Cem DENİZ, Şihmir ŞİMŞEK, Engin TUTAR, Gülnur TOKUÇ, Sedat ÖKTEM

Hışıltılı Çocuklarda Mycoplasma pneumoniae ve Chlamydia pneumoniae Prevalansı

Amaç: Mycoplasma pneumoniae ve Chlamidia pneumoniae infeksiyonlarının çocukluk çağında hışıltılı çocuk etiyolojisindeki prevalansını belirlemek. Gereç ve Yöntem: Muayenesinde hışıltı tespit edilen, 2-14 yaş arası, 66’sı astım tanılı 130 hasta ve 46 sağlıklı çocuk, M.pneumoniae ve C.pneumoniae infeksiyonu yönünden prospektif olarak incelendi. Her iki patojen için de, IgM titresi ELISA yöntemi ile bakıldı. Bulgular: Serolojik tetkikler sonucunda, 8 vakada % 6.2 M.pneumoniae, 9 vakada % 6.9 C.pneumoniae tespit edildi. Kontrol grubunda ise 1 vakada % 2.2 C.pneumoniae bulundu. hışıltılı hasta grubumuzda, her iki patojen için antikor pozitifliği açısından, kontrol grubuna göre istatistiksel bir fark bulamadık. Sonuç: Kontrol grubuna oranla hışıltılı hastalarda M.pneumoniae ve C.pneumoniae infeksiyonu daha sık olmasına karşın, vaka sayısının azlığı nedeniyle M.pneumoniae ve C.pneumoniae infeksiyonu ile hışıltı arasında bir ilişki saptamadık.

Anahtar Kelimeler:

Astım, hışıltı, Mycoplasma pneumoniae, Chlamydia pneumoniae

Prevalance of Mycoplasma pneumoniae and Chlamydia pneumoniae in Children with Wheezing

Aim: In order to detect the prevalance of M.pneumoniae and C.pneumoniae in childhood wheezing etiology. Material and Method: We checked the IgM titre for these two bacteria using the ELISA test, in 130 wheezing children 66 with asthma and 46 healthy chidren prospectively. Results: M.pneumoniae was detected in 8 6.2 % and C.pneumoniae in 9 patients 6.9 % . In the control group only one case of C.pneumoniae 2.2 % was detected. There was no statistically significant difference between the values of the wheezing group and the control group. Conclusion: As a result, due to the small size of the study population, although the number of cases with C.pneumoniae and M.pneumoniae was higher in patients with wheezing group than control group, we were not relationship between wheezing and these pathogens.

Keywords:

Asthma, wheezing, Mycoplasma pneumoniae, Chlamydia pneumoniae,

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Esposito S, Blasi F, Arosio C, et al. Importance of acute Mycoplasma pneumoniae and Chlamydia pneumoniae infecti- ons in children with wheezing. Eur Respir J 2000;16:1142-6. http://dx.doi.org/10.1034/j.1399-3003.2000.16f21.x
American Academy of Pediatrics. Mycoplasma pneumoniae infections. In: Pickering LK, ed Red Book 2003 Reports of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, II: American Academy of Pediatrics: 2003:443-5.
Kamesaki S, Suehiro Y, Shinomiya K, Matsushima H, Ouchi K. Chlamydia pneumoniae infections in children with asthma exacerbation. Arerugi 1998;47(7):667-73. PMid:9780441
Gil JC, Mayagoitia BG, Paz MD. Isolation of Mycoplasma pneumoniae from asthmatic patients. Ann Allergy 1993;70:23- 5. PMid:8424592
Biscardi S, Lorrot M, Marc E, et al. Mycoplasma pneumo- niae and asthma in children. Clin Infect Dis 2004;38(10):1341- 1346. http://dx.doi.org/10.1086/392498 PMid:15156467
Miller TC, Baman SI, Albers WH. Massive pericardial effu- sion due to Mycoplasma hominis in a newborn. Am J Dis Child 1982;136:271-2.
Leaver R, Weinberg EG. Is Mycoplasma pneumoniae a pre- cipitating factor in acute severe asthma in children? Sout Arf Med J 1985;68:78-9.
Zorrati EM, Busse WW. The role of respiratory infections in airway responsiveness and the patogenesis of asthma. Immun Allergy Clin North Am 1990;10/3:449-61.
Korppi M, Halonen P, Kleemola M, Launiala K. Viral fin- dings in children under the age of two years with expiratory difficulties. Acta Pediatr Scand 1986;75:457-64. http://dx.doi.org/10.1111/j.1651-2227.1986.tb10230.x
Schmidt SM, Muller CE, Wiersbitzky SK. Inverse associa- tion between Chlamydia pneumoniae respiratory tract infecti- on and initiation of asthma or allergic rhinitis in children. Pediatr Allergy Immunol 2005;16(2):137-44. http://dx.doi.org/10.1111/j.1399-3038.2005.00229.x PMid:15787871
Powell DA. Mycoplasmal infections. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Saunders Company, 2004:990-2.
Block S, Hedrick J, Hammerschlag MR, et al. Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erytromycin ethylsuccinate. Pediatr Infect Dis J 1995;14:471-7. http://dx.doi.org/10.1097/00006454-199506000-00002 PMid:7667050
Jantos CA, Wienpahl B, Schiefer HG, et al. Infection with Chlamydia pneumoniae in infants and children with acute lower respiratory tract disease. Pediatr Infect Dis J 1995;14: 117-22. http://dx.doi.org/10.1097/00006454-199502000-00007 PMid:7746693
Sidal M, Kilic A, Unuvar E, ve ark. Frequency of Chlamydia pneumoniae and Mycoplasma pneumoniae infections in child- ren. J Trop Pediatr 2007;53(4):225-31. http://dx.doi.org/10.1093/tropej/fmm003 PMid:17517817
Bütün Y, Köse S, Babayiğit A, ve ark. Chlamydia and Mycoplasma serology in respiratory tract infections of child- ren. Tuberk Toraks 2006;54(3):254-8. PMid:17001543
Hammerschlag MR. Chlamydial infections. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Saunders Company, 2004: 994-5.
Broughton RA. Infections due to Mycoplasma pneumoniae in childhood. Pediatr Infect Dis J 1986;5:71-85. http://dx.doi.org/10.1097/00006454-198601000-00014
Gencay M, Dereli D, Ertem E, et al. Prevalance of Chlamydia pneumoniae specific antibodies in different clini- cal situations and health subjects in İzmir, Turkey. Eur J Epidemiol 1998;14:505-9. http://dx.doi.org/10.1023/A:1007404315879 PMid:9744685
Einarsson S, Sigurdsson HK, Magnusdottir S, Erlendsdottir H, Briem H, Gudmundsson S. Age specific prevalence of antibodies againts Chlamydia pneumoniae in Iceland. Scand J Infect Dis 1994;26:393-7. http://dx.doi.org/10.3109/00365549409008610 PMid:7984969
Johnston SL. The role of viral and atypical bacterial patho- gens in asthma pathogenesis. Pediatr Pulmonol Suppl 1999; 18:141-3. http://dx.doi.org/10.1002/(SICI)1099-0496(1999)27: 18+3.0.CO;2-A
Hahn DL, McDonald R. Can acute Chlamydia pneumoniae respiratory tract infection initiate chronic Asthma? Ann Allergy Asthma Immunol 1998;81(4):339. http://dx.doi.org/10.1016/S1081-1206(10)63126-2
Emre U, Sokolovskaya N, Roblin PM, Schachter J, Hammerschlag MR. Detection of anti-Chlamydia pneumoni- ae IgE in children with reactive airway disease. J Infect Dis 1995;172(1):265-7. http://dx.doi.org/10.1093/infdis/172.1.265 PMid:7797928
Mandhane PJ, Greene JM, Cowan JO, Taylor DR, Sears MR. Sex differences in factors associated with childhood and adolescent onset wheeze. Am J Respir Crit Care Med 2005; [Epub ahead of print] http://dx.doi.org/10.1164/rccm.200412-1738OC PMid:15805179 PMCid:2718447
Biscardi S, Lorrot M, Marc E, Moulin F, Boutonnat- Faucher B, Heilbronner C, et al. Mycoplasma pneumoniae and asthma in children. Clin Infect Dis 2004;38(10):1341-6. http://dx.doi.org/10.1086/392498 PMid:15156467
Thumerelle C, Deschildre A, Bouquillon C, et al. Role of viruses and atypical bacteria in exacerbations of asthma in hospitalized children: a prospective study in the Nord-Pas de Calais region (France). Pediatr Pulmonol 2003;35(2):75-82. http://dx.doi.org/10.1002/ppul.10191 PMid:12526066
Chanock RM. Mycoplasma infections of man. N Eng J Med 1965;273:1199-206, 1257-64.
Brouard J, Freymuth F, Toutain F, et al. Role of viral infec- tions and Chlamydia pneumoniae and Mycoplasma pneumo- niae infections in asthma in infants and young children. Epidemiologic study of 118 children. Arch Pediatr 2002;9 Suppl 3:365-71. http://dx.doi.org/10.1016/S0929-693X(02)00145-8
Buse WW. The relationship between viral infections and onset of allergic diseases and asthma. Clin Exp Allergy 1989; 19:1-9. http://dx.doi.org/10.1111/j.1365-2222.1989.tb02336.x
Jebrak G, Brugiere O, Uffredi ML. Impact of Chlamydia pneumoniae infections on asthma. Presse Med 2000;29(25): 1425-31. PMid:11036520
Al Rashed A. Role of Mycoplasma pneumoniae in acute respiratory-tract infections in Saudi paediatric patients. Annals of Tropical Medicine & Parasitology 1998;92(5):595-601. http://dx.doi.org/10.1080/00034989859294
Ouchi K, Komura H, Fujii M, Matsushima H, Maki T, Hasegawa K. Chlamydia pneumoniae infection and Mycoplasma pneumoniae infection in pediatric patients. Kansenshogaku Zasshi 1999;73(12):1177-82. PMid:10655676
Duff AL, Pomeranz ES, Gelber LE, et al. Risk factors for acute wheezing in infants and children: viruses, passive smoke, IgE antibodies to inhalant allergens. Pediatrics 1993; 92:535-40. PMid:8414823
Newson RC, Strachan D, Archibald E, Emberlin J, Hardaker P, Collier C. Acute asthma epidemics, weather and pollen in England, 1987-1994. Eur Respir J 1998;11:694- 701. PMid:9596123
Bosnak M, Dikici B, Bosnak V, Dogru O, Ozkan I, Ceylan A, Haspolat K. Prevalence of Mycoplasma pneumoniae in children in Diyarbakir, the South-east of Turkey. Pediatr Int 2002;44(5):510-2. http://dx.doi.org/10.1046/j.1442-200X.2002.01606.x
Usluer G, Colak H. Mycoplasma pneumoniae cultured from healthy population aged 8 to 16. Mikrobiyol Bul 1987;21(3): 206-11. PMid:3141751