Bacterial Infection May Cause or Worsen Asthma Attacks in Children

A type of bacteria called Mycoplasma pneumoniae could be responsible for triggering asthma attacks in children who have never experienced them before, and may exacerbate wheezing in children who already have asthma, according to a study in the May 15, 2004 issue of Clinical Infectious Diseases.

Mycoplasma, which causes respiratory infections like bronchitis and pneumonia, seems to infect children more often than adults. The study concluded that about half of the participating children who experienced their first asthma attack were infected with mycoplasma. About 20 percent of the children who had been previously diagnosed with asthma suffered attacks apparently aggravated by mycoplasma infection.

It's important for physicians to know about the potential consequences of mycoplasma infection in asthmatic children, according to Dr. Dominique Gendrel, senior author of the study. Gendrel is with Hospital Saint Vincent de Paul in Paris. "Mycoplasma pneumoniae infections are frequently mild or asymptomatic," said Gendrel, but if mycoplasma infection is detected in an asthmatic child, "the child must receive macrolide treatment because severe relapse of asthma crisis is possible" if the infection goes untreated.

Familial mycoplasma infections are frequent, so testing parents or siblings for mycoplasma infection could help prevent attack exacerbation in asthmatic children, said Gendrel, and may even keep children who are predisposed to asthma from having an initial attack. But the diagnosis is rarely made because these familial infections are often limited to a slight case of bronchitis or pharyngitis.

An accompanying editorial commentary by Vanderbilt researchers points out that, despite the apparent connection between mycoplasma infection and asthmatic attacks, regular testing and treatment of asthmatic children for infections that could worsen wheezing are still far off. Once "sensitive and specific bedside rapid diagnostic techniques to identify the pathogen" are available, the commentary concludes, it will be far easier to treat infections that may initiate or aggravate children's asthma.

Source: Infectious Diseases Society of America