1
|
Yun Q, Ma SF, Cui Y, Ge HY, Zhang QY, Zhang N, Lu DM, Gu M. Application of LAMP coupled with NALF for precise detection of mycoplasma pneumoniae. Biochem Biophys Res Commun 2024; 717:150028. [PMID: 38714016 DOI: 10.1016/j.bbrc.2024.150028] [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: 04/24/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/09/2024]
Abstract
Mycoplasma pneumoniae (MP),as the most commonly infected respiratory pathogen in community-acquired pneumonia in preschool children,has becoming a prominent factor affecting children's respiratory health.Currently, there is a lack of easy, rapid, and accurate laboratory testing program for MP infection, which causes comparatively difficulty for clinical diagnostic.Here,we utilize loop-mediated isothermal amplification (LAMP) to amplify and characterize the P1 gene of MP, combined with nucleic acid lateral flow (NALF) for fast and visuallized detection of MP.Furthermore, we evaluated and analyzed the sensitivity, specificity and methodological consistency of the method.The results showed that the limit of detection(LoD) of MP-LAMP-NALF assay was down to 100 copys per reaction and there was no cross-reactivity with other pathogens infected the respiratory system. The concordance rate between MP-LAMP-NALF assay with quantitative real-time PCR was 94.3 %,which exhibiting excellent testing performance.We make superior the turnaround time of the MP-LAMP-NALF assay, which takes only about 50 min. In addition, there is no need for precision instruments and no restriction on the laboratory site.Collectively, LAMP-NALF assay targeting the P1 gene for Mycoplasma pneumoniae detection was a easy, precise and visual test which could be widely applied in outpatient and emergency departments or primary hospitals.When further optimized, it could be used as "point-of-care testing" of pathogens or multiple testing for pathogens.
Collapse
Affiliation(s)
- Qi Yun
- Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu Province, 213003, China
| | - Si Fei Ma
- Changzhou Blood Center, Changzhou, Jiangsu Province, 213000, China
| | - Yue Cui
- Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu Province, 213003, China
| | - Hao Ying Ge
- Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu Province, 213003, China
| | - Qian Yun Zhang
- Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu Province, 213003, China
| | - Ning Zhang
- Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu Province, 213003, China
| | - Dong Ming Lu
- Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu Province, 213003, China
| | - Meng Gu
- Changzhou Children's Hospital Affiliated to Nantong University, Changzhou, Jiangsu Province, 213003, China.
| |
Collapse
|
2
|
Kanwal K, Asif M, Khalid SG, Liu H, Qurashi AG, Abdullah S. Current Diagnostic Techniques for Pneumonia: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:4291. [PMID: 39001069 PMCID: PMC11244398 DOI: 10.3390/s24134291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/22/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024]
Abstract
Community-acquired pneumonia is one of the most lethal infectious diseases, especially for infants and the elderly. Given the variety of causative agents, the accurate early detection of pneumonia is an active research area. To the best of our knowledge, scoping reviews on diagnostic techniques for pneumonia are lacking. In this scoping review, three major electronic databases were searched and the resulting research was screened. We categorized these diagnostic techniques into four classes (i.e., lab-based methods, imaging-based techniques, acoustic-based techniques, and physiological-measurement-based techniques) and summarized their recent applications. Major research has been skewed towards imaging-based techniques, especially after COVID-19. Currently, chest X-rays and blood tests are the most common tools in the clinical setting to establish a diagnosis; however, there is a need to look for safe, non-invasive, and more rapid techniques for diagnosis. Recently, some non-invasive techniques based on wearable sensors achieved reasonable diagnostic accuracy that could open a new chapter for future applications. Consequently, further research and technology development are still needed for pneumonia diagnosis using non-invasive physiological parameters to attain a better point of care for pneumonia patients.
Collapse
Affiliation(s)
- Kehkashan Kanwal
- College of Speech, Language, and Hearing Sciences, Ziauddin University, Karachi 75000, Pakistan
| | - Muhammad Asif
- Faculty of Computing and Applied Sciences, Sir Syed University of Engineering and Technology, Karachi 75300, Pakistan
| | - Syed Ghufran Khalid
- Department of Engineering, Faculty of Science and Technology, Nottingham Trent University, Nottingham B15 3TN, UK
| | - Haipeng Liu
- Research Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | | | - Saad Abdullah
- School of Innovation, Design and Engineering, Mälardalen University, 721 23 Västerås, Sweden
| |
Collapse
|
3
|
Wang M, Ren R, Xu Y, Wang T, Liang X, Li S. Oxidative stress in the alveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia. Pediatr Pulmonol 2024. [PMID: 39031860 DOI: 10.1002/ppul.27120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/12/2024] [Accepted: 05/30/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVE To investigate the correlation between oxidative stress in the bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumoniae pneumonia (MPP) and the clinical characteristics of severe MPP (SMPP) and refractory MPP (RMPP). METHODS Clinical and BALF-related data were collected from 83 patients with MPP, of which 29 had SMPP and 54 had general MPP (GMPP); 37 patients were in the RMPP group and 46 in the non-RMPP group. The levels of malondialdehyde (MDA) and advanced oxidation protein products (AOPP) as well as the activity levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) in BALF were detected. Logistic regression analyses were performed on MDA, AOPP, SOD, GSH-PX, gender, heat peak, neutrophil percentage, C-reactive protein, lactate dehydrogenase, d-dimer, lung consolidation, sputum embolus, and pleural effusion. RESULTS The levels of MDA and AOPP in the BALF of the MPP group were significantly higher than those in the control group (p < .05), whereas SOD and GSH-PX levels were lower than those in the control group (p < .05). The BALF AOPP levels in the RMPP group were higher than those in the non-RMPP group, and the SOD and GSH-PX levels in the BALF were lower than those in the non-RMPP group; the difference was statistically significant (p < .05). The levels of MDA and AOPP in the BALF of children in the SMPP group were higher than those in the GMPP group, and the levels of SOD and GSH-PX were lower than those in the GMPP group, with statistically significant differences (p < .05). The C-index of the logistic regression model was 0.960 (95% confidence interval 0.958-0.963), which indicates that the model has good predictive ability. CONCLUSION Advanced oxidation protein products may be a marker for predicting the conditions of SMPP and RMPP, and the prediction model can assess the risk of progression in children to RMPP, which is conducive to clinical diagnosis and treatment.
Collapse
Affiliation(s)
- Mengzhu Wang
- Children's Intensive Care Unit, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Ruijuan Ren
- Children's Intensive Care Unit, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Yuping Xu
- Children's Intensive Care Unit, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Tuanjie Wang
- Children's Intensive Care Unit, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Xiaojun Liang
- Children's Intensive Care Unit, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Shujun Li
- Children's Intensive Care Unit, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| |
Collapse
|
4
|
Li W, Deng F. Clinical significance of measuring MP-DNA, C-reactive protein, and inflammatory cytokines in children with mycoplasma pneumoniae pneumonia. Am J Transl Res 2024; 16:577-583. [PMID: 38463592 PMCID: PMC10918132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/30/2023] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To explore the clinical significance of detecting mycoplasma pneumoniae (MP)-DNA, C-reactive protein (CRP), interleukin-6 (IL-6), IL-8, and IL-10 in children with mycoplasma pneumoniae pneumonia (MPP). METHODS The data from 106 children who received treatment or underwent health examination in the Children's Medical Center of Anhui Medical University from January 2021 to October 2022 were collected and analyzed retrospectively. The observation group (OG) consisted of 64 children with MPP, while the control group (CG) consisted of 42 healthy children. The levels of IL-6, IL-8, IL-10, CRP, and MP-DNA were compared between the two groups. The diagnostic value of MP-DNA in patients with MPP and its correlation with the levels of IL-6, IL-8, IL-10 and CRP were analyzed. RESULTS The level of MP-DNA in the OG was notably higher than that in the CG (P<0.05). Additionally, the levels of IL-6, IL-8, IL-10, and CRP in the OG were significantly higher than those in the CG (P<0.05). MP-DNA was positively correlated with the levels of IL-6, IL-8, IL-10, and CRP (P<0.05). The area under the curve of MP-DNA in diagnosing MPP was 0.979, with a specificity of 92.19% and a sensitivity of 97.62%. CONCLUSION Indicators such as MP-DAN, IL-6, IL-8 are crucial in the development and progression of MPP, playing an important role in diagnosing and treating patients with MPP.
Collapse
Affiliation(s)
- Wangqiang Li
- Department of Internal Medicine, Children's Medical Center, Anhui Medical University Hefei, Anhui, China
- Department of Internal Medicine, Anhui Children's Hospital Hefei, Anhui, China
| | - Fang Deng
- Department of Internal Medicine, Children's Medical Center, Anhui Medical University Hefei, Anhui, China
- Department of Internal Medicine, Anhui Children's Hospital Hefei, Anhui, China
| |
Collapse
|
5
|
Sui DX, Ma HC, Wang CC, Shao HY, Xu SH, Fang NN. Diagnostic significance of HRCT imaging features in adult mycoplasma pneumonia: a retrospective study. Sci Rep 2024; 14:153. [PMID: 38168479 PMCID: PMC10761950 DOI: 10.1038/s41598-023-50702-3] [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: 09/14/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024] Open
Abstract
Mycoplasma pneumoniae pneumonia (MPP) often overlaps with the clinical manifestations and chest imaging manifestations of other types of community-acquired pneumonia (CAP). We retrospectively analyzed the clinical and imaging data of a group of patients with CAP, summarized their clinical and imaging characteristics, and discussed the diagnostic significance of their certain HRCT findings. The HRCT findings of CAP researched in our study included tree-in-bud sign (TIB), ground-glass opacity (GGO), tree fog sign (TIB + GGO), bronchial wall thickening, air-bronchogram, pleural effusion and cavity. The HRCT findings of all cases were analyzed. Among the 200 cases of MPP, 174 cases showed the TIB, 193 showed the GGO, 175 showed the tree fog sign, 181 lacked air-bronchogram. In case taking the tree fog sign and lack of air-bronchogram simultaneously as an index to distinguish MPP from OCAP, the sensitivity was 87.5%, the specificity was 97.5%, the accuracy was 92.5%. This study showed that that specific HRCT findings could be used to distinguish MPP from OCAP. The combined HRCT findings including the tree fog sign and lacked air-bronchogram simultaneously would contribute to a more accurate diagnosis of MPP.
Collapse
Affiliation(s)
- Dong-Xin Sui
- Department of Respiration, The Second Hospital of Shandong University, Jinan, China
| | - Han-Chen Ma
- Department of Respiration, The Second Hospital of Shandong University, Jinan, China
| | - Chao-Chao Wang
- Department of Respiration, The Second Hospital of Shandong University, Jinan, China
| | - Hong-Yan Shao
- Department of Respiration, The Second Hospital of Shandong University, Jinan, China
| | - Shao-Hua Xu
- Department of Respiration, The Second Hospital of Shandong University, Jinan, China
| | - Ning-Ning Fang
- Department of Anesthesiology, Qilu Hospital of Shandong University, No. 107, Wenhua Xi Road, Jinan, 250012, Shandong, China.
| |
Collapse
|
6
|
Lin L, Chi H, Chiu NC, Huang CY, Wang JY, Huang DTN. Assessing the utilization of antimicrobial agents in pediatric pneumonia during the era of the 13-valent pneumococcal conjugate vaccine: A retrospective, single-center study. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:1226-1235. [PMID: 37758541 DOI: 10.1016/j.jmii.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND AND PURPOSE Pneumonia and bronchopneumonia are the most common infectious diseases in children. This study aimed to analyze changes in causative pathogens and antibiotic use for bronchopneumonia or pneumonia after the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in children. METHODS This retrospective study was conducted from 2009 to 2019. Hospitalized children aged 6 months-3 years with a discharge diagnosis of bronchopneumonia or pneumonia were included to analyze changes in the potential mismatch between the diagnosed pathogen and antibiotic use. RESULTS The cohort comprised 1100 patients, including 648 (59%) and 452 (41%) with a discharge diagnosis of bronchopneumonia and pneumonia, respectively. The trend of viral pneumonia increased every year (rs = 0.101, p < 0.05) Antibiotics were administered in 97% patients, with an increasing annual trend in macrolide use (rs = 0.031, p = 0.009). Regarding antibiotic utilization, no significant variations were observed in the days of therapy (DOT) (rs = 0.076, p = 0.208) or length of therapy (LOT) (rs = -0.027, p = 0.534) per patient-year throughout the study duration. Interestingly, the LOT for combined therapy with macrolides and first-line beta-lactams was high (rs = 0.333, p = 0.028). In viral pneumonia treatment, neither the DOT nor LOT exhibited significant variations (rs = -0.006, p = 0.787 and rs = -0.156, p = 0.398). CONCLUSION After the introduction of PCV13 in Taiwan, no decrease in antibiotic use has been observed among children aged 6 months-3 years with a discharge diagnosis of bronchopneumonia and pneumonia.
Collapse
Affiliation(s)
- Leng Lin
- Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan; Department of Pediatrics, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Hsin Chi
- Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medicine College, New Taipei, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medicine College, New Taipei, Taiwan
| | - Ching-Ying Huang
- Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan
| | - Jin-Yuan Wang
- Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan
| | - Daniel Tsung-Ning Huang
- Department of Pediatric Infectious Diseases, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medicine College, New Taipei, Taiwan.
| |
Collapse
|
7
|
Shin S, Koo S, Yang YJ, Lim HJ. Characteristics of the Mycoplasma pneumoniae Epidemic from 2019 to 2020 in Korea: Macrolide Resistance and Co-Infection Trends. Antibiotics (Basel) 2023; 12:1623. [PMID: 37998825 PMCID: PMC10669541 DOI: 10.3390/antibiotics12111623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023] Open
Abstract
Mycoplasma pneumoniae, a major etiological agent of community-acquired pneumonia, exhibits distinct cyclic epidemic patterns recurring every three to five years. Several cases of co-infection with severe acute respiratory syndrome coronavirus 2 have been reported globally, resulting in unfavorable clinical manifestations. This study investigated the epidemiological features of the recent M. pneumoniae outbreak (May 2019-April 2020) using retrospective data from the last five years. Molecular test data for macrolide resistance and co-infection were obtained from the Seegene Medical Foundation. National medical expenditure and hospitalization rates were analyzed using data from The Health Insurance Review and Assessment Service of Korea. The macrolide resistance rate was 69.67%, peaking at 71.30% during the epidemic period, which was considerably higher than the 60.89% rate during non-epidemic periods. The co-infection rate with other respiratory pathogens was 88.49%; macrolide-resistant M. pneumoniae strains showed a 2.33% higher co-infection rate than the susceptible strains. The epidemic period had 15.43% higher hospitalization and 78.27% higher medical budget expenditure per patient than non-epidemic periods. The increased rates of macrolide resistance and co-infection observed in macrolide-resistant M. pneumoniae during the epidemic period highlight the importance of monitoring future outbreaks, especially considering macrolide resistance and the risk of co-infection with other pathogens.
Collapse
Affiliation(s)
- Soyoun Shin
- Daejeon & Chungcheong Reference Lab., Seegene Medical Foundation, Daejeon 35203, Republic of Korea;
| | - Sunhoe Koo
- Daejeon & Chungcheong Reference Lab., Seegene Medical Foundation, Daejeon 35203, Republic of Korea;
| | - Yong-Jin Yang
- Department of Molecular Diagnostics, Seegene Medical Foundation, Seoul 04805, Republic of Korea; (Y.-J.Y.); (H.-J.L.)
| | - Ho-Jae Lim
- Department of Molecular Diagnostics, Seegene Medical Foundation, Seoul 04805, Republic of Korea; (Y.-J.Y.); (H.-J.L.)
| |
Collapse
|
8
|
Yusuf SO, Chen P. Clinical characteristics of community-acquired pneumonia in children caused by mycoplasma pneumoniae with or without myocardial damage: A single-center retrospective study. World J Clin Pediatr 2023; 12:115-124. [PMID: 37342450 PMCID: PMC10278075 DOI: 10.5409/wjcp.v12.i3.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/08/2023] [Accepted: 03/30/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Mycoplasma pneumoniae (MP) is a prevalent pathogen that causes respiratory infections in children and adolescents.
AIM To assess the differences in the clinical features of MP-associated community-acquired pneumonia (CAP) in children who presented with mild or severe mycoplasma pneumoniae pneumonia (MPP); to identify the incidence of myocardial damage between the two groups.
METHODS This work is a retrospective study. We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP. We admitted patients to the inpatient department of the Second Hospital of Jilin University, Changchun, China, from January 2019 to December 2019.
RESULTS A total of 409 hospitalized patients were diagnosed with MPP. Among them were 214 (52.3%) males and 195 (47.7%) females. The duration of fever and cough was the longest in severe MPP cases. Similarly, plasma levels of highly sensitive C-reactive protein (t = -2.834, P < 0.05), alanine transaminase (t = -2.511, P < 0.05), aspartate aminotransferase (t = -2.939, P < 0.05), and lactate dehydrogenase (LDH) (t = -2.939, P < 0.05) were all elevated in severe MPP cases compared with mild MPP cases, and these elevations were statistically significant (P < 0.05). Conversely, the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases. The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases (χ2 = 157.078, P < 0.05).
CONCLUSION Mycoplasma pneumoniae is the main cause of CAP. The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.
Collapse
Affiliation(s)
- Shukri Omar Yusuf
- Department of Pediatrics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Peng Chen
- Department of Pediatrics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| |
Collapse
|
9
|
Nuovo GJ. The rapid diagnosis of Mycoplasma pneumonia using in situ hybridization on clinical samples. Ann Diagn Pathol 2023; 63:152100. [PMID: 36608457 DOI: 10.1016/j.anndiagpath.2022.152100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023]
Abstract
The microbiological etiology of seasonal upper respiratory illnesses in the United States is dominated by viruses, including influenza A, B, respiratory syncytial virus, and SARS-CoV2. Mycoplasma pneumonia, treatable with antibiotics, can also cause upper respiratory symptoms and is typically associated with about 15 % of cases. There is no clinical or radiologic finding diagnostic of Mycoplasma pneumonia infection and PCR-based testing is not routinely used in the clinical setting. Further, the bacteria grows slowly in culture and the diagnostic IgM response will take days after the onset of infection. Thus, a rapid diagnostic test for Mycobacterium pneumonia infection is needed. This study documented two cases of Mycoplasma pneumonia infection of the upper respiratory system using in situ hybridization in a series of over 20 patients who were being tested for SARS-CoV2 infection. The respiratory secretions were placed on a glass slide, fixed in 10 % buffered formalin, and then tested using a Mycoplasma pneumonia probe. The high bacterial number associated with acute infection allowed for straightforward detection by in situ hybridization in a few hours. Antibiotic therapy led to rapid resolution of the symptoms. This highlights the ability of standard in situ hybridization as a rapid diagnostic test for Mycoplasma pneumonia in the clinical setting.
Collapse
Affiliation(s)
- Gerard J Nuovo
- Ohio State University Medical Center, Columbus, OH, USA; GnomeDx, Powell, OH, USA.
| |
Collapse
|
10
|
Jia Z, Sun Q, Zheng Y, Xu J, Wang Y. The immunogenic involvement of miRNA-492 in mycoplasma pneumoniae infection in pediatric patients. J Pediatr (Rio J) 2023; 99:187-192. [PMID: 36195304 PMCID: PMC10031331 DOI: 10.1016/j.jped.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the role of miRNA-492 in the progression of mycoplasma pneumoniae (MP) infection in pediatric patients. METHODS Forty-six children admitted to the present study's hospital and diagnosed with mycoplasma pneumonia were recruited as the study group from March 2018 to August 2019, and 40 healthy children were selected as the control group. RESULTS The expression levels of miRNA-492, TNF-α, IL-6 and IL-18 in the study group were significantly higher than those in the control group (p < 0.05). There was no significant correlation between miRNA-492 and most of the immune-correlated indicators in the study group, except for IL-6, IL-18 and HMGB1. Meanwhile, overexpression of miRNA-492 increased IL-6 secretion in PMA-activated monocytes (p < 0.01). CONCLUSION The present study's results suggested that miRNA-492 might play a role in the pathogenesis of mycoplasma pneumoniae pneumonia in children by regulating the secretion of immune-inflammatory factors such as IL-6 and IL-18 in the mononuclear macrophages.
Collapse
Affiliation(s)
- Zhiyi Jia
- Department of Pediatrics, Zibo Central Hospital, Shandong, China
| | - Qiwei Sun
- Department of Pediatrics, Zibo Central Hospital, Shandong, China.
| | - Yanfei Zheng
- Department of Pediatrics, Zibo Central Hospital, Shandong, China
| | - Jing Xu
- Department of Pediatrics, Zibo Central Hospital, Shandong, China
| | - Yanxia Wang
- Department of Pediatrics, Zibo Central Hospital, Shandong, China
| |
Collapse
|
11
|
Jia N, Zhou J, Xiao F, Zheng B, Huang X, Sun C, Fu J, Xu Z, Chen M, Wang Y. A CRISPR-Cas12a-Based platform for ultrasensitive, rapid, and highly specific detection of Mycoplasma pneumonia in clinical application. Front Bioeng Biotechnol 2023; 11:1022066. [PMID: 36733967 PMCID: PMC9887289 DOI: 10.3389/fbioe.2023.1022066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
Mycoplasma pneumoniae (MP), which is responsible for a majority of community-acquired pneumonia (CAP) in children, has been largely underestimated. Here, we coupled multiple cross displacement amplification (MCDA) technique with CRISPR-Cas12a-based biosensing system to design a novel detection platform termed MP-MCDA-CRISPR assay for MP infection diagnosis and clinical application. The MP-MCDA-CRISPR assay amplified the CARDS gene of MP by MCDA method, followed by trans-cleavage of the reporter molecular upon the formation of CRISPR-Cas12a-gRNA-target DNA complex, which was confirmed by the release of fluorescent signals. A set of standard MCDA primers, an engineered CP1 primer, a quenched fluorescent ssDNA reporter, and a gRNA were designed targeting the CARDS gene of MP. The optimal temperature for MCDA pre-amplification is 64°C, and the time for CRISPR-Cas12a-gRNA biosensing process is 5 min. The limit of detection (LoD) of the MP-MCDA-CRISPR assay is 50 fg per reaction without any cross-reaction with other non-MP pathogens. The MP-MCDA-CRISPR assay accurately identified the 50 real time-PCR positive clinical samples and 78 negative ones. Taken together, the MP-MCDA-CRISPR assay designed here is a promising diagnostic tool for point-of care (POC) testing of MP infection.
Collapse
Affiliation(s)
- Nan Jia
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Juan Zhou
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Fei Xiao
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Baoying Zheng
- Respiratory Medicine, Capital Institute of Pediatrics, Beijing, China
| | - Xiaolan Huang
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Chunrong Sun
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Jin Fu
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Zheng Xu
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Min Chen
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Yi Wang
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, China,*Correspondence: Yi Wang,
| |
Collapse
|
12
|
Chen D, Wu P, Liu D, Shen T, Liu S, Zhou H, Wang C. Clinical role of M. pneumoniae typing antibody detected by chemiluminescent immunoassay in the diagnosis of Mycoplasma pneumoniae pneumonia in children. Int Immunopharmacol 2022; 112:109196. [PMID: 36084539 DOI: 10.1016/j.intimp.2022.109196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/25/2022] [Accepted: 08/22/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The levels of serum M. pneumoniae typing antibodies in children with community-acquired pneumonia (CAP) were detected by chemiluminescent immunoassay (CLIA) to explore the clinical role of M. pneumoniae typing antibody (MP-IgM, MP-IgG) in M. pneumoniae pneumonia. METHODS A total of 387 Child patients with CAP diagnosed at the Pediatric outpatient department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, were enrolled between January 2020 to December 2021 and divided into M. pneumoniae pneumonia (MPP) group (n = 210) and non-M. pneumoniae pneumonia (NMPP) group (n = 177). Firstly, Clinical data, full blood count (WBC, NEU%, LYM%, MONO%, EOS%, BASO%, RBC, HGB, PLT) and biochemical tests (AST, LDH, ɑ-HBDH, CK, CKMB, CRP, PCT, IL-6) as well as laboratory diagnostic tests (MP-IgM, MP-IgG) were compared between the two groups. Secondly, we assessed the correlation between the average level of M. pneumoniae typing antibody detected by CLIA and the titer of anti-M. pneumoniae antibody (MP-Ab) tested by passive agglutination (PA) method. Thirdly, receiver operating characteristic (ROC) curve for the MP-IgM and MP-IgG was examined to evaluate the value of diagnosing M. pneumoniae pneumonia. Finally, we follow-up 120 cases of MPP group and analysis medication results. RESULTS (1) Mean age, runny nose, expectoration, LYM%, NEU%, HGB, AST, MP-IgM and MP-IgG were statistically significant in the MPP group and NMPP group (all P < 0.05). (2) Correlation analysis showed that MP-IgM average level was linearly associated with MP-Ab titer (R2 = 0.84) and MP-IgG average level was exponentially correlated with MP-Ab titer under 1:640 (R2 = 0.96). (3) The ROC curve of MP-IgM and MP-IgG were significantly different (both P < 0.001). A serum MP-IgM level above 1 S/CO and MP-IgG level above 14.15 AU/mL were significant predictors for M. pneumoniae pneumonia: area under the curve (AUC) of 0.810, 0.815; standard error (SE) of 0.021, 0.022; 95 % confidence interval (CI) of 0.768-0.852, 0.773-0.858; the diagnostic sensitivity of 74.3 %, 62.1 %; and specificity of 72.9 %, 87.0 %; respectively. (4) Of the 120 children with M. pneumoniae pneumonia followed up, 79 (65.8 %) cases took azithromycin and 68 (86.1 %) cases were recovered. CONCLUSIONS A series of our studies shown that, CLIA, speedy and automated clinical examination method, has higher specificity and sensitivity for the quantitative detection of MP-IgM and MP-IgG, playing an important role of early diagnosis as well as prompt intervention to reduces macrolide-resistant strains and sequelae of children with M. pneumoniae pneumonia.
Collapse
Affiliation(s)
- Dongmiao Chen
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Peiting Wu
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Duoduo Liu
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Tingting Shen
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Shangmin Liu
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Huayou Zhou
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Congrong Wang
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| |
Collapse
|
13
|
Yin Q, Li Y, Pan H, Hui T, Yu Z, Wu H, Zhang D, Zheng W, Wang S, Zhou Z, Xu C, Wu W, Tong Y, Wang H, Pan H. Atypical pneumonia caused by Chlamydia psittaci during the COVID-19 pandemic. Int J Infect Dis 2022; 122:622-627. [PMID: 35842216 PMCID: PMC9276535 DOI: 10.1016/j.ijid.2022.07.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Here, we retrospectively described the diagnosis and treatment of 32 cases diagnosed with Chlamydia psittaci pneumonia during the COVID-19 pandemic. METHODS Clinical information was collected from all the patients. Reverse transcription-PCR and ELISAs were conducted for the detection of COVID-19 using nasal swabs and bronchoalveolar lavage fluid (BALF) samples. Metagenomic next-generation sequencing (mNGS) was performed for the identification of causative pathogens using BALF, peripheral blood and sputum samples. End-point PCR was performed to confirm the mNGS results. RESULTS All 32 patients showed atypical pneumonia and had infection-like symptoms that were similar to COVID-19. Results of reverse transcription-PCR and ELISAs ruled out COVID-19 infection. mNGS identified C. psittaci as the suspected pathogen in these patients within 48 hours, which was validated by PCR, except for three blood samples. The sequence reads that covered fragments of C. psittaci genome were detected more often in BALF than in sputum or blood samples. All patients received doxycycline-based treatment regimens and showed favorable outcomes. CONCLUSION This retrospective study, with the highest number of C. psittaci pneumonia enrolled cases in China so far, suggests that human psittacosis may be underdiagnosed and misdiagnosed clinically, especially in the midst of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Qiaoqiao Yin
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Yuecui Li
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Jinhua, Zhejiang Province, China
| | - Hongyi Pan
- Medical Department, Pujiang People's Hospital, Jinhua, Zhejiang Province, China
| | - Tianchen Hui
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China; Bengbu Medical College, Bengbu, Anhui Province, China
| | - Zhaonan Yu
- Hangzhou D.A. Medical Laboratory, Hangzhou, Zhejiang Province, China
| | - Haiyan Wu
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Xiaoshan Hangzhou, Hangzhou, Zhejiang Province, China
| | - Dehe Zhang
- Department of Infectious Diseases, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang Province, China
| | - Wei Zheng
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Shouhao Wang
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China; Qingdao Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Zhewen Zhou
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China; Bengbu Medical College, Bengbu, Anhui Province, China
| | - Chengan Xu
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China; The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Wenhao Wu
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China; Qingdao Medical College, Qingdao University, Qingdao, Shandong Province, China
| | - Yongxi Tong
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Haoyi Wang
- Hangzhou D.A. Medical Laboratory, Hangzhou, Zhejiang Province, China
| | - Hongying Pan
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
| |
Collapse
|
14
|
Tjoa E, Joon S, Moehario LH, Loe L, Pangalila FJV. Identification of Mycoplasma pneumoniae-associated pneumonia cases among hospitalized patients using CLART® microarray technology. J Int Med Res 2022; 50:3000605221123678. [PMID: 36171729 PMCID: PMC9523878 DOI: 10.1177/03000605221123678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objectives Community-acquired pneumonia (CAP) is a global health condition that affects populations from all age groups. The laboratory identification of Mycoplasma pneumoniae as a causative agent of CAP is challenging because of its atypical and fastidious nature. Therefore, this study assessed the diagnostic potential of PneumoCLART bacteria® in identifying M. pneumoniae as a causative agent of pneumonia in hospitalized adults. Methods This prospective study used a cross-sectional approach to assess the diagnostic potential of PneumoCLART bacteria® for detecting M. pneumoniae in sputum samples procured from 27 patients with pneumonia who required hospitalization. Results The PneumoCLART bacteria® results illustrated that 7 of 27 patients with pneumonia were positive for M. pneumoniae (26%). However, the quality of sputum varied among the M. pneumoniae-positive and M. pneumoniae-negative samples. Fifty percent of the specimens obtained from patients positive for M. pneumoniae were saliva-contaminated and unsuitable for analysis. Conclusions Because the leukocyte count was low and sputum specimens were saliva-contaminated, these findings require further validation to prove the utility of CLART® microarray technology for the identification of M. pneumoniae in pneumonia-positive patients. Conclusively, this prospective study included a small number of clinical samples, which likely affected its outcomes.
Collapse
Affiliation(s)
- Enty Tjoa
- Department of Microbiology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Shikha Joon
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
| | - Lucky Hartati Moehario
- Department of Microbiology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Luse Loe
- Department of Internal Medicine, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Franz J V Pangalila
- Internal Medicine Department, Faculty of Medicine, Universitas Tarumanagara (UNTAR), Jakarta, Indonesia
| |
Collapse
|
15
|
Xiao F, Zhou J, Sun C, Huang X, Zheng B, Fu J, Jia N, Xu Z, Cui X, Wang Y. Loop-Mediated Isothermal Amplification Coupled With Nanoparticle-Based Biosensor: A Rapid and Sensitive Method to Detect Mycoplasma pneumoniae. Front Cell Infect Microbiol 2022; 12:882855. [PMID: 35873146 PMCID: PMC9299420 DOI: 10.3389/fcimb.2022.882855] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Mycoplasma pneumoniae (MP), the causative agent of MP pneumonia (MPP), has posed a substantial burden to public health owing to a lack of rapid and effective diagnostic methods. Here, we designed a loop-mediated isothermal amplification (LAMP)-based assay, termed LAMP, combined with a nanoparticle-based lateral flow biosensor (LAMP-LFB) for rapid and sensitive diagnosis of MP.-LAMP-LFB included a set of six primers targeting the community-acquired respiratory distress syndrome (CARDS) toxin gene and was performed optimally at 63°C for only 30 min. The resulting LAMP products could be visually indicated by LFB within 2 min, thus the whole process could be accomplished within an hour. MP-LAMP-LFB's sensitivity was 50 fg per reaction, which was in complete accordance with these results obtained from real-time turbidity and visual detection reagent (VDR). MP-LAMP-LFB had no cross-reactivity with other pathogens that had similar clinical presentations. Our assay was further validated using 100 nasopharyngeal swab samples collected from children suspected of MPP, and the result was compared with the real-time PCR method. With a positive rate of 50%, the data indicated that MP-LAMP-LFB is a sensitive test for MP detection in clinical settings. Collectively, the MP-LAMP-LFB assay targeting the CARDS toxin gene was a rapid, highly sensitive, and specific test that could be widely applied in point-of-care settings and basic medical facilities in rural areas.
Collapse
Affiliation(s)
- Fei Xiao
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Juan Zhou
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Chunrong Sun
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Xiaolan Huang
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Baoying Zheng
- Department of Respiratory Disease, Capital Institute of pediatrics, Beijing, China
| | - Jin Fu
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Nan Jia
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Zheng Xu
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Xiaodai Cui
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| | - Yi Wang
- Experimental research center, Capital Institute of pediatrics, Beijing, China
| |
Collapse
|
16
|
Kim CH, Lee J. Mycoplasma pneumoniae Pleural Effusion in Adults. J Clin Med 2022; 11:jcm11051281. [PMID: 35268372 PMCID: PMC8911427 DOI: 10.3390/jcm11051281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/20/2022] [Accepted: 02/24/2022] [Indexed: 11/28/2022] Open
Abstract
Parapneumonic effusions often complicate Mycoplasma pneumoniae (MP) pneumonia, contrary to the notion that they are a rare feature of MP infection. Increased research and evidence on MP parapneumonic effusions (MPPE) can help elucidate its clinical significance as one of the variable manifestations of MP infection. This article aims to summarize the existing literature about the clinical characteristics of MPPE in adults and discuss its diagnostic implications from the perspective of pleural fluid analysis. Approximately 20–25% of adult patients with MP pneumonia develop MPPE, and its frequency in children and adults seems to be similar. Although the pathogenesis of MPPE remains to be elucidated, MP-induced cell-mediated immune mechanisms might be partially associated with the development of MPPE. MPPE usually shows mononuclear leukocyte predominance with elevated adenosine deaminase (ADA) activity, similar to tuberculous pleural effusion (TPE). The degree of increase in pleural fluid ADA levels and serum inflammatory biomarkers may help differentiate between MPPE and TPE. During the acute phase, a single positive IgM and positive polymerase chain reaction results allow for a precise and reliable MP infection diagnosis. The mainstay of treatment is the selection of adequate anti-mycoplasma antibiotics with or without corticosteroid, based on the local epidemiologic data on macrolide resistance.
Collapse
Affiliation(s)
| | - Jaehee Lee
- Correspondence: ; Tel.: +82-53-200-5536; Fax: +82-53-426-2046
| |
Collapse
|
17
|
Darabi Z, Niakan M, Khaledi M, Afkhami H, Soltanimoghadam F, Darabi Z. The investigation of P1 gene in Mycoplasma pneumonia isolated from atypic pneumonia by molecular methods, determine IgG antibody and MIC to ciprofloxacin antibiotic. New Microbes New Infect 2022; 46:100954. [PMID: 35251667 PMCID: PMC8889415 DOI: 10.1016/j.nmni.2022.100954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/13/2021] [Accepted: 09/28/2021] [Indexed: 11/09/2022] Open
Abstract
Mycoplasma pneumoniae, which causes atypical pneumonia, is a well-established pathogen of the respiratory tract. This bacterium is intrinsically susceptible to fluoroquinolones. But recently, drug-resistant forms of this bacterium have been reported. This study aims to determine the prevalence of this bacterium by ELISA and PCR and MIC to ciprofloxacin. The clinical samples (blood and nasopharyngeal swab) were collected from 100 patients, who were referred to selective hospitals in Tehran with respiratory complaints, were enrolled in 2017. Nasopharyngeal swab sample collections were cultured on PPLO broth and PPLO agar. After culturing and DNA extraction, PCR was performed by specific P1 genes primers. Ciprofloxacin's MIC of Mycoplasma pneumonia isolated was determined by the Micro-broth dilution method. The serum of IgG antibody titers was also measured by ELISA Mycoplasma pneumonia. In this study, out of 100 samples, 12 bacteria were isolated on PPLO agar. Using specific primers, 7 samples of Mycoplasma speciesism-specific were positive for the presence of M.pneumoniae and 2 Ciprofloxacin resistant isolates were evaluated. ELISA results show that IgG titer antibody is existent in 19 samples and 5 samples are intermediate as well. IgG antibody titer average in the whole sample is 27/66 U/ml, but it is in Positive samples by P1 PCR is 45/75 U/ml. This study showed that PCR is a sensitive and reliable method for rapid detection of M. pneumoniae bacteria in respiratory infectious samples, but the results of this method are different from the ELISA method. Additionally, it seems that the resistance to ciprofloxacin is relatively common among M. pneumoniae.
Collapse
|
18
|
Zhou L, Li Y, Xu Z, Peng X, Gong X, Yang L. Increased Total Serum Immunoglobulin E Is Likely to Cause Complications of Mycoplasma pneumoniae Pneumonia in Children. Front Cell Infect Microbiol 2021; 11:783635. [PMID: 35024356 PMCID: PMC8744470 DOI: 10.3389/fcimb.2021.783635] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/05/2021] [Indexed: 01/05/2023] Open
Abstract
Objective To investigate the correlation between serum immunoglobulin E (IgE) levels and the complications in children with Mycoplasma pneumoniae pneumonia (MPP). Methods A retrospective study of MPP patients hospitalized from May 2019 to July 2021 was performed. We analyzed the clinical manifestations, complications, laboratory findings, and treatments. Results A total of 275 patients who met the inclusion criteria were enrolled in the study. We divided patients into two groups based on whether there were complications. Complications occurred in 147 patients, of which pulmonary complications were more common than extrapulmonary complications. The IgE level in the complication group was higher than that in the non-complication group with p = 0.041. Patients with complications of necrotizing pneumonitis, pneumothorax, skin rash, or bronchiolitis obliterans had higher IgE levels. There was no statistically significant difference in IgE levels between pulmonary complications and extrapulmonary complications. The older the age, the greater the probability of complications (p = 0.001). The group with complications was more likely to have chest pain (p = 0.000), while the group without complications was more likely to have wheezing (p = 0.017). The use of bronchoscopy and glucocorticoids was higher in the complication group than in the non-complication group (p = 0.000). Conclusions MPP patients with higher IgE levels had more severe clinical symptoms and complications. We speculated that IgE might be a biomarker for complications after MP infection.
Collapse
Affiliation(s)
- Lili Zhou
- Department of Respiratory Medicine, Women and Children’s hospital, Gannan Medical University, Ganzhou, China
- *Correspondence: Lili Zhou,
| | - Yuan Li
- Department of Respiratory Medicine, Women and Children’s hospital, Gannan Medical University, Ganzhou, China
| | - Zhufei Xu
- Department of Respiratory Medicine, The Children’s Hospital, Zhejiang University, Hangzhou, China
| | - Xuyun Peng
- Department of Respiratory Medicine, Women and Children’s hospital, Gannan Medical University, Ganzhou, China
| | - Xiaoyan Gong
- Department of Respiratory Medicine, Women and Children’s hospital, Gannan Medical University, Ganzhou, China
| | - Lin Yang
- Department of Respiratory Medicine, Women and Children’s hospital, Gannan Medical University, Ganzhou, China
| |
Collapse
|
19
|
Fang C, Mao Y, Jiang M, Yin W. Serum sTREM-1 and CXCL-16 Levels in Children with Mycoplasma pneumoniae Pneumonia and Their Diagnostic Value. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:7179796. [PMID: 34691220 PMCID: PMC8528593 DOI: 10.1155/2021/7179796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/18/2021] [Indexed: 11/19/2022]
Abstract
Mycoplasma pneumoniae pneumonia (MPP) is an acute respiratory tract infection caused by Mycoplasma pneumoniae. It is characterized by severe symptoms, long course of disease, many intrapulmonary complications, and poor therapeutic effect. In recent years, the incidence of Mycoplasma infection have been gradually rising trend, and the children's own immune system development is not mature, cases differences, children with mild can only show the upper respiratory tract infection, and critically ill children can lead to lung infection and even lead to multiple organ dysfunction, affect life and health of children. Soluble triggering receptors expressed on myeloid cell-1 (sTREM-1) is a subtype secreted by myeloid cell trigger receptor-1, which is released into blood in large amounts when the body is infected, and is a newly discovered inflammatory indicator in recent years. CXC chemokine 16 (CXCL-16) can recruit lymphocytes by chemotaxis through binding to its receptor CXCR6 to participate in the body's immune regulation. The purpose of this study was to investigate serum sTREM-1 and CXCL-16 levels in children with MPP and to analyze their correlation with the disease and diagnostic value. The results showed that the serum levels of sTREM-1 and CXCL-16 were increased in children with Mycoplasma. Serum levels of sTREM-1 and CXCL-16 were positively correlated with the severity of the disease. sTREM-1 combined with CXCL-16 has an important value in the diagnosis of children with MPP.
Collapse
Affiliation(s)
- Chengchao Fang
- Department of Pediatrics, The First People's Hospital of Yuhang, Yuhang District, Hangzhou, Zhejiang 311100, China
| | - Yueyan Mao
- Department of Pediatrics, The First People's Hospital of Yuhang, Yuhang District, Hangzhou, Zhejiang 311100, China
| | - Mingfen Jiang
- Department of Hemodialysis Center, The First People's Hospital of Yuhang, Yuhang District, Hangzhou, Zhejiang 311100, China
| | - Wei Yin
- Department of Pediatrics, The First People's Hospital of Yuhang, Yuhang District, Hangzhou, Zhejiang 311100, China
| |
Collapse
|
20
|
Huang F, Fan H, Yang D, Zhang J, Shi T, Zhang D, Lu G. Ribosomal RNA‑depleted RNA sequencing reveals the pathogenesis of refractory Mycoplasma pneumoniae pneumonia in children. Mol Med Rep 2021; 24:761. [PMID: 34476502 PMCID: PMC8436218 DOI: 10.3892/mmr.2021.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/28/2021] [Indexed: 11/24/2022] Open
Abstract
Pneumonia caused by Mycoplasma pneumoniae (M. pneumoniae) is a major cause of community-acquired pneumonia in children. In some cases, M. pneumoniae pneumonia (MPP) can develop into refractory MPP (RMPP), which shows no clinical or radiological response to macrolides, and can progress to severe and complicated pneumonia. However, the pathogenesis of RMPP remains poorly understood. The present study aimed to identify target genes that could be used as biomarkers for the clinical diagnosis of early-stage RMPP through high-throughput sequencing technology. The differences in long non-coding (lnc)RNAs, mRNAs and circular (circ)RNAs were examined between whole-blood samples from two patients with non-refractory MPP (NRMPP), two patients with RMPP and three healthy children using ribosomal (r)RNA-depleted RNA-sequencing techniques and an integrated mRNA/circRNA analysis. A total of 17 lncRNAs (four upregulated and 13 downregulated), 18 mRNAs (six upregulated and 12 downregulated) and 24 circRNAs (12 upregulated and 12 downregulated) were the most significantly differentially expressed (P<0.05) between the NRMPP and RMPP groups. Upon functional analysis, the significantly differentially expressed genes encoded by the targeting mRNAs (prostaglandin-endoperoxide synthase 2, IL-8 and fos-like antigen 1) were screened and identified to be enriched in the ‘IL-17 signaling pathway’. Furthermore, the key circRNAs in the NRMPP and RMPP comparative groups were primarily enriched in ‘herpes simplex virus 1 infection’, ‘viral carcinogenesis’ and ‘RNA transport’. In the present study, a comprehensive analysis of the differences between the NRMPP and RMPP cases was performed based on rRNA-depleted RNA-sequencing techniques, and the selected genes and circRNAs may be closely associated with the complex pathogenesis of RMPP.
Collapse
Affiliation(s)
- Feng Huang
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Huifeng Fan
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Diyuan Yang
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Junsong Zhang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
| | - Tingting Shi
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Dongwei Zhang
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| | - Gen Lu
- Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China
| |
Collapse
|
21
|
Su M, Wang Q, Li D, Wang LL, Wang CY, Wang JL, Zhang Q, Du LY, Liu JY, Xie GC. Prevalence and clinical characteristics of hospitalized children with community-acquired Mycoplasma pneumoniae pneumonia during 2017/2018, Chengde, China. Medicine (Baltimore) 2021; 100:e23786. [PMID: 33592835 PMCID: PMC7870167 DOI: 10.1097/md.0000000000023786] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 11/13/2020] [Indexed: 01/05/2023] Open
Abstract
Community acquired-pneumonia (CAP) has varying causative pathogens and clinical characteristics. This study investigated the prevalence of Mycoplasma pneumoniae (M pneumoniae) and evaluated the clinical characteristics in infected hospitalized children by disease severity.From throat swabs of hospitalized children (5 months to 14 years) with CAP collected between November 2017 and May 2018, M pneumoniae and other CAP pathogens were identified using polymerase chain reaction (PCR). Differences in clinical and laboratory test data were compared between severe and mild case groups.Of 333 hospitalized children enrolled, 221/333 (66.4%) tested positive for M pneumoniae and 24/221 (10.9%) patients were (n = 9, aged <5 years vs n = 15, ≥5 years) single infection by PCR, however, only 170/333 (51.1%) patients were presented with M pneumoniae IgM-positive. M pneumoniae detection rate by PCR was higher than by immunoglobulin (IgM) serology. In 123/221 (55.7%) M pneumoniae infected patients, coinfection with bacterial pathogens (n = 61, <5 years vs n = 62, ≥5 years) occurred. Children (aged 3-8 years) had most M pneumoniae infection. Severe M pneumoniae pneumonia (MPP) in children occurred mostly in older age (7 [interquartile ranges {IQR}, 6-8] years; P < .0001), with longer cough days (14 [IQR, 10-19.5] days; P = .002) and hospitalization duration (9.5 [IQR, 7-12.3] days; P < .0001), lower lymphocyte ratio (24.1, [IQR, 20.0-31.1] %; P = .001), higher neutrophils ratio (66.0, [IQR, 60.2-70.3]%; P < .0001), and serum C-reactive protein (CRP) level (3.8, [IQR, 1.3-10.9] mg/L; P = .027).M pneumoniae is the most commonly detected pathogen in CAP. High coinfection prevalence increases diagnosis difficulty by clinically nonspecific characteristics. M pneumoniae detection by PCR with IgM may improve precise and reliable diagnosis of community-acquired MPP.
Collapse
Affiliation(s)
- Meng Su
- Department of Pathogenic Biology
| | - Qian Wang
- Department of Respiratory, Children′s Hospital of Hebei Province, Shijiazhuang
| | - Dan Li
- Department of Pathogenic Biology
| | - Ling-Ling Wang
- Department of Preventive Medicine, Chengde Medical University
| | - Chun-Yang Wang
- Clinical Medical College, Xi’an Medical University, Xi’an
| | - Jiang-Li Wang
- Chengde Center for Disease Control and Prevention, Department of Microbiology Laboratory
| | - Qing Zhang
- Chinese Center for Viral Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing
| | | | - Jian-Ying Liu
- Department of Pediatrics, NO.2 Clinical Teaching Hospital Affiliated to Chengde Medical University, Chengde, China
| | | |
Collapse
|
22
|
Mycoplasma pneumoniae may cause dyspnoea and hospitalisations in young healthy adults. Eur J Clin Microbiol Infect Dis 2021; 40:1427-1431. [PMID: 33532945 PMCID: PMC7854024 DOI: 10.1007/s10096-021-04171-z] [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: 08/25/2020] [Accepted: 01/24/2021] [Indexed: 11/26/2022]
Abstract
Polymerase chain reaction (PCR)-based diagnostics for Mycoplasma pneumoniae (M. pneumoniae) from the respiratory tract has become widely available, but the interpretation of the results remains unclear. M. pneumoniae has been suggested to cause mainly mild and self-limiting infections or asymptomatic carriage. However, systematic analyses of the association between PCR results and clinical findings are scarce. This study aimed to clarify the clinical features of PCR-positive M. pneumoniae infections in a hospital setting. We reviewed 103 PCR-positive patients cared for in a university hospital during a 3-year period. Data on age, sex, health condition, acute symptoms, other pathogens found, laboratory and X-ray results and treatments were collected. Over 85% of the patients had a triad of typical symptoms: fever, cough and shortness of breath. Symptoms in the upper respiratory tract were rare. In 91% of the cases, M. pneumoniae was the only pathogen found. The highest incidence was found in the age group of 30–40 years, and 68% of the patients did not have any underlying diseases. Most patients were initially empirically treated with beta-lactam antibiotics and needed 2–4 changes in their treatment. Only 6% were discharged without an antibiotic effective against M. pneumoniae. This study shows that M. pneumoniae often led to hospitalisation and that patients needed appropriate antimicrobial treatment to recover. Mixed infections were rare, and situations that could be interpreted as carriage did not occur.
Collapse
|
23
|
Chen J, Ji F, Yin Y, Yuan S. Time to Mycoplasma Pneumoniae RNA Clearance for Wheezy vs. Non-Wheezy Young Children with Community-Acquired Pneumonia. J Trop Pediatr 2021; 67:6020104. [PMID: 33274390 DOI: 10.1093/tropej/fmaa109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We sought to investigate the dynamics of Mycoplasma pneumoniae (Mp) RNA in hospitalized young children with community-acquired pneumonia (CAP) and to explore whether Mp RNA clearance differed for wheezy and non-wheezy group after the onset of azithromycin treatment. METHODS We included hospitalized young children (1-72 months of age) with CAP caused by Mp infection. Mp RNA was detected as soon as the patient was admitted and the dynamics of Mp-RNA were monitored after the beginning of azithromycin treatment on Days 4, 7, 14 and 28. RESULTS Among 40 hospitalized young children with Mycoplasma pneumoniae pneumonia (Mpp), 16 had wheezing. Time to first positive Mp-RNA confirmation after symptom onset of Mpp was similar for the wheezy group (median 7 days, interquartile range 7-10.5) and the non-wheezy group (median 7 days, interquartile range 5.8-8.3). The duration of positive Mp-RNA detection after the onset of azithromycin treatment was shorter among the wheezy group than in the non-wheezy group (median 4 vs. 7 days; hazard ratio 2.083; 95% confidence interval: 1.023-4.244). CONCLUSIONS Mp-RNA clearance was significantly faster among Mpp young children with wheezing than in those without wheezing after the onset of azithromycin treatment.Lay summaryWe sought to investigate the dynamics of Mycoplasma pneumoniae (Mp) RNA in hospitalized young children with community-acquired pneumonia and to explore whether Mp RNA clearance differed for wheezy and non-wheezy group after the onset of azithromycin treatment. Our study suggested that Mp-RNA clearance was significantly faster among Mycoplasma pneumoniae pneumonia young children with wheezing than in those without wheezing after the onset of azithromycin treatment.
Collapse
Affiliation(s)
- Jiande Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai 200127, China
| | - Fengjuan Ji
- Department of Respiratory Medicine, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai 200127, China.,Department of Neonatology, Women's Hospital School of Medicine, Zhejiang University, Shangcheng, Hangzhou, Zhejiang 310006, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai 200127, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai 200127, China
| |
Collapse
|
24
|
Tang X, Dai G, Jiang X, Wang T, Sun H, Chen Z, Huang L, Wang M, Zhu C, Yan Y, Jiang W. Clinical Characteristics of Pediatric Respiratory Tract Infection and Respiratory Pathogen Isolation During the Coronavirus Disease 2019 Pandemic. Front Pediatr 2021; 9:759213. [PMID: 35071128 PMCID: PMC8767000 DOI: 10.3389/fped.2021.759213] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: We sought to compare the clinical characteristics of pediatric respiratory tract infection and respiratory pathogen isolations during the coronavirus disease (COVID-19) pandemic to those of cases in 2018 and 2019. Methods: Our study included all children from 28 days to 15 years old with respiratory tract infections who were admitted to the Department of Respiration, in the Children's Hospital of Soochow University, between January 2018 and December 2020. Human rhinovirus (HRV) and human metapneumovirus (hMPV) were detected by reverse transcription polymerase chain reaction (RT-PCR). Mycoplasma pneumoniae (MP) and human bocavirus (HBoV) were detected by real-time fluorescence quantitative polymerase chain reaction (qPCR); In parallel, Mycoplasma pneumoniae was detected by enzyme-linked immunosorbent assays, and bacteria were detected by culture in blood, bronchoalveolar lavage specimen, and pleural fluid. Results: Compared to 2018 and 2019, the pathogen detection rate was significantly lower in 2020. With regard to infections caused by single pathogens, in 2020, the detection rates of MP were the lowest and those of HRV were the highest when compared to those in 2018 and 2019. Meanwhile, the positive rates of respiratory syncytial virus (RSV) and hMPV reported in 2020 were less than those recorded in 2018 but similar to those recorded in 2019. Also, the 2020 rate of adenovirus (ADV) was lower than that recorded in 2019, but similar to that recorded in 2018. There were no statistical differences in the positive rates of HBoV and PIV III over the 3 years surveyed. Infections in infants were significantly less common in 2020, but no significant difference was found among children aged 1 to 3 years. The detection rate of pathogens in children old than 5 years in 2020 was significantly lower than those recorded in the previous 2 years. Notably, the pathogen detection rates in the first and second quarters of 2020 were similar to those recorded in the previous 2 years; however, the rates were reduced in the third and fourth quarters of 2020. As for co-infections, the positive rate was at its lowest in 2020. In the previous 2 years, viral-MP was the most common type of mixed infection. By contrast, in 2020, viral-viral infections were the most common combination. Conclusion: The pathogen detection rate was significantly reduced in Suzhou City during the COVID-19 pandemic. Public interventions may help to prevent respiratory pathogen infections in children.
Collapse
Affiliation(s)
- Xifeng Tang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Ge Dai
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Xiaohui Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Ting Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Huiming Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Li Huang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Canhong Zhu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Wujiang District, Children's Hospital of Soochow University, Suzhou, China
| |
Collapse
|
25
|
Wang J, Xia C, Sharma A, Gaba GS, Shabaz M. Chest CT Findings and Differential Diagnosis of Mycoplasma pneumoniae Pneumonia and Mycoplasma pneumoniae Combined with Streptococcal Pneumonia in Children. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8085530. [PMID: 34221302 PMCID: PMC8219438 DOI: 10.1155/2021/8085530] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/22/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In this day and age, 17% of children less than 5 years of age died of pneumonia; it is the common cause of children death. It is one of the main children respiratory infectious diseases, i.e., mycoplasma pneumonia (MP). The imaging examination can be adopted to quickly observe the morphology and scope of the pulmonary lesions and know the effect of disease treatment and subsequent changes in the disease in order to provide a basis for treatment. Therefore, the most commonly applied technology for detecting pneumonia in children is imaging technology, including chest X-ray and CT. OBJECTIVES The main objective of the work is to investigate the chest computed tomography (CT) findings of children patients with Mycoplasma pneumoniae pneumonia (MPP) and MP combined with streptococcal pneumonia (SP). The mixed infection of MP and SP is very common clinically, and the diagnosis of this type of mixed pneumonia is a critical research topic faced by pediatric respiratory physicians. The comparison is done on the incidence of bronchial and pulmonary interstitial lesions, the degree of lymph node enlargement, the volume and depth of pleural effusion, and the location and morphology of the pulmonary lesions in the chest CT images of children patients from the two groups. METHODS There were comparisons on the incidence of bronchial and pulmonary interstitial lesions, the degree of lymph node enlargement, the volume and depth of pleural effusion, and the location and morphology of the pulmonary lesions in the chest CT images of children patients from the two groups. All the experiments are done in the MATLAB. RESULTS The results showed that the proportions of reticular shadow, ground glass shadow, bronchial inflation phase, tube wall thickening, and vascular bundle thickening on the CT images of children patients from the MPP group were dramatically higher than those of the MP + SP group (P < 0.05). The maximum transverse diameter of enlarged lymph node in children patients from the MPP group was obviously larger than the diameter of the MP + SP group (P < 0.05). The number of children patients with pleural effusion was 22 in the MP + SP group, which was greatly higher than the MPP group (P < 0.05). CONCLUSION In conclusion, the chest CT images of children patients from the MPP group were mainly pulmonary interstitial changes. Furthermore, the alveolar inflammation could be observed on the CT images shown when children patients were combined with SP infection. The more obvious manifestations were that the flaky shadows appeared in the lungs, the pleural effusion became thicker, and the transverse diameters of enlarged lymph nodes were bigger.
Collapse
Affiliation(s)
- Jing Wang
- 1Department of Infectious Diseases, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, China
| | - Chen Xia
- 1Department of Infectious Diseases, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, China
| | - Ashutosh Sharma
- 2Institute of Computer Technology and Information Security, Southern Federal University, Rostov-on-Don, Russia
| | - Gurjot Singh Gaba
- 3School of Electronics and Electrical Engineering, Lovely Professional University, Phagwara 144411, India
| | | |
Collapse
|
26
|
Abstract
The major pathogens that cause atypical pneumonia are Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Community-acquired pneumonia (CAP) caused by M. pneumoniae or C. pneumoniae is common in children and presents as a relatively mild and self-limiting disease. CAP due to L. pneumophila is very rare in children and progresses rapidly, with fatal outcomes if not treated early. M. pneumoniae, C. pneumoniae, and L. pneumophila have no cell walls; therefore, they do not respond to β-lactam antibiotics. Accordingly, macrolides, tetracyclines, and fluoroquinolones are the treatments of choice for atypical pneumonia. Macrolides are the first-line antibiotics used in children because of their low minimum inhibitory concentrations and high safety. The incidence of pneumonia caused by macrolide-resistant M. pneumoniae that harbors point mutations has been increasing since 2000, particularly in Korea, Japan, and China. The marked increase in macrolide-resistant M. pneumoniae pneumonia (MRMP) is partly attributed to the excessive use of macrolides. MRMP does not always lead to clinical nonresponsiveness to macrolides. Furthermore, severe complicated MRMP responds to corticosteroids without requiring a change in antibiotic. This implies that the hyper-inflammatory status of the host can induce clinically refractory pneumonia regardless of mutation. Empirical macrolide therapy in children with mild to moderate CAP, particularly during periods without M. pneumoniae epidemics, may not provide additional benefits over β-lactam monotherapy and can increase the risk of MRMP.
Collapse
Affiliation(s)
- Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University of Medicine, Seoul, Korea
| |
Collapse
|
27
|
Deep Vein Thrombosis and Pulmonary Embolism in the Setting of Mycoplasma Infection. Case Rep Med 2020; 2020:8708417. [PMID: 32963546 PMCID: PMC7490632 DOI: 10.1155/2020/8708417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 11/17/2022] Open
Abstract
Thirteen-year-old female twins presented one week apart with documented Mycoplasma pneumoniae respiratory infection. Each developed venous thrombosis and pulmonary emboli in association with transient self-limited para-infectious anti-phospholipid antibodies. Comprehensive evaluation revealed no identifiable genetic prothrombotic variables. Both children recovered after receiving antibiotics and anticoagulation therapy. Thrombotic complications associated with Mycoplasma pneumoniae infections are rare, particularly in children; the occurrence of this complication in identical twins has not been previously reported.
Collapse
|
28
|
Zhou Y, Wang J, Chen W, Shen N, Tao Y, Zhao R, Luo L, Li B, Cao Q. Impact of viral coinfection and macrolide-resistant mycoplasma infection in children with refractory Mycoplasma pneumoniae pneumonia. BMC Infect Dis 2020; 20:633. [PMID: 32847534 PMCID: PMC7447613 DOI: 10.1186/s12879-020-05356-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023] Open
Abstract
Background Cases of refractory Mycoplasma pneumoniae pneumonia have been increasing recently; however, whether viral coinfection or macrolide-resistant M. infection contribute to the development of refractory M. pneumoniae pneumonia remains unclear. This study aimed to investigate the impacts of viral coinfection and macrolide-resistant M. pneumoniae infection on M. pneumoniae pneumonia in hospitalized children and build a model to predict a severe disease course. Methods Nasopharyngeal swabs or sputum specimens were collected from patients with community-acquired pneumonia meeting our protocol who were admitted to Shanghai Children’s Medical Center from December 1, 2016, to May 31, 2019. The specimens were tested with the FilmArray Respiratory Panel, a multiplex polymerase chain reaction assay that detects 16 viruses, Bordetella pertussis, M. pneumoniae, and Chlamydophila pneumoniae. Univariate and multivariate logistic regression models were used to identify the risk factors for adenovirus coinfection and macrolide-resistant mycoplasma infection. Results Among the 107 M. pneumoniae pneumonia patients, the coinfection rate was 56.07%, and 60 (60/107, 56.07%) patients were infected by drug-resistant M. pneumoniae. Adenovirus was the most prevalent coinfecting organism, accounting for 22.43% (24/107). The classification tree confirmed that viral coinfection was more common in patients younger than 3 years old. Adenovirus coinfection and drug-resistant M. pneumoniae infection occurred more commonly in patients with refractory M. pneumoniae pneumonia (P = 0.019; P = 0.001). A prediction model including wheezing, lung consolidation and extrapulmonary complications was used to predict adenovirus coinfection. The area under the receiver operating characteristic curve of the prediction model was 0.795 (95% CI 0.679–0.893, P < 0.001). A prolonged fever duration after the application of macrolides for 48 h was found more commonly in patients infected by drug-resistant M. pneumoniae (P = 0.002). A fever duration longer than 7 days was an independent risk factor for drug-resistant Mycoplasma infection (OR = 3.500, 95% CI = 1.310–9.353, P = 0.012). Conclusions The occurrence of refractory M. pneumoniae pneumonia is associated with adenovirus coinfection and infection by drug-resistant M. pneumoniae. A prediction model combining wheezing, extrapulmonary complications and lung consolidation can be used to predict adenovirus coinfection in children with M. pneumoniae pneumonia. A prolonged fever duration indicates drug-resistant M. pneumoniae infection, and a reasonable change in antibiotics is necessary.
Collapse
Affiliation(s)
- Yajuan Zhou
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Wang
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenjuan Chen
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Nan Shen
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yue Tao
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruike Zhao
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lijuan Luo
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Biru Li
- Department of Critical Care Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Qing Cao
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| |
Collapse
|
29
|
Jiang Q, Yang F, Peng Y, Dong X, Ge Y. Epidemiology and molecular identification of mycoplasma pneumoniae associated with respiratory infections in Zhejiang province, China, 2008-2017. J Clin Lab Anal 2020; 34:e23460. [PMID: 32666532 PMCID: PMC7676177 DOI: 10.1002/jcla.23460] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 01/09/2023] Open
Abstract
Introduction Mycoplasma pneumoniae is a common cause of respiratory infections in humans. The aim of this study was to investigate the infection of Mycoplasma pneumoniae (MP) in patients with acute respiratory tract infections in Zhejiang Province from 2008 to 2017, and to provide evidence for the early diagnosis and prevention of MP pneumonia. Methods MP‐DNA was detected in nasopharyngeal swabs of patients with acute respiratory tract infection by real‐time fluorescent PCR (TaqMan probe). Statistical analysis and epidemiological investigation were carried out on the test results. Results There were 10 296 patients with acute respiratory tract infection in Zhejiang Provincial People's Hospital from 2008 to 2017, including 4387 females and 5909 males. A total of 1251 MP‐DNA–positive patients were detected, with a total positive rate of 12.2% (1251/10296). Among 1251 patients with MP infection, 571 were female positive, with an average positive rate of 13.0% (571/4387), and 680 were male positive, with a positive rate of 11.5% (680/5909). From 2008 to 2017, the positive rates were 22.8% (33 cases), 20.9% (211 cases), 20.9% (350 cases), 5.5% (70 cases), 11.7% (136 cases), 15.2% (190 cases), 7.8% (94 cases), 5.9% (62 cases), 7.8% (56 cases), and 6.0% (49 cases), respectively. Of 1251 MP‐DNA–positive patients, 1243 (99.4%) were younger than 18 years old. Conclusions Mycoplasma pneumoniae infection mainly occurs from late summer to autumn and in the age below 18 years, suggesting that early diagnosis and prevention of MP infection in adolescents should be emphasized.
Collapse
Affiliation(s)
- Qian Jiang
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.,Department of Laboratory Center, Huamei Hospital, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), Ningbo, China
| | - Fangfang Yang
- School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, China
| | | | - XiaoYan Dong
- The Second Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yumei Ge
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| |
Collapse
|
30
|
Zha L, Shen J, Tefsen B, Wang Y, Lu W, Xu Q. Clinical features and outcomes of adult COVID-19 patients co-infected with Mycoplasma pneumoniae. J Infect 2020; 81:e12-e15. [PMID: 32652163 PMCID: PMC7342079 DOI: 10.1016/j.jinf.2020.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Lei Zha
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, Jiangsu 215123, China; Institute of Infection and Global Health, University of Liverpool, L69 7BE Liverpool, UK
| | - Jian Shen
- Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Street, Jiang,an District, Wuhan, Hubei 430014, China
| | - Boris Tefsen
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, Jiangsu 215123, China
| | - Yujun Wang
- Department of Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Street, Jiang,an District, Wuhan, Hubei 430014, China.
| | - Weihua Lu
- Department of Critical Care Medicine, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), No. 2, West road of Zheshan, Jinghu District, Wuhu, Anhui 241000, China.
| | - Qiancheng Xu
- Department of Critical Care Medicine, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), No. 2, West road of Zheshan, Jinghu District, Wuhu, Anhui 241000, China.
| |
Collapse
|
31
|
Chen L, Chen J, Ramesh T, Seshadri VD, Zhu L. Zinc oxide nanoparticles from Corydalis yanhusuo attenuated the mycoplasmal pneumonia in mice through inhibiting the MAPKs signaling pathway. Microb Pathog 2020; 147:104270. [PMID: 32446872 DOI: 10.1016/j.micpath.2020.104270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Mycoplasma pneumoniae (M.pneumoniae) was accounted to 3-10% of total pneumonia incidences. In recent decades, metallic nanoparticles were extensively examined as nano-antibiotics. OBJECTIVE In this investigation, we intended to inspect the therapeutic potential of Zinc oxide nanoparticles (ZnONPs) from (Corydalis yanhusuo) C. yanhusuo against the mycoplasma infected pneumonia in mice. METHODOLOGY The ZnONPs were formulated via green route technique and characterized by UV-vis spectroscopy, transmission electron microscopy, Fourier transform infrared technique, and atomic force microscopy. The antimicrobial activity of formulated ZnONPs was tested by well diffusion method. The total protein, interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-α) and transforming growth factor (TGF) status in the BALF of M. pneumonia infected animals were investigated via kit method. The expressions of ERK1/2, JNK1/2, and NF-κB were examined through the Western blotting. The Histopathological analysis of lung tissues of experimental animals was done. RESULTS The UV-vis spectroscopy and TEM examinations were proved the existence of CY-ZnONPs. The formulated CY-ZnONPs were displayed the potential antimicrobial activity. The supplementation of CY-ZnONPs were noticeably diminished the total protein and IL-6, IL-8, and TNF-α levels in the BALF of pneumonia mice. The ERK1/2, JNK1/2, and NF-κB expressions were appreciably diminished in the CY-ZnONPs supplemented mice. It also reduced the inflammatory cells penetration, and exhibited normal tissue arrangements in the lung tissues of pneumonia mice. CONCLUSION The findings of this investigation were proved that the synthesized CY-ZnONPs has the potential to ameliorate the M. pneumoniae infected pneumonia in investigational mice.
Collapse
Affiliation(s)
- Liang Chen
- Department of Infectious Disease, Beijing Jishuitan Hospital, 4 Th Medical College of Peking University, Beijing, 100096, China.
| | - Jun Chen
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, 210008, China
| | - Thiyagarajan Ramesh
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Vidya Devanathadesikan Seshadri
- Department of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Limei Zhu
- Department of Chronic Disease and Infectious Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China
| |
Collapse
|
32
|
Bonagiri P, Park D, Ingebritsen J, Christie LJ. Seropositive anti-MOG antibody-associated acute disseminated encephalomyelitis (ADEM): a sequelae of Mycoplasma pneumoniae infection. BMJ Case Rep 2020; 13:13/5/e234565. [PMID: 32434879 DOI: 10.1136/bcr-2020-234565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Acute disseminated encephalomyelitis (ADEM) is a demyelinating, autoimmune disease of the central nervous system (CNS). It causes motor and sensory deficits, altered mental status and other neurological symptoms. Though rarely fatal, it has been associated with residual motor and neurocognitive deficits. Our case consisted of a 4-year-old girl who presented with fatigue and unsteady gait after a respiratory illness. During her hospital course, she became progressively weaker and experienced seizures. Imaging showed sections of demyelination in the CNS, and appropriate treatment was started. Additional labs resulted in positive Mycoplasma pneumoniae serum serology. Antimyelin oligodendrocyte glycoprotein (anti-MOG) antibodies were also found, which is a risk factor for relapsing, multiphasic ADEM. To our knowledge, this is the first case of anti-MOG antibody-associated ADEM due to M. pneumoniae infection. Our patient has made a complete recovery. The parents only report slightly increased fatigue and irritability.
Collapse
Affiliation(s)
- Pranay Bonagiri
- Department of Medicine, Touro University California College of Osteopathic Medicine, Vallejo, California, USA
| | - Daniel Park
- Department of Medicine, Touro University California College of Osteopathic Medicine, Vallejo, California, USA
| | - Joanna Ingebritsen
- Department of Family Medicine, Kaiser Permanente Vallejo Medical Center, Vallejo, California, USA
| | - Laura J Christie
- Department of Pediatric Infectious Disease, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
| |
Collapse
|
33
|
Li QL, Dong HT, Sun HM, Zhang XX, Gu WJ, Huang L, Wang YQ, Yan YD, Ji W, Hao CL, Zhu CH, Chen ZR. The diagnostic value of serological tests and real-time polymerase chain reaction in children with acute Mycoplasma pneumoniae infection. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:386. [PMID: 32355830 PMCID: PMC7186703 DOI: 10.21037/atm.2020.03.121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background This study set out to evaluate the clinical significance and diagnostic effectiveness of serological tests and real-time polymerase chain reactions (RT-PCR) in children of different age groups and disease durations infected with Mycoplasma pneumoniae (MP). Methods Pediatric patients with lower respiratory tract infection (LRTI) confirmed by polymerase chain reaction (PCR) were enrolled and subjected to bronchoalveolar lavage fluid PCR (BALF-PCR) for MP infection. The diagnostic values of the serum immunoglobulin M (IgM) test, paired sera immunoglobulin G (IgG) test, RT PCR applied to nasopharyngeal aspirates (NPA-PCR), and combined IgM and NPA-PCR test were evaluated. Results When BALF PCR was used as the gold standard, the MP positivity rate of combined IgM and NPA PCR was 78.85%in children aged 3–5 years. The positivity rates of IgM, NPA PCR, and combined IgM and NPA PCR in children older than 5 years were 71.21%, 72.72%, and 84.85%, respectively. The detection rate of combined IgM and NPA PCR was consistent with BALF PCR (Kappa =0.727). The MP positivity rates of combined IgM and NPA PCR at 1–2 weeks was as high as 91.11%, and was consistent with the BALF PCR (Kappa =0.756). Moreover, the positivity rates of IgM or NPA PCR at 2-3 weeks were 63.16%, and were consistent with each other (Kappa =0.771). Conclusions Combined IgM and NPA PCR is the optimal test to confirm MP infection among children aged 3–5 years in cases with a disease duration of less than2 weeks, and either NPA PCR or IgM is recommended for children older than 5 years with a disease duration of 2–3 weeks. Keywords Mycoplasma pneumoniae pneumonia (MPP); diagnosis; children; age; disease duration
Collapse
Affiliation(s)
- Qing-Ling Li
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China.,The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, China
| | - He-Ting Dong
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Hui-Ming Sun
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Xin-Xing Zhang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Wen-Jing Gu
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Li Huang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Yu-Qing Wang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Yong-Dong Yan
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Wei Ji
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Chuang-Li Hao
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Can-Hong Zhu
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| | - Zheng-Rong Chen
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou 215003, China
| |
Collapse
|
34
|
Meta-analysis of the Clinical Efficacy and Safety of High- and Low-dose Methylprednisolone in the Treatment of Children With Severe Mycoplasma Pneumoniae Pneumonia. Pediatr Infect Dis J 2020; 39:177-183. [PMID: 31738328 DOI: 10.1097/inf.0000000000002529] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mycoplasma pneumoniae pneumonia is generally a self-limiting disease, but it can develop into severe Mycoplasma pneumoniae pneumonia (SMPP). Immunologic mechanisms are thought to play an important role in the pathogenesis of SMPP. Therefore, the use of systemic glucocorticoids may have beneficial effects. However, to date, the use of glucocorticoid therapy in SMPP is limited to small case series, and the glucocorticoid dosage for children with SMPP has not been established. METHODS Here, we used a meta-analysis method to collect data from randomized control trials of different doses of methylprednisolone in SMPP to assess the safety and efficacy of treatment with low- versus high-dose methylprednisolone in children with SMPP. RESULTS We included 13 Chinese randomized control trials that included 1049 children. The high- and low-dose groups were comprised of 524 and 525 children, respectively. The high-dose group was significantly more effective than the low-dose group in clinical efficacy [risk ratio = 1.30, 95% confidence interval (CI) (1.23, 1.38), P < 0.05]. In addition, compared with low-dose methylprednisolone, high-dose methylprednisolone significantly shortened hospital stays and antipyretic therapy, pulmonary rales disappearance, cough disappearance and pulmonary shadow absorption times. There was no significant difference in adverse events between the high- and low-dose groups: risk ratio= 0.85, 95% CI (0.53, 1.36), P > 0.05. CONCLUSIONS We conclude that high-dose methylprednisolone is effective in the treatment of SMPP without increasing the incidence of adverse reactions.
Collapse
|
35
|
Xue G, Li S, Zhao H, Yan C, Feng Y, Cui J, Jiang T, Yuan J. Use of a rapid recombinase-aided amplification assay for Mycoplasma pneumoniae detection. BMC Infect Dis 2020; 20:79. [PMID: 31992210 PMCID: PMC6988361 DOI: 10.1186/s12879-019-4750-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/28/2019] [Indexed: 12/29/2022] Open
Abstract
Background Mycoplasma pneumoniae is one of the most common causative pathogens of community-acquired pneumonia (CAP), accounting for as many as 30–50% of CAP during peak years. An early and rapid diagnostic method is key for guiding clinicians in their choice of antibiotics. Methods The recombinase-aided amplification (RAA) assay is a recently developed, rapid detection method that has been used for the detection of several pathogens. The assays were performed in a one-step single tube reaction at 39° Celsius within 15–30 min. In this study, we established an RAA assay for M. pneumoniae using clinical specimens for validation and commercial real-time PCR as the reference method. Results The analytical sensitivity of the RAA assay was 2.23 copies per reaction, and no cross-reactions with any of the other 15 related respiratory bacterial pathogens were observed. Compared with the commercial real-time PCR assay used when testing 311 respiratory specimens, the RAA assay obtained 100% sensitivity and 100% specificity with a kappa value of 1. Conclusions These results demonstrate that the proposed RAA assay will be of benefit as a faster, sensitive, and specific alternative tool for the detection of M. pneumoniae.
Collapse
Affiliation(s)
- Guanhua Xue
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China
| | - Shaoli Li
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China
| | - Hanqing Zhao
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China
| | - Chao Yan
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China
| | - Yanling Feng
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China
| | - Jinghua Cui
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China
| | - Tingting Jiang
- Department of Obstetrics, Southern District of the Fifth Medical Center of PLA General Hospital, No. 8 Dongdajie Road, Fengtai District, Beijing, 100071, China
| | - Jing Yuan
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China.
| |
Collapse
|
36
|
The Prevalence of Atypical Pneumonia Caused by Mycoplasma pneumoniae (P1 gene) in Patients with Respiratory Infections by Culture and Molecular PCR Methods in Tehran, Iran. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.84174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
37
|
Predictive Model for Discrimination of Tuberculous Pleural Effusion From Severe Mycoplasma pneumoniae Pneumonic Effusion in Children. Pediatr Infect Dis J 2019; 38:1100-1103. [PMID: 31626044 DOI: 10.1097/inf.0000000000002438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Tuberculous pleural effusion (TPE) is often misdiagnosed as severe Mycoplasma pneumoniae pneumonic effusion (SMPPE) in children at early stage. The aim of this study was to develop a predictive model based on clinical and laboratory indices to make accurate differential diagnosis. METHODS Patients included in this study were 167 children (83 patients with TPE and 84 with SMPPE), containing 117 patients for predictive model development and 50 patients for external validation. Multivariate logistic regression analysis was conducted to select potentially useful characteristics for discrimination of TPEs. External validation was performed for model evaluation. RESULTS Multivariate analysis revealed that blood neutrophils and serum lactate dehydrogenase were significant independent factors to discriminate between TPEs and SMPPEs. The results indicated that blood neutrophils ≤69.6% and concentration of serum lactate dehydrogenase ≤297 U/L were the extremely important discrimination factors of TPEs. The area under the receiver operating characteristic curve of the model was 0.9839. The accuracy rate, sensitivity and specificity of the model were 94.02%, 98.28% and 89.83%, respectively. Meanwhile, the accuracy rate of the external validation from the 50 patients was 94.0%. CONCLUSIONS Applying a predictive model with clinical and laboratory indices can facilitate the differential diagnosis of TPE from SMPPE in children, which seems helpful when a microbiologic or histologic diagnosis of pleural tuberculosis could not be established.
Collapse
|
38
|
Multiplex Polymerase Chain Reaction Panel for Suspected Pertussis: What About a Positive Mycoplasma pneumoniae Result? Pediatr Infect Dis J 2019; 38:1015-1019. [PMID: 31568140 DOI: 10.1097/inf.0000000000002423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The use of bacterial multiplex polymerase chain reaction (PCR) in children with suspected pertussis sometimes yields unexpected positive results for Mycoplasma pneumoniae. We aimed to evaluate the clinical significance of positive M. pneumoniae results in this population. METHODS Retrospective cohort of consecutive patients with suspected pertussis tested with a bacterial multiplex PCR (including Bordetella pertussis and M. pneumoniae) between June 2015 and March 2017. Medical records were reviewed to compare demographics, clinical presentations and outcomes of patients positive for M. pneumoniae with those positive for B. pertussis and those with negative results, using multivariable logistic regression. RESULTS A total of 1244 patients were included as follows: 56 (4.5%) with M. pneumoniae, 116 (9.3%) with B. pertussis and 1029 (82.7%) with negative results. Mean age was respectively 4.8 years, 6.5 years and 2.8 years (P < 0.05). Children with M. pneumoniae were less likely to present with cardinal symptoms of pertussis such as paroxysmal cough [adjusted odds ratio (OR): 0.19, 95% confidence interval (CI): 0.08-0.40) but were more likely to have fever (adjusted OR: 10.53, 95% CI: 3.54-39.49) and other nonspecific respiratory symptoms compared with children with B. pertussis. Children with M. pneumoniae had very similar clinical presentations to those with a negative PCR, but were more likely to have radiologically confirmed pneumonia (adjusted OR: 5.48, 95% CI: 2.96-9.99) and were less likely to be diagnosed with a concomitant viral infection (adjusted OR: 0.32, 95% CI: 0.07-0.99). CONCLUSIONS In children with suspected pertussis, the detection of M. pneumoniae is clinically relevant. However, the impact of this finding on patients' outcome is still unclear.
Collapse
|
39
|
Laroussi M, Gaillard-Farrugia A, Lamèche D. Syndrome de détresse respiratoire aiguë à Mycoplasma pneumoniae chez un adolescent. ANNALES FRANCAISES DE MEDECINE D URGENCE 2019. [DOI: 10.3166/afmu-2019-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
40
|
Kurkela S, Puolakkainen M, Hokynar K, Nieminen T, Saxen H, Mannonen L, Pietikäinen R. Mycoplasma pneumoniae outbreak, Southeastern Finland, 2017-2018: molecular epidemiology and laboratory diagnostic lessons. Eur J Clin Microbiol Infect Dis 2019; 38:1867-1871. [PMID: 31263967 PMCID: PMC6778538 DOI: 10.1007/s10096-019-03619-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/18/2019] [Indexed: 01/09/2023]
Abstract
This study characterizes a large Mycoplasma pneumoniae outbreak observed in Kymenlaakso in Southeastern Finland during August 2017–January 2018. The first part of the investigation included 327 patients, who sought healthcare consultation at local GPs or hospitals due to clinical symptoms, and were tested for M. pneumoniae antibodies (Patient cohort). The second part of the investigation, conducted approximately 4 weeks after the peak of the outbreak, consisted of school screening of pupils (N = 239) in three different school buildings by PCR on respiratory specimens and questionnaires (Screening cohort). PCR positive respiratory specimens were subsequently utilized for molecular typing. The outbreak peaked in late October 2017. Of the Patient cohort, 9/106 (8.5%) respiratory specimens were PCR positive. In contrast, 3/182 (1.6%) of the Screening cohort were PCR positive. Asymptomatic carriage was observed. Multiple-locus variable-number tandem-repeat analysis (MLVA) identified two distinct MLVA types. All typed M. pneumoniae strains belonged to P1 type 1. No mutations leading to macrolide resistance were observed. In total, 61/327 (19%) of the Patient cohort had a serological indication of recent infection. The IgM test reactivity at the time of a negative PCR test result varied from a completely non-reactive value up to very strong reactivity, highlighting the difficulty in a single specimen serodiagnosis.
Collapse
Affiliation(s)
- Satu Kurkela
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Mirja Puolakkainen
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kati Hokynar
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tea Nieminen
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harri Saxen
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Laura Mannonen
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | |
Collapse
|
41
|
Merida-Vieyra J, Aquino-Andrade A, Palacios-Reyes D, Murata C, Ribas-Aparicio RM, De Colsa Ranero A. Detection of Mycoplasma pneumoniae in Mexican children with community-acquired pneumonia: experience in a tertiary care hospital. Infect Drug Resist 2019; 12:925-935. [PMID: 31118700 PMCID: PMC6503500 DOI: 10.2147/idr.s193076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/29/2019] [Indexed: 01/02/2023] Open
Abstract
Purpose: Mycoplasma pneumoniae is an important cause of community-acquired pneumonia (CAP). Information on the prevalence of M. pneumoniae in pediatric patients with CAP in Mexico is limited. The aim of this study was to detect M. pneumoniae in hospitalized pediatric patients with CAP. Patients and methods: We performed a descriptive study in a tertiary-level pediatric reference center, obtaining 154 respiratory samples from patients under 18 years of age and diagnosed with CAP. M. pneumoniae was detected by real-time polymerase chain reaction (PCR) targeting the p1 and CARDS genes. Complete blood cell count, measurement of C-reactive protein and detection of IgM and IgG anti-P1 were performed. Clinical, epidemiological and radiological data of the patients were analyzed. Results: M. pneumoniae was detected by real-time PCR in 26.6% of the samples. 39% of the cases occurred during the spring season. A total of 83% of the patients with M. pneumoniae had some underlying disease; renal disease, autoimmune disease and primary immunodeficiencies had a significant association with M. pneumoniae CAP. Children under 6 years of age represented 53.7% of the cases. Fever and cough were the most frequent symptoms. IgM and IgG were positive in 1.9% and 14% of the patients, respectively. In the chest X-ray, 17.1% of the patients showed multifocal alveolar infiltrates pattern. The complications in this series were 26.8%. The mortality in this study was 4.9%. Conclusion: This is the first report in Mexico about M. pneumoniae as a causal agent of CAP in a tertiary care pediatric hospital using real-time PCR and serology. M. pneumoniae was responsible for 26.6% of the cases and was frequent in children under 6 years of age. In addition, we described the clinical presentation in patients with underlying diseases.
Collapse
Affiliation(s)
- Jocelin Merida-Vieyra
- Molecular Microbiology Laboratory, Instituto Nacional de Pediatria (INP), Mexico City, Mexico
- Biological Production and Control Laboratory, Escuela Nacional de Ciencias Biológicas, Instituto Politecnico Nacional, Mexico City, Mexico
| | | | | | | | - Rosa Maria Ribas-Aparicio
- Biological Production and Control Laboratory, Escuela Nacional de Ciencias Biológicas, Instituto Politecnico Nacional, Mexico City, Mexico
| | - Agustin De Colsa Ranero
- Molecular Microbiology Laboratory, Department of Pediatric Infectious Diseases, INP, Mexico City, Mexico
| |
Collapse
|
42
|
Haodang L, Lianmei Q, Ranhui L, Liesong C, Jun H, Yihua Z, Cuiming Z, Yimou W, Xiaoxing Y. HO-1 mediates the anti-inflammatory actions of Sulforaphane in monocytes stimulated with a mycoplasmal lipopeptide. Chem Biol Interact 2019; 306:10-18. [PMID: 30965051 DOI: 10.1016/j.cbi.2019.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/24/2019] [Accepted: 04/04/2019] [Indexed: 12/14/2022]
Abstract
Exposure to Mycoplasma pneumoniae leads to lung inflammation through a host defense pathway. Increasing evidence has indicated that the mycoplasma-derived membrane lipoprotein, or its analogue macrophage-activating lipopeptide-2 (MALP-2), excretes LPS as an immune system-stimulating substance and plays a crucial role in pathological injury during M. pneumoniae infection. It has been established that Sulforaphane confers anti-inflammatory properties. However, the underlying mechanism responsible for the inhibitory actions of Sulforaphane in the context of mycoplasmal pneumoniae are poorly understood. Here, we report that Sulforaphane is an inducer of heme oxygenase (HO)-1, a cytoprotective enzyme that catalyzes the degradation of heme through signaling pathways in human monocytes. Sulforaphane stimulated NF-E2-related factor 2 (Nrf2) translocation from the cytosol to the nucleus, and small interfering RNA-mediated knock-down of Nrf2 significantly inhibited Sulforaphane-induced HO-1 expression. Additionally, PI3K/Akt and ROS were also involved in Sulforaphane-induced Nrf2 activation and HO-1 expression, as revealed by the pharmacological inhibitors LY294002 and NAC. Moreover, Sulforaphane treatment inhibited MALP-2-induced pro-inflammatory cytokine secretion and pulmonary inflammation in mice, as well as MALP-2-triggered NF-κB activation. Furthermore, SnPP, a selective inhibitor of HO-1, reversed the inhibitory actions of Sulforaphane, while a carbon monoxide-releasing molecule, CORM-2, caused a significant decrease in MALP-2-induced cytokine secretion. Collectively, these results suggest that Sulforaphane functions as a suppressor of the MALP-2-induced inflammatory response, not only by inhibiting the expression of cytokines and the induction of HO-1 but also by diminishing NF-κB activation in cultured monocytes and the lungs of mice.
Collapse
Affiliation(s)
- Luo Haodang
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China
| | - Qin Lianmei
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China
| | - Li Ranhui
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China
| | - Chen Liesong
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China
| | - He Jun
- Department of Clinical Laboratory, The Affiliated Nanhua Hospital of University of South China, Hengyang, 421001, China
| | - Zeng Yihua
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China
| | - Zhu Cuiming
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China
| | - Wu Yimou
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China
| | - You Xiaoxing
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, 421001, China.
| |
Collapse
|
43
|
Kumar S, Garg IB, Sethi GR. Serological and molecular detection of Mycoplasma pneumoniae in children with community-acquired lower respiratory tract infections. Diagn Microbiol Infect Dis 2019; 95:5-9. [PMID: 31097260 DOI: 10.1016/j.diagmicrobio.2019.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 11/26/2022]
Abstract
This study was designed to evaluate the incidence of Mycoplasma pneumoniae infection in children with community-acquired lower respiratory tract infections (LRTIs). A total of 245 patients 6 months to 12 years of age were investigated for M. pneumoniae employing serological tests, polymerase chain reaction (PCR), nested PCR, and reverse transcription PCR (RT-PCR) on throat swab samples. Forty five (59.2%) children <5 years and 31 (40.7%) children ≥5 years age group were positive for M. pneumoniae infection, and this difference was statistically significant (P ≤ 0.01).Clinical and radiological findings across M.pneumoniae-positive and -negative cases were comparable. Serology, PCR, nested PCR, and RT-PCR together detected M. pneumoniae infection in 76 (31%) patients. Sensitivity, specificity, and positive and negative predictive values of PCR were 16.18%, 95.48%, 57.89%, and 74.78%, respectively, and those of serology were 57.89%, 74.78%, 16.18%, and 95.48%, respectively. Serological and molecular detection in combination is useful for rapid and reliable diagnosis of M. pneumoniae infections in children with LRTIs.
Collapse
Affiliation(s)
- Surinder Kumar
- Department of Microbiology, Maulana Azad Medical College, New Delhi 110002, India.
| | - Indu Bala Garg
- Department of Microbiology, Maulana Azad Medical College, New Delhi 110002, India.
| | - G R Sethi
- Department of Pediatrics, Maulana Azad Medical College, New Delhi 110002, India.
| |
Collapse
|
44
|
Mycoplasma pneumoniae with para-infectious cerebral complications. Respir Med Case Rep 2019; 27:100859. [PMID: 31193705 PMCID: PMC6538952 DOI: 10.1016/j.rmcr.2019.100859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 11/20/2022] Open
Abstract
Mycoplasma pneumoniae infection most commonly manifests as a mild respiratory illness and headache. Pneumonia occurs in approximately 10% of patients with respiratory symptoms. M. pneumoniae infection can also cause neurological and other extrapulmonary complications. In this case report we describe a 33-year-old Caucasian man presenting with headache and raised intracranial pressure, found to be a para-infectious complication of M. pneumoniae infection. Nasopharyngeal PCR was highly useful in facilitating early diagnosis, as IgM antibodies were negative during the early stages of illness. Azithromycin is the preferred agent for M. pneumoniae treatment. The addition of M. pneumoniae PCR to hospitals' rapid respiratory viral PCR panels could promote early directed therapy and antimicrobial stewardship.
Collapse
|
45
|
Wu Y, Duan G, Cheng M, Wu W, Yu Q, Yu D. Comparison of multiple detection methods of Mycoplasma pneumoniae antibody for the early diagnosis of pediatric mycoplasma pneumonia. EUR J INFLAMM 2019. [DOI: 10.1177/2058739219838712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mycoplasma pneumoniae pneumonia (MPP) is a common disease in infants and young children. MPP can also be a potential cause of healthcare-associated pneumonia. However, it is challenging to make an accurate diagnosis in a timely fashion. Our goal is to determine the assay consistencies of acridinium ester chemiluminescence immunoassay (AECLIA) and gelatin particle agglutination (GPA) test for the detection of Mycoplasma pneumoniae (MP) antibody. In this study, a total of 1404 children with suspected MPP were enrolled. Among them, 130 were diagnosed as MPP positive by mycoplasma culture, and 186 were negative. MP antibodies were detected by AECLIA, enzyme-linked immunosorbent assay (ELISA) and GPA. Consistency rates, differences among assays, and diagnosis performance were compared for the three methods. The independent χ2 test results of AECLIA and ELISA for the detection of MP-IgG and MP-IgM antibodies were χ2 = 29.210, P < 0.001; χ2 = 9.081, P = 0.017, respectively, suggesting that the two detection methods are well correlated. Similar analyses were done for the comparison of AECLIA and GPA as well as the comparison of ELISA and GPA. The positive rates of these methods agree with epidemiology data and have good consistency. Thus, AECLIA with a much shorter assay time could be a better option for the screening of MPP.
Collapse
Affiliation(s)
- Yan Wu
- Shenzhen People’s Hospital, Shenzhen, China
| | - Guikai Duan
- Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China
| | | | - Weiqing Wu
- Shenzhen People’s Hospital, Shenzhen, China
| | - Qin Yu
- Zhuhai No. 2 High School, Zhuhai, China
| | - Dapeng Yu
- Shenzhen YHLO Biotech Co., Ltd., Shenzhen, China
| |
Collapse
|
46
|
Review on the laboratory diagnosis of Mycoplasma pneumoniae infection. INFECTION INTERNATIONAL 2018. [DOI: 10.2478/ii-2018-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractMycoplasma pneumoniae(MP) is an important pathogen of community-acquired pneumonia in children. As a type of self-limited disease, most MP infections cause mild clinical symptoms, but they can also lead to severe pneumonia or extrapulmonary complications. The resistance rate of MP has increased in recent years. Early and rapid diagnosis of MP infection is important for the treatment and prognosis of the disease. Current methods for diagnosing MP infection include isolation culture, serological diagnosis, and molecular biological diagnosis. This review summarizes the recent research progress in the internal and external laboratory diagnoses of MP infection both at home and abroad and the advantages and disadvantages of various diagnostic methods.
Collapse
|
47
|
Ameliorative Effects of Infantile Feire Kechuan Oral Solution on Mycoplasma Pneumoniae Pneumonia in Infant Mouse and Rat Models. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:8139040. [PMID: 30305831 PMCID: PMC6166364 DOI: 10.1155/2018/8139040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 08/08/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022]
Abstract
Mycoplasma pneumoniae (MP) infection is a major pathogen of community-acquired pneumonia (CAP) in children worldwide. Infantile Feire Kechuan Oral Solution (IFKOS) has been used for the treatment of MP pneumonia clinically in China for many years. The present study was designed to investigate the therapeutic effect of IFKOS on MP pneumonia and explore the potential mechanism of the actions. The infant BALB/c mouse and Wistar rat models of MP infection were successfully established to confirm the therapeutic effects of IFKOS, followed by assays for related cytokines and investigations of the IgM response involved. The results showed that IFKOS exhibited an inhibitory effect on pulmonary index (PI) and effectively reduced the degree of lesions in the lungs. The lethal rate of mice was significantly decreased while survival time of mice was dramatically increased by IFKOS treatment in comparison to infection control, respectively. IFKOS treatment (40, 20, and 10ml/kg) significantly decreased the level of MP-IgM in a dose-dependent manner, whereas IFKOS showed no obvious inhibitory effect on the increase of relative expression of MP-DNA. In addition, the elevated IL-2 and TNF-α levels were significantly reduced and the decreased IL-6 level was significantly enhanced by IFKOS treatment. Our study demonstrates that IFKOS has inhibitory effect on MP infection in infant mouse and rat models of MP pneumonia and protective effect from lethal MP challenge in infant murine model. These anti-MP effects might be related to suppression of the IgM response and a reversal the imbalance of Th1/Th2 cytokines induced by MP infection.
Collapse
|
48
|
Lin LJ, Chang FC, Chi H, Jim WT, Tsung-Ning Huang D, Kung YH, Huang CY, Chiu NC, Chang L. The diagnostic value of serological studies in pediatric patients with acute Mycoplasma pneumoniae infection. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 53:351-356. [PMID: 30266544 DOI: 10.1016/j.jmii.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/27/2018] [Accepted: 09/02/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mycoplasma pneumoniae is a common pathogen of respiratory tract infections in pediatric patients. Serological studies are traditional methods for the diagnosis. However, early diagnosis of M. pneumoniae infections remains problematic. We investigate the value of early serum immunoglobulin A (IgA), in addition to immunoglobulin G (IgG), and immunoglobulin M (IgM) levels, in children infected with M. pneumoniae. METHODS From August 2016 to February 2017, we enrolled pediatric patients based on both clinical symptoms and chest x-ray, and confirmed by positive throat culture for M. pneumoniae. Serum titers of M. pneumoniae IgM, IgG, and IgA during the acute phase were checked. All respiratory samples were further analyzed by polymerase chain reaction (PCR). Diagnostic values of different tests were evaluated. RESULTS Fifty-six patients fulfilled the diagnostic criteria, with a median age of 4.84 years. Most of them (89.3%) were enrolled within 7 days of disease onset. PCR was positive in 71.4% of the study population. Early IgG samples were of limited value in diagnosing M. pneumoniae infection, of which 89.3% showed a negative result. Positive rates of early serum IgA and IgM were 48.2% and 46.4%, respectively. In combination with IgA and/or IgM, the sensitivity increased to 71.4% during their early clinical course. CONCLUSIONS In the pediatric population, combined serological tests of M. pneumoniae IgA and IgM, offer an accurate method of early diagnosis comparable to that of PCR, and can be an alternative choice for prompt detection of mycoplasma infections when PCR and culture are not available.
Collapse
Affiliation(s)
- Lih-Ju Lin
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Pediatrics, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Fu-Chieh Chang
- Infection Control Center, MacKay Memorial Hospital, College of Management, Yuan Ze University, Taiwan
| | - Hsin Chi
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Wai-Tim Jim
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Daniel Tsung-Ning Huang
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Hsin Kung
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan
| | - Ching-Ying Huang
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
| | - Lung Chang
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
49
|
Valade S, Biard L, Lemiale V, Argaud L, Pène F, Papazian L, Bruneel F, Seguin A, Kouatchet A, Oziel J, Rouleau S, Bele N, Razazi K, Lesieur O, Boissier F, Megarbane B, Bigé N, Brulé N, Moreau AS, Lautrette A, Peyrony O, Perez P, Mayaux J, Azoulay E. Severe atypical pneumonia in critically ill patients: a retrospective multicenter study. Ann Intensive Care 2018; 8:81. [PMID: 30105627 PMCID: PMC6089852 DOI: 10.1186/s13613-018-0429-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/02/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chlamydophila pneumoniae (CP) and Mycoplasma pneumoniae (MP) patients could require intensive care unit (ICU) admission for acute respiratory failure. METHODS Adults admitted between 2000 and 2015 to 20 French ICUs with proven atypical pneumonia were retrospectively described. Patients with MP were compared to Streptococcus pneumoniae (SP) pneumonia patients admitted to ICUs. RESULTS A total of 104 patients were included, 71 men and 33 women, with a median age of 56 [44-67] years. MP was the causative agent for 76 (73%) patients and CP for 28 (27%) patients. Co-infection was documented for 18 patients (viruses for 8 [47%] patients). Median number of involved quadrants on chest X-ray was 2 [1-4], with alveolar opacities (n = 61, 75%), interstitial opacities (n = 32, 40%). Extra-pulmonary manifestations were present in 34 (33%) patients. Mechanical ventilation was required for 75 (72%) patients and vasopressors for 41 (39%) patients. ICU length of stay was 16.5 [9.5-30.5] days, and 11 (11%) patients died in the ICU. Compared with SP patients, MP patients had more extensive interstitial pneumonia, fewer pleural effusion, and a lower mortality rate [6 (8%) vs. 17 (22%), p = 0.013]. According MCA analysis, some characteristics at admission could discriminate MP and SP. MP was more often associated with hemolytic anemia, abdominal manifestations, and extensive chest radiograph abnormalities. SP-P was associated with shock, confusion, focal crackles, and focal consolidation. CONCLUSION In this descriptive study of atypical bacterial pneumonia requiring ICU admission, mortality was 11%. The comparison with SP pneumonia identified clinical, laboratory, and radiographic features that may suggest MP or CP pneumonia.
Collapse
Affiliation(s)
- S. Valade
- AP-HP, Medical ICU, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
| | - L. Biard
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
- AP-HP, DBIM, Hôpital Saint-Louis, Paris, France
| | - V. Lemiale
- AP-HP, Medical ICU, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
| | - L. Argaud
- Hôpital Edouard Herriot, Service de Réanimation Médicale, Hospices Civils de Lyon, Lyon, France
| | - F. Pène
- AP-HP, Réanimation médicale, Hôpital Cochin, Paris, France
| | - L. Papazian
- Réanimation des Détresses Respiratoires et Infections Sévères, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - F. Bruneel
- Service de Réanimation, Centre Hospitalier de Versailles, Le Chesnay, France
| | - A. Seguin
- Department of Medical Intensive Care, CHU de Caen, Caen, France
| | - A. Kouatchet
- Service de Réanimation Médicale et Médecine Hyperbare, Hôpital Angers, Angers, France
| | - J. Oziel
- AP-HP, Medical-Surgical Intensive Care Unit, Avicenne University Hospital, Bobigny, France
| | - S. Rouleau
- Service de Réanimation polyvalente, Angoulême, France
| | - N. Bele
- Intensive Care Unit, Draguignan Hospital, Draguignan, France
| | - K. Razazi
- AP-HP, Groupe Henri Mondor-Albert Chenevier, Service de Réanimation Médicale, Hôpital Henri Mondor, Créteil, France
| | - O. Lesieur
- Service de Réanimation, CH Saint-Louis, La Rochelle, France
| | - F. Boissier
- AP-HP, Réanimation médicale, Hôpital Européen Georges Pompidou, Paris, France
| | - B. Megarbane
- AP-HP, Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris, France
| | - N. Bigé
- AP-HP, Medical Intensive Care Unit, Hôpital Saint-Antoine, Paris, France
| | - N. Brulé
- Medical Intensive Care Unit, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - A. S. Moreau
- Centre de réanimation, Hôpital Salengro, CHU-Lille, Lille, France
| | - A. Lautrette
- Service de Réanimation Médicale Polyvalente, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - O. Peyrony
- AP-HP, Service des urgences, Hôpital Saint-Louis, Paris, France
| | - P. Perez
- Service de Réanimation médicale, Hôpital Brabois, Nancy, France
| | - J. Mayaux
- AP-HP, Pneumology and Critical Care Medicine Department, Universitary Hospital La Pitié Salpêtrière-Charles Foix, Paris, France
| | - E. Azoulay
- AP-HP, Medical ICU, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75010 Paris, France
- UFR de Médecine, University Paris-7 Paris-Diderot, Paris, France
| |
Collapse
|
50
|
Chen D, Zhang Y, Xu Y, Shen T, Cheng G, Huang B, Ruan X, Wang C. Comparison of chemiluminescence immunoassay, enzyme-linked immunosorbent assay and passive agglutination for diagnosis of Mycoplasma pneumoniae infection. Ther Clin Risk Manag 2018; 14:1091-1097. [PMID: 29928124 PMCID: PMC6001742 DOI: 10.2147/tcrm.s159227] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective This study aimed to compare the performance of chemiluminescence immunoassay (CLIA), enzyme-linked immunosorbent assay (ELISA), and passive agglutination (PA) method in detecting Mycoplasma pneumoniae (MP) infection. Methods This study enrolled a total of 280 patients who were consecutively seen at the Nanfang Hospital of the Southern Medical University in Guangdong Province, China, between August and December 2016. Serum was collected and examined by CLIA, ELISA, and PA, respectively. Results There were 180 positive (64.3%) and 100 negative cases (35.7%) by PA, 184 positive (65.7%) and 96 negative cases (34.3%) by CLIA MP-immunoglobulin (Ig) M, 89 positive (31.8%) and 191 negative cases (68.2%) by CLIA MP-IgG, 196 positive (70%) and 84 negative cases (30%) by ELISA MP-IgM, and 114 positive (40.7%) and 166 negative cases (59.3%) by ELISA MP-IgG. Patients were allocated to two groups based on PA results. In PA-negative group (≤1:40), the positive rates of MP-IgM by CLIA were 22.8% and 51.2% and by ELISA were 33.3% and 53.5%, respectively. In the PA-positive group (1:80 to ≥1:1,280), MP-IgM negative cases showed a decreasing trend: 40%, 18%, 14.3%, 10%, and 6.7% (CLIA), and 43.3%, 8%, 14.3%, 5%, and 6.7% (ELISA). The consistency between CLIA/ELISA MP-IgM, -IgG, and -IgG+MP-IgM was >92% for negative cases and >75% for positive cases, resulting in an overall consistency rate >88%. The kappa coefficients were 0.804, 0.763, and 0.806, respectively. Conclusion CLIA and ELISA have a higher sensitivity compared with PA. CLIA has a high concordance with ELISA. Moreover, CLIA has a higher specificity and sensitivity for the detection of IgM and IgG and should be used for the clinical diagnosis of MP infection.
Collapse
Affiliation(s)
- Dongmiao Chen
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yajie Zhang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yinjuan Xu
- Department of Laboratory, Xintang Hospital, Southern Medical University, Zengcheng, Guangzhou 511340, Guangdong, China
| | - Tingting Shen
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Guorui Cheng
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Bingkang Huang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Xiandong Ruan
- Department of Laboratory, Xintang Hospital, Southern Medical University, Zengcheng, Guangzhou 511340, Guangdong, China
| | - Congrong Wang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| |
Collapse
|