Date Published: July 3, 2017
Publisher: Public Library of Science
Author(s): Ching-Shu Tsai, Vincent Chin-Hung Chen, Yao-Hsu Yang, Tai-Hsin Hung, Mong-Liang Lu, Kuo-You Huang, Michael Gossop, Etsuro Ito.
Manifestations of Mycoplasma pneumoniae infection can range from self-limiting upper respiratory symptoms to various neurological complications, including speech and language impairment. But an association between Mycoplasma pneumoniae infection and speech and language impairment has not been sufficiently explored. In this study, we aim to investigate the association between Mycoplasma pneumoniae infection and subsequent speech and language impairment in a nationwide population-based sample using Taiwan’s National Health Insurance Research Database. We identified 5,406 children with Mycoplasma pneumoniae infection (International Classification of Disease, Revision 9, Clinical Modification code 4830) and compared to 21,624 age-, sex-, urban- and income-matched controls on subsequent speech and language impairment. The mean follow-up interval for all subjects was 6.44 years (standard deviation = 2.42 years); the mean latency period between the initial Mycoplasma pneumoniae infection and presence of speech and language impairment was 1.96 years (standard deviation = 1.64 years). The results showed that Mycoplasma pneumoniae infection was significantly associated with greater incidence of speech and language impairment [hazard ratio (HR) = 1.49, 95% CI: 1.23–1.80]. In addition, significantly increased hazard ratio of subsequent speech and language impairment in the groups younger than 6 years old and no significant difference in the groups over the age of 6 years were found (HR = 1.43, 95% CI:1.09–1.88 for age 0–3 years group; HR = 1.67, 95% CI: 1.25–2.23 for age 4–5 years group; HR = 1.14, 95% CI: 0.54–2.39 for age 6–7 years group; and HR = 0.83, 95% CI:0.23–2.92 for age 8–18 years group). In conclusion, Mycoplasma pneumoniae infection is temporally associated with incident speech and language impairment.
Mycoplasma pneumoniae (M. pneumoniae), belonging to the class Mollicutes, is a ubiquitous and well-established pathogen of the respiratory tract. Manifestations of M. pneumoniae infection can range from self-limiting upper respiratory illness to severe pneumonia. Between 10% and 20% of radiologically proven pneumonia cases in endemic periods and up to 50% of all cases in epidemic periods are caused by M. pneumoniae [1, 2].
To our knowledge, this is the first study to investigate the relationship between M. pneumoniae infection and speech and language impairment using a nationwide longitudinal dataset. The results identified a greater risk for speech and language impairment with M. pneumoniae infection, after adjusting for age, sex, urban, income, preterm labor and small for gestational age, perinatal complications, autistic spectrum disorder, intellectual disability, other disorders of the CNS, attention deficit hyperactivity disorder, otitis media, hearing loss and traumatic brain injury. In the present study, the mean latency period from initial M. pneumoniae infection to subsequent speech and language impairment was 1.96 years.
M. pneumoniae infection is temporally associated with incident speech and language impairment. Clinicians should advise parents of children with M. pneumoniae infection to attend to symptoms that are associated with the development of speech and language impairment, especially when the child is less than 6 years old.