The association of Chlamydia pneumoniae infection and reactive airway disease in children [see comments]

Emre U,      Roblin PM,      Gelling M,      Dumornay W,      Rao M,      Hammerschlag MR      Schachter J     

Asthma
Chlamydia pneumoniae
Chlamydia Infections
Adolescence
Case-Control Studies
Child

Child, Preschool
Female
Human
Male
Prospective Studies
Support, Non-U.S. Gov't

Abstract
OBJECTIVE: To determine the possible association of Chlamydia pneumoniae infection and reactive airway disease in children. 

DESIGN: Prospective observational study. 

SETTING: Pediatric emergency department in Children's Medical Center of Brooklyn (NY), Kings County Hospital Center. 

PARTICIPANTS: One hundred eighteen children with acute episodes of wheezing and 41 age- and sex-matched healthy controls, aged 5 to 16 years. 

INTERVENTIONS: Children with cultures positive for C pneumoniae were treated with antibiotics. 

MEASUREMENTS/MAIN RESULTS: Cultures for C pneumoniae and serum samples for antibody testing were obtained from subjects and healthy controls.  We isolated C pneumoniae from 13 (11%) children with wheezing and from two (4.9%) controls.  Seven (58.3%) of 12 children with positive cultures had no detectable antibody to C pneumoniae and only three (25%) children had serologic evidence of acute infection.  Six children had positive cultures on multiple occasions, ranging from 1 to 5 months.  The children with wheezing were treated with erythromycin or clarithromycin, a new macrolide antibiotic approved for use in adults; all eventually had a negative culture.  Nine (75%) of these children demonstrated clinical and laboratory improvement of the reactive airway disease after the eradication of chlamydial infection. 

CONCLUSIONS: Infection with C pneumoniae can trigger acute episodes of wheezing in children with asthma.  Treatment of C pneumoniae infection may improve the course of reactive airway disease in these patients.

Comment in: Arch Pediatr Adolesc Med 1995 Feb;149(2):219-21
Comment in: Arch Pediatr Adolesc Med 1995 Mar;149(3):341-2