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Tekrarlayan Hışıltılı Süt Çocuklarında Mycoplasma Pneumoniae ve Chlamydia Pneumoniae Etkenlerinin Sıklığı ve Atopi İlişkisi

Yıl 2021, Cilt: 43 Sayı: 6, 625 - 632, 24.09.2021
https://doi.org/10.20515/otd.873131

Öz

Hışıltılı çocuklarda; etyolojide en sık neden solunum yolu enfeksiyonlarıdır. Solunum yolu virüsleri (özellikle RSV) ve Chlamydia Pneumoniae ve Mycoplasma Pneumoniae gibi bazı bakteriler insanlarda alt solunum yollarına ulaştıklarında doku hasarı ve enflamasyonu başlatarak geçici hava yolu aşırı duyarlılığına ve hışıltıya neden olabilmektedir. Bu iki atipik bakterinin astım ile ilişkisi olduğu gösterilmiş ve niteliği sıklıkla tartışma konusu olmuştur. Astım riskini tahmin etmek için majör ve minör parametreler belirlenerek, tekrarlayan hışıltılı çocuklarda astım prediktif indeksi (API) geliştirilmiş ve tekrarlayan hışıltılı infantlarda atopi ve atipik bakteriyel enfeksiyonların ilişkisini incelemek için bu çalışma planlanmıştır. Tekrarlayan hışıltısı olan süt çocuklarında atopi ile atipik bakteri enfeksiyonlarının ilişkisini araştırmak amacıyla; 2 yaş altı kriterlerimize uygun elli sekizi erkek otuzikisi kız hasta çalışmaya alındı. Yapılan değerlendirmelerin sonucunda elli altı hastada (%62.2) API pozitif, otuz dört hasta da (%37.8) negatif olarak değerlendirildi. Hastalardan alınan kan örneklerinde M. Pneumoniae ve C. Pneumoniae için ELISA ve PCR yöntemi ile enfeksiyon varlığı araştırıldı. Her iki enfeksiyonun incelenmesi sonucunda hayatın ilk yılına göre, 2. yılında (12-24 ay arası) anlamlı derecede daha fazla enfeksiyon saptandı. Ancak hastaların her iki enfeksiyonun varlığı ve API pozitifliği yönünden karşılaştırması yapıldığında istatistiksel olarak herhangi bir anlamlı sonuca ulaşılamadı. API bağımsız olarak 0-2 yaş grubundaki hışıltılı çocuklarda subgrup analizi yapıldığında özellikle 1-2 yaş aralığında bu etkenlerin varlığı istatistiksel olarak anlamlı saptandı. Bu gruptaki hışıltılı çocuklarda; bu iki mikroorganizmanın varlığı akılda tutulmalıdır. Her iki enfeksiyon ajanı için de hayatın 2. yılında istatistiksel olarak anlamlı bir artış olduğunu ve bu hastaların tekrarlayan hışıltı atakları geliştirebileceğini saptadık.

Destekleyen Kurum

Eskişehir Osmangazi Üniversitesi Bilimsel Araştırma Projeleri Komisyonu

Proje Numarası

2014-294

Kaynakça

  • 1. Bacharier LB, Guılbert TW. Diagnosis and management of early astma in preschool-aged children. J Allergy Clin Immunol. 2012; 130: 287-296
  • 2. Camargo CA Jr, Rachelefsky G, Schatz M. Managing asthma exacerbations in the emergency department: summary of the National Asthma Education and Prevention Program Expert Panel Report 3 guidelines fort he management of asthma exacerbations. J. Allergy Clin Immunol. 2009; 124 (2 suppl): 5-14
  • 3. Global Initiative for Asthma. Global strategy for asthma diagnosis and preventation (updated 2011) Available at: http/ /www.ginaasthma.org
  • 4. Fitzgerald DA, Kilham HA. Bronchiolitis: assessment and evidence-based medicine. MJA 2004;180:399-404
  • 5. Bialy L, Smith M, Bourke T, Becker L. The Cochrane Library and bronchiolitis: an umbrella review. Evid.-Based Child Health I 2006:939-47.
  • 6. Hammerschlag MR. Chlamydia pneumoniae. In: Berhman RE, Kliegman RM, Jenson HB Eds. Nelson Textbook of Pediadrics, 17th. Ed. Philadelphia: Saunders Co; 2004: 994-5. 7. The management of acute bronchitis in children. Douglas M F, Elliot A J. Expert Opin. Pharmacother. (2007) 8(4):415-426
  • 8. Folkerts G, Busse WW, Nijkamp FP. Virus induced airway hyperresponsivenes and asthma. Am J Respir Crit Care Med 1998;157:1708-20
  • 9. Atypical Pneumonia: Updates on Legionella, Chlamydophila, and Mycoplasma Pneumonia. Sharma L, Losier A, Tolbert T, Dela Cruz CS, Marion CR. Clin Chest Med. 2017 Mar;38(1):45-58
  • 10. Asner SA, Jaton K, Kyprianidou S, Nowak AM, Greub G. Chlamydia pneumoniae: possible association with asthma in children. Clin Infect Dis. 2014 Apr;58(8):1198-9
  • 11. Kraft M, Cassell GH, Henson JE, Watson H, et al. Detection of Mycoplasma Pneumoniae in the airways of adults with chronic asthma. Am J Respir Crit Care Med 1998; 158: 998-100
  • 12. Teoh L, Mackay IM, Van Asperen PP, Acworth JP et al. Presence of atopy increases the risk of asthma relapse. Arch Dis Child. 2017 Oct 11. pii: arch dis child-2017-312982.
  • 13. von Hertzen L, Vasankari T, Liippo K, Wahlström E et al. 3 Pneumoniae and severity of asthma. Scand J Infect Dis 2002; 34: 22-27
  • 14. Emre U, Roblin PM.Gelling M et al. The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med, 1994; 148: 121-25
  • 15. Cunningham A.F, Johnston SL, Julious SA, et al. Chronic Chlamydia pneumoniae infection and asthma exacerbations in children. Eur J Respir, 1998; 11: 345-49.
  • 16. Black PN, Scicchitano R, Jenkins CR, et al. Serological evidence of infection with Chlamydia pneumoniae is related to the severity of asthma. Eur J Respir, 2000; 15: 254-59.
  • 17. ten Brinke A, van Dissel JT, Sterk PJ, et al. Persistent airflow limitation in adult-onset nonatopic asthma is associated with serologic evidence of Chlamydia pneumoniae infection. J Allergy Clin Immunol, 2001; 107: 449-54.
  • 18. Smith-Norowitz TA, K. Chotikanatis, D. P. Erstein, J.perlman, et al. Chlamydia pneumoniae enhances the Th2 profile of stimulated peripheral blood mononuclear cells from asthmatic patients. Human Immunology 77 (2016) 382-388
  • 19. Smith-Norowitz TA, Weaver D, Chorny V, Norowitz YM, et al. Chlamydia pneumoniae Induces Interferon Gamma Responses in Peripheral Blood Mononuclear Cells in Children with Allergic Asthma Scandinavian Journal of Immunology, 2017, 86, 59-64
  • 20. Esposito, S., Blasi, F., Arosio, C., Importance of acute Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with wheezing. Eur J Respir, 2000; 16: 1142–1146.
  • 21. Biscardi S, Lorrot M, Marc E, Moulin F et al. Mycoplasma pneumoniae and Asthma in Children Clinical Infectious Diseases 2004; 38:1341–6
  • 22. Bébéar C, Raherison C, Nacka F, de Barbeyrac B. Comparison of Mycoplasma pneumoniae Infections in asthmatic children versus asthmatic adults. Pediatr Infect Dis J. 2014 Mar; 33: 71-78.
  • 23. Ozturk R. Toplumda Edinilmiş Pnomoni: Tanı yontemleri. In : Eraksoy H, Yenen OŞ, eds. İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji 2000. İstanbul : Nobel Tıp Kitapevleri 2000: 61-4.
  • 24. Hardy RD, Jafri HS, Olsen K, et al. Mycoplasma pneumoniae induces chronic respiratory infection, airway hyperreactivity, and pulmonary inflammation: a murine model of infection associated chronic reactive airway disease. Infect Immun, 2002; 70; 649-54
  • 25. Jeong YC, Yeo MS, Kim JH, Lee HB et al. Mycoplasma pneumoniae Infection Affects the Serum Levels of Vascular Endothelial Growth Factor and Interleukin-5 in Atopic Children. Allergy Asthma Immunol Res. 2012 March; 4(2): 92-97.
  • 26. Kim J, Cho T, Moon J, Kim C R et al. Oh Serial Changes in Serum Eosinophil- associated Mediators between Atopic and Non-atopic Children after Mycoplasma pneumoniae pneumonia. Allergy Asthma Immunol Res. 2014 September; 6(5):428-433.
  • 27. Wood PR, Kampschmidt JC, Dube PH, Cagle MP et al. Mycoplasma pneumoniae and health outcomes in children with asthma. Ann Allergy Asthma Immunol. 2017 Aug; 119(2):146-152.e2.
  • 28. Daxboeck F, Krause R, Wenisch C. Laboratory diagnosis of Mycoplasma pneumoniae infection. Clin Microbiol Infect, 2003; 9: 263-273.
  • 29. Stephens, RS. The cellular paradigm of chlamydial pathogenesis. Trends Microbiol, 2003; 11: 44-51.

Prevalence and Atopy Association of Mycoplasma Pneumoniae and Chlamydia Pneumoniae Infections in Infants with Recurrent Wheezing

Yıl 2021, Cilt: 43 Sayı: 6, 625 - 632, 24.09.2021
https://doi.org/10.20515/otd.873131

Öz

The most common cause in the etiology of wheezing is respiratory tract infections. Viruses (in especially RSV), Chlamydia Pneumoniae and Mycoplasma Pneumoniae bacteria can cause transient airway hypersensitivity and wheezing by causing tissue damage and inflammation when they reach the lower respiratory tract. The association has been demonstrated and discussed between these two atypical bacteria and asthma. By setting major and minor parameters for predicting asthma risk, the asthma predictive index (API) was developed in children with excessive wheezing. This study was planned to examine the relationship of atopy and atypical bacterial infections in infants with persistent wheezing. Thirty-two females and fifty-eight males children under 2 years of age were included in the study. Fifty-six cases (62.2%) were positive for API and thirty-four cases (37.8%) were negative. The presence of infection was investigated by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) method. It was found that both infections were substantially more serious in the second year than in the first year of life. However no statistically meaningful outcome was obtained, when comparing the presence of both pathogens and API positivity. Regardless of the API, the existence of bacterial agents was found to be statistically meaningful, especially in the range of 1-2 years, when subgroup analysis was performed in children with wheezing under the age of 2 years. It is appropriate to keep in mind the existence of these two bacteria in wheezy children. In the second year of life, both infection agents also showed a statistically significant increase and found that these patients could develop persistent wheezing.

Proje Numarası

2014-294

Kaynakça

  • 1. Bacharier LB, Guılbert TW. Diagnosis and management of early astma in preschool-aged children. J Allergy Clin Immunol. 2012; 130: 287-296
  • 2. Camargo CA Jr, Rachelefsky G, Schatz M. Managing asthma exacerbations in the emergency department: summary of the National Asthma Education and Prevention Program Expert Panel Report 3 guidelines fort he management of asthma exacerbations. J. Allergy Clin Immunol. 2009; 124 (2 suppl): 5-14
  • 3. Global Initiative for Asthma. Global strategy for asthma diagnosis and preventation (updated 2011) Available at: http/ /www.ginaasthma.org
  • 4. Fitzgerald DA, Kilham HA. Bronchiolitis: assessment and evidence-based medicine. MJA 2004;180:399-404
  • 5. Bialy L, Smith M, Bourke T, Becker L. The Cochrane Library and bronchiolitis: an umbrella review. Evid.-Based Child Health I 2006:939-47.
  • 6. Hammerschlag MR. Chlamydia pneumoniae. In: Berhman RE, Kliegman RM, Jenson HB Eds. Nelson Textbook of Pediadrics, 17th. Ed. Philadelphia: Saunders Co; 2004: 994-5. 7. The management of acute bronchitis in children. Douglas M F, Elliot A J. Expert Opin. Pharmacother. (2007) 8(4):415-426
  • 8. Folkerts G, Busse WW, Nijkamp FP. Virus induced airway hyperresponsivenes and asthma. Am J Respir Crit Care Med 1998;157:1708-20
  • 9. Atypical Pneumonia: Updates on Legionella, Chlamydophila, and Mycoplasma Pneumonia. Sharma L, Losier A, Tolbert T, Dela Cruz CS, Marion CR. Clin Chest Med. 2017 Mar;38(1):45-58
  • 10. Asner SA, Jaton K, Kyprianidou S, Nowak AM, Greub G. Chlamydia pneumoniae: possible association with asthma in children. Clin Infect Dis. 2014 Apr;58(8):1198-9
  • 11. Kraft M, Cassell GH, Henson JE, Watson H, et al. Detection of Mycoplasma Pneumoniae in the airways of adults with chronic asthma. Am J Respir Crit Care Med 1998; 158: 998-100
  • 12. Teoh L, Mackay IM, Van Asperen PP, Acworth JP et al. Presence of atopy increases the risk of asthma relapse. Arch Dis Child. 2017 Oct 11. pii: arch dis child-2017-312982.
  • 13. von Hertzen L, Vasankari T, Liippo K, Wahlström E et al. 3 Pneumoniae and severity of asthma. Scand J Infect Dis 2002; 34: 22-27
  • 14. Emre U, Roblin PM.Gelling M et al. The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med, 1994; 148: 121-25
  • 15. Cunningham A.F, Johnston SL, Julious SA, et al. Chronic Chlamydia pneumoniae infection and asthma exacerbations in children. Eur J Respir, 1998; 11: 345-49.
  • 16. Black PN, Scicchitano R, Jenkins CR, et al. Serological evidence of infection with Chlamydia pneumoniae is related to the severity of asthma. Eur J Respir, 2000; 15: 254-59.
  • 17. ten Brinke A, van Dissel JT, Sterk PJ, et al. Persistent airflow limitation in adult-onset nonatopic asthma is associated with serologic evidence of Chlamydia pneumoniae infection. J Allergy Clin Immunol, 2001; 107: 449-54.
  • 18. Smith-Norowitz TA, K. Chotikanatis, D. P. Erstein, J.perlman, et al. Chlamydia pneumoniae enhances the Th2 profile of stimulated peripheral blood mononuclear cells from asthmatic patients. Human Immunology 77 (2016) 382-388
  • 19. Smith-Norowitz TA, Weaver D, Chorny V, Norowitz YM, et al. Chlamydia pneumoniae Induces Interferon Gamma Responses in Peripheral Blood Mononuclear Cells in Children with Allergic Asthma Scandinavian Journal of Immunology, 2017, 86, 59-64
  • 20. Esposito, S., Blasi, F., Arosio, C., Importance of acute Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with wheezing. Eur J Respir, 2000; 16: 1142–1146.
  • 21. Biscardi S, Lorrot M, Marc E, Moulin F et al. Mycoplasma pneumoniae and Asthma in Children Clinical Infectious Diseases 2004; 38:1341–6
  • 22. Bébéar C, Raherison C, Nacka F, de Barbeyrac B. Comparison of Mycoplasma pneumoniae Infections in asthmatic children versus asthmatic adults. Pediatr Infect Dis J. 2014 Mar; 33: 71-78.
  • 23. Ozturk R. Toplumda Edinilmiş Pnomoni: Tanı yontemleri. In : Eraksoy H, Yenen OŞ, eds. İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji 2000. İstanbul : Nobel Tıp Kitapevleri 2000: 61-4.
  • 24. Hardy RD, Jafri HS, Olsen K, et al. Mycoplasma pneumoniae induces chronic respiratory infection, airway hyperreactivity, and pulmonary inflammation: a murine model of infection associated chronic reactive airway disease. Infect Immun, 2002; 70; 649-54
  • 25. Jeong YC, Yeo MS, Kim JH, Lee HB et al. Mycoplasma pneumoniae Infection Affects the Serum Levels of Vascular Endothelial Growth Factor and Interleukin-5 in Atopic Children. Allergy Asthma Immunol Res. 2012 March; 4(2): 92-97.
  • 26. Kim J, Cho T, Moon J, Kim C R et al. Oh Serial Changes in Serum Eosinophil- associated Mediators between Atopic and Non-atopic Children after Mycoplasma pneumoniae pneumonia. Allergy Asthma Immunol Res. 2014 September; 6(5):428-433.
  • 27. Wood PR, Kampschmidt JC, Dube PH, Cagle MP et al. Mycoplasma pneumoniae and health outcomes in children with asthma. Ann Allergy Asthma Immunol. 2017 Aug; 119(2):146-152.e2.
  • 28. Daxboeck F, Krause R, Wenisch C. Laboratory diagnosis of Mycoplasma pneumoniae infection. Clin Microbiol Infect, 2003; 9: 263-273.
  • 29. Stephens, RS. The cellular paradigm of chlamydial pathogenesis. Trends Microbiol, 2003; 11: 44-51.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Gülçin Bozan Bu kişi benim 0000-0002-6236-9925

Gürkan Bozan 0000-0001-5041-8892

Hulya Anıl 0000-0002-0889-2491

Tercan Us 0000-0002-9772-6777

Koray Harmanci 0000-0002-8494-648X

Proje Numarası 2014-294
Yayımlanma Tarihi 24 Eylül 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 43 Sayı: 6

Kaynak Göster

Vancouver Bozan G, Bozan G, Anıl H, Us T, Harmanci K. Prevalence and Atopy Association of Mycoplasma Pneumoniae and Chlamydia Pneumoniae Infections in Infants with Recurrent Wheezing. Osmangazi Tıp Dergisi. 2021;43(6):625-32.


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