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Chen R, Bao J, Huang X, Chen Q, Huang M, Gao M, Yu F, Chen J, Zou W, Shi L, Chen X, Feng B, Wang R, Feng B, Zheng S, Yu F. Comparison of "hock-a-loogie" saliva versus nasopharyngeal and oropharyngeal swabs for detecting common respiratory pathogens. Heliyon 2023; 9:e20965. [PMID: 37867842 PMCID: PMC10587520 DOI: 10.1016/j.heliyon.2023.e20965] [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: 05/18/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023] Open
Abstract
Self-collection of saliva samples has attracted considerable attention in recent years, particularly during the coronavirus disease 2019 pandemic. However, studies investigating the detection of other common respiratory pathogens in saliva samples are limited. In this study, nasopharyngeal swabs (NPS), oropharyngeal swabs (OPS), and "hock-a-loogie" saliva (HLS) were collected from 469 patients to detect 13 common respiratory pathogens. Overall positivity rates for NPS (66.1 %), HLS (63.5 %), and OPS (57.8 %) were statistically different (P = 0.028), with an overall concordance of 72.7 %. Additionally, detection rates for NPS (85.9 %) and HLS (83.2 %) for all pathogens were much higher than for OPS (73.3 %). Coronavirus and human rhinovirus were most frequently detected pathogens in NPS (P < 0.001). Mycoplasma pneumoniae was significantly more prevalent in the HLS group (P = 0.008). In conclusion, NPS was a reliable sample type for detecting common respiratory pathogens. HLS was more easily collected and can be used in emergencies or specific conditions. Mixed NPS/OPS and NPS/HLS specimens have the potential to improve detection rates, although OPS testing alone has a relatively high risk for missed detection.
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Affiliation(s)
- Renke Chen
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiaqi Bao
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, China
- Institute of Laboratory Medicine, Zhejiang University, Hangzhou, China
| | - Xiaojuan Huang
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qianna Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Maowen Huang
- Center of Clinical Laboratory, Ningbo Beilun People's Hospital, Ningbo, China
| | - Min Gao
- Department of Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
| | - Fanghao Yu
- Department of Clinical Laboratory, Yiwu Central Hospital, Yiwu, China
| | - Jiayao Chen
- Department of Clinical Laboratory, Zhoushan Hospital of Zhejiang Province, Zhoushan, China
| | - Weihua Zou
- Department of Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
| | - Lumei Shi
- Center of Clinical Laboratory, Ningbo Beilun People's Hospital, Ningbo, China
| | - Xiao Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, China
- Institute of Laboratory Medicine, Zhejiang University, Hangzhou, China
| | - Bo Feng
- Department of Nephrology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
| | - Ruonan Wang
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, China
- Institute of Laboratory Medicine, Zhejiang University, Hangzhou, China
| | - Baihuan Feng
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, China
- Institute of Laboratory Medicine, Zhejiang University, Hangzhou, China
| | - Shufa Zheng
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, China
- Institute of Laboratory Medicine, Zhejiang University, Hangzhou, China
| | - Fei Yu
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, China
- Institute of Laboratory Medicine, Zhejiang University, Hangzhou, China
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Liu B, Chang X, Yan N. Clinical analysis of the epidemiology and changes in inflammatory indexes of Mycoplasma pneumonia in acute and recovery stage pediatric patients. Transl Pediatr 2022; 11:1645-1655. [PMID: 36345443 PMCID: PMC9636459 DOI: 10.21037/tp-22-416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND As Mycoplasma pneumoniae pneumonia (MPP) is on the rise in children and adolescents, this work explored the clinical analysis of epidemiological and inflammatory changes in children with MPP during the acute and convalescent phases, and analyzed their relationship with clinical manifestations. METHODS One hundred and twenty MP patients (experimental group) and 100 healthy children (control group) were selected as the research objects. Enzyme-linked immunosorbent assay (ELISA) was used to detect the changes in tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and procalcitonin (PCT). RESULTS The proportion of children aged 3-7 years was significantly higher than that of other age groups (0-1, 1-3, and 7-14 years old) (P<0.05). The serum levels of TNF-α, IL-6, IL-8, IL-10, and PCT in children with MP were significantly higher than those in the control group (P<0.05). Changes in pulmonary fibrosis and serum and pleural fluid TNF-α, IL-6, IL-8, IL-10, and PCT concentrations on chest X-ray and computed tomography (CT) in children with MP with pleural effusion significantly higher than that in children without pulmonary fibrosis (P<0.05). CONCLUSIONS MPP was more common in children aged 3-7 years. In addition, the changes of inflammatory markers TNF-α, IL-6, IL-8, IL-10, and PCT in serum and pleural effusion of children with MP were of great value for the diagnosis, treatment, and prognosis of the disease.
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Affiliation(s)
- Bo Liu
- Department of Pediatrics, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Xu Chang
- Department of Pediatrics, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Ningsheng Yan
- Department of Pediatrics, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
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Kim K, Jung S, Kim M, Park S, Yang HJ, Lee E. Global Trends in the Proportion of Macrolide-Resistant Mycoplasma pneumoniae Infections: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2220949. [PMID: 35816304 PMCID: PMC9274321 DOI: 10.1001/jamanetworkopen.2022.20949] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE The proportion of macrolide-resistant Mycoplasma pneumoniae (MRMP) infections has changed, and it differs according to geographical region. OBJECTIVE To analyze the global patterns, including the temporal trends, regional variations, and variant types, in the proportion of MRMP infections in this systematic review and meta-anaysis. DATA SOURCES PubMed, Cochrane Library, and Embase databases were searched for observational studies from inception to September 10, 2021. STUDY SELECTION Observational studies reporting the proportion of MRMP infections were screened independently by 2 authors. The presence of MRMP infection was defined as any case of M pneumoniae infection positive for any variants associated with macrolide resistance identified using respiratory samples. DATA EXTRACTION AND SYNTHESIS Data were extracted independently and in duplicate by 2 reviewers. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was used. Random-effects meta-analyses were used to estimate the proportion of MRMP infections. MAIN OUTCOMES AND MEASURES The global patterns in the proportion of MRMP infections were estimated, and the temporal trends and variant types of MRMP infection with regional differences were investigated. RESULTS This study included 153 studies from 150 articles (27 408 samples in 26 countries) in the meta-analysis. The global patterns in the proportion of MRMP infections showed an increasing trend with regional differences. The proportion of MRMP infections was highest in the Western Pacific regions (53.4%; 95% CI, 47.4%-60.3%), followed by the South East Asian region (9.8%; 95% CI, 0.8%-100%), the region of the Americas (8.4%; 95% CI, 6.1%-11.6%), and the European region (5.1%; 95% CI, 3.3%-8.0%). The most commonly identified variant of MRMP infection was A2063G (96.8%; 95% CI, 95.8%-97.7%), followed by A2064G (4.8%; 95% CI, 3.5%-6.7%). The proportion of MRMP infections was the highest in studies including only children (37.0%; 95% CI, 29.8%-46.1%), followed by those including only adults (15.9%; 95% CI, 6.4%-39.7%) and those including both children and adults (16.7%; 95% CI, 10.1%-27.6%). CONCLUSIONS AND RELEVANCE This study provides global trends in the proportion of MRMP infections and suggests that strategies to prevent the spread of MRMP infection and to treat MRMP infections are needed to decrease disease burden.
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Affiliation(s)
- Kyunghoon Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Mina Kim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Suyeon Park
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
- Department of Biostatistics, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
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Choo S, Lee YY, Lee E. Clinical significance of respiratory virus coinfection in children with Mycoplasma pneumoniae pneumonia. BMC Pulm Med 2022; 22:212. [PMID: 35637540 PMCID: PMC9150047 DOI: 10.1186/s12890-022-02005-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of refractory Mycoplasma pneumoniae (MP) pneumonia has been increasing. However, few studies have investigated the impact of respiratory virus coinfection in patients with MP pneumonia, and their results have been inconclusive. This study aimed to investigate the impact of respiratory virus coinfection in children hospitalized with MP pneumonia. METHODS This study enrolled 145 children hospitalized with MP pneumonia between May 2019 and March 2020. The patients were divided into two groups: the respiratory virus coinfection and non-coinfection groups. All the children underwent polymerase chain reaction testing for respiratory virus infection. Information on clinical, laboratory, and radiologic findings were obtained retrospectively via medical chart reviews. RESULTS Children in the respiratory virus coinfection group were younger than those in the non-coinfection group. Respiratory virus coinfection in children hospitalized with MP pneumonia was significantly associated with persistence of fever more than 6 days (adjusted odds ratio [aOR], 2.394; 95% confidence interval [95% CI], 1.172-4.892), severe pneumonia (aOR, 4.602; 95% CI, 1.154-18.353), and poor response to the stepwise approach for MP pneumonia (aOR, 4.354; 95% CI, 1.374-13.800). In addition, higher levels of liver enzymes and lactate dehydrogenase at admission were associated with respiratory virus coinfection in children with MP pneumonia. CONCLUSIONS The results of this study suggest that respiratory virus coinfection in children hospitalized with MP pneumonia may be associated with refractory MP pneumonia.
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Affiliation(s)
- Soojeong Choo
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Yun Young Lee
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
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Choo S, Kim SH, Lee E. Clinical significance of Mycoplasma pneumoniae specific IgM titer in children hospitalized with Mycoplasma pneumoniae pneumonia. BMC Infect Dis 2022; 22:470. [PMID: 35578177 PMCID: PMC9109195 DOI: 10.1186/s12879-022-07456-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/10/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The present study aimed to identify the clinical significance of Mycoplasma pneumoniae (MP)-specific immunoglobulin M (IgM) titer, in addition to a diagnosis of MP infection, in children with MP pneumonia. METHODS This study was performed in 155 children hospitalized with MP pneumonia. The clinical features and laboratory and radiographic findings on admission in children with positive or negative MP-specific IgM titers were retrospectively reviewed from the electronic medical records. RESULTS The mean age of the included children was 6.0 years, and 118 (76.1%) of the children were positive for MP-specific IgM. A longer duration between symptom onset and admission (adjusted odds ratio [aOR] 1.47, 95% confidence interval [CI] 1.24-1.75), longer duration of symptoms during the illness (aOR 1.15, 95% CI 1.02-1.30), and development of extra-pulmonary manifestations (aOR 9.16, 95% CI 1.96-42.81) were significantly associated with a positive MP-specific IgM titer. Serum lactate dehydrogenase levels (aOR 1.00, 95% CI 1.00-1.01) and pneumonic infiltration involving > 50% of the total lung volume on chest radiography (aOR 4.68, 95% CI 1.12-19.55) were associated with positive MP-specific IgM in children with MP pneumonia. A poor response to stepwise treatment for MP pneumonia was more common in children with a positive MP-specific IgM titer than those with a negative MP-specific IgM titer on admission. CONCLUSIONS A positive MP-specific IgM titer at diagnosis of MP pneumonia may partially suggest an exaggerated immune response with a higher disease burden compared to children with MP pneumonia with a negative MP-specific IgM titer.
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Affiliation(s)
- Soojeong Choo
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Seo-Hee Kim
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
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Matsui H, Sugimura M, Inoue-Tsuda M, Iwabuchi K, Hanaki H. Development of an immunochromatographic test for the detection of Mycoplasma pneumoniae GroES antigen. J Microbiol Methods 2021; 191:106359. [PMID: 34744002 DOI: 10.1016/j.mimet.2021.106359] [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: 07/13/2021] [Revised: 10/12/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022]
Abstract
Mycoplasma pneumoniae frequently causes community-acquired pneumonia in children; β-lactam antibiotics are ineffective against this bacterium because of its lack of a cell wall. Hence, a rapid and simple detection method is required to ensure appropriate treatment. In this study, we developed a rapid and simple immunochromatography-based detection method using monoclonal antibodies that react with the co-chaperone GroES of M. pneumoniae. Mice were immunized with recombinant GroES, and hybridoma cells producing anti-GroES monoclonal antibodies were established. For the development of the immunochromatographic test, antibody pairs with superior reactivity and specificity were selected. The developed immunochromatographic test could detect 0.1 ng/mL of recombinant GroES within 20 min. Moreover, no cross-reaction was observed with other microorganisms, including six Mycoplasma species, 20 other bacterial species, and one yeast species. Macrolide-resistant and -susceptible M. pneumoniae clinical isolates were detected at approximately 104 to 105 colony-forming units/mL. The study indicates that immunochromatographic tests targeting GroES are useful for rapid and simple detection of M. pneumoniae.
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Affiliation(s)
- Hidehito Matsui
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan
| | - Makoto Sugimura
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan
| | - Megumi Inoue-Tsuda
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan
| | - Kazuya Iwabuchi
- Department of Immunology, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara-shi, Kanagawa 252-0373, Japan
| | - Hideaki Hanaki
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan.
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Ishiguro N, Kikuta H, Konno M, Sato R, Manabe A. Evaluation of a novel immunochromatographic assay using silver amplification technology for detection of Mycoplasma pneumoniae from throat swab samples in pediatric patients. J LAB MED 2021. [DOI: 10.1515/labmed-2020-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objectives
Mycoplasma pneumoniae is one of the common causative pathogens of community-acquired respiratory tract infections mainly in children and young adults. Rapid and accurate diagnostic techniques for identifying the causative pathogen would be useful for initiating treatment with an appropriate antibiotic. The purpose of the present study was to evaluate the sensitivity and specificity of a novel immunochromatographic assay using silver amplification technology using FUJI DRI-CHEM IMMUNO AG2 and FUJI DRI-CHEM IMMUNO AG cartridge Myco (FUJIFILM Co., Tokyo, Japan) for detection of M. pneumoniae.
Methods
Throat swab samples were collected from 170 pediatric patients who were diagnosed with bronchitis or pneumonia. The silver amplification immunochromatographic (SAI) assay was performed using these samples and the results were compared with those of real-time PCR. The time required for the SAI assay is approximately 20 min (5 min for sample preparation and 15 min for waiting time after starting the assay).
Results
The sensitivity and specificity of the SAI assay for detection of M. pneumoniae were 85.2 and 99.1%, respectively, and the assay showed positive and negative predictive values of 98.1 and 92.3%, respectively, compared with the results of real-time PCR. The diagnostic accuracy was 94.1%.
Conclusions
FUJI DRI-CHEM IMMUNO AG2 and FUJI DRI-CHEM IMMUNO AG cartridge Myco are appropriate for clinical use. The optimal timing of this assay is five days or more after the onset of M. pneumoniae infection. However, PCR or other molecular methods are superior, especially with regard to sensitivity and negative predictive value.
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Affiliation(s)
- Nobuhisa Ishiguro
- Department of Pediatrics , Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo , Japan
| | | | - Mutsuko Konno
- Department of Pediatrics , Sapporo Kosei General Hospital , Sapporo , Japan
| | - Rikako Sato
- Department of Pediatrics , Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo , Japan
| | - Atsushi Manabe
- Department of Pediatrics , Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo , Japan
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