The role of Mycoplasma pneumoniae in acute exacerbation of asthma in children.

Chun-Yen Ou, Yu-Fang Tseng, Yee-Hsuan Chiou, Bao-Re Nong, Yung-Feng Huang, Kai-Sheng Hsieh
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Abstract

Background: The aim of this retrospective study was to test the connection between acute M. pneumoniae infection and the exacerbation of asthma. The clinical characteristics of Mycoplasma infection seen during emergent visits in asthmatic children were reviewed.

Methods: We examined the cases of 316 asthma exacerbation patients aged from two to fourteen-years-old. They were divided into two groups according to their asthma history. One hundred and eighty-eight cases had evidence of a history of asthma (group 1) and 128 had only had their first asthma attack (group 2). The control group (group 3) was made up of 151 asthmatic children who had no acute exacerbation during the previous six months. In all three groups, we looked whether those children had acute M. pneumoniae infection or not. Acute M. pneumoniae infection was defined by positive results in serologic testing, with specific immunoglobulin M (IgM) antibody or with a > or = fourfold increase in IgG titer by the third week in the same children.

Results: In group 1, acute M. pneumionae infection was found in 42 (23%) of the 188 children. In group 2, acute M. pneumoniae infection was proven in 57 (45%) of the 128 children. In the control group, 10 (7%) of the 151 children had M. pneumoniae infection. Twenty-three (54%) asthmatic children that presented with fever as the chief complaint were infected with M. pneumoniae, compared with 18 (12%) children without infection (p = 0.014). Twenty-nine (50%) children having their first asthma attack with fever were infected with M. pneumoniae, compared with 22 (32%) without infection (p = 0.009). In group 1, 17 (41%) children with M. pneumoniae infections and 28 (19%) children without M. pneumoniae infections presented with rale breathing sounds of the physical examination (p = 0.027). In group 2, 26 (46%) children with M. pneumoniae infections and 17 (24%) children without M. pneumoniae infections presented with rale breathing sounds (p = 0.019).

Conclusions: We found that M. pneumoniae may play a role in asthmatic exacerbation among children, especially in those experiencing their first asthma attack. Moreover, among children with acute M. pneumoniae infection, the number was significantly increased of children having fever as the chief complaint and rales in auscultations compared with those without M. pneumoniae infection.

肺炎支原体在儿童哮喘急性加重中的作用。
背景:本回顾性研究的目的是检验急性肺炎支原体感染与哮喘加重之间的联系。本文综述了哮喘患儿急诊时支原体感染的临床特点。方法:对316例2 ~ 14岁哮喘加重患者进行分析。根据哮喘病史将患者分为两组。188例有哮喘病史(第一组),128例只有第一次哮喘发作(第二组)。对照组(第三组)由151名哮喘儿童组成,他们在过去6个月内没有急性发作。在这三组中,我们观察了这些儿童是否患有急性肺炎支原体感染。急性肺炎支原体感染的定义是血清学检测结果阳性,具有特异性免疫球蛋白M (IgM)抗体,或者在同一儿童中,IgG滴度在第三周增加>或= 4倍。结果:1组188例患儿中有42例(23%)出现急性肺炎支原体感染。2组128例患儿中有57例(45%)确诊急性肺炎支原体感染。对照组151例患儿中有10例(7%)发生肺炎支原体感染。以发热为主诉的哮喘患儿感染肺炎支原体23例(54%),未感染的患儿18例(12%)(p = 0.014)。29例(50%)首次哮喘发作伴有发热的儿童感染肺炎支原体,22例(32%)未感染(p = 0.009)。第1组肺炎支原体感染患儿17例(41%),非肺炎支原体感染患儿28例(19%)体检时出现呼吸音重(p = 0.027)。第2组肺炎支原体感染患儿26例(46%),非肺炎支原体感染患儿17例(24%)出现呼吸音重(p = 0.019)。结论:我们发现肺炎支原体可能在儿童哮喘加重中起作用,特别是在首次哮喘发作的儿童中。在急性肺炎支原体感染患儿中,以发热为主诉和听诊啰音的患儿数量明显高于非肺炎支原体感染患儿。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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