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To the Editor—The possible association between Chlamydia pneumoniae infection and multiple sclerosis (MS) was first described in a case study by Sriram and colleagues at Vanderbilt University Medical Center (VUMC), which was then followed by a study of a series of patients from VUMC in whom the researchers reported that the organism was identified by culture and polymerase chain reaction (PCR) [1, 2]. The results of subsequent studies performed by a number of other groups have been conflicting, finding C. pneumoniae DNA in 0% to >80% of cerebrospinal fluid (CSF) samples from patients with MS and in 0%–20% of CSF samples from patients with other neurologic diseases [3]. This discrepancy in results is similar to inconsistencies in findings reported for the association between C. pneumoniae infection and atherosclerosis; some studies have identified the organism by PCR and/or immunohistochemical (IHC) staining in up to 100% of atheromatous tissues tested, but other studies have not confirmed these findings [4, 5]. These discrepancies may indicate methodologic differences, sampling error, or other unknown problems. Several multicenter studies have demonstrated major differences in methodologies and results, including significant inter- and intralaboratory variability in PCR testing when the same specimens were tested in different laboratories, even among those using the same assays [4–6]

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