Comparison of complement fixation and microimmunofluorescence tests in respiratory infections caused by chlamydia and an evaluation of the serum amyloid a protein in chlamydial infections

We retrospectively analyzed serum samples for antibodies to chlamydia species using the micro-immunofluorescence (MIF) test from 72 patients previously tested by the clamydia complement fixation (CF) test, which is used to detect pulmonary psittacosis. Nineteen patients were positive for chlamydia with the CF test. Of these, 9 patients (47.4%) were also positive forC. psittaci infection, and 7 patients (36.8%) were positive forC. pneumoniae infection by the MIF test. Five (9.4%) and (11.3%) of the 53 CF-negative patients were positive for psittacosis andC. pneumoniae infection by the MIF test, respectively. Our results indicate that the serum of patients suspected of pulmonary psittacosis should be examined by the MIF test as well as CF in order to distinguish between infections caused byC. psittaci, C. pneumoniae andC. trachomatis, and to improve the sensitivity of serodiagnosis. Serum samples of all 7 patients positive by both CF and the MIF test forC. pneumoniae infection showed a diagnostic IgG antibody change toC. pneumoniae without IgM antibody changes, which suggested a primary infection. These results suggest that the diagnostic CF antibody response occasionally appears in reinfection, especially inC. pneumoniae infection. There was a positive correlation (r=0.858) between C-reactive protein and serum amyloid protein A, a sensitive acutephase serum reactant, over a wide range of concentrations in 19 patients with chlamydia respiratory infections.