Chlamydia Pneumoniae Infection Associated with Uncontrolled Asthma: a Hospital Based Cross Sectional Study

Objectives: To evaluate the proportion of anti- Chlamydia pneumoniae (Cp) IgM positivity in patients with uncontrolled asthma and partly controlled childhood asthma and their clinical correlates.

Methods: This was a hospital based cross sectional study. Children aged 1 to 12 y suffering from asthma were included after written informed parental consent. For diagnosis and classification of uncontrolled and partly controlled asthma, GINA guidelines 2009 were used. Anti-Cp IgM was tested by using an enzyme linked immunosorbent assay (ELISA) and value of antibody index ≥ 0.90 was considered positive. Data was collected on demographic, clinical and investigative variables including chest radiograph posterior-anterior view.

Results: From August 2010 through August 2011 44 patients hospitalized with uncontrolled asthma in exacerbation and 45 patients with partly controlled asthma from ambulatory care settings were included. Anti-Cp IgM was positive in 25 % (n = 11/44) and 6.7 % (n = 3/45) patients with uncontrolled and partly controlled asthma, respectively (Odds ratio = 4.67, χ (2) = 5.64, 95 % CI 1.20-18.10, p 0.0 17). Among the patients of uncontrolled asthma, duration of hospital stay was longer in anti-Cp IgM positive patients (9 ± 2.19 vs. 7.19 ± 2.10 d, p 0.02).

Conclusions: Since anti-Cp IgM positivity was associated with age >5 y and radiological consolidation in uncontrolled asthma in exacerbation, specific treatment of Chlamydia pneumoniae must be actively considered.