Abstract
Manifestations of Mycoplasma pneumoniae infection can range from self-limiting upper respiratory symptoms to various neurological complications, including speech and language impairment. But an association between Mycoplasma pneumoniae infection and speech and language impairment has not been sufficiently explored. In this study, we aim to investigate the association between Mycoplasma pneumoniae infection and subsequent speech and language impairment in a nationwide population-based sample using Taiwan’s National Health Insurance Research Database. We identified 5,406 children with Mycoplasma pneumoniae infection (International Classification of Disease, Revision 9, Clinical Modification code 4830) and compared to 21,624 age-, sex-, urban- and income-matched controls on subsequent speech and language impairment. The mean follow-up interval for all subjects was 6.44 years (standard deviation = 2.42 years); the mean latency period between the initial Mycoplasma pneumoniae infection and presence of speech and language impairment was 1.96 years (standard deviation = 1.64 years). The results showed that Mycoplasma pneumoniae infection was significantly associated with greater incidence of speech and language impairment [hazard ratio (HR) = 1.49, 95% CI: 1.23–1.80]. In addition, significantly increased hazard ratio of subsequent speech and language impairment in the groups younger than 6 years old and no significant difference in the groups over the age of 6 years were found (HR = 1.43, 95% CI:1.09–1.88 for age 0–3 years group; HR = 1.67, 95% CI: 1.25–2.23 for age 4–5 years group; HR = 1.14, 95% CI: 0.54–2.39 for age 6–7 years group; and HR = 0.83, 95% CI:0.23–2.92 for age 8–18 years group). In conclusion, Mycoplasma pneumoniae infection is temporally associated with incident speech and language impairment.
Highlights
Mycoplasma pneumoniae (M. pneumoniae), belonging to the class Mollicutes, is a ubiquitous and well-established pathogen of the respiratory tract
This study investigates the association between M. pneumoniae infection and subsequent speech and language impairment in a nationwide population-based sample
The study sample comprised 5,406 individuals with M. pneumoniae infection and 21,624 age, sex, urban- and income-matched individuals ascertained from the database
Summary
Mycoplasma pneumoniae (M. pneumoniae), belonging to the class Mollicutes, is a ubiquitous and well-established pathogen of the respiratory tract. Manifestations of M. pneumoniae infection can range from self-limiting upper respiratory illness to severe pneumonia. About 25% of M. pneumoniae infected persons may be complicated by the involvements of various extrapulmonary systems, and the central nervous system (CNS) is the most frequently affected [3, 4]. Within hospitalized patients with serologically confirmed M. pneumoniae infection, approximately 1–10% is associated with neurological manifestations [5]. Cerebellar syndrome, polyradiculitis, cranial nerve palsies, aseptic meningitis, encephalitis, meningoencephalitis, acute disseminated encephalomyelitis, optic neuritis, diplopia, cranial nerve palsy, ataxia, choreoathetosis, and ascending paralysis (Guillain-Barre syndrome) are examples of neurological complications in M. pneumoniae infection [6]. More than 80% of patients with CNS findings have prior or concomitant respiratory illness [7]. The time interval between the onset of respiratory symptoms and neurological symptoms varies from 2 to 14 days [8, 9]. Late onset encephalitis after several days to a few weeks was reported [5]
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