THE ASSOCIATION OF CHLAMYDIA-PNEUMONIAE INFECTION AND REACTIVE AIRWAYDISEASE IN CHILDREN

Objective: To determine the possible association of Chlamydia pneumoni ae infection and reactive airway disease in children. Design: Prospect ive observational study. Setting: Pediatric emergency department in Ch ildren's Medical Center of Brooklyn (NY), Kings County Hospital Center . Participants: One hundred eighteen children with acute episodes of w heezing and 41 age- and sex-matched healthy controls, aged 5 to 16 yea rs. Interventions: Children with cultures positive for C pneumoniae we re treated with antibiotics. Measurements/Main Results: Cultures for C pneumoniae and serum samples for antibody testing were obtained from subjects and healthy controls. We isolated C pneumoniae from 13 (11%) children with wheezing and from two (4.9%) controls. Seven (58.3%) of 12 children with positive cultures had no detectable antibody to C pne umoniae and only three (25%) children had serologic evidence of acute infection. Six children had positive cultures on multiple occasions, r anging from 1 to 5 months. The children with wheezing were treated wit h erythromycin or clarithromycin, a new macrolide antibiotic approved for use in adults; all eventually had a negative culture. Nine (75%) o f these children demonstrated clinical and laboratory improvement of t he reactive airway disease after the eradication of chlamydial infecti on. Conclusions: Infection with C pneumoniae can trigger acute episode s of wheezing in children with asthma. Treatment of C pneumoniae infec tion may improve the course of reactive airway disease in these patien ts.