WEDNESDAY, Oct. 10 (HealthDay News) -- Babies who had certain bacterial infections in their first month of life were more likely to develop asthma by the time they were 5 years old, a new study found.

Danish researchers found that infants who tested positive for Streptococcus pneumoniae, Haemophilus influenzae or Moraxella catarrhalis bacteria had more than double the risk of asthma compared to infants who weren't infected. And they had four times the risk of being hospitalized for severe asthma when compared to infants who didn't test positive for these bacteria.

"Colonization of pathogenic bacteria in the newborn child is a strong predictor for the risk of asthma later in childhood," said the study's lead author, Dr. Hans Bisgaard, professor and head of the Danish Pediatric Asthma Center at Copenhagen University Hospital.

Results of the study are published in the Oct. 11 issue of the New England Journal of Medicine.

Despite the increasing prevalence of asthma, scientists still aren't sure exactly what causes the development of this potentially life-threatening airway disease. Genetics appear to be at least partly to blame, and environmental factors also likely play a role. Bacterial infections can trigger asthma symptoms in people who have the disease, but it hasn't been known if bacteria play a role in the initial development of asthma.

To assess the effects of bacteria in the development of asthma, Bisgaard and his colleagues obtained cultures from 321 babies when they were 1 month old. They tested the cultures for S. pneumonia, H. influenzae, M. catarrhalis and Staphylococcus aureus.

The researchers found that 21 percent of the babies were infected with S. pneumoniae, H. influenzae or M. catarrhalis. They also found that infection with these bacteria was associated with a 2.4 times increased risk of a persistent wheeze, a 2.99 times greater risk of acute severe exacerbation of wheeze, and a 3.85 times increased risk of hospitalization for wheeze. No such association was found with S. aureus infection, according to the study.

Once these children reached 5 years old, the prevalence of asthma was 33 percent for those who had earlier bacterial infections, compared to 10 percent for those who hadn't been infected.

"There are two possible interpretations: either this finding suggests that the initiating events of asthma and allergy are caused by bacterial colonization -- in analogy with the discovery that ulcer was caused by the Helicobacter pylori infection -- or this association between bacterial colonization in neonates and later development of asthma is [the result of underlying asthma and a deficient immune response to the bacteria]," Bisgaard said.

Dr. Erika von Mutius is a professor of pediatrics at University Children's Hospital in Munich, Germany, who wrote an accompanying editorial in the journal. She said it is hard to tell from this study "whether [bacteria] really are a causal factor or merely an indicator that the disease is developing."

In her editorial, von Mutius wrote, "In my opinion, the data presented by Bisgaard and colleagues may be interpreted to suggest that bacterial colonization of the [throat] in the first four weeks of life indicates a defective innate immune response very early in life, which promotes the development of asthma."

Whether bacterial infections in the first month of life are a cause of asthma or simply a sign of an already susceptible immune system, Bisgaard said early colonization with bacteria could be an early warning of a child who's at risk of developing asthma. He and his colleagues are planning to conduct a randomized, controlled trial to see if using probiotics (dietary supplements or foods containing beneficial bacteria normally found in the body) to prevent these bacterial infections could reduce the risk of asthma.

More information

To learn more about the potential causes of asthma, visit the U.S. National Heart, Lung, and Blood Institute.

TUESDAY, Oct. 9 (HealthDay News) -- Hospitalized patients with community-acquired pneumonia are less likely to die or end up in intensive care if they've previously received the pneumonia vaccine, Canadian research finds.

A team at the University of Alberta analyzed data on more than 3,400 patients with community-acquired pneumonia who were admitted to six hospitals between 2000 and 2002.

Of those patients, 22 percent had previously received the pneumococcal polysaccharide vaccine (PPV).

In total, 624 patients died or were admitted to the ICU. But patients who'd received the PPV were less likely to die or to be admitted to the ICU than those who hadn't been vaccinated (10 percent vs. 21 percent).

The study, which appears in the Oct. 8 issue of the Archives of Internal Medicine, received funding from pharmaceutical companies Abbott, Pfizer, and Jannsen-Ortho Canada.

Even though 2,416 of the patients were eligible for PPV when discharged from the hospital, only 215 (9 percent) received it, the researchers noted. Most guidelines recommend the vaccine for people at high risk of developing pneumonia, including older adults and nursing home residents.

"We believe that our results further emphasize the importance of adopting current adult pneumococcal vaccination guidelines, particularly since only 22 percent of our (study) population were vaccinated before their hospitalization and less than 10 percent of eligible patients were vaccinated before hospital discharge," the study authors concluded.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about pneumonia.

FRIDAY, Sept. 7 (HealthDay News) -- When compared with other chronic diseases, depression may well be the most disabling disease in the world, a new global study finds.

People with chronic physical diseases such as angina, arthritis, asthma and diabetes also fare far worse if they also suffer from depression, the team of international researchers found.

"Being sad is bad for your health," according to lead researcher Dr. Somnath Chatterji, from the World Health Organization (WHO) in Geneva, Switzerland.

But all too often, he said, depression doesn't get the serious attention paid to physical ailments.

"Treatment of mental health conditions such as depression are a necessity, not a luxury. Mental health conditions such as depression must be treated on a par with physical health conditions," Chatterji said.

In the study, published in the Sept. 8 issue of The Lancet, Chatterji's team perused data on more than 245,000 people from 60 countries participating in WHO's World Health Survey.

They found that 3.2 percent of people had experienced a depressive episode in the past year. For people with angina, the rate was 4.5 percent; for people with arthritis, it was 4.1 percent; for those with asthma, it was 3.3 percent; and for people with diabetes, it was 2 percent.

Moreover, between 9 percent and 23 percent of people had depression in addition to suffering from one or more of these conditions. That's significantly higher than the likelihood of having depression without having a chronic disease, Chatterji's group noted.

After the researchers had accounted for socioeconomic factors and health conditions, they confirmed that depression had the biggest effect on worsening health compared with the other four major chronic illnesses. In different countries, people with depression plus one or more chronic diseases were in the worst health of all the disease states studied, Chatterji's team reported.

"Compared to the chronic physical illnesses of angina, arthritis, asthma and diabetes, depression produces the most decline in health," Chatterji said. "Having depression over and above a physical illness significantly worsens health even further," he said.

Depression needs to be recognized and treated as an urgent public health priority, Chatterji said. "Persons with physical illnesses should also be examined for depression and treated appropriately. Primary care providers must learn to recognize and manage concurrent physical illnesses and depression to reduce disease burden and improve population health," he added.

One expert hailed the findings.

"It is encouraging to see that results that we have been seeing from our country, from studies in the United States about the devastating effects of comorbid depression with other chronic illnesses, are replicable internationally," said David L. Shern, the president and CEO of the nonprofit advocacy group Mental Health America.

Depression is a huge public health issue, Shern said. "Continuing to have these inane debates about whether we should have insurance coverage for mental health care, in the light of data like these, is just silly," he said.

The study also highlights the need for integrated care and screening for depression, Shern said. "Practitioners need to be educated to look for depression, and consumers need to push their doctors to be aware of their depression," he said.

Depression is treatable, Shern noted. "That's one of the big stories of the last 20 years -- the development of pharmacological treatments that have broad scale effectiveness," he said. "There are psychosocial treatments, for people who don't want to take medication, that are just as effective," he said. "Combining the two is the preferred regimen."

More information

For more on depression, visit the U.S. National Institute of Mental Health.