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Pneumologie 2003; 57(8): 449-458
DOI: 10.1055/s-2003-41550
Serie: Update Erreger von Atemwegsinfektionen (3)
© Georg Thieme Verlag Stuttgart · New York

Klinisches Bild, Diagnostik und Therapie der Chlamydien-Pneumonie

Clinical Picture, Diagnosis and Treatment of Chlamydia PneumoniaO.  Burkhardt1 , E.  Straube2 , T.  Welte1
  • 1Abteilung für Pneumologie und Internistische Intensivtherapie (Leiter: Priv.-Doz. Dr. med. T. Welte), Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg
  • 2Institut für Medizinische Mikrobiologie (Leiter: Prof. Dr. med. E. Straube), Friedrich-Schiller-Universität Jena
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Publication History

Publication Date:
29 April 2004 (online)

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Einleitung

In den letzten Jahren wurde mehrfach über einen kontinuierlichen Wandel im Erregerspektrum der ambulant erworbenen Pneumonie berichtet. Hierbei zeigte sich der allgemeine Trend einer relativen Zunahme so genannter atypischer Pneumonieerreger bei gleichzeitigem Rückgang grampositiver Mikroorganismen [1] [2] [3] [4] [5] [6] [7] [8]. Zu diesen atypischen bzw. intrazellulär agierenden Bakterien gehören auch die Chlamydien. In epidemiologischen Studien wurde in bis zu 15 % aller erfassten Pneumoniefälle Chlamydia pneumoniae identifiziert [1] [2] [3] [4] [5] [9] [10]. Gleichzeitig gelang jedoch häufig der Nachweis eines zweiten oder dritten Erregers im Sinne einer Mischinfektion, so dass die Frage nach der pathogenetischen Bedeutung von Chlamydia pneumoniae für die Pneumonie zum Teil sehr kontrovers diskutiert wurde [11] [12] [13]. Das derzeitige Hauptproblem und der Schwerpunkt in der Chlamydienforschung betrifft die Diagnostik dieser obligat intrazellulären, gramnegativen Bakterien [14]. Trotz einer Vielzahl von Nachweismethoden ist zur Zeit keine Technik in der Lage, einen schnellen und zugleich verlässlichen Erregernachweis zu erbringen. Zudem fehlt noch jegliche Standardisierung. Zur Therapie von Chlamydieninfektionen insbesondere der Pneumonie stehen sehr potente Antibiotika wie die Makrolide und das Azalid Azithromycin, das Ketolid Telithromycin, das Tetracyclin Doxycyclin und die Fluorochinolone der neuen Generation zur Verfügung.

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Priv.-Doz. Dr. med. T. Welte

Otto-von-Guericke-Universität Magdeburg, Medizinische Fakultät · Abteilung für Pneumologie und Internistische Intensivtherapie

Leipziger Straße 44

39120 Magdeburg

Email: tobias.welte@medizin.uni-magdeburg.de