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1.
BMJ Open Respir Res ; 11(1)2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39097412

RESUMEN

BACKGROUND: Pneumonia due to typical bacterial, atypical bacterial and viral pathogens can be difficult to clinically differentiate. Host response-based diagnostics are emerging as a complementary diagnostic strategy to pathogen detection. METHODS: We used murine models of typical bacterial, atypical bacterial and viral pneumonia to develop diagnostic signatures and understand the host's response to these types of infections. Mice were intranasally inoculated with Streptococcus pneumoniae, Mycoplasma pneumoniae, influenza or saline as a control. Peripheral blood gene expression analysis was performed at multiple time points. Differentially expressed genes were used to perform gene set enrichment analysis and generate diagnostic signatures. These murine-derived signatures were externally validated in silico using human gene expression data. The response to S. pneumoniae was the most rapid and robust. RESULTS: Mice infected with M. pneumoniae had a delayed response more similar to influenza-infected animals. Diagnostic signatures for the three types of infection had 0.94-1.00 area under the receiver operator curve (auROC). Validation in five human gene expression datasets revealed auROC of 0.82-0.96. DISCUSSION: This study identified discrete host responses to typical bacterial, atypical bacterial and viral aetiologies of pneumonia in mice. These signatures validated well in humans, highlighting the conserved nature of the host response to these pathogen classes.


Asunto(s)
Modelos Animales de Enfermedad , Mycoplasma pneumoniae , Neumonía por Mycoplasma , Streptococcus pneumoniae , Animales , Humanos , Ratones , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/aislamiento & purificación , Neumonía por Mycoplasma/diagnóstico , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/aislamiento & purificación , Femenino , Neumonía Neumocócica/microbiología , Infecciones por Orthomyxoviridae/inmunología , Curva ROC , Perfilación de la Expresión Génica , Neumonía Viral/diagnóstico , Neumonía Viral/inmunología , Ratones Endogámicos C57BL , Neumonía Bacteriana/microbiología , Neumonía Bacteriana/diagnóstico , Interacciones Huésped-Patógeno
2.
Ann Med ; 56(1): 2386636, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39097794

RESUMEN

Mycoplasma pneumoniae (MP) is the cause of Mycoplasma pneumoniae pneumonia (MPP) in children and adolescents, with the clinical manifestations highlighted by intermittent irritating cough, accompanied by headache, fever and muscle pain. This paper aimed to study the research status and focal points in MP infection, especially the common laboratory diagnostic methods and clinical treatment of Mycoplasma pneumoniae. Laboratory diagnostic methods include molecular assay, serological antibody detection, rapid antigen detection and isolation and culture. Polymerase chain reaction (PCR) is the gold standard with high sensitivity and specificity. The serological antibody can detect various immune antibodies qualitatively or quantitatively in serum. Rapid antigen can be detected faster, with no equipment environment requirements, which can be used for the early diagnosis of MP infection. While the culture growth cycle is long and insensitive, not recommended for routine diagnosis. Macrolides were the preferred drug for children with MPP, while the drug resistance rate was rising in China. Tetracycline can be substituted but was not recommended for children under 8 years of age, quinolone drugs are not necessary, severe MPP can be combined with glucocorticoids, involving the nervous or immune system can choose gamma globulin. Other treatments for MPP including symptomatic treatment which can alleviate symptoms, improve lung function and improve prognosis. A safe and effective vaccine needed to be developed which can provide protective immunity to children and will reduce the incidence of MPP.


Asunto(s)
Antibacterianos , Mycoplasma pneumoniae , Neumonía por Mycoplasma , Humanos , Niño , Neumonía por Mycoplasma/diagnóstico , Neumonía por Mycoplasma/tratamiento farmacológico , Mycoplasma pneumoniae/aislamiento & purificación , Mycoplasma pneumoniae/inmunología , Antibacterianos/uso terapéutico , Adolescente , Preescolar , Reacción en Cadena de la Polimerasa , Anticuerpos Antibacterianos/sangre , Macrólidos/uso terapéutico , Antígenos Bacterianos/inmunología
3.
Euro Surveill ; 29(32)2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39119723

RESUMEN

Since November 2023, the absolute number of attendances at emergency departments for pneumonia among children aged 5-14 years in England have been above expected levels for the time of year. This increased signal peaked during March 2024 but then persisted into early summer 2024 despite decreases in prevalence of seasonal respiratory pathogens. Record linkage between emergency department and laboratory databases points to this unusual activity being driven largely by Mycoplasma pneumoniae.


Asunto(s)
Servicio de Urgencia en Hospital , Mycoplasma pneumoniae , Neumonía , Humanos , Niño , Inglaterra/epidemiología , Preescolar , Adolescente , Incidencia , Neumonía/epidemiología , Masculino , Femenino , Mycoplasma pneumoniae/aislamiento & purificación , Servicio de Urgencia en Hospital/estadística & datos numéricos , Prevalencia , Neumonía por Mycoplasma/epidemiología , Neumonía por Mycoplasma/diagnóstico , Estaciones del Año , Vigilancia de la Población
4.
Virol J ; 21(1): 162, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39044252

RESUMEN

OBJECTIVES: Influenza and Mycoplasma pneumoniae infections often present concurrent and overlapping symptoms in clinical manifestations, making it crucial to accurately differentiate between the two in clinical practice. Therefore, this study aims to explore the potential of using peripheral blood routine parameters to effectively distinguish between influenza and Mycoplasma pneumoniae infections. METHODS: This study selected 209 influenza patients (IV group) and 214 Mycoplasma pneumoniae patients (MP group) from September 2023 to January 2024 at Nansha Division, the First Affiliated Hospital of Sun Yat-sen University. We conducted a routine blood-related index test on all research subjects to develop a diagnostic model. For normally distributed parameters, we used the T-test, and for non-normally distributed parameters, we used the Wilcoxon test. RESULTS: Based on an area under the curve (AUC) threshold of ≥ 0.7, we selected indices such as Lym# (lymphocyte count), Eos# (eosinophil percentage), Mon% (monocyte percentage), PLT (platelet count), HFC# (high fluorescent cell count), and PLR (platelet to lymphocyte ratio) to construct the model. Based on these indicators, we constructed a diagnostic algorithm named IV@MP using the random forest method. CONCLUSIONS: The diagnostic algorithm demonstrated excellent diagnostic performance and was validated in a new population, with an AUC of 0.845. In addition, we developed a web tool to facilitate the diagnosis of influenza and Mycoplasma pneumoniae infections. The results of this study provide an effective tool for clinical practice, enabling physicians to accurately diagnose and differentiate between influenza and Mycoplasma pneumoniae infection, thereby offering patients more precise treatment plans.


Asunto(s)
Gripe Humana , Mycoplasma pneumoniae , Neumonía por Mycoplasma , Humanos , Neumonía por Mycoplasma/diagnóstico , Neumonía por Mycoplasma/sangre , Gripe Humana/diagnóstico , Gripe Humana/sangre , Masculino , Femenino , Mycoplasma pneumoniae/aislamiento & purificación , Adulto , Persona de Mediana Edad , Diagnóstico Diferencial , Adulto Joven , Adolescente , Algoritmos , Niño , Anciano
5.
BMC Infect Dis ; 24(1): 707, 2024 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-39026207

RESUMEN

BACKGROUND: The prevalence and severity of pediatric Mycoplasma pneumoniae pneumonia (MPP) poses a significant threat to the health and lives of children. In this study, we aim to systematically evaluate the value of routine blood parameters in predicting MPP and develop a robust and generalizable ensemble artificial intelligence (AI) model to assist in identifying patients with MPP. METHODS: We collected 27 features, including routine blood parameters and hs-CRP levels, from patients admitted to The Affiliated Dazu's Hospital of Chongqing Medical University with or without MPP between January, 2023 and January, 2024. A classification model was built using seven machine learning (ML) algorithms to develop an integrated prediction tool for diagnosing MPP. It was evaluated on both an internal validation set (982 individuals) and an external validation set (195 individuals). The primary outcome measured the accuracy of the model in predicting MPP. RESULTS: The GBDT is state-of-the-art based on 27 features. Following inter-laboratory cohort testing, the GBDT demonstrated an AUC, accuracy, specificity, sensitivity, PPV, NPV, and F1-score of 0.980 (0.938-0.995), 0.928 (0.796-0.970), 0.929 (0.717-1.000), 0.926 (0.889-0.956), 0.922 (0.727-1.000), 0.937 (0.884-0.963), and 0.923 (0.800-0.966) in stratified 10-fold cross-validation. A GBDT-based AI Lab was developed to facilitate the healthcare providers in remote and impoverished areas. CONCLUSIONS: The GBDT-based AI Lab tool, with high sensitivity and specificity, could help discriminate between pediatric MPP infection and non-MPP infection based on routine blood parameters. Moreover, a user-friendly webpage tool for AI Lab could facilitate healthcare providers in remote and impoverished areas where advanced technologies are not accessible.


Asunto(s)
Aprendizaje Automático , Mycoplasma pneumoniae , Neumonía por Mycoplasma , Humanos , Neumonía por Mycoplasma/diagnóstico , Neumonía por Mycoplasma/sangre , Neumonía por Mycoplasma/microbiología , Niño , Femenino , Masculino , Mycoplasma pneumoniae/aislamiento & purificación , Preescolar , Sensibilidad y Especificidad , Algoritmos
6.
Zhonghua Er Ke Za Zhi ; 62(7): 669-675, 2024 Jul 02.
Artículo en Chino | MEDLINE | ID: mdl-38955686

RESUMEN

Objective: To investigate and summarize pediatric patients with severe Mycoplasma pneumoniae pneumonia (MPP) presenting with varied clinical and chest imaging features in order to guide the individualized treatment. Methods: This was a retrospective cohort study. Medical records of clinical, imaging and laboratory data of 505 patients with MPP who were admitted to the Department Ⅱ of Respirology Center, Beijing Children's Hospital, Capital Medical University from January 2016 to October 2023 and met the enrollment criteria were included. They were divided into severe group and non-severe group according to whether lower airway obliterans was developed. The clinical and chest imaging features of the two groups were analyzed. Those severe cases with single lobe ≥2/3 consolidation (lobar consolidation) were further divided into subtype lung-necrosis and subtype non-lung-necrosis based on whether lung necrosis was developed. Comparison on the clinical manifestations, bronchoscopic findings, whole blood C-reactive protein (CRP) and other inflammatory indicators between the two subtypes was performed. Comparisons between two groups were achieved using independent-sample t-test, nonparametric test or chi-square test. Univariate receiver operating characteristic (ROC) curve analyses were performed on the indicators such as CRP of the two subtypes. Results: Of the 505 cases, 254 were male and 251 were female. The age of the onset was (8.2±2.9) years. There were 233 severe cases, among whom 206 were with lobar consolidation and 27 with diffuse bronchiolitis. The other 272 belonged to non-severe cases, with patchy, cloudy infiltrations or single lobe <2/3 uneven consolidation or localized bronchiolitis. Of the 206 cases (88.4%) severe cases with lobar consolidation, 88 harbored subtype lung-necrosis and 118 harbored subtype non-lung-necrosis. All 206 cases (100.0%) presented with persistent high fever, among whom 203 cases (98.5%) presented with inflammatory secretion obstruction and plastic bronchitis under bronchoscopy. Of those 88 cases with subtype lung-necrosis, there were 42 cases (47.7%) with dyspnea and 39 cases (44.3%) with moderate to massive amount of pleural effusion. There were 35 cases (39.8%) diagnosed with lung embolism during the disease course, of which other 34 cases (38.6%) were highly suspected. Extensive airway mucosal necrosis was observed in 46 cases (52.3%), and the level of their whole blood CRP was significantly higher than that of subtype non-lung-necrosis (131.5 (91.0, 180.0) vs. 25.5 (12.0, 43.1) mg/L, U=334.00, P<0.001). They were regarded as subtype "lung consolidation-atelectasis-necrosis". Of those 118 cases with subtype non-lung-necrosis, 27 cases (22.9%) presented with dyspnea and none were with moderate to massive amount of pleural effusion. Sixty-five cases (55.1%) presented with plastic bronchitis and localized airway mucosal necrosis was observed in 32 cases (27.1%). They were deemed as subtype "lung consolidation-atelectasis". ROC curve analyses revealed that whole blood CRP of 67.5 mg/L on the 6-10 th day of disease course exhibited a sensitivity of 0.96, a specificity of 0.89, and an area under the curve of 0.97 for distinguishing between these two subtypes among those with lobar consolidation. Conclusions: Pediatric patients with severe MPP present with lobar consolidation or diffuse bronchiolitis on chest imaging. Those with lobar consolidation harbor 2 subtypes as "lung consolidation-atelectasis-necrosis" and "lung consolidation-atelectasis". Whole blood CRP of 67.5 mg/L can be applied as an early discriminating indicator to discriminate between these two subtypes.


Asunto(s)
Proteína C-Reactiva , Pulmón , Mycoplasma pneumoniae , Fenotipo , Neumonía por Mycoplasma , Humanos , Femenino , Masculino , Neumonía por Mycoplasma/diagnóstico , Estudios Retrospectivos , Niño , Pulmón/patología , Pulmón/diagnóstico por imagen , Proteína C-Reactiva/análisis , Broncoscopía/métodos , Índice de Severidad de la Enfermedad , Preescolar , Necrosis , Bronquiolitis/diagnóstico , Bronquiolitis/patología
7.
Respir Res ; 25(1): 266, 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38965565

RESUMEN

BACKGROUND: This study explored the relationship between inflammatory markers and glucocorticoid dosage upon admission. METHODS: We conducted a retrospective analysis of 206 patients with refractory Mycoplasma pneumoniae pneumonia (RMPP) admitted to a Children's Hospital from November 2017 to January 2022. Patients were categorized into three groups based on their methylprednisolone dosage: low-dose (≤ 2 mg/kg/d), medium-dose (2-10 mg/kg/d), and high-dose (≥ 10 mg/kg/d). We compared demographic data, clinical manifestations, laboratory findings, and radiological outcomes. Spearman's rank correlation coefficient was used to assess relationships between variables. RESULTS: The median age was highest in the low-dose group at 7 years, compared to 5.5 years in the medium-dose group and 6 years in the high-dose group (P < 0.001). The body mass index (BMI) was also highest in the low-dose group at 16.12, followed by 14.86 in the medium-dose group and 14.58 in the high-dose group (P < 0.001). More severe radiographic findings, longer hospital stays, and greater incidence of hypoxia were noted in the high-dose group (P < 0.05). Additionally, significant increases in white blood cells, C-reactive protein, procalcitonin, lactate dehydrogenase (LDH), alanine transaminase, aspartate transaminase, ferritin, erythrocyte sedimentation rate, and D-dimer levels were observed in the high-dose group (P < 0.05). Specifically, LDH and ferritin were markedly higher in the high-dose group, with levels at 660.5 U/L and 475.05 ng/mL, respectively, compared to 450 U/L and 151.4 ng/mL in the medium-dose group, and 316.5 U/L and 120.5 ng/mL in the low-dose group. Correlation analysis indicated that LDH and ferritin levels were significantly and positively correlated with glucocorticoid dose (Spearman ρ = 0.672 and ρ = 0.654, respectively; P < 0.001). CONCLUSIONS: Serum LDH and ferritin levels may be useful biomarkers for determining the appropriate corticosteroid dosage in treating children with RMPP.


Asunto(s)
Biomarcadores , Ferritinas , L-Lactato Deshidrogenasa , Neumonía por Mycoplasma , Humanos , Femenino , Masculino , Neumonía por Mycoplasma/tratamiento farmacológico , Neumonía por Mycoplasma/sangre , Neumonía por Mycoplasma/diagnóstico , Niño , Ferritinas/sangre , Estudios Retrospectivos , Preescolar , Biomarcadores/sangre , L-Lactato Deshidrogenasa/sangre , Relación Dosis-Respuesta a Droga , Adolescente , Mycoplasma pneumoniae/efectos de los fármacos , Metilprednisolona/administración & dosificación , Glucocorticoides/administración & dosificación
9.
Sci Rep ; 14(1): 16172, 2024 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-39003340

RESUMEN

The prediction of refractory Mycoplasma pneumoniae pneumonia (RMPP) remains a clinically significant challenge. This study aimed to develop an early predictive model utilizing artificial intelligence (AI)-derived quantitative assessment of lung lesion extent on initial computed tomography (CT) scans and clinical indicators for RMPP in pediatric inpatients. A retrospective cohort study was conducted on patients with M. pneumoniae pneumonia (MP) admitted to the Children's Hospital of Nanjing Medical University, China from January 2019 to December 2020. An early prediction model was developed by stratifying the patients with Mycoplasma pneumoniae pneumonia (MPP) into two cohorts according to the presence or absence of refractory pneumonia. A retrospective cohort of 126 children diagnosed with Mycoplasma pneumoniae pneumonia (MPP) was utilized as a training set, with 85 cases classified as RMPP. Subsequently, a prospective cohort comprising 54 MPP cases, including 37 instances of RMPP, was assembled as a validation set to assess the performance of the predictive model for RMPP from January to December 2021. We defined a constant Φ which can combine the volume and CT value of pulmonary lesions and be further used to calculate the logarithm of Φ to the base of 2 (Log2Φ). A clinical-imaging prediction model was then constructed utilizing Log2Φ and clinical characteristics. Performance was evaluated by the area under the receiver operating characteristic curve (AUC). The clinical model demonstrated AUC values of 0.810 and 0.782, while the imaging model showed AUC values of 0.764 and 0.769 in the training and test sets, respectively. The clinical-imaging model, incorporating Log2Φ, temperature(T), aspartate aminotransferase (AST), preadmission fever duration (PFD), and preadmission macrolides therapy duration (PMTD), achieved the highest AUC values of 0.897 and 0.895 in the training and test sets, respectively. A prognostic model developed through automated quantification of lung disease on CT scans, in conjunction with clinical data in MPP may be utilized for the early identification of RMPP.


Asunto(s)
Inteligencia Artificial , Mycoplasma pneumoniae , Neumonía por Mycoplasma , Tomografía Computarizada por Rayos X , Humanos , Neumonía por Mycoplasma/diagnóstico por imagen , Neumonía por Mycoplasma/tratamiento farmacológico , Neumonía por Mycoplasma/diagnóstico , Femenino , Tomografía Computarizada por Rayos X/métodos , Masculino , Niño , Estudios Retrospectivos , Preescolar , Pulmón/diagnóstico por imagen , Pulmón/microbiología , Pulmón/patología , Estudios Prospectivos , Adolescente , China , Curva ROC
10.
Top Companion Anim Med ; 61: 100891, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38972504

RESUMEN

Treatment of Mycoplasma spp. pneumonia has rarely been described in domestic ferrets (Mustela putorius furo). A 10-month-old, 0.53 kg, female spayed domestic ferret was presented for oxygen-dependent, chronic dyspnea of one-month's duration. Physical examination findings included dyspnea, tachypnea, increased bronchovesicular sounds bilaterally, and an intermittent non-productive cough. Bloodwork abnormalities included a mild leukocytosis (8.6×103/µL), mild neutrophilia (4.0×103/µL), mild hypoalbuminemia (2.7 g/dL), mild hyperglobulinemia (3.3 g/dL), mild hyponatremia (147 mEq/L), and mild hypochloremia (111.4 mEq/L). Radiographs revealed a marked diffuse bronchial pattern with peribronchial cuffing, a mild main pulmonary artery bulge, distended caudal lobar pulmonary arteries, and decreased serosal detail within the abdomen. An echocardiogram revealed indications of moderate pulmonary hypertension and systolic anterior motion of the mitral valve. Polymerase chain reaction testing for Mycoplasma spp. was positive, and treatment was initiated with doxycycline (10 mg/kg PO q 12 h for 16 weeks), prednisolone (0.4 mg/kg PO q 12 h for 13 weeks, tapered to 0.2 mg/kg PO q 12 h for two weeks, then eventually increased to 0.7 mg/kg PO q 12 h until further notice), sildenafil (0.3 mg/kg PO q 24 h for 13 weeks), and oxygen supplementation via an oxygen cage for six weeks. On repeat echocardiogram eleven weeks after initiation of doxycycline therapy, the pulmonary hypertension had resolved. At follow up six months later, the ferret was stable on previously prescribed medications and did not require oxygen supplementation. Mycoplasma spp. and pulmonary hypertension should be considered in cases of respiratory distress in ferrets.


Asunto(s)
Antibacterianos , Hurones , Hipertensión Pulmonar , Animales , Femenino , Hipertensión Pulmonar/veterinaria , Antibacterianos/uso terapéutico , Neumonía por Mycoplasma/veterinaria , Neumonía por Mycoplasma/tratamiento farmacológico , Neumonía por Mycoplasma/diagnóstico , Doxiciclina/uso terapéutico , Prednisolona/uso terapéutico , Citrato de Sildenafil/uso terapéutico
11.
Zhongguo Dang Dai Er Ke Za Zhi ; 26(7): 716-722, 2024 Jul 15.
Artículo en Chino | MEDLINE | ID: mdl-39014948

RESUMEN

OBJECTIVES: To investigate the role of calprotectin S100 A8/A9 complex in evaluating the condition of children with severe Mycoplasma pneumoniae pneumonia (SMPP). METHODS: A prospective study was conducted among 136 children with Mycoplasma pneumoniae pneumonia (MPP) and 30 healthy controls. According to the severity of the condition, the children with MPP were divided into mild subgroup (40 children) and SMPP subgroup (96 children). The levels of S100 A8/A9 complex and related inflammatory factors were compared between the MPP group and the healthy control group, as well as between the two subgroups of MPP. The role of S100 A8/A9 in assessing the severity of MPP was explored. RESULTS: The MPP group had a significantly higher level of S100 A8/A9 than the healthy control group, with a significantly greater increase in the SMPP subgroup (P<0.05). The multivariate logistic regression analysis showed that the increases in serum C reactive protein (CRP) and S100A8/A9 were closely associated with SMPP (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that the combined measurement of serum S100 A8/A9 and CRP had an area under the ROC curve of 0.904 in predicting SMPP, which was significantly higher than the AUC of S100 A8/A9 or CRP alone (P<0.05), with a specificity of 0.718 and a sensitivity of 0.952. CONCLUSIONS: S100 A8/A9 is closely associated with the severity of MPP, and the combination of S100 A8/A9 with CRP is more advantageous for assessing the severity of MPP in children.


Asunto(s)
Calgranulina A , Calgranulina B , Neumonía por Mycoplasma , Humanos , Neumonía por Mycoplasma/sangre , Neumonía por Mycoplasma/diagnóstico , Masculino , Femenino , Calgranulina A/sangre , Calgranulina B/sangre , Preescolar , Niño , Estudios Prospectivos , Modelos Logísticos , Índice de Severidad de la Enfermedad , Proteína C-Reactiva/análisis , Complejo de Antígeno L1 de Leucocito/sangre , Complejo de Antígeno L1 de Leucocito/análisis , Lactante
12.
An Pediatr (Engl Ed) ; 101(1): 46-57, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38987075

RESUMEN

Mycoplasma pneumoniae (M. pneumoniae) is a bacterium with particular characteristics that give rise to a broad clinical spectrum, being respiratory infection the most frequent presentation. Infection by M. pneumoniae occurs in cyclical epidemics, and paediatricians in Spain have noticed an increase in cases since January 2024, establishing hospital registers to collect surveillance data (as it is not a notifiable disease in Spain). The diagnosis of infection by M. pneumoniae is made through serological testing and/or the detection of genetic material by means of polymerase chain reaction (PCR). Neither methods can differentiate between colonization and active infection, so a precise diagnosis is not possible and testing should only be requested in the case of high clinical suspicion. The role of antibiotherapy in infection by M. pneumoniae in its different clinical variants is not well defined. Most infections are self-limiting and mild, and there is insufficient evidence to support the use of antibiotherapy in these cases. Antibiotic treatment is justified in patients with risk factors for the development of severe disease (Down syndrome, anatomical or functional asplenia, immunosuppression), in hospitalized patients with respiratory infection and in patients with moderate or severe extrapulmonary forms. Taking into account aspects concerning the rational use of antimicrobials, the treatment of choice would be clarithromycin, with azithromycin as an alternative, reserving the use of doxycycline and levofloxacin for cases of antimicrobial resistance and/or infections of the central nervous system.


Asunto(s)
Antibacterianos , Mycoplasma pneumoniae , Neumonía por Mycoplasma , Humanos , Neumonía por Mycoplasma/diagnóstico , Neumonía por Mycoplasma/tratamiento farmacológico , Neumonía por Mycoplasma/epidemiología , Antibacterianos/uso terapéutico , Niño , España/epidemiología , Mycoplasma pneumoniae/aislamiento & purificación
13.
Ital J Pediatr ; 50(1): 117, 2024 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-38886770

RESUMEN

BACKGROUND: Mycoplasma pneumoniae pneumonia is a common respiratory infection among children. However, the occurrence of thromboembolism with plastic bronchitis in association with Mycoplasma pneumoniae pneumonia is extremely rare. This case series presents five cases of children with Mycoplasma pneumoniae pneumonia who developed thromboembolism and plastic bronchitis. The clinical presentation, diagnostic approach, and management strategies are discussed. METHODS: A retrospective analysis was conducted on medical records from a pediatric hospital. Patient demographics, clinical features, laboratory findings, imaging results, treatment modalities, and outcomes were collected. RESULTS: The patients in our case series presented with varying degrees of respiratory distress, cough, and fever. Imaging studies revealed evidence of thromboembolism based on pulmonary artery occlusion. Bronchial casts were observed by bronchoscopy. Laboratory tests demonstrated elevated D-dimer levels and fibrinogen degradation products. All patients received a combination of low molecular weight heparin anticoagulation and supportive care. CONCLUSION: Thromboembolism with plastic bronchitis associated with Mycoplasma pneumoniae pneumonia is a rare but potentially serious complication in children. Prompt recognition and management are crucial for improving patient outcomes. This case series highlights the diverse clinical presentations, diagnostic challenges, and treatment strategies for this unique clinical entity. Further research is needed to better understand the pathogenesis and optimal management of this condition.


Asunto(s)
Bronquitis , Neumonía por Mycoplasma , Humanos , Neumonía por Mycoplasma/complicaciones , Neumonía por Mycoplasma/diagnóstico , Masculino , Bronquitis/microbiología , Bronquitis/complicaciones , Bronquitis/diagnóstico , Femenino , Niño , Preescolar , Estudios Retrospectivos , Tromboembolia , Broncoscopía , Anticoagulantes/uso terapéutico
14.
Ital J Pediatr ; 50(1): 92, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38715105

RESUMEN

BACKGROUND: To explore the alterations of inflammatory markers and immune-related cytokines in children infected with Mycoplasma pneumoniae (MP) combined with Adenovirus (ADV). METHODS: The study population consisted of 201 children with MPP, and they were grouped according to whether they were coinfected with ADV infection and critically ill. Additionally, comparative analyses were performed. The diagnostic value of different indicators and combined indicators for SMPP combined with ADV was assessed using ROC curves. RESULTS: There was no difference between group A1 and group A2, group B1 and group B2 in terms of age, gender, duration of hospitalisation and fever. The levels of calcitoninogen(PCT), lactate dehydrogenase concentration(LDH), interleukin(IL)-6, IL-8, IL-10, IL-4, IL-12P70, and IFN-γ in group A were higher than group B. The severe group (A1, B1) was significantly higher than the mild group (A2, B2) in terms of D-dimer, CRP, PCT, LDH, IL-6, IL-8, IL-10, IL-17a and number of patients with pleural effusion, solid lung changes. Among the individual indexes of D-dimer, CRP, N%,LDH, and PCT, the AUC of the combined test was 0.977, which was higher than that of the individual indicators. Among IL-6, IL-8, IL-10, and IL-17a, the AUC of the combined assay was 0.802, which was higher than that of the individual indicators. CONCLUSION: MP combined with ADV infection was associated with increased expression levels of IL-6, IL-8, IL-10, IL-4, IL-12P70, IFN-γ, and LDH. IL-6, IL-8, IL-10, IL-17a, LDH, PCT, CRP, and D-dimer could be used as predictors of SMPP and the combined test can improve the diagnostic value.


Asunto(s)
Citocinas , Neumonía por Mycoplasma , Humanos , Masculino , Femenino , Neumonía por Mycoplasma/diagnóstico , Neumonía por Mycoplasma/complicaciones , Citocinas/sangre , Niño , Preescolar , Biomarcadores/sangre , Infecciones por Adenoviridae/diagnóstico , Índice de Severidad de la Enfermedad , Coinfección/diagnóstico , Curva ROC , Estudios Retrospectivos
15.
Anal Methods ; 16(19): 3020-3029, 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38690766

RESUMEN

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.


Asunto(s)
Técnicas Electroquímicas , Límite de Detección , Mycoplasma pneumoniae , Técnicas de Amplificación de Ácido Nucleico , Mycoplasma pneumoniae/aislamiento & purificación , Mycoplasma pneumoniae/genética , Técnicas Electroquímicas/métodos , Técnicas Electroquímicas/instrumentación , Técnicas de Amplificación de Ácido Nucleico/métodos , Humanos , Hidrógeno/química , Neumonía por Mycoplasma/diagnóstico , Neumonía por Mycoplasma/microbiología , Técnicas Biosensibles/métodos , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Diagnóstico Molecular/instrumentación , Electrodos
16.
PLoS One ; 19(5): e0299928, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38771810

RESUMEN

Mycoplasmal pneumonia in sheep and goats usually result covert but huge economic losses in the sheep and goat industry. The disease is prevalent in various countries in Africa and Asia. Clinical manifestations in affected animals include anorexia, fever, and respiratory symptoms such as dyspnea, polypnea, cough, and nasal discharge. Due to similarities with other respiratory infections, accurate diagnosis can be challenging, and isolating the causative organism is often problematic. However, the utilization of molecular techniques, such as PCR, allows for rapid and specific identification of pathogens. Thus, a goat infection model with Mycoplasma was established and the pathogen was tested using PCR. The results indicated that this approach could be effectively utilized for the rapid detection of mycoplasma in clinical settings. Additionally, the prevalence of contagious pleuropneumonia of sheep in Qinghai Province was further investigated through PCR analysis. A total of 340 nasal swabs were collected from 17 sheep farms in Qinghai province. Among these samples, 84 tested positive for Mycoplasma mycoides subsp. capri (Mmc) and 148 tested positive for Mycoplasma ovipneumoniae (Movi), resulting in positive rates of 24.71% and 43.53% respectively. Furthermore, our investigation revealed positive PCR results for nasal swabs, trachea, and lung samples obtained from sheep exhibiting symptoms suggestive of mycoplasma infection. Moreover, three distinct strains were isolated from these positive samples. Additionally, the inflammatory cytokines of peripheral blood mononuclear cells (PBMCs) were assessed using RT-PCR. The findings demonstrated a high susceptibility of sheep to Movi in Qinghai province, with infected sheep displaying an inflammatory response. Consequently, the outcomes of this study will furnish valuable epidemiological insights for the effective prevention and control of this disease within Qinghai Province.


Asunto(s)
Neumonía por Mycoplasma , Enfermedades de las Ovejas , Animales , Ovinos , Neumonía por Mycoplasma/epidemiología , Neumonía por Mycoplasma/veterinaria , Neumonía por Mycoplasma/microbiología , Neumonía por Mycoplasma/diagnóstico , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Ovejas/microbiología , Enfermedades de las Ovejas/diagnóstico , China/epidemiología , Mycoplasma ovipneumoniae/aislamiento & purificación , Mycoplasma ovipneumoniae/genética , Cabras , Prevalencia , Reacción en Cadena de la Polimerasa
17.
Health Informatics J ; 30(2): 14604582241255818, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38779978

RESUMEN

Mycoplasma pneumonia may lead to hospitalizations and pose life-threatening risks in children. The automated identification of mycoplasma pneumonia from electronic medical records holds significant potential for improving the efficiency of hospital resource allocation. In this study, we proposed a novel method for identifying mycoplasma pneumonia by integrating multi-modal features derived from both free-text descriptions and structured test data in electronic medical records. Our approach begins with the extraction of free-text and structured data from clinical records through a systematic preprocessing pipeline. Subsequently, we employ a pre-trained transformer language model to extract features from the free-text, while multiple additive regression trees are used to transform features from the structured data. An attention-based fusion mechanism is then applied to integrate these multi-modal features for effective classification. We validated our method using clinic records of 7157 patients, retrospectively collected for training and testing purposes. The experimental results demonstrate that our proposed multi-modal fusion approach achieves significant improvements over other methods across four key performance metrics.


Asunto(s)
Registros Electrónicos de Salud , Neumonía por Mycoplasma , Humanos , Neumonía por Mycoplasma/diagnóstico , Registros Electrónicos de Salud/estadística & datos numéricos , Niño , Estudios Retrospectivos , Mycoplasma pneumoniae/patogenicidad , Femenino , Masculino , Preescolar
18.
Biochem Biophys Res Commun ; 717: 150028, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38714016

RESUMEN

Mycoplasma pneumoniae (MP),as the most commonly infected respiratory pathogen in community-acquired pneumonia in preschool children,has becoming a prominent factor affecting children's respiratory health.Currently, there is a lack of easy, rapid, and accurate laboratory testing program for MP infection, which causes comparatively difficulty for clinical diagnostic.Here,we utilize loop-mediated isothermal amplification (LAMP) to amplify and characterize the P1 gene of MP, combined with nucleic acid lateral flow (NALF) for fast and visuallized detection of MP.Furthermore, we evaluated and analyzed the sensitivity, specificity and methodological consistency of the method.The results showed that the limit of detection(LoD) of MP-LAMP-NALF assay was down to 100 copys per reaction and there was no cross-reactivity with other pathogens infected the respiratory system. The concordance rate between MP-LAMP-NALF assay with quantitative real-time PCR was 94.3 %,which exhibiting excellent testing performance.We make superior the turnaround time of the MP-LAMP-NALF assay, which takes only about 50 min. In addition, there is no need for precision instruments and no restriction on the laboratory site.Collectively, LAMP-NALF assay targeting the P1 gene for Mycoplasma pneumoniae detection was a easy, precise and visual test which could be widely applied in outpatient and emergency departments or primary hospitals.When further optimized, it could be used as "point-of-care testing" of pathogens or multiple testing for pathogens.


Asunto(s)
Técnicas de Diagnóstico Molecular , Mycoplasma pneumoniae , Técnicas de Amplificación de Ácido Nucleico , Neumonía por Mycoplasma , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/aislamiento & purificación , Técnicas de Amplificación de Ácido Nucleico/métodos , Humanos , Neumonía por Mycoplasma/diagnóstico , Neumonía por Mycoplasma/microbiología , Técnicas de Diagnóstico Molecular/métodos , Sensibilidad y Especificidad , Límite de Detección , ADN Bacteriano/genética
19.
Medicine (Baltimore) ; 103(19): e37817, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38728486

RESUMEN

This study aimed to investigate the expression and significance of serum procalcitonin (PCT), leukotriene B4 (LTB4), Serum amyloid A (SAA), and C-reactive protein (CRP) in children with different types of pneumonia caused by different pathogenic infections. One hundred and one children with pneumonia admitted to The Fifth People Hospital of Zhuhai from July 2019 to June 2020 were enrolled and divided into 38 cases in the bacterial group, 30 cases in the mycoplasma group, and 33 cases in the virus group according to the different types of pathogens. The patients were divided into 42 cases in the noncritical group, 33 cases in the critical group, and 26 cases in the very critical group according to the pediatric clinical illness score (PCIS), and 30 healthy children were selected as the control group during the same period. Comparison of serum PCT, SAA: bacterial group > mycoplasma group > viral group > control group with significant differences (P < .05). Receiver operator characteristic (ROC) analysis showed that the area under the curves (AUCs) of serum PCT, LTB4, SAA, and CRP for the diagnosis of bacterial pneumonia were 1.000, 0.531, 0.969, and 0.833, respectively, and the AUCs for the diagnosis of mycoplasma pneumonia were 0.653, 0.609, 0.547, and 0.652, respectively, and the AUCs for the diagnosis of viral pneumonia were 0.888, 0.570, 0.955, and 1.000, respectively. Comparison of serum PCT, LTB4, SAA: very critical group > critical group > noncritical group > control group, with significant differences (P < .05). Serum PCT, LTB4, and SAA were negatively correlated with PCIS score by Pearson analysis (P < .05). Serum PCT and SAA showed diagnostic value for bacterial pneumonia, and serum SAA and CRP showed diagnostic value for viral pneumonia; serum PCT, LTB4, and SAA correlate with severity of disease and show higher expression with worsening of the condition.


Asunto(s)
Biomarcadores , Proteína C-Reactiva , Leucotrieno B4 , Neumonía Bacteriana , Polipéptido alfa Relacionado con Calcitonina , Proteína Amiloide A Sérica , Humanos , Proteína C-Reactiva/análisis , Proteína Amiloide A Sérica/análisis , Proteína Amiloide A Sérica/metabolismo , Masculino , Femenino , Polipéptido alfa Relacionado con Calcitonina/sangre , Preescolar , Neumonía Bacteriana/sangre , Neumonía Bacteriana/diagnóstico , Niño , Leucotrieno B4/sangre , Biomarcadores/sangre , Curva ROC , Neumonía por Mycoplasma/sangre , Neumonía por Mycoplasma/diagnóstico , Lactante , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Neumonía/sangre , Neumonía/diagnóstico
20.
Biosens Bioelectron ; 260: 116428, 2024 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-38805891

RESUMEN

To address the limitations of the CRISPR/Cas12f1 system in clinical diagnostics, which require the complex preparation of single-stranded DNA (ssDNA) or in vitro transcripts (RNA), we developed a fluorescent biosensor named PDTCTR (PAM-dependent dsDNA Target-activated Cas12f1 Trans Reporter). This innovative biosensor integrates Recombinase Polymerase Amplification (RPA) with the Cas12f_ge4.1 system, facilitating the direct detection of double-stranded DNA (dsDNA). PDTCTR represents a significant leap forward, exhibiting a detection sensitivity that is a hundredfold greater than the original Cas12f1 system. It demonstrates the capability to detect Mycoplasma pneumoniae (M. pneumoniae) and Hepatitis B virus (HBV) with excellent sensitivity of 10 copies per microliter (16.8 aM) and distinguishes single nucleotide variations (SNVs) with high precision, including the EGFR (L858R) mutations prevalent in non-small cell lung cancer (NSCLC). Clinical evaluations of PDTCTR have demonstrated its high sensitivity and specificity, with rates ranging from 93%-100% and 100%, respectively, highlighting its potential to revolutionize diagnostic approaches for infectious diseases and cancer-related SNVs.This research underscores the substantial advancements in CRISPR technology for clinical diagnostics and its promising future in early disease detection and personalized medicine.


Asunto(s)
Técnicas Biosensibles , Sistemas CRISPR-Cas , ARN Guía de Sistemas CRISPR-Cas , Técnicas Biosensibles/métodos , Humanos , ARN Guía de Sistemas CRISPR-Cas/genética , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/aislamiento & purificación , ADN/genética , ADN/química , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/aislamiento & purificación , Proteínas Asociadas a CRISPR/genética , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Proteínas Bacterianas/genética , Proteínas Bacterianas/química , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/diagnóstico , Endodesoxirribonucleasas/genética , Endodesoxirribonucleasas/química , Neumonía por Mycoplasma/diagnóstico
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