Abstract：Objective To investigate the respiratory pathogens and clinical features in children with acute exacerbation of bronchial asthma. Methods Nasopharyngeal swabs were collected from 225 children with acute exacerbation of bronchial asthma, aged < 14 years, who attended the outpatient service or were hospitalized from August 2017 to August 2019. Quantitative real-time PCR was used to detect 12 pathogens, i.e., respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus A (IFVA), influenza virus B (IFVB), parainfluenza virus types 1-3 (PIV1-3), human metapneumovirus (HMPV), adenovirus (ADV), Bordetella pertussis (BP), Chlamydia pneumoniae (CP), and Mycoplasma pneumoniae (MP). Results The overall detection rate of virus was 46.2% (104/225), and 7 kinds of viruses were detected, i.e., HRV (19.6%, 44/225), ADV (16.0%, 36/225), IFVB (5.8%, 13/225), RSV (4.9%, 11/225), IFVA (3.6%, 8/225), PIV3 (1.8%, 4/225), and HMPV (0.4%, 1/225). Of all pathogens, BP had the highest detection rate of 28.4% (64/225), and the detection rates of MP and CP were 16.4% (37/225) and 0.4% (1/225), respectively. The mild exacerbation group had a higher detection rate of BP than the severe exacerbation group (P < 0.05), while the severe exacerbation group had significantly higher detection rates of RSV and MP than the mild exacerbation group (P < 0.05). There were significant differences in the proportion of children with paroxysmal cough, spasmodic cough, fever, lung rales and abnormal lung imaging findings among the simple BP infection, simple virus infection and simple MP infection groups (P < 0.05). Conclusions BP, HRV, and MP are common respiratory pathogens detected in children with acute exacerbation of bronchial asthma, and respiratory virus infection is an important pathogen of acute exacerbation of asthma in children. Acute exacerbation of asthma caused by different pathogens has different clinical features and severities.
XIE Tian,ZHONG Li-Li,HUANG Han et al. Detection of respiratory pathogens and clinical features in 225 children with acute exacerbation of bronchial asthma[J]. CJCP, 2020, 22(11): 1198-1203.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention (2017 update)[EB/OL].[2020-01-10]. https://ginasthma.org/wp-content/uploads/2019/04/wmsGINA-2017-main-report-final_V2.pdf.
Duenas Meza E, Jaramillo CA, Correa E, et al. Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation[J]. J Asthma, 2016, 53(3):253-260.
[10]
Maffey AF, Barrero PR, Venialgo C, et al. Viruses and atypical bacteria associated with asthma exacerbations in hospitalized children[J]. Pediatr Pulmonol, 2010, 45(6):619-625.
Kassisse E, García H, Prada L, et al. Prevalence of Mycoplasma pneumoniae infection in pediatric patients with acute asthma exacerbation[J]. Arch Argent Pediatr, 2018, 116(3):179-185.
[18]
Capili CR, Hettinger A, Rigelman-Hedberg N, et al. Increased risk of pertussis in patients with asthma[J]. J Allergy Clin Immunol, 2012, 129(4):957-963.
[19]
Rubin K, Glazer S. The pertussis hypothesis:Bordetella pertussis colonization in the etiology of asthma and diseases of allergic sensitization[J]. Med Hypotheses, 2018, 120:101-115.
