الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Background: Mycoplasma pneumoniae is a human pathogen that preferentially infects the respiratory tract causing acute and chronic pulmonary disease. Recent data suggest Mycoplasma pneumoniae is responsible for 15-20% of the cases of LRTI. It has been specifically associated with CAP, is frequently linked to upper respiratory infections, and is implicated in airway dysfunction, including exacerbation of bronchial asthma or COPD. Clinically, M. pneumoniae infection is mild in nature and may pass unnoticed. However, it can produce severe pulmonary and extrapulmonary manifestations. So, rapid and correct diagnosis of M. pneumoniae infection allows the appropriate antibiotic treatment of patients, improves the outcome of pneumonia and reduces the associated mortality and morbidity. Aim of Work: The aim of this study was to investigate the occurrence of M. pneumoniae as an etiologic pathogen in children with AEBA and CAP and in adults with AECOPD and to evaluate PCR, antigen detection and IgM serology as rapid methods for diagnosis of M. pneumoniae infection. Methods: The current study was conducted in the period from September 2008 to December 2009 and included 78 patients in 3 clinical groups; Asthma group included 37 children with AEBA with the mean age 5.38±3.91, pneumonia group included 21 children with CAP with the mean age 8.31±5.18, and COPD group included 20 adult patients with AECOPD with the mean age 53.95±9.5. Seventy eight different respiratory specimens including (35 NPA, 34 sputa, 9 BAL) were collected from the studied patients for PCR and direct antigen detection. And also serum sample from each patient for IgM serology by ELISA. In our study; the overall prevalence of M. pneumoniae among studied cases of LRTI was 16.7% based on results of IgM serological test (9/78), PCR (11/78) or Ag EIA (5/78). The prevalence of M. pneumoniae infection in asthma group was 18.9% (7/37), in pneumonia group was 19.1% (4/21), and in COPD group was 10% (2/20). Results: Our data suggest an association between M. pneumoniae infection and AEBA, AECOPD in addition to its role in CAP. The present study emphasizes the importance of rapid laboratory diagnosis of M. pneumoniae with its reflection in therapeutic methods in children with AEBA or CAP. There was no significant statistical difference in age, sex, or chest X-ray findings of M. pneumoniae positive and M. pneumoniae negative cases in any of the three studied clinical groups. Absence of Coryza and presence of fine rales in breathing sounds on chest auscultation implicate M. pneumoniae infection-triggered asthma exacerbation lesion development. M. pneumoniae infection was significantly associated with the presence of co-morbidity especially in asthma group. M. pneumoniae infection is associated with positive CRP but without statistical significance difference. Conclusion: M. pneumoniae is a common bacterial pathogen associated with CAP, AEBA in children and AECOPD in adults. PCR is superior to other methods for diagnosis of M. pneumoniae regarding sensitivity and specificity. M. pneumoniae PCR has better sensitivity as compared to serology and direct antigen detection. Moreover, the assay is conventional and fast enough to be used on routine bases.