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Pan X, Guo X, Shi J. Design of a novel multiepitope vaccine with CTLA-4 extracellular domain against Mycoplasma pneumoniae: A vaccine-immunoinformatics approach. Vaccine 2024; 42:3883-3898. [PMID: 38777697 DOI: 10.1016/j.vaccine.2024.04.098] [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: 09/17/2023] [Revised: 04/16/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Community-acquired pneumonia often stems from the macrolide-resistant strain of Mycoplasma pneumoniae, yet no effective vaccine exists against it. METHODS This study proposes a vaccine-immunoinformatics strategy for Mycoplasma pneumoniae and other pathogenic microbes. Specifically, dominant B and T cell epitopes of the Mycoplasma pneumoniae P30 adhesion protein were identified through immunoinformatics method. The vaccine sequence was then constructed by coupling with CTLA-4 extracellular region, a novel molecular adjuvant for antigen-presenting cells. Subsequently, the vaccine's physicochemical properties, antigenicity, and allergenicity were verified. Molecular dynamics modeling was employed to confirm interaction with TLR-2, TLR-4, B7-1, and B7-2. Finally, the vaccine underwent in silico cloning for expression. RESULTS The vaccine exhibited both antigenicity and non-allergenicity. Molecular dynamics simulation, post-docking with TLR-2, TLR-4, B7-1, and B7-2, demonstrated stable interaction between the vaccine and these molecules. In silico cloning confirmed effective expression of the vaccine gene in insect baculovirus vectors. CONCLUSION This vaccine-immunoinformatics approach holds promise for the development of vaccines against Mycoplasma pneumoniae and other pathogenic non-viral and non-bacterial microbes.
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Affiliation(s)
- Xiaohong Pan
- Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China
| | - Xiaomei Guo
- Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China; Kunming Medical University, Kunming, Yunnan, China
| | - Jiandong Shi
- Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China; National Kunming High-level Biosafety Primate Research Center, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Yunnan China.
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Nguyen DD, Ho NT, Dover LG, Vo AHM, Ly HTT, Doan PM, Nguyen HT, Luu NTT, Pham AN, Tran HTT. Novel Variant and Known Mutation in 23S rRNA Gene of Mycoplasma pneumoniae, Northern Vietnam, 2023. Emerg Infect Dis 2024; 30:1034-1036. [PMID: 38573165 PMCID: PMC11060462 DOI: 10.3201/eid3005.231632] [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] [Indexed: 04/05/2024] Open
Abstract
During a 2023 outbreak of Mycoplasma pneumoniae-associated community-acquired pneumonia among children in northern Vietnam, we analyzed M. pneumoniae isolated from nasopharyngeal samples. In almost half (6 of 13) of samples tested, we found known A2063G mutations (macrolide resistance) and a novel C2353T variant on the 23S rRNA gene.
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Wang H, Li Y, Tian L, Li X, Gao Q, Liu Y, Ma C, Wang Q, Shi C. A LAMP-based hydrogen ion selective electrochemical sensor for highly sensitive detection of Mycoplasma pneumoniae. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024. [PMID: 38690766 DOI: 10.1039/d4ay00341a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
A concise and rapid detection method for Mycoplasma pneumoniae is urgently required due to its severe impact on human health. To meet such a need, this study proposed and constructed an innovative point-of-care testing (POCT) platform that consists of a hydrogen ion-selective loop-mediated isothermal amplification (H+-LAMP) sensor and an electrochemical detection device. The H+-LAMP sensor successfully integrated the working and reference electrodes and converted the H+ generated during the LAMP process into an electrochemical signal. High sensitivity and stability for pathogen detection were also achieved by treating the working electrode with an electrodeposited polyaniline solid contact layer and by using an ion-selective membrane. As a result, the sensor shows a sensitivity of 68.26 mV per pH, a response time of less than 2 s, and a potential drift of less than 5 mV within one hour, which well meets the urgent need. The results also demonstrated that the detection limit for Mycoplasma pneumoniae was lowered to 1 copy per μL, the nucleic acid extraction and detection process could be completed in 30 minutes, and the impact of interfering ions on the sensor was negligible. Validation with 20 clinical samples yielded satisfactory results. More importantly, the storage lifespan of such an electrochemical sensor is over seven days, which is a great advantage for on-site pathogen detection. Therefore, the hydrogen ion-selective sensor constructed in this investigation is particularly suitable as a core component for instant pathogen detection platforms.
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Affiliation(s)
- Huiqing Wang
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
| | - Yang Li
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
| | - Lin Tian
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
| | - Xinyi Li
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
| | - Qian Gao
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
| | - Yaru Liu
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
| | - Cuiping Ma
- Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, Qingdao Key Laboratory of Nucleic Acid Rapid Detection, Sino-UAE International Cooperative Joint Laboratory of Pathogenic Microorganism Rapid Detection, College of Biological Engineering, Qingdao University of Science and Technology, 266042, Qingdao, China
| | - Qing Wang
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
| | - Chao Shi
- Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, PR China.
- Qingdao JianMa Gene Technology Co., Ltd, Qingdao, 266114, PR China
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4
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Liu C, Wang R, Ge S, Wang B, Li S, Yan B. Research status and challenges of Mycoplasma pneumoniae pneumonia in children: A bibliometric and visualization analysis from 2011 to 2023. Medicine (Baltimore) 2024; 103:e37521. [PMID: 38489686 PMCID: PMC10939570 DOI: 10.1097/md.0000000000037521] [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: 11/29/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae (MP) infections occur in regional outbreaks every 3 to 7 years, lasting up to 2 years. Since this fall, there has been a significant rise in MP infections among children in China, indicating a regional epidemiological trend that imposes an increased national public health burden. To date, bibliometric methods have not been applied to studies on MP infection in children. METHODS We searched for all relevant English publications on MP pneumonia in children published from 2011 to 2023 using Web of Science. Analytical software tools such as Citespace and VOSviewer were employed to analyze the collected literature. RESULTS 993 articles on MP pneumonia in children were published in 338 academic journals by 5062 authors affiliated with 1381 institutions across 75 countries/regions. China led in global productivity with 56.19%. Among the top 10 prolific organizations, 8 were Chinese institutions, with Soochow University being the most active, followed by Capital Medical University and Zhejiang University. Zhimin Chen from Zhejiang University School of Medicine exhibited the highest H-index of 32. Keyword co-occurrence network analysis revealed 7 highly relevant clusters. CONCLUSION The current research hotspots and frontiers in this field are primarily MP pneumonia, refractory MP pneumonia, lactate dehydrogenase, asthma, and biomarker. We anticipate that this work will provide novel insights for advancing scientific exploration and the clinical application of MP pneumonia in children.
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Affiliation(s)
- Congcong Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuyi Ge
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Binding Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siman Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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5
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Zhang XB, He W, Gui YH, Lu Q, Yin Y, Zhang JH, Dong XY, Wang YW, Ye YZ, Xu H, Wang JY, Shen B, Gu DP, Wang LB, Wang Y. Current Mycoplasma pneumoniae epidemic among children in Shanghai: unusual pneumonia caused by usual pathogen. World J Pediatr 2024; 20:5-10. [PMID: 38231466 DOI: 10.1007/s12519-023-00793-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/21/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Xiao-Bo Zhang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China
| | - Wen He
- Department of Respiratory Medicine, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China
| | - Yong-Hao Gui
- State Key Laboratory of Genetic Engineering at School of Life Sciences, Institute of Reproduction & Development, Children's Hospital of Fudan University, Shanghai, China
| | - Quan Lu
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiao Tong University, Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jian-Hua Zhang
- Department of Pediatric Respiratory, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Yan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiao Tong University, Shanghai, China
| | - Ying-Wen Wang
- Department of Nursing, Children's Hospital of Fudan University, Shanghai, China
| | - Ying-Zi Ye
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Hong Xu
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Jia-Yu Wang
- NHC Key Laboratory of Neonatal Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Bing Shen
- Shanghai Shenkang Hospital Development Center, Shanghai, China
| | - Dan-Ping Gu
- Center for Medical Quality Control Management of Shanghai, Shanghai, China
| | - Li-Bo Wang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China.
| | - Yi Wang
- Department of Neurology, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China.
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6
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Yan C, Xue GH, Zhao HQ, Feng YL, Cui JH, Yuan J. Current status of Mycoplasma pneumoniae infection in China. World J Pediatr 2024; 20:1-4. [PMID: 38185707 PMCID: PMC10827902 DOI: 10.1007/s12519-023-00783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Chao Yan
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, People's Republic of China
| | - Guan-Hua Xue
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, People's Republic of China
| | - Han-Qing Zhao
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, People's Republic of China
| | - Yan-Ling Feng
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, People's Republic of China
| | - Jing-Hua Cui
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, People's Republic of China
| | - Jing Yuan
- Department of Bacteriology, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, People's Republic of China.
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Yoshimoto K, Matsubara M, Kobayashi T, Nishio K. A Case of Mycoplasma Infection with an Atypical Presentation of Abducens Nerve Palsy, Erythema Multiforme and Polyarthritis without Respiratory Manifestations. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:36. [PMID: 38256298 PMCID: PMC10818581 DOI: 10.3390/medicina60010036] [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: 11/14/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
Mycoplasma pneumoniae is a self-propagating microorganism that commonly causes respiratory tract infections. It can also cause a variety of extrapulmonary symptoms with or independently of respiratory symptoms, such as skin lesions, arthralgia, myalgia, hemolysis, cardiac lesions, gastrointestinal symptoms, and central nervous system lesions, which are rare manifestations reported in approximately 0.1% of cases. In this study, we present a unique case of Mycoplasma-related abducens nerve palsy, polyarthritis, and erythema multiforme without respiratory disease. The patient was a 69-year-old woman who presented to our hospital with a skin rash, fever, arthralgia, and diplopia without respiratory symptoms. Brain magnetic resonance imaging showed optic neuritis on the right side, suggesting the diplopia was caused by right abducens nerve palsy. However, the etiologies of abducens nerve palsy were not revealed by the physical examination, blood biochemistry tests, or bacteriological examinations, including the cerebrospinal fluid examination obtained at admission. Mycoplasma infection was suspected from erythema multiforme revealed by a skin biopsy and polyarthralgia, and it was finally diagnosed according to elevated Mycoplasma particle agglutination (PA) antibodies in paired serum. Though minocycline did not improve her diplopia, the daily administration of 30 mg of prednisolone gradually improved her symptoms, and the Mycoplasma PA antibody titer, which was regularly measured in the clinical course, also decreased, suggesting a relationship between Mycoplasma infection and abducens nerve palsy. This is the first case of isolated abducens nerve palsy, which was reported as the only central neurological symptom in an adult patient with Mycoplasma infection. The mechanism or pathogenesis of CNS manifestations caused by Mycoplasma pneumoniae remains to be elucidated, and further investigation is needed. Hence, Mycoplasma infection is a common disease. Clinicians should be aware of the diverse manifestations, including abducens nerve palsy, of Mycoplasma infection and should consider Mycoplasma infection even in the absence of typical respiratory symptoms.
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Affiliation(s)
- Kiyomi Yoshimoto
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
| | - Masaki Matsubara
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
| | - Tadanao Kobayashi
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
- Department of General Medicine, Uda City Hospital, Uda 633-0298, Nara, Japan
| | - Kenji Nishio
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
- Department of General Medicine, Uda City Hospital, Uda 633-0298, Nara, Japan
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Kenri T, Yamazaki T, Ohya H, Jinnai M, Oda Y, Asai S, Sato R, Ishiguro N, Oishi T, Horino A, Fujii H, Hashimoto T, Nakajima H, Shibayama K. Genotyping of Mycoplasma pneumoniae strains isolated in Japan during 2019 and 2020: spread of p1 gene type 2c and 2j variant strains. Front Microbiol 2023; 14:1202357. [PMID: 37405159 PMCID: PMC10316025 DOI: 10.3389/fmicb.2023.1202357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/24/2023] [Indexed: 07/06/2023] Open
Abstract
We characterized 118 Mycoplasma pneumoniae strains isolated from three areas of Japan (Saitama, Kanagawa, and Osaka) during the period of 2019 and 2020. Genotyping of the p1 gene in these strains revealed that 29 of them were type 1 lineage (29/118, 24.6%), while 89 were type 2 lineage (89/118, 75.4%), thereby indicating that type 2 lineage was dominant in this period. The most prevalent variant of type 2 lineage was type 2c (57/89, 64%), while the second-most was type 2j, a novel variant identified in this study (30/89, 33.7%). Type 2j p1 is similar to type 2 g p1, but cannot be distinguished from reference type 2 (classical type 2) using the standard polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) with HaeIII digestion. Thus, we used MboI digestion in the PCR-RFLP analysis and re-examined the data from previous genotyping studies as well. This revealed that most strains reported as classical type 2 after 2010 in our studies were actually type 2j. The revised genotyping data showed that the type 2c and 2j strains have been spreading in recent years and were the most prevalent variants in Japan during the time-period of 2019 and 2020. We also analyzed the macrolide-resistance (MR) mutations in the 118 strains. MR mutations in the 23S rRNA gene were detected in 29 of these strains (29/118, 24.6%). The MR rate of type 1 lineage (14/29, 48.3%) was still higher than that of type 2 lineage (15/89, 16.9%); however, the MR rate of type 1 lineage was lower than that found in previous reports published in the 2010s, while that of type 2 lineage strains was slightly higher. Thus, there is a need for continuous surveillance of the p1 genotype and MR rate of M. pneumoniae clinical strains, to better understand the epidemiology and variant evolution of this pathogen, although M. pneumoniae pneumonia cases have decreased significantly since the COVID-19 pandemic.
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Affiliation(s)
- Tsuyoshi Kenri
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Hitomi Ohya
- Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan
| | - Michio Jinnai
- Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan
| | | | | | - Rikako Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuhisa Ishiguro
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tomohiro Oishi
- Department of Clinical Infectious Diseases, Kawasaki Medical School, Okayama, Japan
| | - Atsuko Horino
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | | | | | - Hiroshi Nakajima
- Okayama Prefectural Institute for Environmental Science and Public Health, Okayama, Japan
| | - Keigo Shibayama
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tashiro M, Sato S, Endo A, Hamashima R, Ito Y, Ashizawa N, Takeda K, Iwanaga N, Ide S, Fujita A, Takazono T, Yamamoto K, Tanaka T, Furumoto A, Yanagihara K, Mukae H, Fushimi K, Izumikawa K. Decreased community-acquired pneumonia coincided with rising awareness of precautions before governmental containment policy in Japan. PNAS NEXUS 2023; 2:pgad153. [PMID: 37234205 PMCID: PMC10208112 DOI: 10.1093/pnasnexus/pgad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/18/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023]
Abstract
The effectiveness of population-wide compliance to personal precautions (mask-wearing and hand hygiene) in preventing community-acquired pneumonia has been unknown. In Japan, different types of nonpharmaceutical interventions from personal precautions to containment and closure policies (CACPs, e.g. stay-at-home requests) were sequentially introduced from late January to April 2020, allowing for separate analysis of the effects of personal precautions from other more stringent interventions. We quantified the reduction in community-acquired pneumonia hospitalizations and deaths and assessed if it coincided with the timing of increased public awareness of personal precautions before CACPs were implemented. A quasi-experimental interrupted time-series design was applied to non-COVID-19 pneumonia hospitalization and 30-day death data from April 2015 to August 2020 across Japan to identify any trend changes between February and April 2020. We also performed a comparative analysis of pyelonephritis and biliary tract infections to account for possible changes in the baseline medical attendance. These trend changes were then compared with multiple indicators of public awareness and behaviors related to personal precautions, including keyword usage in mass media coverage and sales of masks and hand hygiene products. Hospitalizations and 30-day deaths from non-COVID-19 pneumonia dropped by 24.3% (95% CI 14.8-32.8) and 16.1% (5.5-25.5), respectively, in February 2020, before the implementation of CACPs, whereas pyelonephritis and biliary tract infections did not suggest a detectable change. These changes coincided with increases in indicators related to personal precautions rather than those related to contact behavior changes. Community-acquired pneumonia could be reduced by population-wide compliance to moderate precautionary measures.
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Affiliation(s)
| | | | | | - Ryosuke Hamashima
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Nobuyuki Ashizawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Shotaro Ide
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Ayumi Fujita
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Akitsugu Furumoto
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
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10
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Leng M, Yang J, Zhou J. The molecular characteristics, diagnosis, and treatment of macrolide-resistant Mycoplasma pneumoniae in children. Front Pediatr 2023; 11:1115009. [PMID: 36937963 PMCID: PMC10017863 DOI: 10.3389/fped.2023.1115009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
The purpose of this study is to review the molecular characteristics, the diagnosis, and treatment of the widespread infection of macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae; MRMP) in children, thus providing a better knowledge of this infection and presenting the associated problems. Single point mutations in the V region of the 23S rRNA gene of M. pneumoniae genome are associated with macrolide resistance. P1-1, MLVA4-5-7-2, and ST3 are usually the predominated genetic types in the M. pneumoniae epidemics. The short-term two times serological IgM (or together with IgG) test in the acute stage can be used for confirmation. Combined serological testing and PCR might be a more prudent method to reduce macrolide consumption and antibiotic selective pressure in a clinical setting. Molecular methods for the detection of single-nucleotide mutations in the V region of the 23S rRNA gene can be used for the diagnosis of MRMP. The routine use of macrolide for the treatment of macrolide-sensitive Mycoplasma pneumoniae (MSMP) infections can get good effect, but the effects are limited for severe MRMP infections. Additional corticosteroids may be required for the treatment of severe MRMP infections in children in China during the era of MRMP.
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11
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The role of flexible bronchoscopy in children with Mycoplasma pneumoniae pneumonia. Pediatr Res 2023; 93:198-206. [PMID: 35459766 DOI: 10.1038/s41390-021-01874-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/23/2021] [Accepted: 11/13/2021] [Indexed: 01/28/2023]
Abstract
PURPOSE To explore the effectiveness of flexible bronchoscopy in pediatric Mycoplasma pneumoniae pneumonia (MPP). METHODS This retrospective cohort study included children with MPP admitted between 2016 and 2019 in Shanghai. Tracheobronchial manifestations, etiologic findings, therapeutic effect, and health-economic indicators were assessed in bronchoscopy (plus bronchoalveolar lavage (BAL)) and non-bronchoscopy group. We used propensity-score matching and multivariable logistic regression to investigate the effect of bronchoscopy and BAL on disease recovery. RESULTS In 900 children with MPP, 24/278 (8.6%) of those who underwent bronchoscopy had sputum plugs. Coinfection rate was four-fold enhanced by BAL (19.6% vs. 4.5%, p < 0.01) in patients with severe MPP (SMPP) and nearly doubled (10.8% vs. 5.9%, p = 0.03) in those without SMPP, compared with no BAL. Total of 224 (24.9%) patients had multilobar consolidation; after BAL, a significantly shorter lesion-resolution duration was observed on imaging (OR: 0.2, 95% CI: 0.0-0.7). However, longer fever duration (OR: 2.8, 95% CI: 1.7-4.8), hospital stay (OR: 3.1, 95% CI: 1.9-5.1), and higher costs were found in the bronchoscopy group than in the non-bronchoscopy group. CONCLUSIONS Through BAL, coinfection may explain one-fifth of causes for SMPP. Bronchoscopy with BAL may increase the detection rate of pathogen and resolve pulmonary lesions in patients with multilobar consolidation. IMPACT Flexible bronchoscopy with bronchoalveolar lavage is of great assistance in the timely detection of coinfection, sputum plug and inflammatory polyps in children with Mycoplasma pneumoniae pneumonia (MPP), and improves the recovery of lung damage in MPP patients with multilobar consolidation. This study provides new insights into the indications of flexible bronchoscopy for the diagnosis and treatment of pediatric patients with MPP.
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Roh EJ, Shim JY, Chung EH. Epidemiology and surveillance implications of community-acquired pneumonia in children. Clin Exp Pediatr 2022; 65:563-573. [PMID: 36265520 PMCID: PMC9742763 DOI: 10.3345/cep.2022.00374] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/26/2022] [Indexed: 11/05/2022] Open
Abstract
Community-acquired pneumonia (CAP) is the single largest infectious cause of hospitalization and death in children worldwide. With improved immunizations, the incidence of bacterial pneumonia and the number of colonized bacteria have decreased. However, respiratory viruses are still an important cause of CAP, especially as new infectious agents such severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerge. The SARS-CoV-2 virus emerged in 2019 and caused the current coronavirus disease 2019 pandemic. Therefore, it is necessary to elucidate the epidemiology and causative pathogens of CAP. Recently, the Pneumonia and Respiratory Disease Study Group, affiliated with the Korean Academy of Pediatric Allergy and Respiratory Disease, investigated the causative pathogens of respiratory infections in children hospitalized with CAP, the serotype of Streptococcus pneumoniae, and the prevalence of Mycoplasma pneumoniae with gene mutations. Antibiotic resistance and serotype test results can determine the use of empirical antibiotics. Moreover, it is possible to help develop future vaccines by comparing bacterial culture results with vaccine serotype and identifying the changes and prevalence of each serotype. Therefore, we will perform continuous national surveillance and monitor the epidemiology of respiratory pathogens in Korea and worldwide. The surveillance of these respiratory infections can play a role in monitoring the emergence of new infectious diseases such as SARS-CoV-2.
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Affiliation(s)
- Eui Jeong Roh
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
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Lv YT, Sun XJ, Chen Y, Ruan T, Xu GP, Huang JA. Epidemic characteristics of Mycoplasma pneumoniae infection: a retrospective analysis of a single center in Suzhou from 2014 to 2020. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1123. [PMID: 36388772 PMCID: PMC9652570 DOI: 10.21037/atm-22-4304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/09/2022] [Indexed: 07/23/2023]
Abstract
BACKGROUND Mycoplasma pneumoniae (M. Pneumoniae) is a common pathogen of respiratory tract infections, but there is still a lack of detailed investigation on the large sample of M. Pneumoniae infection in the all age population. And patients with severe M. Pneumoniae pneumonia (SMPP) still have a certain risk of death. How to identify the clinical characteristics and population of patients with SMPP as soon as possible is still an urgent problem in clinical practice. METHODS Demographic characteristics, patient clinical information, and laboratory data of 81,131 patients with respiratory tract infections (RTIs) in the Affiliated Suzhou Hospital of Nanjing Medical University from 2014 to 2020 were retrospectively collected from all patient records. The serum particle agglutination (PA) test was used to determine M. Pneumoniae infection by detecting specific antibodies. The white blood cell count, the proportion of neutrophils and lymphocytes, C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels between children and adults with SMPP were compared by Student's t-test; other clinical features were analyzed by χ2 test or Fisher's exact test. RESULTS A total of 81,131 patients with RTIs were included, and 21,582 (26.60%) M. Pneumoniae immunoglobulin M (IgM)-positive patients were detected. From 2014 to 2020, the annual proportions of M. Pneumoniae RTIs were 23.60%, 28.18%, 38.08%, 27.05%, 23.44%, 25.26%, and 18.33%, respectively. In terms of seasonal distribution, April-June and September-November were the peak seasons of M. Pneumoniae infection each year. Children and women have a high proportion of M. Pneumoniae infection. The peak age of M. Pneumoniae infection was between 4 and 14 years old. There were 301 cases of SMPP, including 281 children and 20 adults (8 cases of pregnant women). Children and pregnant women accounted for a high proportion of SMPP. Children with SMPP had more extrapulmonary symptoms, multilobar infiltrates, and increased CRP and LDH levels compared with adults. CONCLUSIONS M. Pneumoniae infection has seasonal, sex, and age distribution trends. Children and pregnant women accounted for a high proportion of SMPP. Extrapulmonary symptoms, multilobar infiltrates, and increased CRP and LDH levels may be helpful to identify SMPP in children than in adults.
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Affiliation(s)
- Yan-Tian Lv
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Respiratory and Critical Medicine, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Xiao-Jing Sun
- Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ying Chen
- Department of Respiratory and Critical Medicine, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Ting Ruan
- Department of Respiratory and Critical Medicine, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Guo-Peng Xu
- Department of Respiratory and Critical Medicine, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jian-An Huang
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
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Pletz MW, Jensen AV, Bahrs C, Davenport C, Rupp J, Witzenrath M, Barten-Neiner G, Kolditz M, Dettmer S, Chalmers JD, Stolz D, Suttorp N, Aliberti S, Kuebler WM, Rohde G. Unmet needs in pneumonia research: a comprehensive approach by the CAPNETZ study group. Respir Res 2022; 23:239. [PMID: 36088316 PMCID: PMC9463667 DOI: 10.1186/s12931-022-02117-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Despite improvements in medical science and public health, mortality of community-acquired pneumonia (CAP) has barely changed throughout the last 15 years. The current SARS-CoV-2 pandemic has once again highlighted the central importance of acute respiratory infections to human health. The “network of excellence on Community Acquired Pneumonia” (CAPNETZ) hosts the most comprehensive CAP database worldwide including more than 12,000 patients. CAPNETZ connects physicians, microbiologists, virologists, epidemiologists, and computer scientists throughout Europe. Our aim was to summarize the current situation in CAP research and identify the most pressing unmet needs in CAP research.
Methods
To identify areas of future CAP research, CAPNETZ followed a multiple-step procedure. First, research members of CAPNETZ were individually asked to identify unmet needs. Second, the top 100 experts in the field of CAP research were asked for their insights about the unmet needs in CAP (Delphi approach). Third, internal and external experts discussed unmet needs in CAP at a scientific retreat.
Results
Eleven topics for future CAP research were identified: detection of causative pathogens, next generation sequencing for antimicrobial treatment guidance, imaging diagnostics, biomarkers, risk stratification, antiviral and antibiotic treatment, adjunctive therapy, vaccines and prevention, systemic and local immune response, comorbidities, and long-term cardio-vascular complications.
Conclusion
Pneumonia is a complex disease where the interplay between pathogens, immune system and comorbidities not only impose an immediate risk of mortality but also affect the patients’ risk of developing comorbidities as well as mortality for up to a decade after pneumonia has resolved. Our review of unmet needs in CAP research has shown that there are still major shortcomings in our knowledge of CAP.
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Dawood A, Algharib SA, Zhao G, Zhu T, Qi M, Delai K, Hao Z, Marawan MA, Shirani I, Guo A. Mycoplasmas as Host Pantropic and Specific Pathogens: Clinical Implications, Gene Transfer, Virulence Factors, and Future Perspectives. Front Cell Infect Microbiol 2022; 12:855731. [PMID: 35646746 PMCID: PMC9137434 DOI: 10.3389/fcimb.2022.855731] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022] Open
Abstract
Mycoplasmas as economically important and pantropic pathogens can cause similar clinical diseases in different hosts by eluding host defense and establishing their niches despite their limited metabolic capacities. Besides, enormous undiscovered virulence has a fundamental role in the pathogenesis of pathogenic mycoplasmas. On the other hand, they are host-specific pathogens with some highly pathogenic members that can colonize a vast number of habitats. Reshuffling mycoplasmas genetic information and evolving rapidly is a way to avoid their host's immune system. However, currently, only a few control measures exist against some mycoplasmosis which are far from satisfaction. This review aimed to provide an updated insight into the state of mycoplasmas as pathogens by summarizing and analyzing the comprehensive progress, current challenge, and future perspectives of mycoplasmas. It covers clinical implications of mycoplasmas in humans and domestic and wild animals, virulence-related factors, the process of gene transfer and its crucial prospects, the current application and future perspectives of nanotechnology for diagnosing and curing mycoplasmosis, Mycoplasma vaccination, and protective immunity. Several questions remain unanswered and are recommended to pay close attention to. The findings would be helpful to develop new strategies for basic and applied research on mycoplasmas and facilitate the control of mycoplasmosis for humans and various species of animals.
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Affiliation(s)
- Ali Dawood
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
- Hubei Hongshan Laboratory, Wuhan, China
| | - Samah Attia Algharib
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, HZAU, Wuhan, China
- Department of Clinical Pathology, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt
| | - Gang Zhao
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Tingting Zhu
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Mingpu Qi
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Kong Delai
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Zhiyu Hao
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Marawan A. Marawan
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- Infectious Diseases, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt
| | - Ihsanullah Shirani
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- Para-Clinic Department, Faculty of Veterinary Medicine, Jalalabad, Afghanistan
| | - Aizhen Guo
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
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16
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Cheng Y, Cheng Y, Dai S, Hou D, Ge M, Zhang Y, Fan L, Pei Y, Yu L, Xue G, Ma L, Sun H. The Prevalence of Mycoplasma Pneumoniae Among Children in Beijing Before and During the COVID-19 Pandemic. Front Cell Infect Microbiol 2022; 12:854505. [PMID: 35573799 PMCID: PMC9103471 DOI: 10.3389/fcimb.2022.854505] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/24/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community acquired pneumonia. With the outbreak of coronavirus disease 2019 (COVID-19), the prevalence of some infectious respiratory diseases has varied. Epidemiological features of M. pneumoniae in children from Beijing (China) before and during the COVID-19 pandemic were investigated. Methods Between June 2016 and May 2021, a total of 569,887 children with respiratory infections from Children’s Hospital Affiliated to Capital Institute of Pediatrics (Beijing, China) were included in this study. M. pneumoniae specific-IgM antibody in serum specimens of these patients was tested by a rapid immunochromatographic assay kit. The relevant clinical data of M. pneumoniae-positive cases were also collected, and analyzed by RStudio software. Results The results showed that 13.08% of collected samples were positive for M. pneumoniae specific-IgM antibody. The highest annual positive rate was 17.59% in 2019, followed by 12.48% in 2018, 12.31% in 2017, and 11.73% in 2016, while the rate dropped to 8.9% in 2020 and 4.95% in 2021, with significant difference. Among the six years, the positive rates in summer and winter seasons were significantly higher than those in spring and autumn seasons (p < 0.001). The positive rate was the highest in school-age children (22.20%), and lowest in the infant group (8.76%, p < 0.001). The positive rate in boys (11.69%) was lower than that in girls (14.80%, p < 0.001). There were no significant differences in different seasons, age groups, or genders before and during the COVID-19 pandemic (p > 0.05). Conclusions Our study demonstrated that an M. pneumoniae outbreak started from the summer of 2019 in Beijing. After the COVID-19 pandemic outbreak in the end of 2019, the M. pneumoniae positive rates dropped dramatically. This may be due to the restrictive measures of the COVID-19 pandemic, which effectively controlled the transmission of M. pneumoniae. The relationships between M. pneumoniae positive rates and season, age, and gender were not statistically significant before and during the COVID-19 pandemic.
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Affiliation(s)
- Yuan Cheng
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Yijing Cheng
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Shuzhi Dai
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Menglei Ge
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Yi Zhang
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Lei Fan
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Yingying Pei
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Li Yu
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Guanhua Xue
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Lijuan Ma, ; Guanhua Xue,
| | - Lijuan Ma
- Department of Clinical Laboratory, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Lijuan Ma, ; Guanhua Xue,
| | - Hongmei Sun
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
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Park YK, Park YN, Moon JE, Kim HB, Shin M, Lee E, Kim CH, Lee JS, Lee YJ, Kim BS, Kim HY, Jung S, Kim Y, Kim S, Park C, Seo JH, Shim JY, Sol IS, Sung M, Song DJ, Ahn YM, Oh HL, Yu J, Lee KS, Jang GC, Jang YY, Chung HL, Chung EH, Choi SM, Choi YJ, Han MY, Kim JT, Kim CK, Yang HJ. The incidence and risk factors of extrapulmonary manifestations in Mycoplasma pneumoniae pneumonia. ALLERGY ASTHMA & RESPIRATORY DISEASE 2022. [DOI: 10.4168/aard.2022.10.4.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoo Kyung Park
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - You Na Park
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ji Eun Moon
- Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Chul-Hong Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Yong Ju Lee
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Yunsun Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Sangyoung Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Chorong Park
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Ju-Hee Seo
- Departmentof Pediatrics, Dankook University Hospital, Dankook University Medical School, Cheonan, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Suk Sol
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myongsoon Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Min Ahn
- Department of Pediatrics, Eulji General Hospital, Eulji University, Seoul, Korea
| | - Hea Lin Oh
- Department of Pediatrics, Korea Cancer Center Hospital, Ilsan, Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Yoon-Young Jang
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Hai Lee Chung
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sung-Min Choi
- Department of Pediatrics, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Yun Jung Choi
- Departmentof Pediatrics, Seoul National University Children Hospital, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jin Tack Kim
- Department of Pediatrics, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
| | - Chang-Keun Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Liu Z, Huo JH, Dong WT, Sun GD, Li FJ, Zhang YN, Qin ZW, Pengna J, Wang WM. A Study Based on Metabolomics, Network Pharmacology, and Experimental Verification to Explore the Mechanism of Qinbaiqingfei Concentrated Pills in the treatment of Mycoplasma Pneumonia. Front Pharmacol 2021; 12:761883. [PMID: 34803705 PMCID: PMC8599429 DOI: 10.3389/fphar.2021.761883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Qinbaiqingfei concentrated pills (QB) are a commonly used medicine for the treatment of mycoplasma pneumonia in China, and the mechanism of action of QB needs to be studied further. Therefore, we use a combination of metabolomics and network pharmacology to clarify the mechanism of QB. Nontarget metabolomics studies were performed on rat serum, urine, and lung tissues, and 56 therapeutic biomarkers were found. Subsequently, the components of QB absorbed into the blood and lung tissues were clarified, and based on this finding, the core target of network pharmacology was predicted. The enrichment analysis of biomarkers–genes finally confirmed their close relationship with the NF-κB signaling pathway. By western blotting expression of the proteins in the lung tissue–related signaling pathways, it is finally confirmed that QB inhibits the NF-κB signaling pathway through SIRT1, IL-10 and MMP9, CTNNB1, EGFR, and other targets. It plays a role in regulating immunity, regulating metabolism, and treating diseases.
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Affiliation(s)
- Zheng Liu
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Jin-Hai Huo
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Wen-Ting Dong
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Guo-Dong Sun
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Feng-Jin Li
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Ya-Nan Zhang
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Zhi-Wei Qin
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Jiang Pengna
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wei-Ming Wang
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
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Efficacy of tetracyclines and fluoroquinolones for the treatment of macrolide-refractory Mycoplasma pneumoniae pneumonia in children: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:1003. [PMID: 34563128 PMCID: PMC8465761 DOI: 10.1186/s12879-021-06508-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 07/30/2021] [Indexed: 11/26/2022] Open
Abstract
Background Mycoplasma pneumoniae is a common pathogen that causes community-acquired pneumonia in school-age children. Macrolides are considered a first-line treatment for M. pneumoniae infection in children, but macrolide-refractory M. pneumoniae (MRMP) strains have become more common. In this study, we assessed the efficacy of tetracyclines and fluoroquinolones in MRMP treatment in children through a systematic review and meta-analysis. Methods Two reviewers individually searched 10 electronic databases (Medline/Pubmed, Embase, the Cochrane Library, and core Korean, Chinese, and Japanese journals) for papers published from January 1, 1990 to March 8, 2018. The following data for each treatment group were extracted from the selected studies: intervention (tetracyclines and fluoroquinolones/comparator), patient characteristics (age and sex), and outcomes (fever duration, hospital stay length, treatment success rate, and defervescence rates 24, 48, and 72 h after starting treatment). Results Eight studies involving 537 participants were included. Fever duration and hospital stay length were shorter in the tetracycline group than in the macrolide group (weighted mean difference [WMD] = − 1.45, 95% confidence interval [CI]: − 2.55 to − 0.36, P = 0.009; and WMD = − 3.33, 95% CI: − 4.32 to − 2.35, P < 0.00001, respectively). The therapeutic efficacy was significantly higher in the tetracycline group than in the macrolide group (odds ratio [OR]: 8.80, 95% CI: 3.12–24.82). With regard to defervescence rate, patients in the tetracycline group showed significant improvement compared to those in the macrolide group (defervescence rate after 24 h, OR: 5.34, 95% CI: 1.81–15.75; after 48 h, OR 18.37, 95% CI: 8.87–38.03; and after 72 h, OR: 40.77, 95% CI: 6.15–270.12). There were no differences in fever improvement within 24 h in patients in the fluoroquinolone group compared to those in the macrolide group (OR: 1.11, 95% CI: 0.25–5.00), although the defervescence rate was higher after 48 h in the fluoroquinolone group (OR: 2.78, 95% CI: 1.41–5.51). Conclusion Tetracyclines may shorten fever duration and hospital stay length in patients with MRMP infection. Fluoroquinolones may achieve defervescence within 48 h in patients with MRMP infection. However, these results should be carefully interpreted as only a small number of studies were included, and they were heterogeneous. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06508-7.
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Ishiguro N, Sato R, Kikuta H, Nakanishi M, Aoyagi H, Mori T, Nagano N, Tabata Y, Hazama K, Konno M, Yamanaka T, Azuma K, Tanaka H, Narita M, Morita K, Odagawa Y, Ishizaka A, Tsuchida A, Sasaki S, Horino A, Kenri T, Togashi T, Manabe A. P1 gene of Mycoplasma pneumoniae isolated from 2016 to 2019 and relationship between genotyping and macrolide resistance in Hokkaido, Japan. J Med Microbiol 2021; 70. [PMID: 34165424 DOI: 10.1099/jmm.0.001365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We characterized 515 Mycoplasma pneumoniae specimens in Hokkaido. In 2013 and 2014, the p1 gene type 1 strain, mostly macrolide-resistant, was dominant and the prevalence of macrolide resistance was over 50 %. After 2017, the p1 gene type 2 lineage, mostly macrolide-sensitive, increased and the prevalence of macrolide resistance became 31.0 % in 2017, 5.3 % in 2018 and 16.3 % in 2019.
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Affiliation(s)
- Nobuhisa Ishiguro
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Rikako Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hideaki Kikuta
- Pediatric Clinic, Touei Hospital, Sapporo, Hokkaido, Japan
| | - Masanori Nakanishi
- Department of Pediatrics, Kushiro Red Cross Hospital, Kushiro, Hokkaido, Japan
| | - Hayato Aoyagi
- Department of Pediatrics, Obihiro Kyokai Hospital, Obihiro, Hokkaido, Japan
| | - Toshihiko Mori
- Department of Pediatrics, NTT East Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Naoko Nagano
- Nagano Pediatric Clinic, Asahikawa, Hokkaido, Japan
| | - Yuichi Tabata
- Iwamizawa Pediatric and Gynecology Clinic, Iwamizawa, Hokkaido, Japan
| | | | - Mutsuko Konno
- Department of Pediatrics, Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan
| | | | | | - Hiroshi Tanaka
- Sapporo Cough Asthma Allergy Center, Sapporo, Hokkaido, Japan
| | - Mitsuo Narita
- Department of Pediatrics, Sapporo Tokushukai Hospital, Sapporo, Hokkaido, Japan
| | - Keisuke Morita
- Department of Pediatrics, Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan
| | - Yasuhisa Odagawa
- Department of Pediatircs, Otaru General Hospital, Otaru, Hokkaido, Japan
| | | | | | - Satoshi Sasaki
- Department of Pediatrics, Aiiku Hospital, Sapporo, Hokkaido, Japan
| | - Atsuko Horino
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tsuyoshi Kenri
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takehiro Togashi
- Hokkaido Anti-Tuberculosis Association Sapporo Fukujuji Clinic, Sapporo, Hokkaido, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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21
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Chen YC, Hsu WY, Chang TH. Macrolide-Resistant Mycoplasma pneumoniae Infections in Pediatric Community-Acquired Pneumonia. Emerg Infect Dis 2021; 26:1382-1391. [PMID: 32568052 PMCID: PMC7323531 DOI: 10.3201/eid2607.200017] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A high prevalence rate of macrolide-resistant Mycoplasma pneumoniae (MRMP) has been reported in Asia. We performed a systematic review and meta-analysis to investigate the effect of macrolide resistance on the manifestations and clinical judgment during M. pneumoniae infections. We found no difference in clinical severity between MRMP and macrolide-sensitive Mycoplasma pneumoniae (MSMP) infections. However, in the pooled data, patients infected with MRMP had a longer febrile period (1.71 days), length of hospital stay (1.61 day), antibiotic drug courses (2.93 days), and defervescence time after macrolide treatment (2.04 days) compared with patients infected with MSMP. The risk of fever lasting for >48 hours after macrolide treatment was also significantly increased (OR 21.24), and an increased proportion of patients was changed to second-line treatment (OR 4.42). Our findings indicate diagnostic and therapeutic challenges after the emergence of MRMP. More precise diagnostic tools and clearly defined treatment should be appraised in the future.
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22
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Kim Y, Park GW, Kim S, Moon HJ, Won S, Chung W, Yang HJ. Fluoroquinolone and no risk of Achilles-tendinopathy in childhood pneumonia under eight years of age-a nationwide retrospective cohort. J Thorac Dis 2021; 13:3399-3408. [PMID: 34277036 PMCID: PMC8264711 DOI: 10.21037/jtd-20-2256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 04/14/2021] [Indexed: 11/26/2022]
Abstract
Background The emergence of macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMP) has made its treatment challenging. A few guidelines have recommended fluoroquinolones (FQs) as second-line drugs of choice for treating MRMP in children under the age of eight, but concerns about potential adverse events (i.e., Achilles tendinopathy; AT) have been raised. The aim of this study was to investigate the relationship between the use of FQs and the risk of AT in pneumonia in children under eight years of age. Methods Children hospitalized with pneumonia (total of 2,213,807 episodes) from 2002 to 2017 were enrolled utilizing the Korean National Health Insurance Sharing Service (NHISS) database. The independent risk of FQs for AT was analyzed by a generalized estimating equation with adjustment for age, sex, and underlying diseases. Results Among 2,213,807 episodes of pneumonia hospitalization, children in a total of 6,229 episodes (0.28%) were treated with FQs (levofloxacin 40.9%, ciprofloxacin 36.1%, moxifloxacin 11.6%, and others 11.4%). The FQ-exposure group showed a 0.19% (12/6,229) incidence of AT within 30 days after the first administration of FQ. The use of FQs increased the risk of AT (OR 3.00; 95% CI: 1.71–5.29), but became null after adjusting for age, sex, and underlying diseases (aOR 0.85; 95% CI: 0.48–1.51). All AT related to the use of FQs occurred after the use of ciprofloxacin or levofloxacin, and not in children under eight years of age. Conclusions AT was a rare adverse event of FQ use for childhood pneumonia, particularly under eight years of age. Clinicians could consider using FQs as a second-line option in the treatment of childhood pneumonia when there are no alternative therapeutic options.
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Affiliation(s)
- Yunsun Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Gun Woo Park
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Sangyoung Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hui Jeong Moon
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Sungho Won
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea.,Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Korea.,Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Wankyo Chung
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Hyeon-Jong Yang
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea.,Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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23
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Yan Q, Niu W, Jiang W, Hao C, Chen M, Hua J. Risk factors for delayed radiographic resolution in children with refractory Mycoplasma pneumoniae pneumonia. J Int Med Res 2021; 49:3000605211015579. [PMID: 34034536 PMCID: PMC8161875 DOI: 10.1177/03000605211015579] [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: 10/30/2022] Open
Abstract
OBJECTIVE To determine the risk factors for delayed radiographic resolution in children with refractory Mycoplasma pneumoniae pneumonia (RMPP) and explore the most suitable time for interventional bronchoscopy. METHODS This retrospective study involved 142 children with RMPP who were admitted to our hospital from 1 January 2015 to 31 December 2017. They were divided into a common resolution group and a delayed resolution group based on their chest radiograph series. RESULTS Among the 142 patients, 67 showed common resolution on chest radiographs and 75 showed delayed resolution. Independent risk factors for delayed resolution were a clinical course of ≥11.5 days before the performance of interventional bronchoscopy, mucus plug formation, corticosteroid resistance, and atelectasis. When bronchoscopy was performed before the disease had been present for <11.5 days, the length of hospitalization, total fever duration, and duration of time until disappearance of coughing were shorter than those in children who underwent bronchoscopy after the disease had been present for ≥11.5 days. CONCLUSIONS Corticosteroid resistance, the time to interventional bronchoscopy, atelectasis, and mucus plug formation were associated with delayed resolution on chest radiographs. Performance of interventional bronchoscopy before the clinical course has reached 11.5 days may help alleviate clinical symptoms and improve radiographic resolution.
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Affiliation(s)
- Qiuli Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.,Children's Hospital of Wujiang District, Suzhou, China
| | - Wensi Niu
- Children's Hospital of Wujiang District, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meiyuan Chen
- Children's Hospital of Wujiang District, Suzhou, China
| | - Jun Hua
- Children's Hospital of Wujiang District, Suzhou, China
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Characteristics and Outcome of Severe Mycoplasma pneumoniae Pneumonia Admitted to PICU in Shanghai: A Retrospective Cohort Study. Crit Care Explor 2021; 3:e0366. [PMID: 33786442 PMCID: PMC7994047 DOI: 10.1097/cce.0000000000000366] [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] [Indexed: 01/16/2023] Open
Abstract
Objectives: We aimed to describe the characteristics and outcome in children with severe Mycoplasma pneumoniae pneumonia in a Chinese PICU. Design: A retrospective observational study from 2017 to 2019. Setting: A 36-bed university tertiary PICU at Shanghai Children’s Hospital. Patients: Patients admitted to a tertiary PICU 29 days to 18 years old screened for laboratory-confirmed severe M. pneumoniae pneumonia. Interventions: None. Measurements and Main Results: Descriptive analysis of baseline characteristics for patients included hospital mortality, organ dysfunctions, use of mechanical ventilation, continuous renal replacement therapy, and/or extracorporeal membrane oxygenation. A total of 817 children with severe pneumonia were admitted to PICU, and 203 of 817 cases (24.8%) with severe M. pneumoniae pneumonia were included in this study. The median age was 41 months (interquartile range, 20–67 mo), of which 77.3% (157/203) were younger than 6 years old. Among 163 patients with the test for macrolide resistance, 90.2% cases (147/163) were macrolide-resistant M. pneumoniae. Severe M. pneumoniae pneumonia-associated organ dysfunction included acute respiratory failure (203 cases, 100%), followed by cardiovascular disorder (79/203, 38.9%), gastrointestinal dysfunction (24/203, 11.8%). The main complications were pleural effusion (79/203, 38.9%), capillary leak syndrome (58/203, 28.6%), and plastic bronchitis (20/203, 9.9%). All patients needed respiratory support, including 64.5% patients (131/203) who received mechanical ventilation and 35.5% patients (72/203) who received high-flow nasal oxygen. Twenty-five patients (12.3%) treated with continuous renal replacement therapy and nine cases (4.4%) received extracorporeal membrane oxygenation. The case fatality rate was 3.9% (8/203). Furthermore, cardiovascular dysfunction, liver injury, or multiple organ dysfunction syndrome were associated with longer mechanical ventilation duration, delayed PICU discharge, and high hospital mortality. Coinfection was a risk factor of delayed PICU discharge. Conclusions: Children with severe M. pneumoniae pneumonia mainly occur under the age of 6 years, showing a high proportion of extrapulmonary organ dysfunction and macrolide resistances. Extrapulmonary organ dysfunction and coinfection are associated with worse outcomes. The overall mortality is relatively low after treated with appreciate antibiotics, respiratory support, and extracorporeal life support.
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Chen C, Lin C, Zhong X, Wen D, Zhang J. Bronchiolitis Associated with Mycoplasma pneumoniae Infection in Infants in Foshan China: An Epidemiologic Study. Med Sci Monit 2021; 27:e928148. [PMID: 33493141 PMCID: PMC7845151 DOI: 10.12659/msm.928148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Bronchiolitis is common in infants under 2 years of age. Most infections are caused by respiratory syncytial virus (RSV), but the importance of Mycoplasma pneumoniae (MP) in the etiology of bronchiolitis is unclear. Material/Methods We investigated the clinical characteristics of bronchiolitis caused by MP in 79 infants admitted to Shunde Women’s and Children’s Hospital of Guangdong Medical University and Sanshui Women’s and Children’s Healthcare Hospital from January 2016 to December 2018. Infection with MP was confirmed by the presence of serum immunoglobulin M. Results The peak detection rates of MP in the years 2016, 2017, and 2018 were 19.2%, 21.3%, and 24.0%, respectively. In each year, the peak of MP infections occurred during June and July. MP-associated bronchiolitis was mainly seen in infants from 6 to 12 months of age. Compared with RSV-associated bronchiolitis, the age of patients with bronchiolitis associated with MP was significantly older and they had a shorter hospital stay (all P<0.01 or P<0.05). Conclusions Our study indicated that MP is an important cause of bronchiolitis, with peaks of occurrence during June and July every year. Pulmonary interstitial infiltration was a characteristic of this infection. Azithromycin treatment can shorten the course of MP-associated bronchiolitis. Investigation of the epidemiological characteristics of pediatric MP-associated bronchiolitis can help diagnose and treat the disease correctly.
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Affiliation(s)
- Cheng Chen
- Department of Pediatric Respiratory, Shunde Women's and Children's Hospital of Guangdong Medical University, Foshan, Guangdong, China (mainland)
| | - Chunwang Lin
- Department of Pediatric Respiratory, Shunde Women's and Children's Hospital of Guangdong Medical University, Foshan, Guangdong, China (mainland)
| | - Xiangming Zhong
- Department of Pediatric Respiratory, Sanshui Women's and Children's Healthcare Hospital, Foshan, Guangdong, China (mainland)
| | - Diemei Wen
- Department of Pediatric Respiratory, Shunde Women's and Children's Hospital of Guangdong Medical University, Foshan, Guangdong, China (mainland)
| | - Jingping Zhang
- Department of Pediatric Respiratory, Shunde Women's and Children's Hospital of Guangdong Medical University, Foshan, Guangdong, China (mainland)
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Mycoplasma pneumoniae: Atypical Pathogen in Community Acquired Pneumonia. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.4.04] [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
Mycoplasma pneumoniae is a one of most common reasons of respiratory tract infections in both adolescents and children with severity ranged from moderate to high. Many facts in the previous years regarding infections were induced via this organism having extra pathogenic mechanisms. Clinically, resistance to macrolide has produced internationally and represents a treatment trouble. Antimicrobial sensitivity checking out techniques have been applied, and novel antibiotics which are effective towards M. pneumoniae are present processing development. That evaluate concentrates on the several trends occurring in the previous quite a few years which beautify the grasp of that microorganism, which is one of the smallest pathogenic bacteria; however, is of extreme medical significance.
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Gavrilova AA, Bontsevich RA, Vovk YR, Balabanova AA. Modern approaches to pharmacotherapy of Community-Acquired Pneumonia. RESEARCH RESULTS IN PHARMACOLOGY 2020. [DOI: 10.3897/rrpharmacology.6.52318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The study presents current views on the pharmacotherapy of community-acquired pneumonia (CAP). This study also describes in general terms the current pharmacoepidemiological situation of the CAP in Russia and abroad, which can both help medical professionals make an informed choice when choosing a pharmacotherapy, and inspire them to follow-up research and observations.
The aim of the study is to conduct an analysis of the available research on the pharmacotherapy of CAP in order to accelerate the accumulation and assimilation of knowledge in the field of this pathology.
Materials and methods: The following databases of medical publications and electronic libraries were used to search for the relevant sources of information: PubMed, Medline, Google Scholar, Crossref, and eLIBRARY.RU.
Results and discussion: The choice of a rational antimicrobial therapy (AMT) for CAP is of high relevance due to the widespread of the pathology. The article highlights modern approaches to the pharmacotherapy of CAP in adults, including a review of promising new drugs, and presents the main problematic issues related to the emergence of antibiotic resistance of pathogens, as well as methods to combat it.
Conclusion: The analyzed and generalized results of the conducted research allow the authors to make a conclusion about the feasibility of a more detailed study and raising the level of awareness of medical professionals in this pathology.
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Sadohara M, Arai T, Matsuura K. Clinically mild encephalitis/encephalopathy with reversible splenial lesion (MERS) associated with Mycoplasma pneumoniae pneumonia: An adult case and review of the literature. Clin Case Rep 2020; 8:2955-2961. [PMID: 33363858 PMCID: PMC7752583 DOI: 10.1002/ccr3.3342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/04/2020] [Accepted: 08/12/2020] [Indexed: 11/24/2022] Open
Abstract
Mycoplasma pneumonia with mild CNS involvements should be considered of MERS, even in adult. From the case series, splenial single lesions by MRI and prodromal fever with varied neurological manifestations recovered completely by antibiotics were seen.
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Affiliation(s)
- Michito Sadohara
- Department of Community, Family, and General MedicineKumamoto University HospitalKumamotoJapan
| | - Tatsuya Arai
- Department of NephrologySakai City Medical CenterSakaiJapan
| | - Kou Matsuura
- Department of GastroenterologyKishiwada Tokushukai HospitalKishiwadaJapan
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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.
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Affiliation(s)
- Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University of Medicine, Seoul, Korea
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Morinaga Y, Suzuki H, Notake S, Mizusaka T, Uemura K, Otomo S, Oi Y, Ushiki A, Kawabata N, Kameyama K, Morishita E, Uekura Y, Sugiyama A, Kawashima Y, Yanagihara K. Evaluation of GENECUBE Mycoplasma for the detection of macrolide-resistant Mycoplasma pneumoniae. J Med Microbiol 2020; 69:1346-1350. [PMID: 33141009 DOI: 10.1099/jmm.0.001264] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Resistance against macrolide antibiotics in Mycoplasma pneumoniae is becoming non-negligible in terms of both appropriate therapy and diagnostic stewardship. Molecular methods have attractive features for the identification of Mycoplasma pneumoniae as well as its resistance-associated mutations of 23S ribosomal RNA (rRNA).Hypothesis/Gap Statement. The automated molecular diagnostic sytem can identify macrolide-resistant M. pneumoniae.Aim. To assess the performance of an automated molecular diagnostic system, GENECUBE Mycoplasma, in the detection of macrolide resistance-associated mutations.Methodology. To evaluate whether the system can distinguish mutant from wild-type 23S rRNA, synthetic oligonucleotides mimicking known mutations (high-level macrolide resistance, mutation in positions 2063 and 2064; low-level macrolide resistance, mutation in position 2067) were assayed. To evaluate clinical oropharyngeal samples, purified nucleic acids were obtained from M. pneumoniae-positive samples by using the GENECUBE system from nine hospitals. After confirmation by re-evaluation of M. pneumoniae positivity, Sanger-based sequencing of 23S rRNA and mutant typing using GENECUBE Mycoplasma were performed.Results. The system reproducibly identified all synthetic oligonucleotides associated with high-level macrolide resistance. Detection errors were only observed for A2067G (in 2 of the 10 measurements). The point mutation in 23S rRNA was detected in 67 (26.9 %) of 249 confirmed M. pneumoniae-positive clinical samples. The mutations at positions 2063, 2064 and 2617 were observed in 65 (97.0 %), 2 (3.0 %) and 0 (0.0 %) of the 67 samples, respectively. The mutations at positions 2063 and 2064 were A2063G and A2064G, respectively. The results from mutant typing using GENECUBE Mycoplasma were in full agreement with the results from sequence-based typing.Conclusion. GENECUBE Mycoplasma is a reliable test for the identification of clinically significant macrolide-resistant M. pneumoniae.
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Affiliation(s)
- Yoshitomo Morinaga
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama, Japan.,Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Hiromichi Suzuki
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.,Department of Clinical Laboratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Takashi Mizusaka
- Department of Clinical Laboratory, Kakogawa City Hospital, Kakogawa, Hyogo, Japan
| | - Keiichi Uemura
- Department of Clinical Laboratory, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
| | - Shinobu Otomo
- Department of Clinical Laboratory, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan
| | - Yuka Oi
- Department of Clinical Laboratory, Osaka General Medical Center, Osaka, Osaka, Japan
| | - Akihito Ushiki
- Department of Clinical Laboratory, Tone-chuo-hospital, Numata, Gunma, Japan
| | - Naoki Kawabata
- Department of Clinical Laboratory, Municipal Tsuruga Hospital, Tsuruga, Fukui, Japan
| | - Kazuaki Kameyama
- Department of Clinical Laboratory, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Eri Morishita
- Department of Clinical Laboratory, Akashi Medical Center, Akashi, Hyogo, Japan
| | - Yoshiko Uekura
- Tsuruga Institute of Biotechnology, TOYOBO Co., Ltd, Tsuruga, Fukui, Japan
| | - Akio Sugiyama
- Diagnostic System Department, TOYOBO Co., Ltd, Osaka, Osaka, Japan
| | - Yosuke Kawashima
- Tsuruga Institute of Biotechnology, TOYOBO Co., Ltd, Tsuruga, Fukui, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
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Suzuki S, Ishimaru N, Akashi Y, Takeuchi Y, Ueda A, Ushiki A, Kinami S, Suzuki H, Tokuda Y, Maeno T. Physicians' prediction for the assessment of atypical pathogens in respiratory tract infections. J Gen Fam Med 2020; 21:226-234. [PMID: 33304716 PMCID: PMC7689225 DOI: 10.1002/jgf2.350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/29/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Patients with acute respiratory tract infections are frequently prescribed antimicrobials despite high rates of virus detection. Physicians may overprescribe antimicrobials owing to the concern of bacterial infections, including those because of atypical pathogens. We investigated the accuracy of clinical predictions concerning atypical pathogen infections. METHODS We prospectively enrolled adult patients who presented with a fever and cough in outpatient clinics between December 2016 and August 2018. After taking a history and performing physical examinations, physicians predicted the possibility of respiratory infections because of atypical pathogens. Disease probabilities were categorized into 3 grades (high: ≥50%, intermediate: 20% ≥ and <50%, and low: <20%) and were judged by physicians who were taking care of the patients. Confirmation of atypical pathogens was performed by comprehensive molecular analyses of respiratory samples. RESULTS Atypical pathogens were detected in 21 of 210 patients. A close contact history (odds ratio [OR]: 11.4, 95% confidence interval [CI]: 2.4-53.5) and the presence of pneumonia (OR: 12.9, CI: 4.3-39.2) were associated with the detections. Atypical pathogens were detected in 32.3% of high-probability cases (10/31), while atypical pathogens were only detected in 8.8% of intermediate-probability cases (8/91) and 3.4% of low-probability cases (3/88) (P < .001). CONCLUSIONS The current study indicates that physicians' predictions were associated with the detection of atypical pathogens; however, overestimation was observed.
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Affiliation(s)
- Satoshi Suzuki
- Division of General MedicineTone Chuo HospitalGunmaJapan
| | - Naoto Ishimaru
- Department of General Internal MedicineAkashi Medical CenterJapan
| | - Yusaku Akashi
- Division of Infectious DiseasesDepartment of MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Yuto Takeuchi
- Division of Infectious DiseasesDepartment of MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Atsuo Ueda
- Department of Clinical LaboratoryTsukuba Medical Center HospitalTsukubaJapan
| | - Akihito Ushiki
- Department of Clinical LaboratoryTone Chuo HospitalGunmaJapan
| | - Saori Kinami
- Department of General Internal MedicineAkashi Medical CenterJapan
| | - Hiromichi Suzuki
- Division of Infectious DiseasesDepartment of MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
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Correlation Between the Clinical Severity, Bacterial Load, and Inflammatory Reaction in Children with Mycoplasma Pneumoniae Pneumonia. Curr Med Sci 2020; 40:822-828. [PMID: 33123897 PMCID: PMC7595045 DOI: 10.1007/s11596-020-2261-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/08/2020] [Indexed: 11/09/2022]
Abstract
Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia (MPP), quantitative polymerase chain reaction (qPCR) has become a useful diagnostic method. This study was performed to explore the relationship between the qPCR findings, clinical symptoms, and inflammatory markers in children with MPP. Four hundred children with MPP have been enrolled in this retrospective analysis. All clinical and analytical information, including mycoplasma pneumoniae (MP) PCR results, has been collected. Based on the PCR results, the patients were divided into groups with load values (copy number) < 105 (54 cases), ≥105 and <106 (71 cases), ≥106 and <107 (112 cases), ≥107 and ≤108 (114 cases), and >108 (49 cases). The clinical features (including symptoms and signs) and inflammatory indicators were compared among the groups. The incidence of high fever (above 39°C), thermal peak during the entire hospitalization period, fever duration, days of hospitalization, and plasma lactate dehydrogenase (LDH) levels were statistically correlated with the MP PCR load value in children with MPP. The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization > duration of fever > period of hospitalization > LDH value > C-reactive protein value. The host immune response was significantly greater in the complication group than in the non-complication group.
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Tsai TA, Tsai CK, Kuo KC, Yu HR. Rational stepwise approach for Mycoplasma pneumoniae pneumonia in children. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 54:557-565. [PMID: 33268306 DOI: 10.1016/j.jmii.2020.10.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 10/04/2020] [Accepted: 10/08/2020] [Indexed: 01/14/2023]
Abstract
Mycoplasma pneumoniae is a common pathogen that causes community-acquired pneumonia. In the past, M. pneumoniae was sensitive to macrolide antibiotics, and M. pneumoniae pneumonia (MPP) was usually a benign and self-limiting disease. However, despite use of the appropriate antibiotics, persistent fever and clinical deterioration may occur, leading to severe disease. Two major complicated conditions that may be clinically encountered are macrolide-resistant MPP and refractory MPP. Regarding the epidemics in Taiwan, before 2017, the mean rate of macrolide resistance was below 30%. Notably, since 2018, the prevalence of macrolide-resistant MPP in Taiwan has increased rapidly. Macrolide-resistant MPP shows persistent fever and/or no radiological regression to macrolide antibiotics and may even progress to severe and complicated pneumonia. Tetracyclines (doxycycline or minocycline) or fluoroquinolones are alternative treatments for macrolide-resistant MPP. Refractory MPP is characterized by an excessive immune response against the pathogen. In this context, corticosteroids have been suggested as an immunomodulator for downregulating the overactive host immune reaction. Overuse of macrolides may contribute to macrolide resistance, and thereafter, an increase in macrolide-resistant MPP. Delayed effective antimicrobial treatment is associated with prolonged and/or more severe disease. Thus, the appropriate prescription of antibiotics, as well as the rapid and accurate diagnosis of MPP, is important. The exact starting point, dose, and duration of the immunomodulator are yet to be established. We discuss these important issues in this review.
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Affiliation(s)
- Ti-An Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chang-Ku Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuang-Che Kuo
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hong-Ren Yu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Multiple-locus variable-number tandem-repeat analysis (MLVA) of macrolide-susceptible and -resistant Mycoplasma pneumoniae in children in Taiwan. J Formos Med Assoc 2020; 119:1539-1545. [DOI: 10.1016/j.jfma.2019.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/30/2019] [Accepted: 12/16/2019] [Indexed: 11/18/2022] Open
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Molecular Characterization of Mycoplasma pneumoniae Isolates in the United States from 2012 to 2018. J Clin Microbiol 2020; 58:JCM.00710-20. [PMID: 32817226 PMCID: PMC7512161 DOI: 10.1128/jcm.00710-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/06/2020] [Indexed: 12/25/2022] Open
Abstract
Mycoplasma pneumoniae is a major cause of community-acquired pneumonia. There are limited data in the United States on the molecular epidemiological characteristics of M. pneumoniae. We collected 446 M. pneumoniae-positive specimens from 9 states between August 2012 and October 2018. Culture, antimicrobial susceptibility testing, P1 subtyping, and multilocus VNTR (variable-number tandem repeats) analysis (MLVA) were performed to characterize the isolates. Mycoplasma pneumoniae is a major cause of community-acquired pneumonia. There are limited data in the United States on the molecular epidemiological characteristics of M. pneumoniae. We collected 446 M. pneumoniae-positive specimens from 9 states between August 2012 and October 2018. Culture, antimicrobial susceptibility testing, P1 subtyping, and multilocus VNTR (variable-number tandem repeats) analysis (MLVA) were performed to characterize the isolates. Macrolide-resistant M. pneumoniae (MRMp) was detected in 37 (8.3%) specimens. P1 subtype 2 (P1-2) was the predominant P1 subtype (59.8%). P1 subtype distribution did not change significantly chronologically or geographically. The macrolide resistance rate in P1 subtype 1 (P1-1) samples was significantly higher than that in P1-2 (12.9% versus 5.5%). Six P1-2 variants were identified, including two novel types, and variant 2c was predominant (64.6%). P1-2 variants were distributed significantly differently among geographic regions. Classical P1-2 was more frequent in lower respiratory tract specimens and had longer p1 trinucleotide repeats. Classical P1-2 was most common in MRMp (35.7%), while variant 2c was most common in macrolide-susceptible M. pneumoniae (67.5%). Fifteen MLVA types were identified; 3-5-6-2 (41.7%), 4-5-7-2 (35.3%), and 3-6-6-2 (16.6%) were the major types, and four MLVA clusters were delineated. The distribution of MLVA types varied significantly over time and geographic location. The predominant MLVA type switched from 4-5-7-2 to 3-5-6-2 in 2015. MLVA type was associated with P1 subtypes and P1-2 variant types but not with macrolide resistance. To investigate the M. pneumoniae genotype shift and its impact on clinical presentations, additional surveillance programs targeting more diverse populations and prolonged sampling times are required.
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Kenri T, Suzuki M, Sekizuka T, Ohya H, Oda Y, Yamazaki T, Fujii H, Hashimoto T, Nakajima H, Katsukawa C, Kuroda M, Shibayama K. Periodic Genotype Shifts in Clinically Prevalent Mycoplasma pneumoniae Strains in Japan. Front Cell Infect Microbiol 2020; 10:385. [PMID: 32850484 PMCID: PMC7424021 DOI: 10.3389/fcimb.2020.00385] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Nationwide increases in Mycoplasma pneumoniae pneumonia cases in Japan were reported in 2011, 2012, 2015, and 2016. In this study, we isolated 554 M. pneumoniae strains in 4 areas in Japan (Kanagawa, Okayama, Osaka, and Saitama) between 2006 and 2019, and performed genotyping analysis. More than 80% of the strains isolated in 2011 and 2012 harbored type 1 p1 adhesin gene; however, strains harboring type 2 or its variant p1 gene increased in 2015 and 2016 and dominated after 2017. These findings suggested that a shift in the prevalent genotype of M. pneumoniae clinical strains occurred recently in Japan. More than 90% of the type 1 strains isolated after 2010 harbored macrolide-resistance mutations in their 23S rRNA gene, whereas most type 2 lineage strains had no such mutations. Consequently, the increase in type 2 lineage strains in Japan has reduced the macrolide resistance rate of clinical M. pneumoniae strains. During this analysis, we also identified M. pneumoniae strains carrying a novel variant type 1 p1 gene, and we classified it as type 1b. We then sequenced the genomes of 81 selected M. pneumoniae strains that we collected between 1976 and 2017 in Japan, and compared them with 156 M. pneumoniae genomes deposited in public databases to provide insights into the interpretation of M. pneumoniae genotyping methods, including p1 typing, multiple-locus variable-number tandem repeat analysis (MLVA), multi-locus sequence typing (MLST), and typing by 8 single-nucleotide polymorphism markers (SNP-8). As expected, p1 typing, MLST, and SNP-8 results exhibited good correlation with whole-genome SNP analysis results in terms of phylogenetic relationships; however, MLVA typing results were less comparable to those of the other methods. MLVA may be useful for the discrimination of strains derived from a single outbreak within a limited area; however, is not reliable for classification of strains collected from distantly separated areas at different time points. This study showed the usefulness of genome-based comparison of M. pneumoniae for molecular epidemiology. Genome sequencing of more strains will improve our understanding of global propagation routes of this pathogen and evolutionary aspects of M. pneumoniae strains.
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Affiliation(s)
- Tsuyoshi Kenri
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tsuyoshi Sekizuka
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hitomi Ohya
- Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan
| | | | | | | | | | - Hiroshi Nakajima
- Okayama Prefectural Institute for Environmental Science and Public Health, Okayama, Japan
| | - Chihiro Katsukawa
- Osaka Institute of Public Health, Osaka, Japan.,Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Makoto Kuroda
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
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Xing Y, Wang D, Sheng K, Xiao X, Wei H, Liu L, Zhou W, Tong X. Dynamic change of Mycoplasma pneumoniae pneumonia in hospitalized children in a general hospital: a 3-year retrospective analysis. Transl Pediatr 2020; 9:522-531. [PMID: 32953550 PMCID: PMC7475305 DOI: 10.21037/tp-20-149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The epidemiology and economic burden of hospitalized community-acquired pneumonia (CAP) children due to MP is still poorly understood. This study aimed to investigate the dynamic changes of Mycoplasma pneumoniae pneumonia (MPP) in children in a general hospital. METHODS A total of 2011 CAP children aged 1-16 years hospitalized at Peking University Third Hospital from 2017 to 2019 were enrolled by cross-sectional study for the retrospective analysis of the clinical data mainly including seasonal distribution of MPP, hospital stay, severity, complications, use of flexible bronchoscopy, and hospitalization costs. The dynamic changes of CAP and MPP children within 3 consecutive years and the differences between the MPP group and non-MPP groups were compared. RESULTS The proportion of CAP children among hospitalized children was 32.4%, 38.5%, and 39.5% in 2017, 2018, and 2019, respectively, showing an upward trend (P<0.05).The prevalence rate of MPP was highest in the third quarter (30.2%) and the fourth quarter (39.2%) and lowest in the second quarter (13.2%) (χ2=51.8, P<0.05). Compared with the non-MPP group, the MPP group had significantly higher incidence of severe pneumonia (19.4% vs. 12.0%, χ2=20.99), incidence of complications (16.1% vs. 6.5%, χ2=48.24), proportion of patients undergoing flexible bronchoscopy (38.4% vs. 9.0%, χ2=252.79), and hospitalization costs (all P<0.05), along with significantly longer hospital stay (6 vs. 4 days, z=-11.131). A dynamic comparison of the clinical characteristics of MPP in 3 years showed that the number of children with MPP increased significantly in preschoolers in 2018 (37.3%) and in school-aged or older children in 2019 (53%) (P<0.05). MPP peaks occurred in August 2018 and November 2019. The total hospitalization costs, examination fees, and non-medication treatment costs increased significantly (the z values were 35.24, 46.79, and 9.64, respectively; P<0.05) year by year among MPP children; there was no significant difference in the medication cost over these 3 years (z=4.81, P>0.05). CONCLUSIONS The proportions of severe pneumonia, complications, and use of flexible bronchoscopy as well as the hospitalization days and costs are higher in MPP children. General hospitals should develop integrated clinical quality control programs for MPP children, so as to optimize the allocation of medical resources.
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Affiliation(s)
- Yan Xing
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Dan Wang
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Kai Sheng
- Department of Emergency, Beijing Children's Hospital, Beijing, China
| | - Xiumei Xiao
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China
| | - Hongling Wei
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Ling Liu
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Wei Zhou
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Xiaomei Tong
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
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38
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Tamiya S, Yoshikawa E, Ogura M, Kuroda E, Suzuki K, Yoshioka Y. Vaccination using inactivated Mycoplasma pneumoniae induces detrimental infiltration of neutrophils after subsequent infection in mice. Vaccine 2020; 38:4979-4987. [PMID: 32536549 DOI: 10.1016/j.vaccine.2020.05.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/18/2020] [Accepted: 05/27/2020] [Indexed: 12/21/2022]
Abstract
Mycoplasma pneumoniae (Mp) is one of the most common causes of community-acquired pneumonia. Given the emergence and high rates of antibiotic-resistant Mp strains, vaccines that prevent the pneumonia and secondary complications due to Mp infection are urgently needed. Although several studies have shown the protective efficacy of Mp vaccines in human clinical trials, some reports suggest that vaccination against Mp exacerbates disease upon subsequent Mp challenge. Therefore, to develop optimal vaccines against Mp, understanding the immune responses that contribute to post-vaccination exacerbation of inflammation is crucial. Here we examined whether Mp vaccination might exacerbate pneumonia after subsequent Mp infection in mice. We found that vaccination with inactivated Mp plus aluminum salts as an adjuvant induced Mp-specific IgG, Th1 cells, and Th17 cells. Toll-like receptor 2 signaling contributed to the induction of an Mp-specific IgG response and was necessary for Mp-specific Th17-cell-but not Th1-cell-responses in vaccinated mice. In addition, vaccination with inactivated Mp plus aluminum salts suppressed the number of Mp organisms in the bronchoalveolar lavage fluid, indicating that vaccination can reduce Mp infection. However, the numbers of total immune cells and neutrophils in bronchoalveolar lavage fluid after Mp challenge did not differ between vaccinated mice and non-vaccinated control mice. Furthermore, depletion of CD4+ T cells prior to Mp challenge decreased pulmonary neutrophil infiltration in vaccinated mice, suggesting that Th1 or Th17 cells (or both) are responsible for the vaccination-induced neutrophil infiltration. These results suggest that, despite reducing Mp infection, vaccination of mice by using inactivated Mp fails to suppress inflammation, such as neutrophil infiltration into the lung, after subsequent Mp infection.
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Affiliation(s)
- Shigeyuki Tamiya
- Laboratory of Nano-design for Innovative Drug Development, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan; Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan; Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
| | - Eisuke Yoshikawa
- Laboratory of Nano-design for Innovative Drug Development, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan; Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan; Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
| | - Monami Ogura
- Laboratory of Nano-design for Innovative Drug Development, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan; Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Etsushi Kuroda
- Department of Immunology and Medical Zoology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Laboratory of Adjuvant Innovation, Center for Vaccine and Adjuvant Research, NIBIOHN, Ibaraki, Osaka, Japan
| | - Koichiro Suzuki
- The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan
| | - Yasuo Yoshioka
- Laboratory of Nano-design for Innovative Drug Development, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan; Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan; Vaccine Creation Group, BIKEN Innovative Vaccine Research Alliance Laboratories, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan; The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan; BIKEN Center for Innovative Vaccine Research and Development, The Research Foundation for Microbial Diseases of Osaka University, Suita, Osaka, Japan; Global Center for Medical Engineering and Informatics, Osaka University, Suita, Osaka, Japan.
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Zhao J, Ji X, Wang Y, Wang X. Clinical Role of Serum Interleukin-17A in the Prediction of Refractory Mycoplasma pneumoniae Pneumonia in Children. Infect Drug Resist 2020; 13:835-843. [PMID: 32210598 PMCID: PMC7076716 DOI: 10.2147/idr.s240034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/22/2020] [Indexed: 01/24/2023] Open
Abstract
Background Mycoplasma pneumoniae pneumonia (MPP) is a common community-acquired pneumonia (CAP) in children, which may become refractory MPP (RMPP) to treatment. Objective The purpose of this study was to evaluate the clinical utility of measuring serum interleukin (IL)-17A to predict RMPP. Patients and Methods A retrospective clinical study at a single pediatric center included a review of the medical records of all children hospitalized for CAP between November 2015 and October 2019. The diagnosis of MPP was based on clinical presentation, chest radiography, and measurement of serum anti-Mycoplasma immunoglobulin IgM antibody titer using the microparticle agglutination method or sputum samples for Mycoplasma pneumoniae by PCR. Serum levels of IL-18 and IL-17A were determined by ELISA. Results Of the 625 children diagnosed with CAP, there were 154 children with MPP and without underlying diseases who were divided into a non-refractory MPP (NRMPP) group (n = 109) and a RMPP group (n = 45). The RMPP group had a higher incidence of tachypnea, cyanosis, hypoxia, segmental or lobar pneumonia, pleural effusion, and a longer period of hospitalization compared with NRMPP group (all P-values < 0.05). A serum IL-17A level above 10.8 pg/mL was a predictor for RMPP: area under the curve (AUC) 0.822; standard error (SE) 0.039; 95% confidence interval (CI) 0.746–0.897; diagnostic sensitivity and specificity of 77.8% and 77.1%, respectively. An LDH level above 436.5 IU/L and an IL-18 level above 464.5 pg/mL were the second most useful markers for RMPP: AUC 0.775, 0.775; SE 0.038, 0.039; 95% CI 0.700–0.850, 0.698–0.852; sensitivity 77.8%, 82.2%; specificity 62.4%, 59.6%; respectively. Conclusion This preliminary study of MPP in a pediatric population has shown that measurement of serum IL-17A may be a useful marker for the predictor of RMPP.
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Affiliation(s)
- Jiuling Zhao
- Department of Pediatrics, Tianjin Nankai Hospital, Tianjin, People's Republic of China.,Department of Pediatrics, Nankai Hospital Affiliated to Nankai University, Tianjin, People's Republic of China.,Nankai Clinical School, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xin Ji
- School of Medical English and Health Communication, Tianjin Medical University, Tianjin, People's Republic of China
| | - Yushui Wang
- Department of Pediatrics, Tianjin Nankai Hospital, Tianjin, People's Republic of China
| | - Xin Wang
- Department of Pediatrics, Tianjin Nankai Hospital, Tianjin, People's Republic of China
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40
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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.
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Lee E, Kim CH, Lee YJ, Kim HB, Kim BS, Kim HY, Kim Y, Kim S, Park C, Seo JH, Sol IS, Sung M, Song MS, Song DJ, Ahn YM, Oh HL, Yu J, Jung S, Lee KS, Lee JS, Jang GC, Jang YY, Chung EH, Chung HL, Choi SM, Choi YJ, Han MY, Shim JY, Kim JT, Kim CK, Yang HJ. Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea. BMC Infect Dis 2020; 20:132. [PMID: 32050912 PMCID: PMC7017508 DOI: 10.1186/s12879-020-4810-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/21/2020] [Indexed: 11/24/2022] Open
Abstract
Background Community–acquired pneumonia (CAP) is one of the leading worldwide causes of childhood morbidity and mortality. Its disease burden varies by age and etiology and is time dependent. We aimed to investigate the annual and seasonal patterns in etiologies of pediatric CAP requiring hospitalization. Methods We conducted a retrospective study in 30,994 children (aged 0–18 years) with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Mycoplasma pneumoniae (MP) pneumonia was clinically classified as macrolide-sensitive MP, macrolide-less effective MP (MLEP), and macrolide-refractory MP (MRMP) based on fever duration after initiation of macrolide treatment, regardless of the results of in vitro macrolide sensitivity tests. Results MP and respiratory syncytial virus (RSV) were the two most commonly identified pathogens of CAP. With the two epidemics of MP pneumonia (2011 and 2015), the rates of clinical MLEP and MRMP pneumonia showed increasing trends of 36.4% of the total MP pneumonia. In children < 2 years of age, RSV (34.0%) was the most common cause of CAP, followed by MP (9.4%); however, MP was the most common cause of CAP in children aged 2–18 years of age (45.3%). Systemic corticosteroid was most commonly administered for MP pneumonia. The rate of hospitalization in intensive care units was the highest for RSV pneumonia, and ventilator care was most commonly needed in cases of adenovirus pneumonia. Conclusions The present study provides fundamental data to establish public health policies to decrease the disease burden due to CAP and improve pediatric health.
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Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Chul-Hong Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Yong Ju Lee
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Hyo-Bin Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, South Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Ulsan University Gangneung Asan Hospital, Gangneung, South Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, South Korea
| | - Yunsun Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Sangyoung Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Chorong Park
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University Hospital, Dankook University Medical School, Cheonan, South Korea
| | - In Suk Sol
- Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Myongsoon Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Seoul, South Korea
| | - Min Seob Song
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Pusan, South Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Young Min Ahn
- Department of Pediatrics, Eulji University, Eulji General Hospital, Seoul, South Korea
| | - Hea Lin Oh
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, South Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, Ulsan University Medical School, Seoul, South Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, South Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service, Ilsan Hospital, Ilsan, South Korea
| | - Yoon-Young Jang
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hai Lee Chung
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Sung-Min Choi
- Department of Pediatrics, Dongguk University Kyungju Hospital, Kyungju, South Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University Children Hospital, Seoul, South Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang-Keun Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, South Korea.
| | - Hyeon-Jong Yang
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea. .,Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea.
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Lee YJ, Ahn YM, Jang GC, Chung HL, Chung EH, Hwang YH, Shim JY. Real-world treatment pattern of mycoplasma pneumonia in hospitalized children: A multicenter retrospective study. ALLERGY ASTHMA & RESPIRATORY DISEASE 2020. [DOI: 10.4168/aard.2020.8.2.66] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Young Ju Lee
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Min Ahn
- Department of Pediatrics, Eulji University Eulji General Hospital, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Hai Lee Chung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - Yoon Ha Hwang
- Department of Pediatrics, Busan St. Mary's Hospital, Busan, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim HS, Sol IS, Li D, Choi M, Choi YJ, Lee KS, Seo JH, Lee YJ, Yang HJ, Kim HH. Efficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children: meta-analysis of randomized controlled trials. BMC Pulm Med 2019; 19:251. [PMID: 31852460 PMCID: PMC6921474 DOI: 10.1186/s12890-019-0990-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 11/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background Mycoplasma pneumoniae is one of the most common pathogens causing community acquired pneumonia in children. Although the rate of macrolide-refractory Mycoplasma pneumoniae (MRMP) has increased, systemic glucocorticoids as a treatment option has not been validated yet. The purpose of this study was to assess the efficacy of glucocorticoids add-on in the treatment of MRMP in children through systematic review and meta-analysis. Methods Data sources A systematic literature search was conducted using ten electronic bibliographic databases including English, Korean, Chinese and Japanese languages, up to March 8, 2018. Study selection The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and selected randomized control trials which compared the efficacy of glucocorticoids add-on to macrolide in the treatment of MRMP in children. Data extraction Two independent reviewers extracted: primary outcomes as hospital days, fever duration, and change in C-reactive protein (CRP) and main analysis was performed through meta-analysis with random effects model. Results Twenty-four unique randomized controlled trials met the inclusion criteria. The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in conventional macrolide-treatment group (Weighted mean difference (WMD) = − 4.03 days). The mean length of fever duration was significantly shorter in the glucocorticoid treatment group in comparison with the conventional treatment group (WMD = -3.32 days). Level of CRP after treatment was significantly lower in the glucocorticoid treatment group than that in the conventional treatment group (WMD = -16.03). Sensitivity analysis and subgroup analysis showed no significant improvement in heterogeneity. As limitations of the study, most of the studies included were from a single country and we were unable to control for heterogeneity across interventions, lack of standardized measures, and different time points of assessments across studies. Conclusions Glucocorticoid add-on treatment for MRMP can significantly shorten the duration of fever and hospital stay and decrease the level of CRP. These results should be confirmed by adequately powered studies in the future.
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Affiliation(s)
- Hwan Soo Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - In Suk Sol
- Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Donghe Li
- Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, South Korea
| | - Miyoung Choi
- Division of Health Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, South Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Ju Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, South Korea
| | - Yong Ju Lee
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, South Korea.
| | - Hyeon-Jong Yang
- Pediatric Allergy and Respiratory Center, Department of Pediatrics, SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea.
| | - Hyun Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Ranjbar R, Halaji M. Epidemiology of Mycoplasma pneumoniae prevalence in Iranian patients: a systematic review and meta-analysis. J Med Microbiol 2019; 68:1614-1621. [PMID: 31524582 DOI: 10.1099/jmm.0.001079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Mycoplasma pneumoniae is regarded as the important infectious agent of acute respiratory infections (ARIs) in the world. However, there is little knowledge about the prevalence of M. pneumoniae in Iran. Therefore, the aim of this study was to investigate the prevalence of M. pneumoniae in Iran through a meta-analysis of included studies.Methods. A systematic search was done by using electronic databases from papers that were published by Iranian authors to the end of February 2019. Then, 12 publications, which met our inclusion criteria, were enrolled for data extraction and analysis by using the 'metaprop program' in stata version 14.0.Results. The pooled prevalence of M. pneumoniae was 9 % (95 % confidence intervals: 5-16 %) ranging from 1 to 26 %. There was a significant heterogeneity among the 12 studies (X2=128.29; P<0.001; I 2=91.43 %). The funnel plot for publication bias showed no evidence of asymmetry.Conclusions. The frequency of M. pneumoniae in Iran is comparable with other parts of the world. Although the overall prevalence of M. pneumoniae was low, awareness about the distribution of these agent is very important because of higher infection rates in susceptible groups. In addition, these results showed the rates of M. pneumoniae had variation based on location, type of infection and sample, gender and detection rate and there was evidence of publication bias.
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Affiliation(s)
- Reza Ranjbar
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehrdad Halaji
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Teratani Y, Hagiya H, Koyama T, Adachi M, Ohshima A, Zamami Y, Tanaka HY, Tatebe Y, Tasaka K, Mikami N, Shinomiya K, Kitamura Y, Kano MR, Hinotsu S, Sendo T. Pattern of antibiotic prescriptions for outpatients with acute respiratory tract infections in Japan, 2013-15: a retrospective observational study. Fam Pract 2019; 36:402-409. [PMID: 30272148 DOI: 10.1093/fampra/cmy094] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In this age of antimicrobial resistance, unnecessary use of antibiotics to treat non-bacterial acute respiratory tract infections (ARTIs) and inappropriate use of antibiotics in treating bacterial ARTIs are public health concerns. PURPOSE Our aim is to identify the pattern of oral antibiotic prescriptions for outpatients with ARTIs in Japan. METHODS We analysed health insurance claims data of patients (aged ≤74 years) from 2013 to 2015, to determine the pattern of antibiotic prescriptions for outpatient ARTIs and calculated the proportion of each antibiotic. RESULTS Data on 4.6 million antibiotic prescriptions among 1559394 outpatients with ARTIs were analysed. The most commonly prescribed classes of antibiotics included cephalosporins (41.9%), macrolides (32.8%) and fluoroquinolones (14.7%). The proportion of first-, second- and third-generation cephalosporins was 1.0%, 1.7% and 97.3%, respectively. Fluoroquinolones accounted for a quarter of the prescriptions for ARTIs in patients aged >20 years. In contrast, penicillins accounted for just 8.0% of the total number of antibiotic prescriptions for ARTIs. CONCLUSIONS According to clinical guidelines, penicillins are first-line antibiotics against ARTIs. However, third-generation cephalosporins, macrolides and fluoroquinolones are more frequently prescribed in Japan. Although we could not assess the extent to which appropriate antibiotics are selected, our results support the necessity of improving antibiotic choices in the treatment of ARTIs.
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Affiliation(s)
- Yusuke Teratani
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Hideharu Hagiya
- Department of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan
| | - Toshihiro Koyama
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.,Education and Research Center for Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Mayu Adachi
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ayako Ohshima
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yoshito Zamami
- Department of Clinical Pharmacology and Therapeutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hiroyoshi Y Tanaka
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yasuhisa Tatebe
- Department of Pharmacy, Okayama University Hospital, Okayama, Japan
| | - Ken Tasaka
- Department of Pharmacy, Okayama University Hospital, Okayama, Japan
| | - Naoko Mikami
- Division of Pharmacy, Chiba University Hospital, Chiba, Japan
| | - Kazuaki Shinomiya
- Education and Research Center for Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.,Department of Toji Pharmacy, Smile Co., Ltd, Hiroshima, Japan
| | | | - Mitsunobu R Kano
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.,Department of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Shiro Hinotsu
- Department of Biostatistics and Clinical Epidemiology, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Toshiaki Sendo
- Department of Pharmacy, Okayama University Hospital, Okayama, Japan
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Guo D, Hu W, Xu B, Li J, Li D, Li S, Wu Z, Wei R, Tian X, Shen K, Xin D. Allele-specific real-time PCR testing for minor macrolide-resistant Mycoplasma Pneumoniae. BMC Infect Dis 2019; 19:616. [PMID: 31299916 PMCID: PMC6626384 DOI: 10.1186/s12879-019-4228-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/26/2019] [Indexed: 11/17/2022] Open
Abstract
Background The point mutations in 23S rRNA gene of Mycoplasma pneumoniae (M. pneumoniae) can lead to high-level resistance to macrolides. This study aimed to evaluate allele-specific real-time PCR (ASPCR) to detect the resistance-related mutations located at positions A2063G and A2064G of 23S rRNA gene. Methods We detected 178 pharyngeal swab specimens and calculated the proportions of resistant and sensitive quasispecies using ASPCR assays. ASPCR assays can detect down to 10 copies of 23S rRNA gene and achieved sensitivities of < 0.1% for A2063G and A2064G. We also compared the findings of ASPCR with the results of nested PCR with sequencing. Results Of 178 samples, 164 were found to have M. pneumoniae including 90.85% (149/164) samples with macrolide-resistant M. pneumoniae (MRMP) quasispecies by ASPCR, while 153 were found to be M. pneumoniae-positive including 71.90% (110/153) samples with MRMP quasispecies by nested PCR with sequencing. Of the 164 M. pneumoniae-positive samples, 61.59% (101/164) had the mixed population of wild-type and mutant M. pneumoniae, and 56.44% (57/101) of the latter contained the mutations at low frequency (≤50%). Conclusion ASPCR indicated that sensitive and resistant quasispecies coexisted in most of the M. pneumoniae positive samples. The ASPCR was a highly sensitive, accurate and rapid method for detecting the macrolide resistance-associated mutations and it could provide earlier and more drug-resistant information for M. pneumoniae research and the clinical therapy.
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Affiliation(s)
- Dongxing Guo
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China
| | - Wenjuan Hu
- Department of Paediatrics, Civil Aviation General Hospital, Beijing, China
| | - Baoping Xu
- Department of Respiratory, Beijng Children's Hospital, Capital Medical University, No. 56 South Lishi Road, Xicheng District, Beijing, China
| | - Jingyi Li
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China
| | - Dan Li
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China
| | - Shaogang Li
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China
| | - Zhaoyong Wu
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China
| | - Ran Wei
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China
| | - Xiujun Tian
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China
| | - Kunling Shen
- Department of Respiratory, Beijng Children's Hospital, Capital Medical University, No. 56 South Lishi Road, Xicheng District, Beijing, China.
| | - Deli Xin
- Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong an Road, Xicheng District, Beijing, China.
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Yan C, Xue G, Zhao H, Feng Y, Li S, Cui J, Ni S, Sun H. Molecular and clinical characteristics of severe Mycoplasma pneumoniae pneumonia in children. Pediatr Pulmonol 2019; 54:1012-1021. [PMID: 31119869 DOI: 10.1002/ppul.24327] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/25/2019] [Accepted: 03/16/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To analyze the molecular and the clinical characteristics of Mycoplasma pneumoniae (Mp) pneumonia (MPP) and to explore the related factors predicting severe MPP (SMPP). METHODS A total of 423 pediatric cases of MPP were retrospectively analyzed, in 2013-2017, in Beijing, China. Clinical information was collected from the medical records. Mp-positive specimens were characterized using P1 typing and multiple locus variable-number tandem repeat analysis (MLVA). The macrolide resistance-associated mutations were also detected. RESULTS The predominant genotype was P1-1 (88.2%) and M4-5-7-2 (87.5%), whereas percentages of type P1-2 and M3-5-6-2 increased across the 5-year period. The mutation rate of genotype M4-5-7-2 (365/370, 98.6%) was significantly higher than that of the genotype M3-5-6-2 (15/48, 32.25%; P = 0.000). Overall, 180 (42.6%) of the 423 Mp-positive patients were coinfected with other pathogens. Respiratory syncytial virus coinfection (24/180, 13.3%) was more common in cases typed M3-5-6-2 (4/23, 17.4%) than that of M4-5-7-2 (20/155, 12.9%; P = 0.038). Pleural effusion accounted for 52.6% (169/321) of the observed complications. In the mono-infection cases, cases typed M3-5-6-2 (56%, 14/25) were significantly (P = 0.020) associated with pleural effusion compared with those typed M4-5-7-2 (32.6%, 70/215); 84% (21/25) of specimens typed M3-5-6-2 were diagnosed as SMPP, whereas 63.7% (137/215) of specimens typed M4-5-7-2 were diagnosed as SMPP (P = 0.043). CONCLUSIONS In our study, we proposed for the first time that the mono-infection patients with Mp typed M3-5-6-2 appear to have a higher risk for progressing to SMPP. MLVA typing can provide hints on the clinical characteristics of Mpp.
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Affiliation(s)
- Chao Yan
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Guanhua Xue
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Hanqing Zhao
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Yanling Feng
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Shaoli Li
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Jinghua Cui
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Shanshan Ni
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
| | - Hongmei Sun
- Department of Bacteriology, Capital Institute of Pediatrics, Beijing, China
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Molecular Typing of Mycoplasma pneumoniae Strains in Sweden from 1996 to 2017 and the Emergence of a New P1 Cytadhesin Gene, Variant 2e. J Clin Microbiol 2019; 57:JCM.00049-19. [PMID: 30918047 PMCID: PMC6535615 DOI: 10.1128/jcm.00049-19] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 03/21/2019] [Indexed: 01/03/2023] Open
Abstract
Mycoplasma pneumoniae causes respiratory infections, such as community-acquired pneumonia (CAP), with epidemics recurring every 3 to 7 years. In 2010 and 2011, many countries experienced an extraordinary epidemic peak. Mycoplasma pneumoniae causes respiratory infections, such as community-acquired pneumonia (CAP), with epidemics recurring every 3 to 7 years. In 2010 and 2011, many countries experienced an extraordinary epidemic peak. The cause of these recurring epidemics is not understood, but decreasing herd immunity and shifts in the strains’ antigenic properties have been suggested as contributing factors. M. pneumoniae PCR-positive samples were collected between 1996 and 2017 from four neighboring counties inhabited by 12% of Sweden’s population. A total of 578 isolates were characterized directly from 624 clinical samples using P1 typing by sequencing and multilocus variable number tandem repeat analysis (MLVA). A fluorescence resonance energy transfer (FRET)-PCR approach was also used to detect mutations associated with macrolide resistance in the 23S rRNA gene. Through P1 typing, the strains were classified into type 1 and type 2, as well as variants 2a, 2b, 2c, and a new variant found in nine of the strains, denoted variant 2e. Twelve MLVA types were distinguished, and 3-5-6-2 (42.4%), 4-5-7-2 (37.4%), and 3-6-6-2 (14.9%) predominated. Several P1 and MLVA types cocirculated each year, but type 2/variant 2 strains and MLVA types 3-5-6-2 and 4-5-7-2 predominated during the epidemic period comprising the peak of 2010 and 2011. In 2016 and 2017, type 1 became more common, and MLVA type 4-5-7-2 predominated. We also found that 0.2% (1/578) of the strains carried a macrolide resistance-associated mutation, indicating a very low prevalence of macrolide resistance in this region of Sweden.
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Early Corticosteroid Therapy for Mycoplasma pneumoniae Pneumonia Irrespective of Used Antibiotics in Children. J Clin Med 2019; 8:jcm8050726. [PMID: 31121867 PMCID: PMC6572103 DOI: 10.3390/jcm8050726] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 01/09/2023] Open
Abstract
Antibiotics’ effect on Mycoplasma pneumoniae (MP) infection still remains controversial. A prospective study of 257 children with MP pneumonia during a recent epidemic (2015–2016) was conducted. All MP pneumonia patients were treated with corticosteroids within 24–36 h after admission. Initially, oral prednisolone (1 mg/kg) or intravenous methylprednisolone (IVMP; 1–2 mg/kg) was administered for mild pneumonia patients, and IVMP (5–10 mg/kg/day) for severe pneumonia patients. If patients showed a persistent fever for 36–48 h or disease progression, additive IVMP (5 mg/kg or 10 mg/kg) was given. Thirty-three percent of patients received only a broad-spectrum antibiotic without a macrolide. The mean age and the male-to-female ratio was 5.6 ± 3.1 years and 1:1, respectively. Seventy-four percent of patients showed immediate defervescence within 24 h, and 96% of patients showed defervescence within 72 h with improvements in clinical symptoms. Three percent of patients (8/257) who received additive IVMP also showed clinical improvement within 48 h without adverse reactions. There were no clinical or laboratory differences between patients treated with a macrolide (n = 172) and without (n = 85). Early corticosteroid therapy might reduce disease morbidity and prevent disease progression in MP pneumonia patients without side effects, and antibiotics may have limited effects on MP infection.
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Choi JH, Seong GM, Ko Y, Kim YR, Kim C. Prevalence and Clinical Features of Community-Acquired Pneumonia Caused by Macrolide-Resistant Mycoplasma pneumoniae Isolated from Adults in Jeju Island. Microb Drug Resist 2019; 25:577-581. [DOI: 10.1089/mdr.2018.0295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jae Hong Choi
- Department of Pediatrics, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Gil Myeong Seong
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Yousang Ko
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Young Ree Kim
- Department of Laboratory Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Changhwan Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
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