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. 2019 Nov;30(7):724-731.
doi: 10.1111/pai.13102. Epub 2019 Aug 12.

Multi-season analyses of causative pathogens in children hospitalized with asthma exacerbation

Nozomi Abe  1 , Hiroki Yasudo  1 , Reiji Fukano  1 , Tamaki Nakamura  1 , Seigo Okada  1 , Hiroyuki Wakiguchi  1 , Fumiko Okazaki  1 , Komei Shirabe  2 , Shoichi Toda  2 , Reiko Okamoto  2 , Kazunobu Ouchi  3 , Shouichi Ohga  1   4 , Shunji Hasegawa  1
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Multi-season analyses of causative pathogens in children hospitalized with asthma exacerbation

Nozomi Abe et al. Pediatr Allergy Immunol. 2019 Nov.

Abstract

Background: Respiratory viral and mycoplasma infections are associated with childhood asthma exacerbations. Here, we explored epidemiologic profile of causative pathogens and possible factors for exacerbation in a single center over a three-year period.

Methods: Hospitalized asthmatic children with attack aged 6 months-17 years were recruited between 2012 and 2015 (n = 216). Nasopharyngeal mucosa cell samples were collected from the participants and examined by reverse transcription-polymerase chain reaction to detect rhinovirus (RV), respiratory syncytial virus (RSV), enterovirus (EV), parainfluenza virus (PIV), Mycoplasma pneumoniae, and others. Clinical features, laboratory data, asthma exacerbation intensity, and asthma severity were compared among participants. Epidemiologic profile of causative pathogens and possible factors for exacerbation were explored.

Results: Viruses and/or Mycoplasma pneumoniae were detected in 75% of the participants. Rhinovirus (48%) was the most commonly detected virus in the participants with single infection, followed by RSV (6%). The median age at admission in the RV group was significantly higher than that in the RSV group. Insufficient asthma control and allergen sensitization were significantly related to RV-associated asthma exacerbation. There was no seasonality of pathogen types associated with asthma exacerbation although a sporadic prevalence of EV-D68 was observehinovirud. Rhinovirus were repeatedly detected in multiple admission cases.

Conclusion: Our three-year analysis revealed that patients with RV infection were significantly prone to repeated RV infection in the subsequent exacerbation and good asthma control could prevent RV-associated asthma development and exacerbation. Multiple-year monitoring allowed us to comprehend the profile of virus- and/or mycoplasma-induced asthma exacerbation.

Keywords: asthma; enterovirus D68; epidemiology; hospitalization; respiratory syncytial virus; rhinovirus.

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Conflict of interest statement

There are no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The relationship between causative viruses and/or Mycoplasma pneumoniae infection and asthma exacerbation
Figure 2
Figure 2
The relationship between asthma exacerbation and virus and/or Mycoplasma pneumoniae distribution based on the month of admission
Figure 3
Figure 3
The relationship between hospital admission due to asthma exacerbation and infection with EV‐D68
See this image and copyright information in PMC

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