Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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국내소아에서 발생한 마이코플라스마 폐렴 메타분석

Mycoplasma pneumoniae pneumonia in Korean children, from 1979 to 2006-a meta-analysis

  • 김진우 (포천중문의과대학 소아과학교실) ;
  • 서현경 (포천중문의과대학 소아과학교실) ;
  • 유은경 (포천중문의과대학 소아과학교실) ;
  • 박성진 (포천중문의과대학 소아과학교실) ;
  • 윤소화 (포천중문의과대학 소아과학교실) ;
  • 정혜영 (포천중문의과대학 소아과학교실) ;
  • 한만용 (포천중문의과대학 소아과학교실)
  • 투고 : 2008.08.25
  • 심사 : 2008.10.31
  • 발행 : 2009.03.15
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초록

목 적 : 소아에서 발생한 마이코플라스마 폐렴에 대한 지난 30년동안의 국내 보고들을 분석하여 유행 시기, 호발 연령, 진단 방법과 기준의 변화를 알아보고자 한다. 방 법 : 국내에서 발간되는 학회지를 검색하여 찾은 총 261편 중, 본 연구 목적과 맞는 62편 11,388명을 분석하였다. 각 문헌의 발표 년도, 발표 잡지, 연구 기간, 연구 대상군의 나이, 연구 지역, 마이코플라스마 폐렴의 진단 방법과 검사기준을 확인하였다. 마이코플라스마 IgM을 절대적인 기준으로 하였을 때 적절한 마이코플라스마 항체가 기준치를 확인하고자 하였다. 결 과 : 국내에서 지난 30여 년 동안 마이코플라스마 폐렴은 3년 간격으로 유행하였으며, 1년 중 10월과 11월에 가장 많은 환자가 발생하였다. 3세 이하의 환자가 차지하는 비율이 점차 높아지고(P<0.01), 6세 이하 학동기 이전의 소아가 차지하는 비율도 증가하고 있었다. 마이코플라스마 감염의 기준으로 마이코플라스마 항체가를 1:640 이상을 선택하는 것이 적절하였다. 결 론 : 지난 30여 년 동안 유행한 마이코플라스마의 보고를 분석하였다. 앞으로 확진을 통한 진단기준 확립과 호발시기의 변화, 3-4년 주기 원인에 대한 연구가 필요하다.

Purpose : This study aimed to perform a systematic review of the reports on Mycoplasma pneumoniae pneumonia in the last 30 years (1980-2006) to investigate the intervals between outbreaks, change in the peak incidence age, and diagnostic methods. We also aimed to validate the proper diagnostic criteria for M. pneumoniae pneumonia. Methods : We reviewed 62 original articles on M. pneumoniae pneumonia in Korean children. We analyzed the annual or seasonal variation, study areas, patient age, journal names, and the date of each report. Further, we checked the methods and criteria used for the diagnosis of M. pneumoniae pneumonia. We also confirmed the proper mycoplasma antibody cutoff using the mycoplasma IgM titer as the gold standard. Results : In the last 30 years, epidemic outbreaks of M. pneumoniae pneumonia occurred every 3 years, except in 1993-1994 and 1996-1997. Seasonal variations were also present and were most prevalent in October and November. The number of preschool children, especially those aged 3 years or younger, with M. pneumoniae pneumonia has increased (P<0.05). The mycoplasma antibody titer of 1:640 or greater was appropriate for diagnosing M. pneumoniae pneumonia, with an acceptable sensitivity and specificity of detection. Conclusion : We analyzed the results of studies on M. pneumoniae pneumonia in Korean children during the last 30 years. Infection in younger children is increasing, and further research is required to reveal the major cause of the changing epidemics.

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참고문헌

  1. Hong JY, Nah SY, Nam SK, Choi EH, Lee JH, Park YJ. Clinical characteristic mycoplasma pneumoniae pneumonia in Seoul from 1986 to 1995. J Korean Pediatr Soc 1997;40: 607-11
  2. Pyun BY, Kim HH, Choung JT, Lee JS. A study as epidemiologic and clinical aspect of mycoplasma pneumoniae pneumonia during the last 5 years. Pediatr Allergy Respir Dis 1998;8:240-7
  3. Lee EY, Lee DJ, Lee JA, Kim SW, Chang MW. Comparison of PCR, culture and serologic tests for diagnosis of mycoplasma pneumoniae infection. Pediatr Allergy Respir Dis 2005;15:359-67
  4. Daxboeck F, Kruse R, Wenisch C.Laboratory diagnosis of mycoplasma pneumoniae infection. Clin Microbiol Infect 2003;9:263-73 https://doi.org/10.1046/j.1469-0691.2003.00590.x
  5. Shin MJ. Mycoplasma pneumonia in children. Med J Red Cross Hospital 1980;7:53-7
  6. Eun BL, Lee HK. Clinical observation on pneumonia due to mycoplasma pneumoniae in children. J Korean Pediatr Soc 1987;30:651-7
  7. Kim SS, Kang H, Ahn BM, Lee WW, Kim ER, Kim SY, et al. Study of exchange phenomenon of mycoplasma pneumoniae in children from 1997-2002. Korean J Pediatr 2004;47: 24-30
  8. Park HY, Woo CW, Choung JT, Son CS, Tockgo YC. Trend of the mycoplasma pneumonia-during recent 9 years period. Pediatr Allergy Respir Dis 1995;5:49-59
  9. Seo WH, Ahn SH, Kim SJ, Hwang SJ, Park HY, Lee JS, et al. An epidemiological study of mycoplasma pneumoniae pneumonia in children from 1995 to 2004 in a tertiary hospital in Seoul. Pediatr Allergy Respir Dis 2005;15:53-60
  10. Kang KS, Woo HO. Pattern of occurence of mycoplasma pneumoniae pneumonia in admitted children: southern central korea, from 1989 to 2002. J Korean Pediatr Soc 2003; 46:474-9
  11. Lee SH, Noh SM, Lee KY, Lee HS, Hong JH, Lee MH, et al. Clinico-epidemiologic study of mycoplasma pneumoniae pneumonia (1993 through 2003). Korean J Pediatr 2005;48: 154-7
  12. Hong CU. Text book of pediatrics. 9 ed. Seoul: Daehan Co., 2007:437-9
  13. Ra YH, Cha SH, Chung SJ, Choi YM, Ahn CI. A clinical study on patients with mycoplasma pneumoniae pneumonia in childhood. J Korean Pediatr Soc 1987;30:759-68
  14. Lee JK, Hong CH, Sohn YM, Kim KE, Kim DH, Kim PK, et al. Mycoplasmal pneumonia in children. Yonsei Med J 1986;27:300-6
  15. Kim CS, Lee CH, Jeon CH, Bae EK, Hong SI. Diagnostic significance of cold agglutinin and antimycoplasma antibody for mycoplasma pneumoniae infection. Yeungnam Univ J Med 1987;4:97-103
  16. Song HJ, Lee HR, Han KS. A clinical study of mycoplasma pneumoniae. J Korean Acad Fam Med 1987;8:1-7
  17. Shin JC, Lee MI, Kim SW, Sohn KC, Jung KE. Clinical study of mycoplasma pneumoniae pneumonia. Infect Chemother 1987;19:47-56
  18. Choi YJ, Oh KK. Radiologic and clinical findings of mycoplasma pneumonia in children. J Korean Radiol Soc 1987;23: 371-7
  19. Yook JW, Kim SO, Kim MS, Lee HS, Ahn YM, Kim DY. A clinical study of mycoplasma pneumoniae pneumonia. J Korean Pediatr Soc 1988;31:1603-11
  20. Lee KW, Seo YO, Kim HB, Oh JS. Clinical study of patients with mycoplasma pneumoniae pneumonia in children. J Korean Pediatr Soc 1988;31:167-76
  21. Kim IK, Kwon HJ, Seong H, Choi CH. Clinical consideration on pneumonia cause by mycoplasma pneumoniae in children. J Korean Pediatr Soc 1989;32:1-10
  22. Shin JC, Kim JY, Lee MI, Kim SW, Sohn KC. Clinical study of interrelationship between cold agglutinin titers and indirect hemagglutination titers in children with mycoplasma pneumoniae pneumonia during recent 3 years. J Korean Pediatr Soc 1989;32:915-25
  23. Choi JW, Lee HJ, Park BK, Moon HR. Clinical study of mycoplasma pneumoniae infection in children. J Korean Pediatr Soc 1990;33:315-23
  24. Choeh HJ, Park JH, Chung CS, Choeh KC. The diagnosis of mycoplasma pneumoniae pneumonia by high density composite particles agglutinin (HDPA) test. J Korean Pediatr Soc 1991;34:1102-9
  25. Joo IJ, Juong JS, Kim SW. A clinical study of pneumonia presented with positive cold agglutinin test. J Korean Pediatr Soc 1991;34:1093-101
  26. Huh SM, Suh JD, Suh ES, Kang CM. Clinical study of mycoplasma pneumoniae pneumonia in children. Infect Chemother 1991;23:181-8
  27. Kim HH, Min HK, Han SH, Kang JH, Lee JS, Cho SH. Clinical study of mycoplasma pneumonia syndrome in children. J Korean Pediatr Soc 1992;35:451-8
  28. Park IS, Lee HB. A clinical study of mycoplasma pneumonia in children during recent 5 years. J Korean Pediatr Soc 1992;35:1082-8
  29. Kim BY, Lee HS, Kim IK, Choi CH. Clinical consideration between the type of pneumonia and cold agglutinin titer, and mycoplasma antibody titer caused by mycoplasma pneumonia in children. J Korean Pediatr Soc 1993;36:959-67
  30. Lee EK, Hong YJ, Lee MI, Ahn DH, Sohn KC. A clinical study on mycoplasma pneumoniae pneumonia. Pediatr Allergy Respir Dis 1993;3:11-9
  31. Kwon JE, Yoon JH, Lee JO, Lee HS, Kang IJ. A clinical study on wheezing of mycoplasma pneumoniae pneumonia in children. J Korean Pediatr Soc 1993;36:1366-74
  32. Seo BD, Kim DN, Lee HB. Mycoplasma respiratory infection precipitated asthma in children. Pediatr Allergy Respir Dis 1994;4:59-67
  33. Eun BL, Park SH, Tockgo YC. Detection of mycoplasma pneumoniae in clinical samples from pediatric patients by polymerase chain reaction. J Korean Pediatr Soc 1995;38: 1077-86
  34. Yoo HS, Kang HY, Jeoung BJ, Kim KE, Lee KY. A clinical study of mycoplasma pneumoniae pneumonia. Pediatr Allergy Respir Dis 1995;5:112-22
  35. Seo IK, Bae WJ, Lee JO, Kang IJ. A study of relationship between bronchial hyperreactivity and atopic findings in mycoplasma pneumoniae pneumonia. J Korean Pediatr Soc 1995;38:1210-9
  36. Oh KY, Lee SK, Kwon WJ, Oh SM, Yoon MK, Hyun JH, et al. A clinical study on mycoplasma pneumoniae pneumonia. Pediatr Allergy Respir Dis 1995;5:125-36
  37. Yoon SH, Jung JK, Oh MH. Cold agglutinin and mycoplasma antibody titers in children with mycoplasma pneumonia during recent 5 years. J Korean Pediatr Soc 1996;39:943-50
  38. Park SJ, Ko TS, Moon HN, Hong CY. Neurologic complications associated with mycoplasma pneumoniae infection. J Korean Pediatr Soc 1996;39:346-53
  39. Rim SS, Cho MH, Moon BM, Kim KS, Kim KB. Relationship between complications of mycoplasma pneumoniae pneumonia and titers of cold agglutinin and mycoplasma antibody in children. J Korean Pediatr Soc 1996;39:1680-9
  40. Jeong MJ, Jeong SE, Kim JS, Hur G, Park JU. Mycoplasma pneumonia in children : radiographic pattern analysis and difference in resolution. J Korean Radiol Soc 1997;37:923-6
  41. Kim CK, Chung CY, Kim JS, Hur G, Lee HE, Koh YY. The development of bronchiolitis obliterans after mycoplasma pneumoniae pneumonia : relationship with antibody titer and X-ray pattern. Pediatr Allergy Respir Dis 1998;8:64-71
  42. Kang HW, Ahn BM, Song MY, Kim ER, Choi SH, Kim IS. The diagnostic value of polymerase chain reaction in mycoplasma pneumoniae pneumonia. J Korean Pediatr Soc 1998; 41:1351-8
  43. Son JA, Park W, Lee DJ. Efficacy of mycoplasma antibody test cold agglutinin test in the diagnosis of mycoplasma pneumonia in children. J Korean Pediatr Soc 1998;41:179-84
  44. Lee JB, Whang KT, Kim JH, Ko KO, Cho JH, Yoo YD. Clinical change of mycoplasma pneumonia. J Korean Pediatr Soc 1998;41:315-22
  45. Choe JH, Shin YK, Lee KH, Choung JT, Park SH, Tockgo YC. Association of mycoplasma pneumoniae pneumonia and allergy in preschool children. Pediatr Allergy Respir Dis 1998;8:55-63
  46. Choi SK, Jung JA, Kim KH, Kim GH. Study of seroprevalence of antimycoplasma antibody in healthy children and diagnostic value. J Korean Pediatr Soc 1998;41:489-97
  47. Ham YD, Yoo JI, Jeong JH, Lee JH, Cho JD. Relationship between chest radiography and cell-mediated immunity in mycoplasma pneumoniae pneumonia. J Korean Pediatr Soc 1998;41:1509-16
  48. Lee GW, Ryu HJ, Kim IK, Seong H, Choi CH. Clinical characteristics of mycoplasma pneumoniae pneumonia in children during recent 10 years. Korean J Pediatr Infect Dis 1999;6:86-91
  49. Lim HK, Chung YH. Significance of polymerase chain reaction test for diagnosis of mycoplasma pneumoniae pneumonia. J Korean Pediatr Soc 1999;42:173-9
  50. Yoon KN, Park SW, Lee EH, Lee WB, Whang KT, Lee HJ. Clinical utility of the sputum polymerase chain reaction obtained by nebulizer in the diagnosis of mycoplasma pneumoniae pneumonia. J Korean Pediatr Soc 1999;42:348-54
  51. Lee SH, Kim JS, Yoon JH, Hur G, Kim CG. Late lung parenchymal changes on HRCT in children with mycoplasma pneumonia. J Korean Radiol Soc 1999;41:407-11
  52. Lee SS, Youn KL, Kang HH, Cho BS, Cha SH. Clinical findings of mycoplasma pneumoniae pneumonia under 3 year-old children. Korean J Pediatr Infect Dis 1999;6:78-85
  53. Rah YG, Lee DK, Lim IS, Choi ES, Chae SA. Clinical significance of serum ECP in mycoplasma pneumoniae pneumonia. J Korean Pediatr Soc 1999;42:672-8
  54. Choi YM, Kim JH, Kwon MJ, Park SS, Lim DH, Son BK. Clinical manifestations of mycoplasma pneumoniae pneumonia in infants. Pediatr Allergy Respir Dis 2000;10:61-8
  55. Oh KC, Yoo JS, Ahn SI, Kim BR, Kim SS, Kim YH, et al. Epidemiological pattern of mycoplasma pneumoniae pneumonia from 1993 through 2002 and clinical characteristics during recent five years. Korean J Pediatr Infect Dis 2004; 11:101-10
  56. Choi WS, Han SR, Lee SB, Sung YS, Jung JA, Cho KL, et al. Clinical considerations about mycoplasma pneumonia in children in south gyeongnam area. Pediatr Allergy Respir Dis 2004;14:215-25
  57. Yoo Y, Suh DI, Kim DK, Yoo JH, Koh YY, Kim CK. Association of HRCT findings suggestive of bronchiolitis obliterans with bronchial hyperresponsiveness after mycoplasma pneumoniae pneumonia. Pediatr Allergy Respir Dis 2004;14:350-7
  58. Lee HJ, Kim ES, Jeong HJ, Rha YH, Chung SJ, Cha SH. Diagnostic availability of PCR in the mycoplasma pneumoniae pneumonia of children. Pediatr Allergy Respir Dis 2005; 14:358-65
  59. Kim JH, Chae SA, Lee DK. Clinical findings of mycoplasma pneumonia in children, from 1998 to 2003. Korean J Pediatr 2005;48:969-75
  60. Lee SM, Lee SM, Tchah H, Jeon IS, Ryoo E, Cho KH, et al. Hepatitis complicated with mycoplasma pneumoniae infection in children. Korean J Pediatr 2005;48:832-8
  61. Kim SS, Lee IK, Ko JH, Oh MH, Bae CW. Human surfactant protein-A(SP-A) gene locus associated with mycoplasma pneumoniae pneumonia in Korean children. Korean J Pediatr 2005;48:376-9
  62. Jung YK, Ko HY, Chung HL, Kim WT, Kim JK, Choi EJ, et al. Increased serum endothelin (ET)-1 in children with mycoplasma pneumoniae pneumonia. Pediatr Allergy Respir Dis 2005;15:133-41
  63. Byun SY, Bae YJ, Yoo JH, Jung JA. Comparison of clinical characteristics of mycoplasma pneumoniae pneumonia according to the pleural effusion. Pediatr Allergy Respir Dis 2006;16:327-34
  64. Shin YH, Lee BC, Song TW, Kim KW, Lee KE, Kim ES, et al. Diagnostic availability of PCR and ELISA in mycoplasma pneumoniae pneumonia. Pediatr Allergy Respir Dis 2006;16: 47-56
  65. Eun BW, Kim NH, Choi EH, Lee HJ. Mycoplasma pneumoniae in Korean children: the epidemiology of pneumonia over an 18-year period. J Infect 2008;56:326-31 https://doi.org/10.1016/j.jinf.2008.02.018
  66. Korea National Statistical Office. Social indicators in Korea. In: Korea Education Development Institude, Kindergarten enrollment ratio. 29 ed. Daejeon: KNSO, 2007:140-2
  67. Waris ME, Toikka P, Saarinen T, Nikkari S, Meurman O, Vainionpaa R, et al. Diagnosis of mycoplasma pneumoniae pneumonia in children. J Clin Microbiol 1998;36:3155-9

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