Searching Mycoplasma pneumonia by serology & PCR in children with adenoid hypertrophy and rhinosinusitis: A case control study, Tehran, Iran
Abstract
Background and Objectives: Chronic infection in childhood is a leading cause of adeno-tonsillectomy. The aim of this study was to determine the role of M. pneumoniae in children with rhino sinusitis and adenoid hypertrophy.
Materials and Methods: This case - control study was carried out in the pediatric and ENT wards of Hazrat Rasul Hospital, Tehran, Iran (2007-2009). In this trial, we investigated 40 cases with adenoid surgery and 32 controls.We looked for M. pneumoniae -DNA (PCR) in adenoid tissues resected from cases and 31 nasopharyngeal swabs in controls and IgM & IgG antibodies (ELISA) were compared between the 2 groups, P < 0.05 was considered to show a significant value.
Results: Positive PCR results were observed in 35% of cases and none of controls, positive-IgG was seen in 20% of cases and 6.4% of controls (P = 0.71) which was higher in older cases (6 vs. 4 years, p < 0.05). Positive –IgM was seen in 10% of cases vs. 9.7% of controls, (P = 0.74); without any difference for age (6.2/ 5.3 years, p = 0.1). A positive PCR result was not related to positive IgG (p = 0.014), but to a positive IgM (p = 0.1).
Conclusion: M. pneumoniae infection was found serologically (IgM & IgG) in10% and 20% of cases, respectively. These numbers along with positive PCR in adenoid tissue of cases (30%) indicates the prominent role for M. pneumoniae in adenoid hypertrophy. We concluded that children in Iran will have been infected with M. pneumoniae and would have obtained immunity between the ages of 6 and 8. Adenoid tissue might act as a reservoir for M. pneumoniae and cause rhino sinusitis concomitant with adenoid hypertrophy in infected children. Theoretically, suitable M. pneumoniae eradicating antibiotics before adenoid surgery (with rhino sinusitis or chronic ear infection) might be helpful treatment, but it needs future RCT studies to be proven.
Tuncer U, Aydogan B, Soylu L, Simsek M, Akcali C, Kucukcan A. Chronic rhinosinusitis and adenoid hypertrophy in childreni. Am J Otolaryngol 2004; 25:5-10.
Anon JB. Acute bacterial rhino sinusitis in pediatric medicine: current issues in diagnosis and management. Paediatric Drugs 2003; 5 Suppl 1: 25-33.
Bernstein J M, Dryja D, Murphy TF. Molecular typing of paired bacterial isolates from the adenoid and lateral wall of the nose in children undergoing adenoidectomy: implications in acute rhino sinusitis. Otolaryngol Head Neck Surg 2001; 125: 593-597.
Brook I Shah K. Bacteriology of adenoids and tonsils in children with recurrent adenotonsillitis. Ann Otol Rhinol Laryngol 2001; 110: 844-848.
Piacentini GL, Peroni DG, Blasi F, Pescollderungg L, Goller P, Gallmetzer L, et al. Atypical bacteria in adenoids and tonsils of children requiring adenotonsillectomy. Acta Otolaryngol 2010; 130: 620-625.
Freymuth F, Vabret A, Brouard J, Toutain F, Verdon R, Petitjean J, et al. Detection of viral, Chlamydia pneumoniae and Mycoplasma pneumoniae infections in exacerbations of asthma in children. J Clin Virol 1999;
: 131-139.
Sprinkle PM, Kirk BE, Mathias PB. Mycoplasma species found in naturally occurring adenotonsillitis. Arch Otolaryngol Head Neck Surg 1993; 119: 1043-1044.
Storgaard M, Tarp B, Ovesen T, Vinther B, Andersen PL, Obel N, Jensen JS.The occurrence of Chlamydia pneumoniae, Mycoplasma pneumoniae, and herpesviruses in otitis media with effusion. Diagn Microbiol Infect Dis 2004; 48: 97-99.
Huminer D, Pitlik S, Levy R, Samra Z, Mycoplasma and Chlamydia in adenoids and tonsils of children undergoing adenoidectomy or tonsillectomy. Ann Otol Rhinol Laryngol 1994; 103: 135-138.
Noorbakhsh S, Farhadi M,Tabatabaei A, Ghafari M.Serum immunoglobulins in children with rhinosinusitis.Med Lab J 2008; 1: 43-49 (In Persian).
Noorbakhsh S, Zarabi V, Farhadi M, Tabatabaei A.Frequency of sinusitis (CT Scan) in hospitalized children with meningitis: A cross section study, Tehran, Iran. 30th Annual Meeting of the European Society for Paediatric Infectious Diseases: 2012 Thessaloniki, Greece.
Noorbakhsh S, Farhadi M,Tabatabaei A. What is the role of Chlamydia pneumoniae in rhinosinusiits of children? Acta Med Iran 2009; 47: 279-284.
Farhadi M, Noorbakhsh S, Ebrahimi Taj F, Javahertrash N, Tabatabaeie A, Bakhshyeh M. Unusual infections in resected adenoid of children: PCR for C. pneumonia, M. pneumonia, H. pylori. Eastern Journal of Medicine 2011; 16: 32-38.
Tabatabaei A, Farhadi M, Nourbakhsh S, Shekarabi M, Shamshiri AR, Alirezaei NA. Evaluation of Mycoplasma and Chlamydia infection with PCR method and serology in patients with nasal polyps and normal subjects. RJMS 2009; 15: 133-139.
Nilsson AC, Bjorkman P, Persson K. Polymerase chain reaction is superior to serology for the diagnosis of acute Mycoplasma pneumoniae infection and reveals a high rate of persistent infection. BMC Microbiol. 2008 Jun 11; 8: 93.
Waites KB, Atkinson TP. The role of Mycoplasma in upper respiratory infections. Curr Infect Dis Rep. 2009;11: 198-206.
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Issue | Vol 5 No 1 (2013) | |
Section | Articles | |
Keywords | ||
Adenoid hypertrophy Adenoid tissue M. pneumoniae Rhino sinusitis |
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