PURPOSE: Chlamydia and Mycoplasma species have been previously linked to various acute and chronic respiratory diseases. The objective of this study was to determine the frequency of Mycoplasma and Chlamydia species carriage in bronchial lavage fluid [BAL] from pediatric patients with chronic respiratory disease.
METHODS: We obtained BAL fluid from 173 pediatric patients with chronic respiratory disease (126 diagnosed with asthma and 47 non-asthmatics), aged 1 month to 18 years old, via fiberoptic bronchoscopy techniques. Samples were analyzed by PCR, tissue culture and immunofluorescence techniques.
RESULTS: There were 94 males and 79 females in this cohort with an average age of 7.8 years old. Chlamydia-specific DNA was detected by PCR in the BAL fluid of 111 [64%] patients examined. Of these 111 patients harboring chlamydial DNA, 74 [67%] were diagnosed with asthma. Overall, 74 [43%] patient samples were positive for the Chlamydia pneumoniae (Cp) DNA, while 63 [36%] were positive for Chlamydia trachomatis (Ct) DNA using genus-specific primers. Twenty-five [15%] patient samples contained both Cp and Ct DNA. Culture analysis revealed that 42% of patients harbored viable Chlamydia; 85% of these patients with viable Chlamydia were diagnosed with asthma. Mycoplasma DNA was detected in 54 (31%) patient samples. Species-specific primers confirmed that only 9 [17%] of these were M. pneumoniae. Overall, 39 (22%) patient samples harbored both Chlamydia and Mycoplasma organisms. When lipid laden macrophage (LLM) counts were assessed, 83% [92/111] Chlamydia DNA-positive samples displayed moderate to many LLM infiltration.
CONCLUSION: Chlamydia and Mycoplasma organisms are often present in BAL fluids from pediatric patients with chronic respiratory disease undergoing the BAL procedure. Asthma patients in this cohort harbored more infectious, viable forms of both Cp and Ct organisms than the non-asthma cohort. Mycoplasma species are also present in the BAL of these patients, although M. pneumoniae DNA appears to account for a smaller proportion of genetic material isolated.
CLINICAL IMPLICATIONS: Both Chlamydia and Mycoplasma might play critical roles in the pathogenesis of chronic respiratory diseases, including inception and exacerbation.
DISCLOSURE: Wilmore Webley, No Financial Disclosure Information; No Product/Research Disclosure Information