The association of Chlamydia pneumoniae infection and reactive airway disease in children.

Objective: To determine the possible association of Chlamydia pneumoniae infection and reactive airway disease in children.

Design: Prospective observational study.

Setting: Pediatric emergency department in Children's Medical Center of Brooklyn (NY), Kings County Hospital Center.

Participants: One hundred eighteen children with acute episodes of wheezing and 41 age- and sex-matched healthy controls, aged 5 to 16 years.

Interventions: Children with cultures positive for C pneumoniae were 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 pneumoniae and only three (25%) children had serologic evidence of acute infection. Six children had positive cultures on multiple occasions, ranging from 1 to 5 months. The children with wheezing were treated with erythromycin or clarithromycin, a new macrolide antibiotic approved for use in adults; all eventually had a negative culture. Nine (75%) of these children demonstrated clinical and laboratory improvement of the reactive airway disease after the eradication of chlamydial infection.

Conclusions: Infection with C pneumoniae can trigger acute episodes of wheezing in children with asthma. Treatment of C pneumoniae infection may improve the course of reactive airway disease in these patients.