@article {851,
	title = {Colonization of paediatric lower respiratory tract with genital Mycoplasma species.},
	journal = {Respirology},
	volume = {16},
	year = {2011},
	month = {2011 Oct},
	pages = {1081-7},
	abstract = {BACKGROUND AND OBJECTIVE: Recently, much attention has been given to the possible role played by pathogens that colonize neonatal or paediatric airway and their potential involvement in chronic respiratory disease. The goal of the current study was to evaluate the prevalence of Mycoplasma organisms in the BAL fluid of paediatric patients suffering from a variety of chronic respiratory diseases to determine if there was any clear disease association with bacterial presence.

METHODS: We examined 319 paediatric BAL samples for the presence of M.genitalium, M.hominis, U.urealyticum, U.parvum and M.pneumoniae DNA with species-specific PCR.

RESULTS: Mycoplasma DNA was found in 32.6\% (104/319) of patient samples; 10\% (32/319) for M.pneumoniae, 8.8\% for U.parvum, 2.8\% for U.urealyticum; 4.7\% for M.hominis and 9.1\% for M.genitalium. There were no significant clinical and laboratory differences except serum IgE in asthmatics according to Mycoplasma colonization or not. Elevated levels of IgE were found more often in Mycoplasma DNA-negative patients than patients with bacterial DNA, 85/109 versus 24/109 respectively (P<0.0001). There was no difference in the frequency of Mycoplasmas between the asthmatics and the non-asthmatics; 30.6\% (69/225) versus 37.2\% (35/94) for Mycoplasma 16S DNA, and 8\% versus 14.9\% for M.pneumoniae, respectively.

CONCLUSIONS: Our data indicate that in addition to M.pneumoniae, urogenital Mycoplasma species may colonize the airway of patients with chronic respiratory diseases. There was, however, no association between chronic asthma diagnosis and Mycoplasma colonization in this study.},
	keywords = {Adolescent, Asthma, Child, Child, Preschool, Cohort Studies, DNA, Bacterial, Female, Humans, Infant, Infant, Newborn, Male, Mycoplasma, Mycoplasma genitalium, Mycoplasma hominis, Mycoplasma Infections, Mycoplasma pneumoniae, Respiratory System, Species Specificity, Ureaplasma, Ureaplasma Infections, Ureaplasma urealyticum, Young Adult},
	issn = {1440-1843},
	doi = {10.1111/j.1440-1843.2011.02016.x},
	author = {Patel, Katir K and Salva, Paul S and Webley, Wilmore C}
}
@article {853,
	title = {Occurrence of Chlamydia trachomatis and Chlamydia pneumoniae in paediatric respiratory infections.},
	journal = {Eur Respir J},
	volume = {33},
	year = {2009},
	month = {2009 Feb},
	pages = {360-7},
	abstract = {An emerging body of evidence suggests that half of asthma in both children and adults is associated with chronic lung infection. The aim of the present study was to determine the frequency of viable Chlamydia pneumoniae (Cp) and C. trachomatis (Ct) in the respiratory tracts of paediatric patients with chronic respiratory diseases. Bronchoalveolar lavage fluid (BALF) samples obtained from 182 children undergoing bronchoscopy for clinical reasons were assayed using PCR analysis, in vitro tissue culture and immunofluorescence staining for the presence of Cp and Ct. Chlamydia-specific DNA was detected by PCR in 124 (68\%) out of 182 patients; 79 were positive for Cp, 77 positive for Ct and 32 for both organisms; 75 patients had cultivable Chlamydia. Ct DNA prevalence decreased, whereas Cp positivity generally increased with age. A total of 59 out of 128 asthma patients and 16 out of 54 nonasthmatics were Chlamydia culture positive. When the patients were divided into inflammatory versus noninflammatory airway disease, there were 69 (46\%) out of 150 and six (18\%) out of 32 BALF samples with cultivable Chlamydia, respectively. Viable Chlamydia pneumoniae and Chlamydia trachomatis occur frequently in children with chronic respiratory diseases and may be more prevalent in asthma patients. To the current authors{\textquoteright} knowledge, this is the first report of viable Chlamydia trachomatis in the lungs of children.},
	keywords = {Adolescent, Bronchoalveolar Lavage Fluid, Bronchoscopy, Child, Child, Preschool, Chlamydia Infections, Chlamydia trachomatis, Chlamydophila pneumoniae, Cohort Studies, Female, Humans, Infant, Infant, Newborn, Male, Microscopy, Fluorescence, Prospective Studies, Respiratory Tract Infections},
	issn = {1399-3003},
	doi = {10.1183/09031936.00019508},
	author = {Webley, W C and Tilahun, Y and Lay, K and Patel, K and Stuart, E S and Andrzejewski, C and Salva, P S}
}
@article {856,
	title = {The bronchial lavage of pediatric patients with asthma contains infectious Chlamydia.},
	journal = {Am J Respir Crit Care Med},
	volume = {171},
	year = {2005},
	month = {2005 May 15},
	pages = {1083-8},
	abstract = {There has been a worldwide increase in the incidence of asthma, and the disease has greatly impacted the public health care system. Chlamydia pneumoniae has been reported as a possible contributing factor in asthma. The organism has been detected by polymerase chain reaction (PCR) in bronchial tissue, but there has been no direct evidence of viability. To determine the frequency of viable Chlamydia in children, blood and bronchoalveolar lavage were collected from 70 pediatric patients undergoing flexible fiberoptic bronchoscopy. Forty-two of these patients had asthma, whereas the remaining patients had various respiratory disorders. Fifty-four percent (38) of the bronchoalveolar lavage samples were PCR-positive for Chlamydia, and 31\% (22) of the PCR-positive samples were positive when cultured on macrophages. Twenty-eight samples (40\%) and 14 samples (20\%) of the PCR- and culture-positive samples, respectively, were from patients with asthma. Culture of the blood samples revealed that 24 (34.3\%) of 70 were positive for Chlamydia compared with 8 (11\%) of 70 matched nonrespiratory control subjects (p < 0.01); 17 (24\%) of the positive blood cultures from the respiratory group were from patients with asthma. Elevation of total IgE was strongly associated with lavage culture positivity for Chlamydia. We therefore conclude that viable Chlamydia pneumoniae organisms are frequently present in the lung lavage fluid from this cohort of predominantly asthmatic pediatric patients.},
	keywords = {Adolescent, Adult, Asthma, Bronchoalveolar Lavage Fluid, Child, Child, Preschool, Chlamydia, Chlamydia Infections, Cohort Studies, Female, Humans, Immunoglobulin E, Infant, Infant, Newborn, Male, Polymerase Chain Reaction, Tissue Culture Techniques},
	issn = {1073-449X},
	doi = {10.1164/rccm.200407-917OC},
	author = {Webley, Wilmore C and Salva, Paul S and Andrzejewski, Chester and Cirino, Frances and West, Corrie A and Tilahun, Yaphet and Stuart, Elizabeth S}
}
@article {776,
	title = {Cryptosporidium parvum in children with diarrhea in Mulago Hospital, Kampala, Uganda.},
	journal = {Am J Trop Med Hyg},
	volume = {68},
	year = {2003},
	month = {2003 Jun},
	pages = {710-5},
	abstract = {A cross-sectional case-control study (ratio = 3:1) was conducted over a 15-month period to determine the prevalence and consequences of cryptosporidiosis in hospitalized diarrheic children (0-5 years old) at Mulago Hospital in Kampala, Uganda. Cryptosporidium parvum was detected and genotyped among 2,446 children of whom 1,779 (72.7\%) had diarrhea, and 667 (27.3\%) were age- and sex-matched controls. Of the 1,779 children with diarrhea, 532 (29.9\%) had persistent (> 14 days) diarrhea and 1,247 (70.1\%) had acute diarrhea. Overall, 444 (25.0\%) of the 1,779 children with diarrhea had C. parvum, compared with only 57 (8.5\%) of the 667 children without diarrhea (chi2 = 80.2, P < or = 0.0001). Within this group of infected children, 72.8\% were infected with genotype 1, 18.4\% with genotype 2, and 4.1\% with a mixture of both genotypes, and 4.1\% isolates were either unclassified or C. meleagridis. The prevalence was highest during the rainy months of April to June. Of the 532 children with persistent diarrhea, 166 (31.2\%) had C. parvum compared with 278 (22.3\%) of the 1,247 children with acute diarrhea (chi2 = 15.8, P < or = 0.0001). There was a significant association between C. parvum and malnutrition including stunting, being underweight, and wasting. Unfavorable outcome (death or failure to resolve within 14 days) occurred in 139 (72.8\%) of the 191 children with C. parvum, and in only 65.1\% of the 545 without (odds ratio = 1.117, 95\% confidence interval = 1.005-1.243, P = 0.05), Of the 191 children with C. parvum, 24 (12.6\%) died, compared with 34 (6.2\%) of the 545 without C. parvum (P = 0.005). Mortality rates were higher among children with severe dehydration and persistent diarrhea, and in stunted or underweight children infected with C. parvum. Among Ugandan children, cryptosporidiosis, which remains untreatable, is frequently associated with diarrhea and other serious and unfavorable consequences.},
	keywords = {Animals, Case-Control Studies, Child, Preschool, Cross-Sectional Studies, Cryptosporidiosis, Cryptosporidium parvum, Diarrhea, Diarrhea, Infantile, DNA, Protozoan, Female, Hospitalization, Humans, Infant, Infant, Newborn, Male, Nutrition Disorders, Polymerase Chain Reaction, Polymorphism, Restriction Fragment Length, Prevalence, Uganda},
	issn = {0002-9637},
	author = {Tumwine, James K and Kekitiinwa, Addy and Nabukeera, Nicolette and Akiyoshi, Donna E and Rich, Stephen M and Widmer, Giovanni and Feng, Xiaochuan and Tzipori, Saul}
}
