RT Journal Article
SR Electronic
T1 Presence of atopy increases the risk of asthma relapse
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 346
OP 351
DO 10.1136/archdischild-2017-312982
VO 103
IS 4
A1 Laurel Teoh
A1 Ian M Mackay
A1 Peter P Van Asperen
A1 Jason P Acworth
A1 Mark Hurwitz
A1 John W Upham
A1 Weng Hou Siew
A1 Claire Y T Wang
A1 Theo P Sloots
A1 Teresa Neeman
A1 Anne B Chang
YR 2018
UL http://adc.bmj.com/content/103/4/346.abstract
AB Objectives To describe the point prevalence of respiratory viruses/atypical bacteria using PCR and evaluate the impact of respiratory viruses/atypical bacteria and atopy on acute severity and clinical recovery in children with hospitalised and non-hospitalised asthma exacerbations.Design This was a prospective study performed during 2009–2011.Setting The study was performed in the emergency departments of two hospitals.Patients 244 children aged 2–16 years presenting with acute asthma to the emergency departments were recruited. A nasopharyngeal aspirate and allergen skin prick test were performed.Main outcome measures The outcomes were divided into (1) acute severity outcomes (Australian National Asthma Council assessment, hospitalisation, Functional Severity Scale, Acute Asthma Score, asthma quality of life questionnaires for parents (PACQLQ) on presentation, asthma diary scores (ADS) on presentation and length of hospitalisation) and (2) recovery outcomes (PACQLQ for 21 days, ADS for 14 days and representation for asthma for 21 days).Results PCR for viruses/atypical bacteria was positive in 81.7% of children (75.1% human rhinovirus, codetection in 14.2%). Mycoplasma pneumoniae and Chlamydophila pneumoniae were rarely detected. The presence of micro-organisms had little impact on acute asthma or recovery outcomes. Children with atopy were significantly more likely to relapse and represent for medical care by day 14 (OR 1.11, 95% CI 1.00 to 1.23).Conclusions The presence of any viruses is associated with asthma exacerbations but does not appear to influence asthma recovery. In contrast, atopy is associated with asthma relapse. M. pneumoniae and C. pneumoniae are rare triggers of acute asthma in young children.