Chlamydia pneumoniae and Mycoplasma pneumoniae pneumonia: comparison of clinical, epidemiological characteristics and laboratory profiles

Serologic Status of Borrelia burgdorferi sensu lato in Patients with Cardiovascular Changes

Cardiovascular diseases, particularly coronary heart disease (CHD) caused by atherosclerosis, have the highest worldwide incidence and mortality rate of any type of disease. Aside from risk factors associated with lifestyle and comorbidities, infectious agents such as Borrelia burgdorferi sensu lato spirochetes, which cause Lyme disease, may also play a role in the development of cardiovascular disease. A growing number of scientific papers have mentioned Lyme carditis. The aim of this study was to find the level of anti-Borrelia IgG antibodies in the blood serum of patients with advanced coronary heart disease. Materials and methods: The study group included 70 patients undergoing coronary artery bypass grafting (CABG) and off-pump coronary artery bypass (OPCAB) surgery aged 50 to 82 (average 68.26). The ELISA test was used to detect anti-Borrelia/IgG antibodies in the blood serum. Serological testing revealed seropositivity in 34.29% of patients and 'borderline results' in 17.14% of patients. We found a link between antibody levels and tick bites but not with other risk factors for the development of CHD. Conclusions: These findings support the idea that, as one of many factors, the contact with spirochetal antigens may indicate a potential positive correlation with the formation of cardiovascular changes. More research, not only at the diagnostic level but also at the advanced research level, is needed.

Laboratory analysis of positive rate of Mycoplasma pneumoniae antibody among 53,273 children with respiratory tract infections in Xi'an from 2017 to 2020

BACKGROUND

Mycoplasma pneumoniae (Mp) is an important pathogen that causes respiratory tract infections in children. Data on epidemiology of paediatric Mp infection in China are little known. The aim of this study was to investigate the infection of children with respiratory tract infection in Xi'an from 2017 to 2020, and to explore the epidemiological features of paediatric Mp infection in Northwest China during the past 4 years.

METHODS

A total of 53,273 paediatric patients diagnosed with respiratory tract infection as the first diagnosis were enrolled. Mp antibody was detected using passive agglutination method. Statistical analysis and epidemiological investigation were carried out on the test results according to different years, seasons, ages and genders. The differences among rates were analyzed by the χ² test. The trends among the rates were analyzed by the Poisson regression.

RESULTS

A total of 14,375 Mp antibody positive patients were detected, with a total positive rate of 26.98%. The rate of Mp infection in 2017 was significantly higher than other years (χ²=431.700; P=0.000), and the rate showed a downward trend year by year [incidence rate ratios (IRR) =0.906; 95% CI: 0.892-0.921; P=0.000]. The rate of Mp infection increased gradually in the order of spring, summer, autumn and winter (IRR =1.078; 95% CI: 1.060-1.097; P=0.000), and peaked in winter (29.08%). As age increased, the positive rate of Mp infection also gradually increased (IRR =1.138; 95% CI: 1.134-1.143; P=0.000). The peak age of Mp infection was between 6 and 12 years, accounting for 51.71%, significantly more compared with other age groups (χ²=4203.000, P=0.000). Female children had significantly higher positive rates than male children (χ²=527.000; P=0.000).

CONCLUSIONS

Mp infection mainly occurs related to year, season, age and gender. Understanding the epidemiological characteristics of paediatric Mp infection can contribute to timely treatment and diagnosis, and may improve the prognosis of children with Mp infection.

Epidemiologic and clinical characteristics of human bocavirus infection in infants and young children suffering with community acquired pneumonia in Ningxia, China

Background

Pneumonia has a high incidence rate and is a major cause of mortality in children, mostly community-acquired pneumonia (CAP). Human bocavirus (HBoV), since it first identified in 2005, has been repeatedly associated with respiratory tract infections. Nevertheless, the role and related information of HBoV as a pathogen of CAP has not been fulfilled. Here our study is to assess the epidemiological and clinical features in HBoV-positive children with CAP.

Methods

A total of 878 secretions of lower respiratory samples were obtained, multiplex PCR was used to detect HBoV and other respiratory viruses.

Results

Of all cases, HBoV was detected in 10.0%, with a peak incidence of infection among children < 2 year old, and predominantly noted in autumn and winter. Only 8 patients were HBoV single infection. Co-infection with other respiratory viruses was observed in 86.4%. Moreover, co-infection with bacteria occurred in 27.3% and with Mycoplasma pneumoniae (MP) in 33.0% of HBoV-positive patients. Among all HBoV-positive samples co-infected with bacteria, 87.5% are gram negative bacteria. Compared with HBoV-negative group, age (P = 0.048), wheezing (P = 0.015), tachypnea (P = 0.016), lactate dehydrogenase (P = 0.026) and severe pneumonia (P = 0.023) were statistically significant in HBoV-positive patients. Furthermore, HBoV-positive patients less than 1 year old were more likely to have co-infection with bacteria (P = 0.007).

Conclusions

HBoV can be detected alone in respiratory samples of children with CAP, maybe it is one of the causes of CAP in infants. The high incidence of severe pneumonia was found in HBoV-positive patients compared with HBoV-negative cases may indicate a relationship between severe pneumonia and HBoV.

Seasonality in testing and positive respiratory bacterial infections in the Australian Capital Territory, 1997-2007

Background

Chlamydia pneumoniae (Cp) and Mycoplasma pneumoniae (Myco) bacteria are atypical pathogens that can cause pneumonia and exacerbate underlying conditions such as asthma and chronic obstructive pulmonary disease. In the Australian Capital Territory, there is limited information on how seasonal patterns for positive infections and testing may vary, a gap that has implications for control strategies.

Methods

We examined seasonal patterns of immunoassay results of patients from Canberra Hospital, Australia, who were tested for Cp and/or Myco. Pathology data, collected from August 1997 to March 2007 from 7,275 patients, were analysed with time series additive decomposition and time series regression.

Results

The proportion of positive Cp infections was highest in March and April (autumn) and lowest in June and August (winter). The proportion of positive Myco infections was highest in December and January (summer) and lowest in August (winter), even though testing for the pathogen peaked in winter with a low in summer. Models with a long-term trend and a variable for month were a better fit for the data than the null models for both infections.

Conclusion

We found differences in seasonal patterns of testing and in the proportion of positive infections. These findings suggest that preventative measures for common infections need to account for seasonal testing practices so as to build an accurate picture of temporal changes in these infections.

Comparison of Clinical Features and Outcomes of Medically Attended COVID-19 and Influenza Patients in a Defined Population in the 2020 Respiratory Virus Season

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), which is causing the coronavirus disease-2019 (COVID-19) pandemic, poses a global health threat. However, it is easy to confuse COVID-19 with seasonal influenza in preliminary clinical diagnosis. In this study, the differences between influenza and COVID-19 in epidemiological features, clinical manifestations, comorbidities and pathogen biology were comprehensively compared and analyzed. SARS-CoV-2 causes a higher proportion of pneumonia (90.67 vs. 17.07%) and acute respiratory distress syndrome (12.00 vs. 0%) than influenza A virus. The proportion of leukopenia for influenza patients was 31.71% compared with 12.00% for COVID-19 patients (P = 0.0096). The creatinine and creatine kinase were significantly elevated when there were COVID-19 patients. The basic reproductive number (R0) for SARS-CoV-2 is 2.38 compared with 1.28 for seasonal influenza A virus. The mutation rate of SARS-CoV-2 ranges from 1.12 × 10-3 to 6.25 × 10-3, while seasonal influenza virus has a lower evolutionary rate (0.60-2.00 × 10-6). Overall, this study compared the clinical features and outcomes of medically attended COVID-19 and influenza patients. In addition, the S477N and N439K mutations on spike may affect the affinity with receptor ACE2. This study will contribute to COVID-19 control and epidemic surveillance in the future.

A retrospective survey of Chlamydia pneumoniae infection rates in paediatric patients from a single centre in Wuxi, China

Objective

To provide some epidemiological data on Chlamydia pneumoniae infection rates in paediatric patients at a single centre in Wuxi, China.

Methods

This was a retrospective analysis of serum samples from paediatric patients (<12 years) with a respiratory tract infection (RTI) and who had been admitted to the Department of Paediatrics, Wuxi No.2 People’s Hospital, China, from 01 January 2015 to 31 December 2016. C. pneumoniae IgM antibodies had been analysed using enzyme-linked immunosorbent assay (ELISA).

Results

Of the 3866 children (2073 boys, 1793 girls) with a RTI that provided serum samples, 19% were positive for C. pneumoniae IgM antibodies. Among these children, 56% were positive for other infections.

Conclusions

Children over 6 years of age with a RTI had a higher C.pneumoniae infection rate than younger children and the infection rate was more common in winter months compared with other times of the year.

Acute haemorrhagic pericarditis: an unusual presentation of Chlamydophila pneumoniae pneumonia infection

, a common cause of respiratory tract infections, rarely leads to serious conditions. A 13-year-old boy with serologically confirmed C. pneumoniae infection presented with pneumonia complicated by pericardial and bilateral pleural effusions. He had a large haemorrhagic pericardial effusion from which 1000 ml of fluid was aspirated over 10 days and a right haemorrhagic pleural effusion which required a chest drain and the removal of 700 ml over 5 days. The addition of clarithromycin to ceftriaxone appeared to enhance recovery. As far as we are aware, this is the first report in the English literature of massive haemorrhagic pericardial and pleural effusions in children owing to C. pneumoniae infection.

Epidemiological and Clinical Characteristics of Patients With Coronavirus Disease-2019 in Shiyan City, China

To investigate the early epidemic of COVID-19, a total of 176 confirmed COVID-19 cases in Shiyan city, Hubei province, China were surveyed. Our data indicated that the rate of emergence of early confirmed COVID-19 cases in Hubei province outside Wuhan was dependent on migration population, and the second-generation of patients were family clusters originating from Wuhan travelers. Epidemiological investigation indicated that the reproductive number (R₀) under containment strategies was 1.81, and asymptomatic SARS-CoV-2 carriers were contagious with a transmission rate of 10.7%. Among the 176 patients, 53 were admitted to the Renmin Hospital of Hubei University of Medicine. The clinical characteristics of these 53 patients were collected and compared based on a positive RT-PCR test and presence of pneumonia. Clinical data showed that 47.2% (25/53) of COVID-19 patients were co-infected with Mycoplasma pneumoniae, and COVID-19 patients coinfected with M. pneumoniae had a higher percentage of monocytes (P < 0.0044) and a lower neutrophils percentage (P < 0.0264). Therefore, it is important to assess the transmissibility of infected asymptomatic individuals for SARS-CoV-2 transmission; moreover, clinicians should be alert to the high incidence of co-infection with M. pneumoniae in COVID-19 patients.

The epidemiology of paediatric Mycoplasma pneumoniae pneumonia in North China: 2006 to 2016

Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2-3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P &lt; 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P &lt; 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2-3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.

Mycoplasma pneumoniae: A Potentially Severe Infection

Mycoplasma pneumoniae infections remain one of the most common etiologies of community-acquired pneumonia (CAP). The clinical presentation and manifestations vary widely and can affect all organs of the body. Diagnosis is challenging because there are no constant findings in physical exams or laboratory or radiological assessments that indicate Mycoplasma pneumoniae pneumonia, and specific diagnostic tools are not readily available. Extrapulmonary manifestations and severe pulmonary manifestations can lead to long-term sequelae. The increasing emergence of Mycoplasma pneumoniae that is resistant to macrolides in some areas of the world and increased world travel could add to the difficulty of controlling and treating Mycoplasma pneumoniae infections. We present a concise and up-to-date review of the current knowledge of Mycoplasma pneumoniae pneumonia.

Atypical Pneumonia: Updates on Legionella, Chlamydophila, and Mycoplasma Pneumonia

Community-acquired pneumonia (CAP) has multiple causes and is associated with illness that requires admission to the hospital and mortality. The causes of atypical CAP include Legionella species, Chlamydophila, and Mycoplasma. Atypical CAP remains a diagnostic challenge and, therefore, likely is undertreated. This article reviews the advancements in the evaluation and treatment of patients and discusses current conflicts and controversies of atypical CAP.

Community-Acquired Pneumonia Caused by Mycoplasma pneumoniae: How Physical and Radiological Examination Contribute to Successful Diagnosis

Mycoplasma pneumoniae is one of the most common causes of community-acquired pneumonia (CAP), particularly in young adults. Vital signs are usually normal except for temperature. On physical examination, general appearance is normal compared with that of typical pneumonia such as pneumococcal pneumonia patients. Mycoplasma sometimes causes ear infections such as otitis media. It is important to distinguish between typical pneumonia and atypical pneumonia such as mycoplasma pneumonia because having the right diagnosis allows for the use of the correct antibiotic to treat CAP while preventing development of drug-resistant bacteria and also decreasing medical cost. The symptoms and diagnosis of mycoplasma pneumonia is multi-fold. Auscultation of patients can demonstrate trace late inspiratory crackles or normal alveolar sounds; however, bilateral polyphonic wheezes can sometimes be heard because of bronchiolitis. With regard to radiological findings, a chest radiogragh often shows bilateral reticulonodular or patchy consolidation in both lower lobes. Pleural effusion is rarely observed in adult cases. Immunocompetent patients tend to reveal more extensive shadowing compared with immunocompromised patients. As serological diagnostic methods are not able to offer 100% reliable diagnosis, integration of physical and radiological examination is crucial to accurately diagnose mycoplasma pneumonia. Herein, I review the typical findings from physical examination and imaging patterns of patients with mycoplasma pneumonia.

Mycoplasma pneumoniae as a causative agent of community-acquired pneumonia in children: clinical features and laboratory diagnosis

BACKGROUND

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP) in children. The aim of this study was to assess the prevalence of Mycoplasma pneumoniae infection in children with CAP and find clinical, radiological and laboratory features helpful to diagnose Mycoplasma pneumoniae pneumonia. Furthermore, we evaluated the value of serology, real-time PCR (RT-PCR) and culture for the accurate diagnosis of Mycoplasma pneumoniae pneumonia.

METHODS

The study included 166 children aged between 1 and 15 years with radiologically confirmed pneumonia. Throat swab specimens were cultured and assessed by RT-PCR for the presence of Mycoplasma pneumoniae. Mycoplasma pneumoniae-specific IgM and IgG antibodies were determined using ELISA in paired sera.

RESULTS

Mycoplasma pneumoniae pneumonia was diagnosed in 14.5% CAP cases. Cough (p=0.029), headache (p=0.001) and wheezing (p=0.036) were more frequent in children with Mycoplasma pneumoniae pneumonia compared to children with pneumonia caused by other pathogens. Logistic regression analysis showed that headache (odds ratio [OR] =36.077, p=0.001) and wheezing (OR=5.681, p=0.003) were significantly associated with MP pneumonia. Neither radiological findings, nor common laboratory parameters distinguished Mycoplasma pneumoniae infection in children with CAP. Using IgG serology in paired sera as the gold standard, we found that sensitivity of IgM serology, RT-PCR and culture was equal (81.82%), while specificity values were 100%, 98.6% and 100% respectively. We observed that combination of IgM detection in acute-phase serum and RT-PCR was positive for 91.7% of cases with Mycoplasma pneumoniae infection.

CONCLUSIONS

There are no characteristic radiological findings, or routine laboratory tests that would distinguish CAP caused by Mycoplasma pneumoniae from other CAP. It was found that clinical features such as headache and wheezing are indicative for Mycoplasma pneumoniae infection. Furthermore, it was found that during the acute phase of disease, detection of IgM antibodies in combination with RT-PCR allows for precise and reliable diagnosis of Mycoplasma pneumoniae infections in children.

Mycoplasma pneumoniae in adult community-acquired pneumonia increases matrix metalloproteinase-9 serum level and induces its gene expression in peripheral blood mononuclear cells

Background

The objective of this study was to assess the concentration of metalloproteinase-2 (MMP-2) and metalloproteinase-9 (MMP-9) in peripheral circulation and their mRNA expression in peripheral blood mononuclear cells (PBMCs) in patients with CAP caused by M. pneumoniae.

Material/Methods

We prospectively analyzed MMPs in 40 hospitalized patients with M. pneumoniae CAP on admission, and in the convalescent phase. Twenty healthy men were used as controls. Quantitative real-time PCR and ELISA tests were used.

Results

MMP-9 mRNA expression in PBMCs was increased in the acute phase of illness compared to the control group as well as in convalescent phase in which case it was statistically significant (Mann-Whitney; p=0.028). The same was found for MMP-9 plasma levels (Mann-Whitney test; p<0.001; p=0.001). Circulating MMP-2 concentration in acute patients was significantly lower than in the control group and convalescent phase (Mann-Whitney test; p=0.012; p=0.001), while no MMP-2 mRNA expression was found in PBMCs. The plasma level of MMP-9 correlated with leukocyte count in peripheral circulation (r=0.67, p<0.001).

Conclusions

We conclude that M. pneumoniae in adult CAP induces activity of MMP-9 in peripheral blood circulation.

Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou

BACKGROUND

Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of pediatric respiratory infections and the relation of M. pneumoniae pneumonia (MPP) with meteorological factors remains obscure. This study aims to investigate the epidemiological characteristics of childhood MPP and observe if there is a relationship between epidemiological characteristics and meteorological factors in Hangzhou.

METHODS

M. pneumoniae DNA in nasopharyngeal aspirates of hospitalized pneumonia children were detected by polymerase chain reaction from January 1, 2007 to December 31, 2009. The positive rates of MPP (MPP rates) in different years, seasons and ages were compared. The relationship between MPP rates and meteorological data, including mean air temperature (°C), mean relative humidity (%), monthly precipitation (mm) and raining days were analyzed.

RESULTS

In 14 799 pneumonia cases found from 2007 to 2009, the MPP rate was 18.5%. Altogether 1610 boys (16.9%) and 1134 girls (21.4%) suffered from MPP with a significant difference between both genders (χ(2)=45.68, P<0.001). In children younger than 1 year, 1-2 years, 3-6 years, and older than 7 years, the MPP rates were 9.8%, 21.1%, 44.4% and 61.6%, respectively. The MPP rates were significantly higher in older children than in younger ones (trends test χ(2)=46.72, P<0.001). In a descending order, the MPP rates in summer, autumn, spring, and winter were 27.8%, 23.9%, 18.0% and 11.6%, respectively (χ(2)=372.75, P<0.001). The MPP rates in 2007 to 2009 were 12.9%, 19.3% and 23.6%, respectively (trends test χ(2)=13.72, P<0.001). Of the four meteorological factors, only monthly mean air temperature was included in the multiple linear regression model (P<0.001).

CONCLUSIONS

This study showed that the MPP rate was higher in older children than in younger ones. Girls had a higher positive rate of MPP than boys. In Hangzhou, MPP was more prevalent in summer and autumn. Air temperature was the only meteorological factor affecting the prevalence of MPP.

Mycoplasma pneumonia: Clinical features and management

Mycoplasma pneumonia is a common respiratory pathogen that produces diseases of varied severity ranging from mild upper respiratory tract infection to severe atypical pneumonia. Apart from respiratory tract infections, this organism is also responsible for producing a wide spectrum of non-pulmonary manifestations including neurological, hepatic, cardiac diseases, hemolytic anemia, polyarthritis and erythema multiforme. This review focuses on molecular taxonomy, biological characteristics, epidemiology, clinical presentation, radiology and various laboratory tools in diagnosis, differential diagnosis, treatment and prevention of mycoplasma pneumonia.

Prevalence of Mycoplasma pneumoniae-associated respiratory tract infections in hospitalized children: results of a 4-year prospective study in Tunis

Specific microbiologic, molecular, and serologic assays are hardly available in Tunis to confirm a suspected infection of Mycoplasma pneumoniae (MP). These diagnosis methods were used for the first time in a Tunisian prospective study to estimate the prevalence of MP infection in children and to evaluate their usefulness for diagnosis. A total of 540 children hospitalized in Tunis for lower respiratory tract infections (LRTIs) between 2005 and 2009 and 580 clinical specimens were investigated for the presence of MP by culture and by end-point polymerase chain reaction (PCR) targeting the P1 and the 16S rRNA genes. Real-time PCR was also used for MP detection on 158 respiratory samples. A total of 525 serum samples were tested for detection of MP-specific IgM and IgG. The P1 adhesin type and the antibiotic susceptibility testing were determined for the 9 clinical strains isolated during the study period. MP was detected in 33 (5.7%) clinical samples. Specific MP seropositivity was confirmed in 54 serum samples (10.3%), among which 19 (3.6%) were indicative of acute MP infection. MP infection was confirmed in 39 (7.2%) patients: 24 positive by PCR and/or culture, 10 serologically positive only, and 5 confirmed positive by both methods. MP infections occurred throughout the year with a slight decrease in autumn. The 9 MP isolates were susceptible to erythromycin, tetracycline, and ciprofloxacin, and all belonged to type I. The prevalence of MP infection in children with LRTI was 7.2% between 2005 and 2009, in Tunisia. Combination of direct detection and serology was required to enhance the clinical sensitivity of MP detection in clinical specimens.

Distinction between bacterial and viral infections

PURPOSE OF REVIEW

To commence proper treatment as rapidly as possible and to reduce unnecessary antibiotic treatments, timely knowledge of whether the infection is bacterial or viral in origin would be beneficial for the clinician. As a reliable prediction of the causative agent of bacterial infection is not possible based on clinical features, there is an ongoing need for sensitive and specific markers of bacterial infection.

RECENT FINDINGS

The most common differential diagnosis methods are reviewed here. It is also demonstrated that the measurement of the expression of complement receptors, particularly CR1 (CD35), on neutrophils can be a useful preliminary test to differentiate between bacterial and viral infections. In addition, a novel marker of local and systemic bacterial infections designated 'clinical infection score (CIS) point', which incorporates quantitative analysis of complement receptors on neutrophils and standard clinical laboratory data and displays 98% sensitivity and 97% specificity in distinguishing between bacterial and viral infections, is presented.

SUMMARY

We conclude that the diagnostic yield of measured individual variables in distinguishing between bacterial and viral infections increases upon combination.

Gamma-Glutamyltransferase Activity and Total Antioxidant Status in Serum and Platelets of Patients with Community-acquired Pneumonia

BACKGROUND

We undertook this study to analyze serum and platelet gamma-glutamyltransferase (GGT) activity and total antioxidant status (TAS) concentration during the course of pneumonia and to compare them between patients with normal platelet count and those who developed reactive thrombocytosis.

METHODS

Platelet count, GGT activity and TAS concentration in serum (S) and platelet (Plt) isolates were measured in 60 patients with community-acquired pneumonia (CAP) on admission and at discharge.

RESULTS

At the end of treatment, platelet count increased significantly from the value recorded on admission. By the end of treatment, 42% of patients developed reactive thrombocytosis. Serum and platelet GGT activity was higher, whereas (S)TAS was significantly lower in CAP patients than in control subjects. On admission, (Plt)TAS was significantly higher in CAP patients as compared with control subjects; at discharge, (Plt)TAS was lower in comparison with either patient admission and control subjects. GGT activity and TAS concentration in serum and platelet isolate on admission did not differ significantly between patients with and without thrombocytosis. At discharge, (S)GGT activity showed no significant changes, whereas (Plt)GGT decreased significantly in patients with thrombocytosis as compared with those without thrombocytosis. In patients with thrombocytosis, (S)TAS concentration showed no significant difference, whereas (Plt)TAS concentration measured at discharge was significantly lower in patients with thrombocytosis as compared to those with normal platelet count.

CONCLUSIONS

The pattern of changes in (Plt)GGT catalytic activity and TAS concentration might be indicative of a certain role of thrombocytosis during treatment in patients with CAP. Further investigations are necessary to clarify these changes.