The role of Mycoplasma Pneumonia infection in child wheezing disorders

Abstract

The study was aimed to evaluate the role of the specific serologic diagnosis of Mycoplasma infection and clinical peculiarities of bronchopulmonary diseases with recurrent episodes of wheezing in children. Seventy-six children (ages 6 months to 7 years) with wheezing disorders (bronchial asthma and obstructive bronchitis) were included in our study. The diagnosis, classification of asthma, and asthma severity levels were based on GINA guidelines. The determination of M. pneumonia and M. hominis IgG, IgA, IgM antibodies were performed by using an enzyme-linked immunosorbent assay (Human, Germania). Analysis of the serologic examination results showed that 56 patients had the Mycoplasma infection and 20 exhibited no signs of Mycoplasma infection. In I group (the Mycoplasma-positive group) 4 patients had bronchial asthma, and 6 patients with obstructive bronchitis had specific antibodies in diagnostic titers (IgM 0,35±0,01 (cut-off 0,25), IgG 0,33±0,13 (cut-off 0,30±0,03) and IgA 1,47±0,01 (cut-off 0,801), IgG 1,18±0,46 (cut-off 0,33±0,02) accordingly). In the remainder of the first group (47 children), 10 children had b\ronchial asthma and 36 children had obstructive bronchitis associated with acute pneumonia. Levels of specific antibodies consisted of: M. pneumonia (4 children) IgM 0,29±0,02 (cut-off 0,25), IgG 0,47±0,02 (cut-off 0,32) and M. hominis (4 children) IgA 0,25±0,15 (cut-off 0,24), IgG 1,03±0,25; cut-off 0,3±0,01 and in 2 children a mix infection (M. hominis and M. pneumonia IgG 0,80±0,2 (cut-off 0,28) and IgG 0,50±0,07 (cut-off 0,33) accordingly) (in the group with pneumonia and bronchial asthma) and M. pneumonia 0,45±0,06 (cut-off 0,34), IgG 0,44±0,02 (cut-off 0,35) and M. hominis IgM 0,34±0,09 (cut-off 0,30), IgG 0,97±0,17 (cut-off 0,29) (in the group with pneumonia and obstructive bronchitis). In II group (the Mycoplasma-negative group) 4 patients had obstructive bronchitis and 16 children had pneumonia, including 6 children with associated bronchial asthma and 10 patients had pneumonia with obstructive bronchitis. The levels of specific antibodies was below the cut-off: M. pneumonia IgM 0,18±0,09 (cut-off 0,52±0,15), IgG 0,17±0,02 (cut-off 0,33±0,03), M. pneumoniae IgM 0,1±0,02 (cut-off 0,25), IgG 0,14±0,02 (cut-off 0,27) and in last group IgM 0,1±0,04 (cut-off 0,25) and IgG 0,17±0,04 (cut-off 0,29) accordingly. The Evolution of pneumonia in children with Mycoplasma infection was complicated in 11 cases: in 6 cases with pleural effusion and in 5 cases with atelectasia (patients from the Mycoplasma-negative group had pleural effusion only in 2 cases). Mycoplasma infection in children with obstructive bronchitis and bronchial asthma is a significant risk factor, thus the identification of this infectious agent is important for the development of efficient programs of treatments in pediatric pneumology