Acute respiratory tract infections in Indian children with special reference to Mycoplasma pneumoniae

A total of 70 Indian children of either sex and under 5 years of age who we re admitted to the All India Institute of Medical Sciences, New Delhi durin g a 1-year period (January 1994-December 1994) with complaints suggestive o f acute respiratory tract infections (ARTI), were investigated for bacteria l aetiology of infection with special reference to Mycoplasma pneumoniae. M icrobial aetiology could be established in 44/70 (62.8 per cent) of cases o f ARTI, Mycoplasma pneumoniae infection was seen in 21/70 (30 per cent), ae robic bacteria in 14/70 (20 per cent), Chlamydia pneumoniae in 2/70 (2.8 pe r cent), and mixed infection with mycoplasma either with bacteria and/or ch lamydia in 7/70 (10 per cent), However, in 26/70 (37.1 per cent) cases no c ause could be detected, Diagnosis of infection with M.pneumoniae was based on culture in 2/20 (10 per cent) eases, antigen detection in throat swab by indirect immunofluorescence assay using specific antibody in 16/70 (22.8 p er cent) cases, and demonstration of IgM antibody in serum by serodia Myco II particle agglutination test in 17/70 (24.2 per cent), Streptococcus pneu moniae (9/70, 12.8 per cent) and Staphylococcus aureus (5/70, 7.1 per cent) were the aerobic isolates from blood in these patients. Results of this st udy indicate that M.pneumoniae plays a significant role in respiratory trac t infection in an Indian paediatric population. Rapid diagnostic procedures , such as antigen detection and IgM antibody demonstration, should be used more widely to determine the infective aetiology early in the course of ill ness, The study also highlights the mixed aetiology in ARTI in children, wh ich has important therapeutic implications.