurila, L Von Hertzen, P Saikku

Chlamydia pneumoniae infection has been implicated in several chronic lung diseases by serology and direct antigen detection. Acute lower respiratory tract infection caused by C. pneumoniae seems often to precede attacks of asthma in both children and adults. Chlamydia pneumoniae is also involved in some exacerbations of chronic bronchitis and chronic obstructive lung disease but, more importantly, seems to be strongly associated with the latter irrespective of exacerbation status. Moreover, persistently elevated C. pneumoniae antibody titres have been observed in sarcoidosis and lung cancer.

通过血清学和直接抗原检测,肺炎衣原体感染与几种慢性肺部疾病有关。肺炎梭菌引起的急性下呼吸道感染似乎经常先于儿童和成人的哮喘发作。肺炎衣原体也参与慢性支气管炎和慢性阻塞性肺疾病的一些加重,但更重要的是,似乎与后者密切相关,无论加重状态如何。此外,在结节病和肺癌中观察到持续升高的肺炎支原体抗体滴度。
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引用次数: 0
Chlamydia pneumoniae. Proceedings of a meeting. Gavle, Sweden, 9-10 November 1995. 衣原体肺炎。会议记录。1995年11月9日至10日,瑞典耶夫勒。
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引用次数: 0
Cell mediated immunity to Chlamydia pneumoniae. 对肺炎衣原体的细胞免疫。
S Halme, H M Surcel

The association of Chlamydia pneumoniae to several chronic diseases such as atherosclerosis has been suggested serologically and by direct demonstration of organisms in disease lesions. Cell mediated immunity is crucial in host defense against intracellular pathogens such as C. pneumoniae. C. pneumoniae is a relatively recently recognized pathogen and the cellular mechanisms in C. pneumoniae immunity have so far remained unstudied. The present review includes the data available on C. pneumoniae proteins and their role as T cell activating antigens and Th1/Th2 balance in C. pneumoniae immunity.

肺炎衣原体与几种慢性疾病(如动脉粥样硬化)的关联已被血清学和疾病病变中生物体的直接证明所证实。细胞介导的免疫在宿主防御细胞内病原体(如肺炎球菌)中起着至关重要的作用。肺炎支原体是一种相对较新的病原体,其免疫的细胞机制迄今尚未得到研究。本文综述了肺炎衣原体蛋白及其作为T细胞活化抗原和Th1/Th2平衡在肺炎衣原体免疫中的作用。
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引用次数: 0
Respiratory tract infection due to Chlamydia pneumoniae in military personnel. 军人肺炎衣原体引起的呼吸道感染。
P A Csángó, S Haraldstad, J E Pedersen, G Jagars, I Føreland

The objective of this investigation was to determine whether Chlamydia pneumoniae was involved in an outbreak of respiratory disease among military recruits, 92 patients (average age 20.1 years) were included in the study if they had a sore throat or cough for more than 1 week. In addition to sore throat and cough, fatigue, headache, dyspnoea and vertigo were the most frequent symptoms. The patients received standard treatment with 100 mg of doxycycline b.i.d. for 14 days. In 38.8% of cases symptoms were alleviated after 1-2 weeks of treatment, and in 22.4% of cases after 2-3 weeks of treatment. Pretreatment throat washings and sera were sampled for Chlamydia. Sera were drawn for Chlamydia, Mycoplasma and adenovirus serology. Cell culture (Hep-2) and 3 different serological methods-microimmunofluorescence (MIF), enzyme immunoassay with a recombinant glycoconjugate antigen (r-EIA) and immunoperoxidase assay (IPA)-were used. Cell culture was found to have too low a sensitivity to be of diagnostic value. Acute infection was demonstrated in 13% by MIF IgM and in an additional 21% by MIF IgG (titre rises). Enzyme immunoassay IgM was found in 17% and IPA IgM in 19% of individuals without MIF IgM antibodies. Microimmunofluorescence was found to be the most useful test for serodiagnosis. The combination of serological methods showed that 40 out of 52 (76.9%) had an acute infection with possible chlamydial aetiology. In conclusion, methodological improvements are necessary for the aetiological diagnosis of chlamydial respiratory infections.

本研究的目的是确定肺炎衣原体是否与新兵呼吸道疾病的爆发有关,92例患者(平均年龄20.1岁)被纳入研究,如果他们喉咙痛或咳嗽超过1周。除了喉咙痛和咳嗽外,疲劳、头痛、呼吸困难和眩晕是最常见的症状。患者给予强力霉素bdd 100mg标准治疗,疗程14天。38.8%的病例在治疗1-2周后症状缓解,22.4%的病例在治疗2-3周后症状缓解。取预处理洗喉液和血清进行衣原体检测。抽取血清进行衣原体、支原体和腺病毒血清学检测。细胞培养(Hep-2)和3种不同的血清学方法-微免疫荧光(MIF)、重组糖缀合抗原(r-EIA)酶免疫测定(IPA)。发现细胞培养的灵敏度太低,不具有诊断价值。MIF IgM的急性感染率为13%,MIF IgG的急性感染率为21%(滴度升高)。在没有MIF IgM抗体的个体中,酶免疫测定IgM占17%,IPA IgM占19%。微免疫荧光是最有效的血清诊断方法。综合血清学方法,52例患者中有40例(76.9%)急性感染,可能是衣原体所致。总之,衣原体呼吸道感染的病原学诊断需要改进方法。
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引用次数: 0
Respiratory Chlamydial infections in a Hong Kong teaching hospital and association with coronary heart disease. 香港一所教学医院的呼吸道衣原体感染与冠心病的关系
G N Thomas, O Scheel, A P Koehler, D C Bassett, A F Cheng

The microimmunofluorescence antibody technique was used to determine the seroprevalence of antibodies to Chlamydia pneumoniae and Chlamydia psittaci from hospitalized patients in Hong Kong. Antibodies to C. pneumoniae were found in 54.8% of 157 patients hospitalized with respiratory disease, in 71.1% of 83 patients with cardiac disease and in 31.2% of 93 patients without either respiratory or cardiac disease. Antibodies to C. psittaci were found in 0.9% of the combined study groups. There was serological evidence of C. pneumoniae being the responsible agent in 24.8% of the severe respiratory cases. A significant correlation between antibody prevalence and coronary heart disease was identified during the study.

应用微免疫荧光抗体技术测定香港住院患者肺炎衣原体和鹦鹉热衣原体抗体的血清阳性率。157例呼吸系统疾病住院患者中有54.8%、83例心脏疾病住院患者中有71.1%、93例无呼吸系统或心脏疾病住院患者中有31.2%存在肺炎原体抗体。在0.9%的联合研究组中发现了鹦鹉螺杆菌抗体。有血清学证据表明,24.8%的严重呼吸道病例的病原是肺炎衣原体。在研究中发现抗体流行率与冠心病之间存在显著相关性。
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引用次数: 0
Reinfection with Chlamydia pneumoniae may induce isolated and systemic vasculitis in small and large vessels. 肺炎衣原体再感染可引起小血管和大血管的孤立性和全身性血管炎。
L Ljungström, C Franzén, M Schlaug, S Elowson, U Viidas

It is a common clinical experience that the onset of the so called non infectious vasculitides is often preceded by upper respiratory tract symptoms. A specific agent is only occasionally recovered. We report five cases in Sweden with manifestations of vasculitis from different organs. In three of the five patients the onset was preceded by upper respiratory tract symptoms. All patients had serologic findings indicating Chlamydia pneumoniae infection and all required corticosteroid treatment for symptomatic recovery. One was diagnosed as an aseptic meningitis. Another was diagnosed as a cerebral arteritis, probably a variant of a giant cell arteritis. A third patient had symptoms similar to a polymyalgia rheumatica engaging the thighs. Two patients had an acute myocardial infarction. One of them had Cogan's syndrome. The other also had pulmonary and hepatic engagement and an elevated level of anti basement membrane IgM antibodies, though not to the Goodpasture antigen. He had no renal involvement. The diagnosis of Chlamydia pneumoniae infection was based on the detection of species-specific IgA, IgG and IgM antibodies to Chlamydia pneumoniae using microimmunofluorescence technique, MIF. Four of the 5 cases exhibited a fourfold increase in antibody titers, and the fifth case was found to have high levels of IgG and IgA antibodies, suggesting recent infection. Investigations for other infectious agents were negative in all patients. The serologic findings in those patients are consistent with a pattern of reinfection with Chlamydia pneumoniae. We therefore suggest that reinfection with Chlamydia pneumoniae may induce isolated and systemic vasculitis in virtually any organ of the body.

这是一种常见的临床经验,即所谓的非感染性血管炎的发作往往先于上呼吸道症状。特定的代理只是偶尔被恢复。我们在瑞典报告五例不同器官血管炎的表现。5例患者中有3例发病前有上呼吸道症状。所有患者的血清学结果均表明肺炎衣原体感染,所有患者均需要皮质类固醇治疗以缓解症状。其中一人被诊断为无菌性脑膜炎。另一个被诊断为脑动脉炎,可能是巨细胞动脉炎的一种变体。第三例患者的症状与累及大腿的风湿性多肌痛相似。2例患者发生急性心肌梗死。其中一人患有科根综合症。另一组也有肺和肝浸润,抗基底膜IgM抗体水平升高,但不是针对good牧草抗原。他没有肾脏受累。应用微免疫荧光技术(MIF)检测肺炎衣原体的IgA、IgG和IgM抗体,诊断肺炎衣原体感染。5例中有4例抗体滴度升高4倍,第5例IgG和IgA抗体水平较高,提示近期感染。所有患者其他感染原调查均为阴性。这些患者的血清学结果与肺炎衣原体再感染的模式一致。因此,我们认为肺炎衣原体的再感染可能在身体的几乎任何器官诱发孤立和全身性血管炎。
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引用次数: 0
Antimicrobial susceptibility testing in Sweden. I. The work of the Swedish Reference Group for Antibiotics (SRGA and SRGA-M). 瑞典的抗菌药物敏感性试验。1 .瑞典抗生素参考小组(SRGA和SRGA- m)的工作。
B Olsson-Liljequist, A Forsgren

The Swedish Reference Group for Antibiotics (SRGA) is an expert committee within the Swedish Medical Society and has been working with different aspects of susceptibility testing of bacteria to antibiotics since 1978. The emphasis has been on standardization of methodology, evaluation of the in vitro activity of new and old antibiotics, and the detection and significance of resistance mechanisms in bacteria. In the following a review is presented of the work conducted by the SRGA.

瑞典抗生素参考小组(SRGA)是瑞典医学会的一个专家委员会,自1978年以来一直从事细菌对抗生素敏感性试验的不同方面的工作。重点是方法学的标准化、新旧抗生素体外活性的评价以及细菌耐药机制的检测和意义。以下是对SRGA开展的工作的回顾。
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引用次数: 0
Antimicrobial susceptibility testing in Sweden. III. Methodology for susceptibility testing. 瑞典的抗菌药物敏感性试验。3药敏试验方法学。
B Olsson-Liljequist, P Larsson, M Walder, H Miörner

A subcommittee of the Swedish Reference Group for Antibiotics, SRGA-M, has worked with standardization of methodology for susceptibility testing. In vitro data obtained with the disk diffusion procedure were collected from 5 clinical laboratories, compiled and presented as histograms of inhibition zones, and compared with data [minimum inhibitory concentrations (MICs) and inhibition zones] obtained from the reference laboratory at the Swedish Institute for Infectious Disease Control on a collection of clinically relevant bacterial species. Results from the reference collection of strains were presented as MIC histograms, and their corresponding inhibition zones were inserted in the compiled zone histograms as identifiable bars. These distributions formed the basis for decisions of breakpoints. Special tests were recommended for the detection of certain resistance mechanisms. A beta-lactamase test should be used for Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae and enterococci. Screening for beta-lactam resistance caused by altered penicillin binding proteins should be done by using oxacillin 1 microgram for Streptococcus pneumoniae and Staphylococcus aureus (MRSA), and by phenoxymethylpenicillin 10 micrograms for H, influenzae. The standardized disk diffusion procedure was helpful in detecting enterobacteria carrying beta-lactamases with extended spectra. Registration of inhibition zones will provide a powerful tool for the epidemiological surveillance of antibiotic resistance.

瑞典抗生素参考小组(SRGA-M)的一个小组委员会一直致力于药敏试验方法的标准化。从5个临床实验室收集了用圆盘扩散法获得的体外数据,汇编并以抑制区直方图的形式呈现,并与瑞典传染病控制研究所参考实验室收集的临床相关细菌种类的数据[最低抑制浓度(mic)和抑制区]进行比较。参考菌株的结果以MIC直方图表示,其对应的抑制区以可识别的条形插入到编译的区域直方图中。这些分布构成了决定断点的基础。建议对某些抗性机制进行特殊检测。β -内酰胺酶试验应用于流感嗜血杆菌、卡他莫拉菌、淋病奈瑟菌和肠球菌。筛查由青霉素结合蛋白改变引起的β -内酰胺耐药,应采用1微克的氧苄西林检测肺炎链球菌和金黄色葡萄球菌(MRSA), 10微克的苯氧甲基青霉素检测流感嗜血杆菌。标准化的圆盘扩散方法有助于检测携带β -内酰胺酶的肠杆菌的扩展光谱。抑制区登记将为抗生素耐药性的流行病学监测提供有力的工具。
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引用次数: 0
Susceptibility testing of bacteria and fungi. Report from "the Norwegian Working Group on Antibiotics". 细菌和真菌的药敏试验。“挪威抗生素工作组”的报告。
T Bergan, J N Bruun, A Digranes, E Lingaas, K K Melby, J Sander
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引用次数: 0
Animal models for Chlamydia pneumoniae infection. 肺炎衣原体感染的动物模型。
K Laitinen, H Alakärppä, A Laurila, M Leinonen

There is accumulating evidence that persistent Chlamydia pneumoniae infections occur in vivo. Animal studies are necessary in order to evaluate the effects of different treatment regimens for eradication of such infections. A mouse model was found to be efficacious for the study of the effects of cortisone and antimicrobial agents on C. pneumoniae infection.

越来越多的证据表明,持续的肺炎衣原体感染发生在体内。为了评估不同治疗方案对根除此类感染的效果,有必要进行动物研究。研究可的松和抗菌药物对肺炎原体感染的影响,发现小鼠模型是有效的。
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引用次数: 0
期刊
Scandinavian journal of infectious diseases. Supplementum
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