Atypical pathogen infection in adults with acute exacerbation of bronchial asthma
Atypical pathogen infection in adults with acute exacerbation of bronchial asthma
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DOI：
10.1164/rccm.200209-996oc
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发表时间：
2003-02-01
影响因子：
24.7
通讯作者：
Boldur, I
中科院分区：
文献类型：
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作者：
Lieberman, D;Lieberman, D;Boldur, I
在一项以血清学为基础的前瞻性研究中，确定了100例因支气管哮喘急性发作住院的成人中4种非典型病原体的急性感染，并与匹配对照组的相应比率进行了比较。配对血清用免疫荧光或酶免疫方法进行检测，以建立血清学诊断。18例患者（18%）有肺炎支原体急性感染的证据，而对照组为3%（p = 0.0006）。在这些患者中，有10例有感染至少一种其他病原体的证据，其中7例为呼吸道病毒。在肺炎衣原体急性感染率（住院患者为8%，对照组为6%）、军团菌属急性感染率（住院患者为6%）、（分别为5%和3%）或贝氏柯克斯体（两组均无患者）。我们认为，在这四种非典型病原体中，只有M.肺炎与支气管哮喘急性加重的住院治疗相关。在大多数的M。肺炎患者也有感染呼吸道病毒的证据。这些发现的病理生理和治疗意义应在专门针对这些问题的进一步研究中进行测试。
In a serologically based prospective study, acute infections with four atypical pathogens were determined in 100 adults hospitalized for acute exacerbation of bronchial asthma, and compared with the corresponding rate in a matched control group. Paired sera were tested using immunofluorescence or enzyme immunoassay methods to establish the serologic diagnosis. In 18 patients (18%), there was evidence of acute infection with Mycoplasma pneumoniae, compared with 3% in the control group (p = 0.0006). In 10 of these patients there was evidence of infection with at least one additional pathogen, a respiratory virus in 7. There was no significant difference between the study groups in the rates of acute infection by Chlamydia pneumoniae (8% in the hospitalized patients versus 6% in the control subjects), Legionella spp. (5 versus 3%, respectively), or Coxiella burnettii (no patients in either group). We conclude that of these four atypical pathogens, only infection with M. pneumoniae is associated with hospitalization for acute exacerbation of bronchial asthma. In most of these M. pneumoniae patients there is evidence of infection with a respiratory virus as well. The pathophysiologic and therapeutic significance of these findings should be tested in further studies specifically designed to address these questions.