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Biomedical subjects

J T Grayston

Publications and source records attributed to J T Grayston.

At least 19 recordsLinked to original sources
PubMed1992

Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease.

OBJECTIVE: To evaluate the association between prior infection with Chlamydia pneumoniae, as measured by IgG antibody, and coronary artery disease. DESIGN: A population-based, case-control study. SETTING: Group Health Cooperative of Puget Sound, a Seattle-based health maintenance organization. PARTICIPANTS: Men 55 years of age and younger and women 65 years of age and younger. Cases (n = 171) were members of Group Health Cooperative undergoing diagnostic coronary angiography who had at least one coronary artery lesion occupying 50% or more of the luminal diameter. The population controls (n = 120) were Group Health Cooperative members without known coronary heart disease. MAIN OUTCOME MEASURE: The adjusted odds ratio (OR) for coronary artery disease associated with prior C pneumoniae infection as measured by the presence of IgG antibody. RESULTS: After adjusting for age, gender, and calendar quarter of blood drawing, the OR for coronary artery disease associated with the presence of antibody was 2.6 (95% confidence interval, 1.4 to 4.8). The association was limited to cigarette smokers, in whom the OR was 3.5 (95% confidence interval, 1.7 to 7.0). Among never-smokers, the OR was 0.8 (95% confidence interval, 0.3 to 1.9). When cases and controls were restricted to those assayed concurrently, the adjusted OR (smokers and nonsmokers combined) was 4.2 (95% confidence interval, 1.8 to 10.0). Adjustment for serum cholesterol, hypertension, alcohol use, diabetes, and socioeconomic status did not change these results. Only a week association was found when cases were compared with 63 subjects whose angiographic results were normal (OR, 1.2; 95% confidence interval, 0.6 to 2.2). CONCLUSIONS: These results generally support the previously reported association between C pneumoniae infection and coronary heart disease. However, caution should be used in interpreting the basis for this association.

Adult↗
PubMed1992

Chronic Chlamydia trachomatis infections in infants.

OBJECTIVE: --To study the natural history of Chlamydia trachomatis infections in infants. DESIGN: --Bacteriologic and serologic study of an inception cohort. SETTING: --University of Washington Medical Center, Seattle. PARTICIPANTS: --Twenty-two infants with C trachomatis infections either not treated early in life or recurring after antimicrobial treatment. MAIN OUTCOME MEASURES: --Persistence of infection in various anatomic sites, antibody responses to specific serovars (serologic variants) of C trachomatis, and serovars of isolates from mothers and infants. RESULTS: --The cumulative proportion of infants still infected at the age of 1 year was 35%. Infection persisted in the conjunctiva, nasopharynx, and oropharynx in one child for as long as 866 days (28.5 months), when she was cured by treatment. In none of the infants did serologic tests suggest acquisition of infection other than at birth. Isolates of C trachomatis from mothers and their respective infants were always of the same serovar. CONCLUSIONS: --Many infants infected with C trachomatis at birth remain infected for months or years in the absence of specific antimicrobial therapy. Such infections may be confused with those acquired by sexual abuse.

Antibodies, Bacterial↗
PubMed1992

Outbreak of Chlamydia pneumoniae infection in four farm families.

The epidemiology of Chlamydia pneumoniae infection was studied in an outbreak in four farm families living close together in Denmark. Eleven of 20 members of the families studied had bronchitis or pneumonia characteristic of Chlamydia pneumoniae infection. Serologic evidence of Chlamydia pneumoniae as causative agent was strengthened by a high incidence of epidemic infection. Transmission within families and a high frequency of disease versus asymptomatic infection are two findings which deviate from epidemiological patterns of Chlamydia pneumoniae infection as currently known.

Adult↗
PubMed1992

Seroepidemiology of Chlamydia pneumoniae TWAR infection in Seattle families, 1966-1979.

Incidence rates of Chlamydia pneumoniae infection and information on reinfection and transmission within families were obtained by serologic study of serum samples from prospective family studies conducted 1966-1979. Specimens (n = 3671) from 343 subjects in 68 families were tested for TWAR antibody using the microimmunofluorescence assay. Acute infection was defined as a fourfold rise in antibody titer between consecutive specimens. Sixty-four episodes of infection were identified in 58 persons; 4 had 2 infections and 1 had 3. From late 1975 until early 1979, when 3 serum specimens were collected yearly, rates of infection by age groups 0-4, 5-9, 10-14, 15-19, and greater than or equal to 20 years were 0, 9.2, 6.2, 2.2, and 1.5/100 person-years, respectively. Reinfections, defined as infections in persons with previous antibody, constituted most acute infections among adults. Acute infections more often affected a single family member than multiple members, but 2 or 3 family members were infected during the same period 12 times.

Adolescent↗
PubMed1992

Detection of Chlamydia pneumoniae by polymerase chain reaction.

While criteria for serodiagnosis of Chlamydia pneumoniae infection are well established, isolation of the organism is often difficult. To increase detection of this organism, C. pneumoniae-specific sequences were identified to permit amplification of C. pneumoniae by polymerase chain reaction (PCR). A cloned C. pneumoniae 474-bp PstI fragment was shown by dot blot and Southern hybridization to differentiate C. pneumoniae from the other Chlamydia spp., react with all C. pneumoniae isolates tested, and not recognize DNA from normal throat flora or common respiratory tract agents. This cloned fragment was sequenced and primers for use in PCR were chosen on the bases of GenBank analysis, G + C ratio, and absence of secondary structure. All C. pneumoniae isolates tested were amplified by the HL-1-HR-1 primer pair or the HM-1-HR-1 primer pair, producing the expected 437- and 229-bp amplification products, respectively. None of the Chlamydia trachomatis serovars (B/TW-5/OT, C/TW-3/OT, D/UW-3/Cx, E/UW-5/Cx, F/UW-6/Cx, H/UW-4/Cx, I/UW-12/Ur, and L2/434/Bu), Chlamydia psittaci strains (Mn, 6BC, GPIC, FP, and OA), HeLa cells, or other organisms tested were amplified. Reaction conditions including MgCl2, oligonucleotides, and primer concentrations and temperature were optimized before application to clinical samples. Clinical specimens from patients from whom C. pneumoniae was isolated were also positive by PCR, while samples from patients with known C. trachomatis or C. psittaci infection were not amplified by PCR.

Base Sequence↗
PubMed1992

Chlamydia pneumoniae, strain TWAR pneumonia.

Chlamydia pneumoniae, strain TWAR is a newly recognized third species of Chlamydia. It is an important cause of pneumonia, bronchitis, sinusitis, and other acute respiratory infections. It is a human pathogen transmitted by the respiratory route. Successful antibiotic treatment with tetracycline or erythromycin requires high dosage and a prolonged course.

Chlamydia Infections↗
PubMed1991

[Prevalence of Chlamydia pneumoniae infection among pneumonias in a sample of Spanish hospital population].

BACKGROUND: The importance of Chlamydia pneumoniae as a cause of respiratory tract infection in humans has been shown recently. There is no data in Mediterranean countries about C. pneumoniae infection. METHODS: We tested acute and convalescent serum collected from 103 Spanish pneumoniae patients from 1979 to 1987. The microimmunofluorescent test (MIF) with C. pneumoniae and other Chlamydia antigens to exclude cross reactions was used. Serological evidence of current infection was a fourfold rise in IgG antibody titer o titer 1/6 in the IgM serum fraction in the MIF test. RESULTS: The mean age of the patients was 52 years (typical deviation 18, with an age range of 13 to 83) and 75% were male. Serological data of recent infection was found in four of the 103 patients and 59 had antibodies in the IgG fraction indicative of previous infection. CONCLUSIONS: These finding show that C. pneumoniae is associated with pneumonia in Spain and that there is a wide contact with this agent in the patient population with lower respiratory tract infection.

Adolescent↗
PubMed1991

Three new serovars of Chlamydia trachomatis: Da, Ia, and L2a.

Three new Chlamydia trachomatis serovars were identified by several monoclonal antibodies in the microimmunofluorescence test and are proposed to be called Da, Ia, and L2a. Each was clearly distinguishable from the related serovars D, I, and L2. To date, 7, 41, and 4 isolates of the respective serovars have been identified. Each appears to be distributed worldwide. The findings meet previously established criteria for establishment of new serovars.

Antibodies, Monoclonal↗
PubMed1991

Vaginal douching and the risk of tubal pregnancy.

To explore the possible association between vaginal douching and tubal pregnancy, we interviewed 273 women who were diagnosed with tubal pregnancy at Group Health Cooperative between September 31, 1981 and October 1, 1986. Their responses were compared with responses of a random sample of 722 female members of Group Health Cooperative who were assumed to be at risk of becoming pregnant at the time the cases conceived. After adjusting for differences between cases and controls with regard to other measured risk factors, we found a modest increase in risk associated with having douched more than two times per year in the past (RR = 1.3, 95% CI: 0.9-1.8). Among women who had more than one sexual partner during their lifetime, however, the risk for those who had douched more than twice per year was somewhat higher (RR = 1.6, 95% CI: 1.1-2.3). There was an indication that women who had been exposed to Chlamydia trachomatis, as indicated by elevated antibody titers, may further increase their risk for tubal pregnancy by douching (RR = 2.4, 95% CI: 0.8-7.3). The associations found in other studies between douching and pelvic inflammatory disease, and between pelvic inflammatory disease and subsequent tubal pregnancy, argue that a relation between douching and tubal pregnancy might be anticipated. Our results offer further support for this hypothesis.

Adolescent↗
PubMed1991

Serotyping of Chlamydia trachomatis by indirect fluorescent-antibody staining of inclusions in cell culture with monoclonal antibodies.

A new method for determining the serovars of Chlamydia trachomatis isolates by utilizing fluorescent-antibody staining of inclusions in cell culture is described. Monoclonal antibodies which have been successfully used previously for serotyping in the microimmunofluorescence test were employed. The cell culture method offers two advantages over the microimmunofluorescence test for many laboratories. It requires less antigen of the new isolate, about 10% cell culture infectivity versus 50% for the microimmunofluorescence test. Although fewer isolates can be typed at one time in cell culture, the technical requirements of the test are less rigorous.

Antibodies, Monoclonal↗
PubMed1991

Chlamydia pneumoniae elementary body antigenic reactivity with fluorescent antibody is destroyed by methanol.

Methanol, used for fixing chlamydia organisms to microscopic slides, was shown to eliminate the antigenic reactivity of Chlamydia pneumoniae elementary bodies with fluorescent antibodies. Acetone fixation had no adverse effect. Chlamydia trachomatis and Chlamydia psittaci were not affected by methanol fixation. The effect of methanol on C. pneumoniae is another characteristic that differentiates this species from the other two chlamydia species.

Antigens, Bacterial↗
PubMed1991

Chlamydia pneumoniae, strain TWAR, infection in patients with chronic obstructive pulmonary disease.

TWAR, the only known serovar of Chlamydia pneumoniae, is a newly described bacterium that has been identified as a cause of both epidemics and endemic cases of pneumonia. The role of TWAR infection in patients with chronic obstructive pulmonary disease (COPD) is not known. We conducted a prospective study to establish whether TWAR infection is a common cause of acute exacerbations of COPD. We studied two groups of patients: 44 patients admitted to the hospital with acute exacerbations of COPD, and 65 stable clinic patients with COPD. We found that evidence of acute TWAR infection was infrequent in patients with exacerbations (5%). In contrast, the majority of patients from both groups had serologic evidence of previous TWAR infection (77%). This was not significantly greater than the prevalence found in a small group of patients of similar age and sex without lung disease from the same institution (73%). TWAR was not isolated from the oropharyngeal specimens obtained from 97 subjects, suggesting that it does not colonize the respiratory tract of patients with COPD. This study shows that at the time of low incidence in the community, acute TWAR infection is uncommon in patients with acute exacerbations of COPD. The majority of patients with COPD have, however, been infected with TWAR in the past. The clinical manifestations of these infections are not known and should be the focus of further studies.

Aged↗
PubMed1991

Chlamydia pneumoniae infections in Norway 1981-87 earlier diagnosed as ornithosis.

Ornithosis has been a notifiable disease in Norway since 1957. During an outbreak of respiratory disease in 1981-82, described as ornithosis, contact with birds was stated in only 50% of the cases, suggesting that the infection was spread by interhuman transmission. A similar outbreak occurred in the western part of Norway in 1987. Serum specimens from altogether 260 patients, collected during the outbreaks in 1981-82 and in 1987, were investigated for antibodies against Chlamydia pneumoniae (strain TWAR). Evidence of recent infection with C. pneumoniae was found in 67.7% of the cases. The results indicate that the increased incidence of ornithosis in 1981-82 and in 1987 was due mainly to C. pneumoniae infections.

Chlamydia Infections↗
PubMed1991

Infections with Chlamydia pneumoniae strain TWAR.

Chlamydia pneumoniae has recently been recognized as an important cause of respiratory tract disease, including atypical pneumonia. Serosurveys suggest that C. pneumoniae is endemic in most countries and is capable of causing outbreaks and epidemics of pneumonia, especially in countries where the antibody prevalence is relatively low. The population incidence of infection appears to be cyclical, with approximately 4-year cycles in the US (Seattle) and 6-year cycles in Denmark having been demonstrated. Pneumonia caused by the organism is unusual in young children in developed countries but may be an important cause of lower respiratory infections among children in developing and tropical countries. In otherwise healthy adults, C. pneumoniae pneumonia usually can be treated effectively on an outpatient basis. Patients with C. pneumoniae pneumonia often have a gradual onset of symptoms: a sore throat and hoarseness followed by a cough. Auscultatory and radiographic findings usually are prominent, even in patients with mild disease, and a cough and malaise may persist for several weeks or more after appropriate therapy. Microimmunofluorescence serologic testing is available in only a few laboratories. However, the new HL cell line holds promise of making culture and isolation of C. pneumoniae more widely available. Questions remain about the routes of transmission of C. pneumoniae, its incubation period, its role in lower respiratory disease in children in developing countries, the optimal antibiotic therapy, the existence and importance of chronic and latent C. pneumoniae infections, and the organism's association with nonrespiratory tract disease.

Anti-Bacterial Agents↗
PubMed1990

Ofloxacin treatment of Chlamydia pneumoniae (strain TWAR) lower respiratory tract infections.

PURPOSE: Limited data suggest that tetracycline or erythromycin is the antibiotic of choice for treating Chlamydia pneumoniae infection, but they are not always effective or well tolerated. Because the fluoroquinolone ofloxacin is effective for Chlamydia trachomatis infections, we investigated its role in treating C. pneumoniae infections. PATIENTS AND METHODS: Eighty-seven patients were enrolled in a randomized trial of antibiotic therapy for acute lower respiratory tract infections. The patients were randomly assigned to oral treatment with either ofloxacin (400 mg twice a day) or erythromycin (400 mg four times a day) for 10 days. Frozen acute and convalescent serologic specimens were tested for TWAR antibody by microimmunofluorescence. Susceptibility testing of C. pneumoniae to ofloxacin was also performed. RESULTS: Four patients who received ofloxacin were retrospectively identified as having C. pneumoniae pneumonia (two) or bronchitis (two). Within 2 weeks of starting ofloxacin therapy, all were cured or markedly improved. The minimum inhibitory concentrations of ofloxacin for three previously isolated clinical strains of C. pneumoniae were determined to be 1.0 to 2.0 micrograms/mL, well within the achievable serum levels (3 to 5 micrograms/mL) with ofloxacin therapy. CONCLUSION: Ofloxacin may be an effective alternative antibiotic treatment for C. pneumoniae respiratory infections.

Aged↗