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Xu M, Li Y, Shi Y, Liu H, Tong X, Ma L, Gao J, Du Q, Du H, Liu D, Lu X, Yan Y. Molecular epidemiology of Mycoplasma pneumoniae pneumonia in children, Wuhan, 2020-2022. BMC Microbiol 2024; 24:23. [PMID: 38229068 DOI: 10.1186/s12866-024-03180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community-acquired pneumonia in children. The factors contributing to the severity of illness caused by M. pneumoniae infection are still under investigation. We aimed to evaluate the sensitivity of common M. pneumoniae detection methods, as well as to analyze the clinical manifestations, genotypes, macrolide resistance, respiratory microenvironment, and their relationship with the severity of illness in children with M. pneumoniae pneumonia in Wuhan. RESULTS Among 1,259 clinical samples, 461 samples were positive for M. pneumoniae via quantitative polymerase chain reaction (qPCR). Furthermore, we found that while serological testing is not highly sensitive in detecting M. pneumoniae infection, but it may serve as an indicator for predicting severe cases. We successfully identified the adhesin P1 (P1) genotypes of 127 samples based on metagenomic and Sanger sequencing, with P1-type 1 (113/127, 88.98%) being the dominant genotype. No significant difference in pathogenicity was observed among different genotypes. The macrolide resistance rate of M. pneumoniae isolates was 96% (48/50) and all mutations were A2063G in domain V of 23S rRNA gene. There was no significant difference between the upper respiratory microbiome of patients with mild and severe symptoms. CONCLUSIONS During the period of this study, the main circulating M. pneumoniae was P1-type 1, with a resistance rate of 96%. Key findings include the efficacy of qPCR in detecting M. pneumoniae, the potential of IgM titers exceeding 1:160 as indicators for illness severity, and the lack of a direct correlation between disease severity and genotypic characteristics or respiratory microenvironment. This study is the first to characterize the epidemic and genomic features of M. pneumoniae in Wuhan after the COVID-19 outbreak in 2020, which provides a scientific data basis for monitoring and infection prevention and control of M. pneumoniae in the post-pandemic era.
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Affiliation(s)
- Meng Xu
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
- Wuhan Institute of Virology, University of Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
| | - Ying Li
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
- Wuhan Institute of Virology, University of Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China, 100 Hongkong Road, Jiangan District, Hubei
| | - Yue Shi
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
| | - Haizhou Liu
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
| | - Xi Tong
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
- Wuhan Institute of Virology, University of Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
| | - Li Ma
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
- Wuhan Institute of Virology, University of Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
| | - Jie Gao
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District
| | - Qing Du
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China, 100 Hongkong Road, Jiangan District, Hubei
| | - Hui Du
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China, 100 Hongkong Road, Jiangan District, Hubei
| | - Di Liu
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District.
- Wuhan Institute of Virology, University of Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District.
| | - Xiaoxia Lu
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China, 100 Hongkong Road, Jiangan District, Hubei.
| | - Yi Yan
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
- National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
- Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China, Xiao Hong Shan No. 44, Wuchang District.
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Bolluyt DC, Euser SM, Souverein D, van Rossum AM, Kalpoe J, van Westreenen M, Goeijenbier M, Snijders D, Eggink D, Jongenotter F, van Lelyveld SF, van Houten MA. Increased incidence of Mycoplasma pneumoniae infections and hospital admissions in the Netherlands, November to December 2023. Euro Surveill 2024; 29:2300724. [PMID: 38275014 PMCID: PMC10986650 DOI: 10.2807/1560-7917.es.2024.29.4.2300724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/24/2024] [Indexed: 01/27/2024] Open
Abstract
Mycoplasma pneumoniae is an important cause of pneumonia and extra-pulmonary manifestations. We observed a rise in admissions due to M. pneumoniae infections starting October 2023 in a regional hospital in the Netherlands and an increased incidence in national surveillance data. The incidence in the Netherlands has not been that high since 2011. The patients had a lower median age compared with 2019 and 2020 (28 vs 40 years). M. pneumoniae should be considered in patients with respiratory symptoms, especially children.
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Affiliation(s)
- Dita C Bolluyt
- Department of Internal Medicine, Spaarne Gasthuis, Haarlem/Hoofddorp, the Netherlands
| | - Sjoerd M Euser
- These authors contributed equally to this work and share authorship
- Regional Public Health Laboratory Kennemerland, Haarlem, The Netherlands
| | - Dennis Souverein
- These authors contributed equally to this work and share authorship
- Regional Public Health Laboratory Kennemerland, Haarlem, The Netherlands
| | | | - Jayant Kalpoe
- Regional Public Health Laboratory Kennemerland, Haarlem, The Netherlands
| | - Mireille van Westreenen
- Department of Medical Microbiology, Erasmus MC University Medical centre, Rotterdam, the Netherlands
| | - Marco Goeijenbier
- Department of Intensive Care Medicine, Spaarne Gasthuis, Haarlem/Hoofddorp, the Netherlands
- Department of Intensive Care Medicine, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Dominic Snijders
- Department of Pulmonary Medicine, Spaarne Gasthuis, Haarlem/Hoofddorp, the Netherlands
| | - Dirk Eggink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Femke Jongenotter
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Steven Fl van Lelyveld
- Department of Internal Medicine, Spaarne Gasthuis, Haarlem/Hoofddorp, the Netherlands
- These authors contributed equally to this work and share authorship
| | - Marlies A van Houten
- These authors contributed equally to this work and share authorship
- Department of Paediatrics, Spaarne Gasthuis, Haarlem/Hoofddorp, The Netherlands
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Bonomo S, Marchetti P, Fasola S, Vesentini R, Marcon A, Ferrante G, Antonicelli L, Battaglia S, Bono R, Squillacioti G, Murgia N, Pirina P, Villani S, La Grutta S, Verlato G, Viegi G. Asthma incidence can be influenced by climate change in Italy: findings from the GEIRD study-a climatological and epidemiological assessment. Sci Rep 2023; 13:19047. [PMID: 37923929 PMCID: PMC10624678 DOI: 10.1038/s41598-023-46423-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
An association between climatic conditions and asthma incidence has been widely assumed. However, it is unclear whether climatic variations have a fingerprint on asthma dynamics over long time intervals. The aim of this study is to detect a possible correlation of the Summer North Atlantic Oscillation (S-NAO) index and the self-calibrated palmer drought severity index (scPDSI) with asthma incidence over the period from 1957 to 2006 in Italy. To this aim, an analysis of non-stationary and non-linear signals was performed on the time series of the Italian databases on respiratory health (ISAYA and GEIRD) including 36,255 individuals overall, S-NAO, and scPDSI indices to search for characteristic periodicities. The ISAYA (Italian Study on Asthma in Young Adults) and GEIRD (Gene Environment Interactions in Respiratory Diseases) studies collected information on respiratory health in general population samples, born between 1925 and 1989 and aged 20-84 years at the time of the interview, from 13 Italian centres. We found that annual asthma total incidence shared the same periodicity throughout the 1957-2006 time interval. Asthma incidence turned out to be correlated with the dynamics of the scPDSI, modulated by the S-NAO, sharing the same averaged 6 year-periodicity. Since climate patterns appear to influence asthma incidence, future studies aimed at elucidating the complex relationships between climate and asthma incidence are warranted.
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Affiliation(s)
- S Bonomo
- CNR Institute of Environmental Geology and Geo-Engineering (CNR-IGAG), Montelibretti, Rome, Italy.
| | - P Marchetti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - S Fasola
- CNR Institute of Translational Pharmacology (CNR-IFT), Palermo, Italy
| | - R Vesentini
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Marcon
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - G Ferrante
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | | | - S Battaglia
- Dipartimento PROMISE, University of Palermo, Palermo, Italy
| | - R Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - G Squillacioti
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - N Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - P Pirina
- Respiratory Unit, Sassari University, Sassari, Italy
| | - S Villani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - S La Grutta
- CNR Institute of Translational Pharmacology (CNR-IFT), Palermo, Italy
| | - G Verlato
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - G Viegi
- CNR Institute of Clinical Physiology (CNR-IFC), Pisa, Italy
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Hirae K, Hoshina T, Koga H. Impact of the COVID-19 pandemic on the epidemiology of other communicable diseases in Japan. Int J Infect Dis 2023; 128:265-271. [PMID: 36642212 PMCID: PMC9837205 DOI: 10.1016/j.ijid.2023.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To elucidate the impact of the COVID-19 pandemic on the epidemiology of other infectious diseases. DESIGN We investigated the epidemiology of 36 communicable diseases during 2015-2021 in Japan and compared the number of cases in each disease between the prepandemic (2015-2019) and intrapandemic (2020-2021) periods. Relationships between the incidence of the infectious diseases and the COVID-19 pandemic were also investigated. RESULTS Of 36 communicable diseases, the number of cases in the 27 diseases (75%) mainly caused by pathogens transmitted by droplet or contact was lower intrapandemic than prepandemic, and the cases of 21 diseases (58%) continued to decrease intrapandemic. The number of cases of six diseases (17%) was higher intrapandemic than prepandemic, and the cases of two diseases (5.6%), Japanese spotted fever and syphilis, continued to increase intrapandemic. Time trend analyses revealed a positive correlation between case numbers of communicable diseases and the COVID-19 pandemic, whereas the case numbers of hand-foot-and-mouth disease and respiratory syncytial virus infection rebounded in 2021 after decreasing in 2020. CONCLUSION The COVID-19 pandemic has greatly impacted the epidemiology of communicable diseases, suggesting that countermeasures against COVID-19 and lifestyle changes might be involved in these epidemiological changes.
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Affiliation(s)
- Kenji Hirae
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
| | - Takayuki Hoshina
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
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Dumke R. Molecular Tools for Typing Mycoplasma pneumoniae and Mycoplasma genitalium. Front Microbiol 2022; 13:904494. [PMID: 35722324 PMCID: PMC9203060 DOI: 10.3389/fmicb.2022.904494] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
Mycoplasma pneumoniae and Mycoplasma genitalium are cell wall-less bacteria with strongly reduced genome content and close phylogenetic relatedness. In humans, the only known natural host, the microorganisms colonize the respiratory or genitourinary mucosa and may cause a broad range of clinical presentations. Besides fundamental differences in their tissue specificity, transmission route, and ability to cause prevalence peaks, both species share similarities such as the occurrence of asymptomatic carriers, preferred populations for infection, and problems with high rates of antimicrobial resistance. To further understand the epidemiology of these practically challenging bacteria, typing of strains is necessary. Since the cultivation of both pathogens is difficult and not performed outside of specialized laboratories, molecular typing methods with adequate discriminatory power, stability, and reproducibility have been developed. These include the characterization of genes containing repetitive sequences, of variable genome regions without the presence of repetitive sequences, determination of single and multi-locus variable-number tandem repeats, and detection of single nucleotide polymorphisms in different genes, respectively. The current repertoire of procedures allows reliable differentiation of strains circulating in different populations and in different time periods as well as comparison of strains occurring subsequently in individual patients. In this review, the methods for typing M. pneumoniae and M. genitalium, including the results of their application in different studies, are summarized and current knowledge regarding the association of typing data with the clinical characteristics of infections is presented.
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Affiliation(s)
- Roger Dumke
- TU Dresden, Institute of Medical Microbiology and Virology, Dresden, Germany
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Sheng CQ, Yang CF, Ao Y, Zhao ZY, Li YM. Mycoplasma pneumoniae pneumonia with pulmonary embolism: A study on pediatric cases in Jilin province of China. Exp Ther Med 2021; 21:201. [PMID: 33574906 PMCID: PMC7818525 DOI: 10.3892/etm.2021.9634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/26/2020] [Indexed: 12/22/2022] Open
Abstract
Mycoplasma is one of the most common pathogens causing community-acquired pneumonia in pediatric patients. In recent years, the number of refractory or severe cases with drug resistance has been gradually increasing and cases that developed embolism after Mycoplasma pneumoniae (M. pneumoniae) infection have been reported. The present study retrospectively analyzed the clinical features, diagnosis and treatment of M. pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in a series of 7 cases encountered between January 1st, 2016 to August 1st, 2019 at the Department of Pediatric Intensive Care Unit of The First Hospital of Jilin University (Changchun, China). Combined with relevant Chinese and international studies published during the last two decades, a comprehensive analysis was performed. All of the pediatric patients of the present study had fever, cough and dyspnea respiratory symptoms at onset and the disease progressed rapidly. Thereafter, PE was confirmed by a series of examinations. Pulmonary CT indicated patchy inflammations and significantly elevated D-dimer levels, accompanied by positive anticardiolipin antibodies. Furthermore, a filling defect in the pulmonary artery branch was observed on CT pulmonary angiography (CTPA) examination. In 2 cases, the condition was improved with anti-infection and anticoagulation treatment with low-molecular-weight heparin and warfarin, respectively, and the pulmonary embolism disappeared after 3-4 months. A total of 5 cases, who were not responsive to the drug treatment, underwent surgical resection. During the operation, the local tissues were determined to be infarcted and the pathological diagnosis was consistent with pulmonary infarction. Among the 5 cases, 2 died of Acute Respiratory Distress Syndrome at 3-8 days after the operation. The remaining patients underwent 6-12 months of follow-up and respiratory rehabilitation and their quality of life is now good. In conclusion, compared with healthy individuals, pediatric patients with critical MPP have an elevated risk of embolism. It is necessary to be vigilant regarding whether MMP is combined with PE and perform timely CTPA examination. Early detection, early treatment and surgical intervention (if necessary) may significantly reduce the risk of mortality and disability.
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Affiliation(s)
- Chu-Qiao Sheng
- Department of Pediatric Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Chun-Feng Yang
- Department of Pediatric Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yu Ao
- Department of Pediatric Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Zhi-Yue Zhao
- Department of Pediatric Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yu-Mei Li
- Department of Pediatric Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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Bertrams W, Jung AL, Schmeck B. Modeling of Pneumonia and Acute Lung Injury: Bioinformatics, Systems Medicine, and Artificial Intelligence. SYSTEMS MEDICINE 2021. [DOI: 10.1016/b978-0-12-801238-3.11689-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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O'Brien KL, Baggett HC, Brooks WA, Feikin DR, Hammitt LL, Higdon MM, Howie SR, Deloria Knoll M, Kotloff KL, Levine OS, Madhi SA, Murdoch DR, Prosperi C, Scott JAG, Shi Q, Thea DM, Wu Z, Zeger SL, Adrian PV, Akarasewi P, Anderson TP, Antonio M, Awori JO, Baillie VL, Bunthi C, Chipeta J, Chisti MJ, Crawley J, DeLuca AN, Driscoll AJ, Ebruke BE, Endtz HP, Fancourt N, Fu W, Goswami D, Groome MJ, Haddix M, Hossain L, Jahan Y, Kagucia EW, Kamau A, Karron RA, Kazungu S, Kourouma N, Kuwanda L, Kwenda G, Li M, Machuka EM, Mackenzie G, Mahomed N, Maloney SA, McLellan JL, Mitchell JL, Moore DP, Morpeth SC, Mudau A, Mwananyanda L, Mwansa J, Silaba Ominde M, Onwuchekwa U, Park DE, Rhodes J, Sawatwong P, Seidenberg P, Shamsul A, Simões EA, Sissoko S, Wa Somwe S, Sow SO, Sylla M, Tamboura B, Tapia MD, Thamthitiwat S, Toure A, Watson NL, Zaman K, Zaman SM. Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study. Lancet 2019; 394:757-779. [PMID: 31257127 PMCID: PMC6727070 DOI: 10.1016/s0140-6736(19)30721-4] [Citation(s) in RCA: 475] [Impact Index Per Article: 95.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings. METHODS We did a multi-site, international case-control study in nine study sites in seven countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. All sites enrolled in the study for 24 months. Cases were children aged 1-59 months admitted to hospital with severe pneumonia. Controls were age-group-matched children randomly selected from communities surrounding study sites. Nasopharyngeal and oropharyngeal (NP-OP), urine, blood, induced sputum, lung aspirate, pleural fluid, and gastric aspirates were tested with cultures, multiplex PCR, or both. Primary analyses were restricted to cases without HIV infection and with abnormal chest x-rays and to controls without HIV infection. We applied a Bayesian, partial latent class analysis to estimate probabilities of aetiological agents at the individual and population level, incorporating case and control data. FINDINGS Between Aug 15, 2011, and Jan 30, 2014, we enrolled 4232 cases and 5119 community controls. The primary analysis group was comprised of 1769 (41·8% of 4232) cases without HIV infection and with positive chest x-rays and 5102 (99·7% of 5119) community controls without HIV infection. Wheezing was present in 555 (31·7%) of 1752 cases (range by site 10·6-97·3%). 30-day case-fatality ratio was 6·4% (114 of 1769 cases). Blood cultures were positive in 56 (3·2%) of 1749 cases, and Streptococcus pneumoniae was the most common bacteria isolated (19 [33·9%] of 56). Almost all cases (98·9%) and controls (98·0%) had at least one pathogen detected by PCR in the NP-OP specimen. The detection of respiratory syncytial virus (RSV), parainfluenza virus, human metapneumovirus, influenza virus, S pneumoniae, Haemophilus influenzae type b (Hib), H influenzae non-type b, and Pneumocystis jirovecii in NP-OP specimens was associated with case status. The aetiology analysis estimated that viruses accounted for 61·4% (95% credible interval [CrI] 57·3-65·6) of causes, whereas bacteria accounted for 27·3% (23·3-31·6) and Mycobacterium tuberculosis for 5·9% (3·9-8·3). Viruses were less common (54·5%, 95% CrI 47·4-61·5 vs 68·0%, 62·7-72·7) and bacteria more common (33·7%, 27·2-40·8 vs 22·8%, 18·3-27·6) in very severe pneumonia cases than in severe cases. RSV had the greatest aetiological fraction (31·1%, 95% CrI 28·4-34·2) of all pathogens. Human rhinovirus, human metapneumovirus A or B, human parainfluenza virus, S pneumoniae, M tuberculosis, and H influenzae each accounted for 5% or more of the aetiological distribution. We observed differences in aetiological fraction by age for Bordetella pertussis, parainfluenza types 1 and 3, parechovirus-enterovirus, P jirovecii, RSV, rhinovirus, Staphylococcus aureus, and S pneumoniae, and differences by severity for RSV, S aureus, S pneumoniae, and parainfluenza type 3. The leading ten pathogens of each site accounted for 79% or more of the site's aetiological fraction. INTERPRETATION In our study, a small set of pathogens accounted for most cases of pneumonia requiring hospital admission. Preventing and treating a subset of pathogens could substantially affect childhood pneumonia outcomes. FUNDING Bill & Melinda Gates Foundation.
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Bonomo S, Ferrante G, Palazzi E, Pelosi N, Lirer F, Viegi G, La Grutta S. Evidence for a link between the Atlantic Multidecadal Oscillation and annual asthma mortality rates in the US. Sci Rep 2019; 9:11683. [PMID: 31406172 PMCID: PMC6690970 DOI: 10.1038/s41598-019-48178-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/16/2019] [Indexed: 11/13/2022] Open
Abstract
An association between climatic conditions and asthma mortality has been widely assumed. However, it is unclear whether climatic variations have a fingerprint on asthma dynamics over long time intervals. The aim of this study is to detect a possible correlation between climatic indices, namely the Atlantic Multidecadal Oscillation and Pacific Decadal Oscillation, and asthma mortality rates over the period from 1950 to 2015 in the contiguous US. To this aim, an analysis of non-stationary and non-linear signals was performed on time series of US annual asthma mortality rates, AMO and PDO indices to search for characteristic periodicities. Results revealed that asthma death rates evaluated for four different age groups (5-14 yr; 15-24 yr; 25-34 yr; 35-44 yr) share the same pattern of fluctuation throughout the 1950-2015 time interval, but different trends, i.e. a positive (negative) trend for the two youngest (oldest) categories. Annual asthma death rates turned out to be correlated with the dynamics of the AMO, and also modulated by the PDO, sharing the same averaged ∼44 year-periodicity. The results of the current study suggest that, since climate patterns have proved to influence asthma mortality rates, they could be advisable in future studies aimed at elucidating the complex relationships between climate and asthma mortality.
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Affiliation(s)
- Sergio Bonomo
- Istituto per la Ricerca e l'Innovazione Biomedica, National Research Council (CNR-IRIB), Via Ugo La Malfa 153, 90146, Palermo, Italy
- Institute for Marine Sciences, National Research Council (CNR-ISMAR), Calata Porta di Massa, 80133, Napoli, Italy
- National Institute of Geophysics and Volcanology (INGV), Via della Faggiola 32, 52126, Pisa, Italy
| | - Giuliana Ferrante
- Dipartimento di Scienze per la Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, Palermo, Italy.
| | - Elisa Palazzi
- Institute of Atmospheric Sciences and Climate, National Research Council (CNR-ISAC), Corso Fiume 4, I-10133, Torino, Italy
| | - Nicola Pelosi
- Institute for Marine Sciences, National Research Council (CNR-ISMAR), Calata Porta di Massa, 80133, Napoli, Italy
| | - Fabrizio Lirer
- Institute for Marine Sciences, National Research Council (CNR-ISMAR), Calata Porta di Massa, 80133, Napoli, Italy
| | - Giovanni Viegi
- Istituto per la Ricerca e l'Innovazione Biomedica, National Research Council (CNR-IRIB), Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Stefania La Grutta
- Istituto per la Ricerca e l'Innovazione Biomedica, National Research Council (CNR-IRIB), Via Ugo La Malfa 153, 90146, Palermo, Italy
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10
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Zhang XS, Zhao H, Vynnycky E, Chalker V. Positively interacting strains that co-circulate within a network structured population induce cycling epidemics of Mycoplasma pneumoniae. Sci Rep 2019; 9:541. [PMID: 30679460 PMCID: PMC6345813 DOI: 10.1038/s41598-018-36325-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 11/13/2018] [Indexed: 02/01/2023] Open
Abstract
Mycoplasma pneumoniae (MP) is considered a common cause of pneumonia, causing about 15–20% of adult community-acquired pneumonia (CAP) and up to 40% of cases in children. It has often been observed that MP epidemics last approximately 1–2 years and occur every 3–7 years, with the dominant strains alternating between epidemics. However, the underlying mechanism by which these cycles and changes in the dominant strains occur remains unclear. The traditional models for the periodicity of MP epidemics neglected two phenomena: structured contact patterns among people and co-circulating strains of MP. We also believe that the two distinctive aspects of MP epidemics: prevalent serotype shifts among epidemics and incidence cycling of MP, are interconnected. We propose a network transmission model that assumes two strains of MP are transmitted within a network structured population and they can interact as secondary infections with primary infections. Our studies show that multiple strains that co-circulate within a network structured population and interact positively generate the observed patterns of recurrent epidemics of MP. Hence our study provides a possible mechanism for the cycling epidemics of MP, and could provide useful information for future vaccine design and vaccine evaluation/monitoring processes.
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Affiliation(s)
- Xu-Sheng Zhang
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK. .,Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College School of Public Health, London, UK.
| | - Hongxin Zhao
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Emilia Vynnycky
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.,TB Modelling Group, TB Centre, Centre for Mathematical Modelling of Infectious Diseases and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Vicki Chalker
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
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11
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Zhang XS, Iacono GL. Estimating human-to-human transmissibility of hepatitis A virus in an outbreak at an elementary school in China, 2011. PLoS One 2018; 13:e0204201. [PMID: 30248120 PMCID: PMC6152969 DOI: 10.1371/journal.pone.0204201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 09/05/2018] [Indexed: 11/24/2022] Open
Abstract
Hepatitis A is caused by hepatitis A virus and occurs worldwide. Estimating the transmissibility, which is usually characterized by the basic reproductive number R0, the mean number of secondary infectious cases generated by a single primary infectious case introduced into a totally susceptible population, provides crucial information for the effort required to stop infection spreading. Hepatitis A virus is usually transmitted indirectly through contaminated food and environment. An outbreak from March to June 2011 was reported to have occurred at an elementary school of 698 pupils in China and it was found that the outbreak was due to direct transmission between school children. Based on the symptom onset date and the social contact network of the children, in this study we estimate the serial interval (i.e. the gap in symptom onset between an infectee and its infector) and use different statistical methods to estimate R0. Combining with the positivity of IgG antibodies tests, we develop a compartmental transmission dynamics model which includes both asymptomatic and symptomatic infections to estimate the overall R0. Our analysis suggests a serial interval of mean = 23.9 days and standard deviation = 20.9 days. The different statistical methods suggest estimates for R0 in the outbreak varying from 2.1 to 2.8, and the estimates from the transmission dynamics model are consistent with this range. Our estimates are in agreement with that from one study in England but are higher than that from one study in the United States. Our transmission dynamics model suggests that the proportion of symptomatic infections is about 9%, implying that there were about 344 asymptomatic infections along with the 32 observed symptomatic cases. Furthermore, it is shown that the inclusion of asymptomatic infection in the epidemic process increases the estimate of R0 but does not do so greatly provided that the proportion of symptomatic infections is constant over the outbreak and there is no difference in transmissibility between symptomatic and asymptomatic infections.
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Affiliation(s)
- Xu-Sheng Zhang
- National Infection Service, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
- Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College School of Public Health, Norfolk Place, London, United Kingdom
- * E-mail:
| | - Giovanni Lo Iacono
- Chemical and Environmental Effects Centre for Radiation, Chemical and Environmental Hazards, Public Health England, London, United Kingdom
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
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12
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Qu J, Yang C, Bao F, Chen S, Gu L, Cao B. Epidemiological characterization of respiratory tract infections caused by Mycoplasma pneumoniae during epidemic and post-epidemic periods in North China, from 2011 to 2016. BMC Infect Dis 2018; 18:335. [PMID: 30016939 PMCID: PMC6050680 DOI: 10.1186/s12879-018-3250-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 07/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mycoplasma pneumoniae (M. pneumoniae) is a commonly causative pathogen for respiratory tract infections (RTIs) in humans. The epidemiological features of M. pneumoniae infections during post-epidemic, including age distribution and the seasonality of the patients, are not well investigated. METHODS We retrospectively analyzed the clinical data of 7835 consecutive RTIs patients (3852 adults and 3983 children) who visited a teaching hospital, and defined an epidemic (2011-2013) and a post-epidemic period (2014-2016). M. pneumoniae was detected by fluorescence-quantatitive PCR in respiratory samples. Informed consent was obtained by all adults and the legal representatives of patients aged < 18 years, and the study was approved by Institutional Review Board of Beijing Chao-Yang Hospital (project approval number 10-KE-49). RESULTS The median (IQR) age was 16 (53) years (range < 0-105 years). The M. pneumoniae positive rate was 14.4% (21.2%, epidemic; 6.7%, post-epidemic), with seasonal peaks from late summer to autumn during epidemic, and from fall to winter during post-epidemic period, which was highest in children aged 7-17 years. In epidemic, no statistical difference was found in the positive rates between children and adults among most months (except February, July and August), neither for the positive rates among age groups (P = 0.801). However, in post-epidemic period, significant differences were observed in the positive rates between children and adults in nearly every month (P< 0.05 or P< 0.001, except May), as well as in the positive rates among age groups (P< 0.001). Most of the older patient admissions and all of ICU admissions occurred during the epidemic. CONCLUSIONS Different patterns of age distribution and seasonality of M. pneumoniae RTIs between epidemic and post-epidemic periods were reported. Our results suggest that M. pneumoniae should be considered as a possible pathogen in pneumonia patients admitted to the ICU in the setting of an epidemic.
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Affiliation(s)
- Jiuxin Qu
- Department of Clinical Laboratory, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China. .,Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
| | - Chunxia Yang
- Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Fang Bao
- Department of Pediatrics, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Shuyan Chen
- Department of Clinical Trial, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Li Gu
- Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
| | - Bin Cao
- Department of Respiratory and Critical Care Medicine, Clinical Microbiology and Infectious Disease Lab, China-Japan Friendship Hospital, Beijing, China
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13
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Leung KY, Trapman P, Britton T. Who is the infector? Epidemic models with symptomatic and asymptomatic cases. Math Biosci 2018; 301:190-198. [PMID: 29654792 DOI: 10.1016/j.mbs.2018.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 11/26/2022]
Abstract
What role do asymptomatically infected individuals play in the transmission dynamics? There are many diseases, such as norovirus and influenza, where some infected hosts show symptoms of the disease while others are asymptomatically infected, i.e. do not show any symptoms. The current paper considers a class of epidemic models following an SEIR (Susceptible → Exposed → Infectious → Recovered) structure that allows for both symptomatic and asymptomatic cases. The following question is addressed: what fraction ρ of those individuals getting infected are infected by symptomatic (asymptomatic) cases? This is a more complicated question than the related question for the beginning of the epidemic: what fraction of the expected number of secondary cases of a typical newly infected individual, i.e. what fraction of the basic reproduction number R0, is caused by symptomatic individuals? The latter fraction only depends on the type-specific reproduction numbers, while the former fraction ρ also depends on timing and hence on the probabilistic distributions of latent and infectious periods of the two types (not only their means). Bounds on ρ are derived for the situation where these distributions (and even their means) are unknown. Special attention is given to the class of Markov models and the class of continuous-time Reed-Frost models as two classes of distribution functions for latent and infectious periods. We show how these two classes of models can exhibit very different behaviour.
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Affiliation(s)
- Ka Yin Leung
- Department of mathematics, Stockholm University, Stockholm 106 91, Sweden.
| | - Pieter Trapman
- Department of mathematics, Stockholm University, Stockholm 106 91, Sweden.
| | - Tom Britton
- Department of mathematics, Stockholm University, Stockholm 106 91, Sweden.
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14
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Kogoj R, Praprotnik M, Mrvič T, Korva M, Keše D. Genetic diversity and macrolide resistance of Mycoplasma pneumoniae isolates from two consecutive epidemics in Slovenia. Eur J Clin Microbiol Infect Dis 2017; 37:99-107. [PMID: 28948376 DOI: 10.1007/s10096-017-3106-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/07/2017] [Indexed: 11/26/2022]
Abstract
Two nationwide Mycoplasma pneumoniae epidemics occurred in Slovenia between 2006 and 2016. The aim of this study was to assess which M. pneumoniae genotypes were present in our area during the selected timeframe, whether the origin of the epidemics was monoclonal or polyclonal and whether the proportion between detected genotypes changed over time. We were also interested in the presence of macrolide resistance (MR) and whether it could be linked to specific genotypes. We performed pyrosequencing of the P1 gene and multiple-locus variable-number tandem repeat (VNTR) analysis (MLVA) typing from 872 M. pneumoniae isolates obtained from respiratory tract infections (RTI)-suffering patients. Additionally, isolates were tested for the presence of MR implicated mutations in the 23S rRNA gene. The MLVA typing results revealed that three main genotypes, MLVA-3,5,6,2, MLVA-3,6,6,2 and MLVA-4,5,7,2, were constantly present and occasionally joined by less abundant, short-lived genotypes, which were detected mostly, but not exclusively, during epidemics. We also noticed a switch in abundance from MLVA-3,5,6,2 and MLVA-3,6,6,2, which dominated in the first epidemic (77.0%; 97/126), to MLVA-4,5,7,2 (71.6%; 428/598), which dominated in the second. Similar to this finding, the dominant P1 type also shifted from type 2 to type 1, although a complete P1 type shift was not observed, since both types remained in circulation. MR was detected in 0.8% (7/872) of M. pneumoniae isolates. Our results seem to suggest that MR remains sporadic in Slovenia at this point in time and that both recent epidemics were polyclonal in nature and, possibly, to some extent, fuelled by the P1 type dominance change.
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Affiliation(s)
- R Kogoj
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
| | - M Praprotnik
- Division of Paediatrics, University Children's Hospital, University Medical Centre Ljubljana, Bohoričeva ulica 20, 1000, Ljubljana, Slovenia
| | - T Mrvič
- Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, 1000, Ljubljana, Slovenia
| | - M Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
| | - D Keše
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia.
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15
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Wood PR, Kampschmidt JC, Dube PH, Cagle MP, Chaparro P, Ketchum NS, Kannan TR, Singh H, Peters JI, Baseman JB, Brooks EG. Mycoplasma pneumoniae and health outcomes in children with asthma. Ann Allergy Asthma Immunol 2017. [PMID: 28634021 DOI: 10.1016/j.anai.2017.05.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Acute infections with Mycoplasma pneumoniae (Mp) have been associated with worsening asthma in children. Mp can be present in the respiratory tract for extended periods; it is unknown whether the long-term persistence of Mp in the respiratory tract affects long-term asthma control. OBJECTIVE To determine the effect of Mp on asthma control. METHODS We enrolled 31 pediatric subjects 3 to 10 years of age with persistent asthma who completed up to 8 visits over a 24-month period. We detected Mp by antigen capture and polymerase chain reaction. Primary outcome measurements included symptom scores, quality of life, medication scores, oral corticosteroid use, health care usage, school absences, and exhaled breath condensate pH. RESULTS Low levels of Mp community-acquired respiratory distress syndrome toxin were detected in 20 subjects (64.5%) at enrollment. Subjects with Mp positivity at a given visit had a .579 probability of remaining Mp positive at the subsequent visit, whereas those with Mp negativity had a .348 probability of becoming Mp positive at the following visit. The incidence of Mp overall was higher in the spring and summer months. Overall, we found no significant relation between the detection of Mp and worse outcome measurements at the same visit or at subsequent visits. CONCLUSION The long-term persistence of Mp in the respiratory tract is common in children with asthma. However, the detection of Mp was not associated significantly with worse asthma symptoms, quality of life, health care usage, school absences, or exhaled breath condensate pH in this pediatric asthma cohort.
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Affiliation(s)
- Pamela R Wood
- Department of Pediatrics, UT Health San Antonio, San Antonio, Texas.
| | | | - Peter H Dube
- Department of Microbiology, Immunology and Molecular Genetics, UT Health San Antonio, San Antonio, Texas
| | - Marianna P Cagle
- Department of Microbiology, Immunology and Molecular Genetics, UT Health San Antonio, San Antonio, Texas
| | - Paola Chaparro
- Department of Microbiology, Immunology and Molecular Genetics, UT Health San Antonio, San Antonio, Texas
| | - Norma S Ketchum
- Department of Epidemiology and Biostatistics, UT Health San Antonio, San Antonio, Texas
| | - Thirumalai R Kannan
- Department of Microbiology, Immunology and Molecular Genetics, UT Health San Antonio, San Antonio, Texas
| | - Harjinder Singh
- Department of Medicine, UT Health San Antonio, San Antonio, Texas
| | - Jay I Peters
- Department of Medicine, UT Health San Antonio, San Antonio, Texas
| | - Joel B Baseman
- Department of Microbiology, Immunology and Molecular Genetics, UT Health San Antonio, San Antonio, Texas
| | - Edward G Brooks
- Department of Pediatrics, UT Health San Antonio, San Antonio, Texas
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16
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Cilloniz C, Ewig S, Gabarrus A, Ferrer M, Puig de la Bella Casa J, Mensa J, Torres A. Seasonality of pathogens causing community-acquired pneumonia. Respirology 2017; 22:778-785. [DOI: 10.1111/resp.12978] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Catia Cilloniz
- Department of Pneumology, Hospital Clinic of Barcelona; University of Barcelona (UB); Barcelona Spain
- Biomedical Research Institute “August Pi Sunyer” (IDIBAPS); Biomedical Research Networking Centres on Respiratory Diseases (CIBERES); Barcelona Spain
| | - Santiago Ewig
- Department of Respiratory Medicine and Infectious Diseases; Evangelic Hospital in Herne and Augusta Hospital in Bochum; Bochum Germany
| | - Albert Gabarrus
- Department of Pneumology, Hospital Clinic of Barcelona; University of Barcelona (UB); Barcelona Spain
- Biomedical Research Institute “August Pi Sunyer” (IDIBAPS); Biomedical Research Networking Centres on Respiratory Diseases (CIBERES); Barcelona Spain
| | - Miquel Ferrer
- Department of Pneumology, Hospital Clinic of Barcelona; University of Barcelona (UB); Barcelona Spain
- Biomedical Research Institute “August Pi Sunyer” (IDIBAPS); Biomedical Research Networking Centres on Respiratory Diseases (CIBERES); Barcelona Spain
| | | | - Josep Mensa
- Department of Infectious Diseases; Hospital Clinic of Barcelona; Barcelona Spain
| | - Antoni Torres
- Department of Pneumology, Hospital Clinic of Barcelona; University of Barcelona (UB); Barcelona Spain
- Biomedical Research Institute “August Pi Sunyer” (IDIBAPS); Biomedical Research Networking Centres on Respiratory Diseases (CIBERES); Barcelona Spain
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17
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Development of a multiplex taqMan real-time PCR assay for typing of Mycoplasma pneumoniae based on type-specific indels identified through whole genome sequencing. Diagn Microbiol Infect Dis 2016; 87:203-206. [PMID: 27923522 DOI: 10.1016/j.diagmicrobio.2016.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/14/2016] [Accepted: 11/19/2016] [Indexed: 11/22/2022]
Abstract
We developed a multiplex real-time PCR assay for simultaneously detecting M. pneumoniae and typing into historically-defined P1 types. Typing was achieved based on the presence of short type-specific indels identified through whole genome sequencing. This assay was 100% specific compared to existing methods and may be useful during epidemiologic investigations.
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18
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Marchello C, Dale AP, Thai TN, Han DS, Ebell MH. Prevalence of Atypical Pathogens in Patients With Cough and Community-Acquired Pneumonia: A Meta-Analysis. Ann Fam Med 2016; 14:552-566. [PMID: 28376442 PMCID: PMC5389400 DOI: 10.1370/afm.1993] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/02/2016] [Accepted: 07/13/2016] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Community-acquired pneumonia (CAP), acute cough, bronchitis, and lower respiratory tract infections (LRTI) are often caused by infections with viruses or Streptococcus pneumoniae. The prevalence of atypical pathogens Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, and Bordetella pertussis among patients with these illnesses in the ambulatory setting has not been previously summarized. We set out to derive prevalence information from the existing literature. METHODS We performed a systematic review of MEDLINE for prospective, consecutive-series studies reporting the prevalence of M pneumoniae, C pneumoniae, L pneumophila and/or B pertussis in outpatients with cough, acute bronchitis, LRTI, or CAP. Articles were independently reviewed by 2 authors for inclusion and abstraction of data; discrepancies were resolved by consensus discussion. A meta-analysis was performed on each pathogen to calculate the pooled prevalence estimates using a random effects model of raw proportions. RESULTS Fifty studies met our inclusion criteria. While calculated heterogeneity was high, most studies reported prevalence for each pathogen within a fairly narrow range. In patients with CAP, the overall prevalences of M pneumoniae and C pneumoniae were 10.1% (95% CI, 7.1%-13.1%) and 3.5% (95% CI, 2.2%-4.9%), respectively. Consistent with previous reports, M pneumoniae prevalence peaked in roughly 6-year intervals. Overall prevalence of L pneumophila was 2.7% (95% CI, 2.0%-3.4%), but the organism was rare in children, with only 1 case in 1,765. In patients with prolonged cough in primary care, the prevalence of B pertussis was 12.4% (95% CI, 4.9%-19.8%), although it was higher in studies that included only children (17.6%; 95% CI, 3.4%-31.8%). CONCLUSIONS Atypical bacterial pathogens are relatively common causes of lower respiratory diseases, including cough, bronchitis, and CAP. Where surveillance data were available, we found higher prevalences in studies where all patients are tested for these pathogens. It is likely that these conditions are underreported, underdiagnosed, and undertreated in current clinical practice.
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Affiliation(s)
- Christian Marchello
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Ariella Perry Dale
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Thuy Nhu Thai
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Duk Soo Han
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Mark H Ebell
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
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19
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Yamazaki T, Kenri T. Epidemiology of Mycoplasma pneumoniae Infections in Japan and Therapeutic Strategies for Macrolide-Resistant M. pneumoniae. Front Microbiol 2016; 7:693. [PMID: 27242718 PMCID: PMC4876131 DOI: 10.3389/fmicb.2016.00693] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/26/2016] [Indexed: 12/02/2022] Open
Abstract
Pneumonia caused by Mycoplasma pneumoniae (M. pneumoniae pneumonia) is a major cause of community-acquired pneumonia worldwide. The surveillance of M. pneumoniae pneumonia is important for etiological and epidemiological studies of acute respiratory infections. In Japan, nation-wide surveillance of M. pneumoniae pneumonia has been conducted as a part of the National Epidemiological Surveillance of Infectious Diseases (NESID) program. This surveillance started in 1981, and significant increases in the numbers of M. pneumoniae pneumonia patients were noted in 1984, 1988, 2006, 2010, 2011, 2012, and 2015. The epidemics in 2011 and 2012 were particularly widespread and motivated researchers to conduct detailed epidemiological studies, including genotyping and drug resistance analyses of M. pneumoniae isolates. The genotyping studies based on the p1 gene sequence suggested that the p1 gene type 1 lineage has been dominant in Japan since 2003, including the epidemic period during 2011-2012. However, more detailed p1 typing analysis is required to determine whether the type 2 lineages become more relevant after the dominance of the type 1 lineage. There has been extensive research interest in implications of the p1 gene types on the epidemiology of M. pneumoniae infections. Serological characterizations of sera from patients have provided a glimpse into these associations, showing the presence of type specific antibody in the patient sera. Another important epidemiological issue of M. pneumoniae pneumonia is the emergence of macrolide-resistant M. pneumoniae (MRMP). MRMPs were noted among clinical isolates in Japan after 2000. At present, the isolation rate of MRMPs from pediatric patients is estimated at 50-90% in Japan, depending on the specific location. In view of the situation, Japanese societies have issued guiding principles for treating M. pneumoniae pneumonia. In these guiding principles, macrolides are still recommended as the first-line drug, however, if the fever does not subside in 48-72 h from first-line drug administration, a change of antibiotics to second-line drugs is recommended.
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Affiliation(s)
| | - Tsuyoshi Kenri
- Laboratory of Mycoplasmas and Haemophilus, Department of Bacteriology II, National Institute of Infectious DiseasesTokyo, Japan
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20
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Brown RJ, Nguipdop-Djomo P, Zhao H, Stanford E, Spiller OB, Chalker VJ. Mycoplasma pneumoniae Epidemiology in England and Wales: A National Perspective. Front Microbiol 2016; 7:157. [PMID: 26909073 PMCID: PMC4754400 DOI: 10.3389/fmicb.2016.00157] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/29/2016] [Indexed: 11/13/2022] Open
Abstract
Investigations of patients with suspected Mycoplasma pneumoniae infection have been undertaken in England since the early 1970s. M. pneumoniae is a respiratory pathogen that is a common cause of pneumonia and may cause serious sequelae such as encephalitis and has been documented in children with persistent cough. The pathogen is found in all age groups, with higher prevalence in children aged 5–14 years. In England, recurrent epidemic periods have occurred at ~4-yearly intervals. In addition, low-level sporadic infection occurs with seasonal peaks from December to February. Voluntarily reports from regional laboratories and hospitals in England from 1975 to 2015 were collated by Public Health England for epidemiological analysis. Further data pertaining cases of note and specimens submitted to Public Health England from 2005 to 2015 for confirmation, molecular typing is included.
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Affiliation(s)
- Rebecca J Brown
- Public Health EnglandLondon, UK; Department of Child Health, University Hospital Wales, Cardiff University School of MedicineCardiff, UK
| | - Patrick Nguipdop-Djomo
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine London, UK
| | | | | | - O Brad Spiller
- Department of Child Health, University Hospital Wales, Cardiff University School of Medicine Cardiff, UK
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