Mycoplasma pneumoniae Infection and Subsequent Wheezing in Childhood Asthma- A Cohort Study

Abstract

Introduction: Prevalence of asthma in children <18 years is approximately 7-8%. Mycoplasma pneumoniae has also been found to be an important trigger of asthma. Many studies have shown the association of Mycoplasma pneumoniae with acute exacerbation of asthma in adults. But the data is limited to determine the role of Mycoplasma pneumoniae in causing subsequent wheezing in children with asthma. Aim: To study the role of Mycoplasma pneumoniae infection in causing subsequent wheezing episodes in asthma in children between 1-14 years of age. Materials and Methods: This was a prospective cohort study conducted from October 2019 to October 2021 at the Paediatric Division of Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. Consecutively 60 patients with bronchial asthma aged between 1 to 14 years were included during the first year of study period. The diagnosis of bronchial asthma was as per Global Initiative for Asthma (GINA) guidelines. Venous sample was tested for Immunoglobulin M (IgM) Mycoplasma pneumoniae antibody with Calbiotech Mycoplasma pneumoniae IgM Enzymelinked Immunosorbent Assay (ELISA) kit. Clinical follow-up for subsequent wheeze was done at 3 months, 6 months, and 12 months starting after 2 weeks of being declared symptom free. All data were recorded and analysed by Statistical Package for Social Sciences software (SPSS) version 22.0. Results: Out of 60 patients, males comprised of 46 (76.67%) and females 14 (23.33%) with the mean age 5.56±4.21 years. Family history of wheeze was also taken and found to be 38.33% among asthamatics (23/60). Among asthmatics, 23 cases (38.33%) were IgM positive. Episodes of subsequent wheeze were present in all the patients with a mean of 4.5±2.7 episodes in one year. On subgroup analysis, mean wheezing episodes were documented as 5.43±3.00 in IgM positive group which was statistically higher than IgM negative group in which mean wheezing episodes were 3.92±2.42 (p-value=0.036). Conclusion: Subsequent wheeze was observed in all patients with asthma. The mean wheezing episodes were statistically more in Mycoplasma pneumoniae infected asthmatics in comparison to non Mycoplasma pneumoniae infected asthmatics.