RESUMO
Children's respiratory tract infection is a common disease affecting children's health, our purpose is to describe the epidemiological characteristics of common pathogens of children's respiratory tract infection in central Shandong, China, and compare them with those in other parts of world, so as to summarize the rules of children's respiratory tract infection in central Shandong, and provide scientific basis for health departments to prevent and treat local children's respiratory tract infection. Sputum, tracheal aspirate, alveolar lavage fluid and other samples of 4804 children admitted to wards of Zibo Maternal and Child Health Hospital for treatment of respiratory tract infection from June 2019 to December 2022 were collected, and 12 common respiratory tract pathogens were detected by PCR capillary electrophoresis fragment analysis, two bacteria (Streptococcus pneumoniae, Haemophilus influenzae), two atypical pathogens (Mycoplasma Pneumoniae, Chlamydia Pneumoniae) and eight viruses (Human rhinovirus, Respiratory Syncytial Virus, Influenza A Virus, Parainfluenza Virus, Human metapneumovirus, Human boca virus, Human coronavirus, Influenza B virus) were included, the positive detection rate of single pathogen, the proportion of each type of respiratory tract mixed infection and the positive detection rate of single pathogen in different ages and seasons were analyzed statistically. (1)Among 4804 children with respiratory tract infection, the total positive rate was 77.87% (3741/4804), the positive rate of single pathogen was 43.40% (1656/4804), Streptococcus pneumoniae, Rhinovirus and Respiratory syncytial virus were the highest, there were 2085 cases of mixed infection with two or more pathogens, the positive rate was 43.40%. (2) The positive rates of infection in infant group (0-1 years old), infant group (1-3 years old), preschool group and school age group (3 years old-) were roughly the same, the infection rates of Streptococcus pneumoniae, Respiratory syncytial virus and Parainfluenza virus in infant group, Rhinovirus in infant group, Influenza A virus, Chlamydia pneumoniae, Mycoplasma pneumoniae and Haemophilus influenzae in school age group were higher than those in other groups, the difference was statistically significant (P < 0.05). (3) The positive detection rates of spring, summer, autumn and winter groups were 43.58%, 38.64%, 33.73% and 29.27%, respectively, the positive rates of Streptococcus pneumoniae and Haemophilus influenzae in spring group, Mycoplasma pneumoniae in summer group, Rhinovirus, Respiratory syncytial virus and Influenza A virus in autumn group, Chlamydia pneumoniae, Boca virus and Influenza B virus in winter group were higher than those in other seasons, and the differences were statistically significant (P < 0.05). The pathogen detection rate of children varies with age and season, and the prevention and treatment of a certain respiratory pathogen infection must be combined with its raging season and age rule.
Assuntos
Infecções Respiratórias , Humanos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Pré-Escolar , Lactente , Feminino , Masculino , China/epidemiologia , Criança , Streptococcus pneumoniae/isolamento & purificação , Estações do Ano , Recém-Nascido , Haemophilus influenzae/isolamento & purificação , Adolescente , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/virologia , Chlamydophila pneumoniae/isolamento & purificaçãoRESUMO
To investigate the status and epidemiological characteristics of respiratory pathogens infections in children with influenza-like illnesses (ILI) in Beijing Children's Hospital from 2022 to 2023. A dual amplification technique was used to detect nucleic acids of seven common respiratory pathogens, including influenza A virus (Flu A), influenza B virus (Flu B), mycoplasma pneumoniae (MP), respiratory syncytial virus (RSV), parainfluenza virus (PIV), adenovirus (ADV), and Chlamydia pneumoniae (CP), in outpatient and inpatient children (aged 0-18 years) with influenza-like symptoms who sought medical care at Beijing Children's Hospital, from January 2022 to March 2023. A total of 43 663 children were included in the study, of which 27 903 tested positive for respiratory pathogens with a total detection rate of 63.91%. Flu A had the highest detection rate of 69.93% (27 332/39 084), followed by MP about 13.22% (380/2 875). The total detection rate of RSV, PIV and ADV was 7.69% (131/1 704). Flu B had a detection rate of 0.16% (64/39 084). No CP was detected in this study. A total of 7 cases of dual infections were detected, with a detection rate of 0.41% (7/1 704). The Chi-square test was used to analyze the differences in detection rates of pathogens among different genders, age groups, and different seasons. Among the seven pathogens, only Flu A had statistically significant differences in gender (χ2=16.712, P<0.001). The detection rates of Flu A and MP showed an increasing trend with age (both P trend<0.001), while the detection rates of RSV and PIV showed a decreasing trend with age (both P trend<0.001). Flu A had its epidemic peak in winter and spring, with detection rates of 61.30% (3 907/6 374) and 77.47% (23 207/29 958) respectively; MP and PIV had higher detection rates in autumn (25.14% and 7.64% respectively); RSV showed a relatively higher detection rate in winter (8.69%); Flu B and ADV had lower detection rates throughout the study period (0.16% and 1.17% respectively). In conclusion, children with ILI in 2022-2023 were mainly infected with a single respiratory pathogen, and occasionally dual pathogen infections were observed. Among them, the detection rate of Flu A was the highest, and only Flu A showed a gender difference in detection rate. As the age of the children patients increased, the detection rate of Flu A and MP showed an increasing trend, while RSV and PIV showed a decreasing trend. The prevalence of Flu A, Flu B, MP, PIV, and RSV were seasonal.
Assuntos
Influenza Humana , Infecções Respiratórias , Humanos , Criança , Pré-Escolar , Lactente , Adolescente , Influenza Humana/epidemiologia , Masculino , Feminino , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Infecções Respiratórias/microbiologia , Pequim/epidemiologia , Vírus da Influenza B/isolamento & purificação , Vírus da Influenza A/isolamento & purificação , Mycoplasma pneumoniae/isolamento & purificação , Recém-Nascido , Vírus Sinciciais Respiratórios/isolamento & purificação , Hospitais Pediátricos , Chlamydophila pneumoniae/isolamento & purificação , Infecções por Vírus Respiratório Sincicial/epidemiologia , China/epidemiologia , Adenoviridae/isolamento & purificaçãoRESUMO
Emerging evidence shows co-infection with atypical bacteria in coronavirus disease 2019 (COVID-19) patients. Respiratory illness caused by atypical bacteria such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila may show overlapping manifestations and imaging features with COVID-19 causing clinical and laboratory diagnostic issues. We conducted a prospective study to identify co-infections with SARS-CoV-2 and atypical bacteria in an Indian tertiary hospital. From June 2020 to January 2021, a total of 194 patients with laboratory-confirmed COVID-19 were also tested for atypical bacterial pathogens. For diagnosing M. pneumoniae, a real-time polymerase chain reaction (PCR) assay and serology (IgM ELISA) were performed. C. pneumoniae diagnosis was made based on IgM serology. L. pneumophila diagnosis was based on PCR or urinary antigen testing. Clinical and epidemiological features of SARS-CoV-2 and atypical bacteria-positive and -negative patient groups were compared. Of the 194 patients admitted with COVID-19, 17 (8.8%) were also diagnosed with M. pneumoniae (n = 10) or C. pneumoniae infection (n = 7). Confusion, headache, and bilateral infiltrate were found more frequently in the SARS CoV-2 and atypical bacteria co-infection group. Patients in the M. pneumoniae or C. pneumoniae co-infection group were more likely to develop ARDS, required ventilatory support, had a longer hospital length of stay, and higher fatality rate compared to patients with only SARS-CoV-2. Our report highlights co-infection with bacteria causing atypical pneumonia should be considered in patients with SARS-CoV-2 depending on the clinical context. Timely identification of co-existing pathogens can provide pathogen-targeted treatment and prevent fatal outcomes of patients infected with SARS-CoV-2 during the current pandemic.
Assuntos
Formas Bacterianas Atípicas/isolamento & purificação , COVID-19/patologia , Infecções por Chlamydophila/epidemiologia , Coinfecção/epidemiologia , Doença dos Legionários/epidemiologia , Pneumonia por Mycoplasma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Chlamydophila pneumoniae/isolamento & purificação , Feminino , Humanos , Índia , Legionella pneumophila/isolamento & purificação , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Mycoplasma pneumoniae/isolamento & purificação , Estudos Prospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND: Chlamydia pneumoniae is a common cause of atypical community acquired pneumonia (CAP). The diagnostic approach of chlamydial infections remains a challenge. Diagnosis of delayed chlamydial-associated complications, involving complex autoimmune pathophysiological mechanisms, is still more challenging. C. pneumoniae-related cardiac complications have been rarely reported, including cases of endocarditis, myocarditis and pericarditis. CASE PRESENTATION: A 40-year old female was hospitalized for pleuropericarditis following lower respiratory tract infection. The patient had been hospitalized for CAP (fever, dyspnea, chest X-ray positive for consolidation on the left upper lobe) 5 weeks ago and had received ceftriaxone and moxifloxacin. Four weeks after her discharge, the patient presented with fever, shortness of breath and pleuritic chest pain and was readmitted because of pericardial and bilateral pleural effusions (mainly left). The patient did not improve on antibiotics and sequential introduction of colchicine and methylprednisolone was performed. The patient presented impressive clinical and laboratory response. Several laboratory and clinical assessments failed to demonstrate any etiological factor for serositis. Chlamydial IgM and IgG antibodies were positive and serial measurements showed increasing kinetics for IgG. Gold standard polymerase chain reaction of respiratory tract samples was not feasible but possibly would not have provided any additional information since CAP occurred 5 weeks ago. The patient was discharged under colchicine and tapered methylprednisolone course. During regular clinic visits, she remained in good clinical condition without pericardial and pleural effusions relapse. CONCLUSIONS: C. pneumoniae should be considered as possible pathogen in case of pleuritis and/or pericarditis during or after a lower respiratory tract infection. In a systematic review of the literature only five cases of C. pneumoniae associated pericarditis were identified. Exact mechanisms of cardiovascular damage have not yet been defined, yet autoimmune pathways might be implicated.
Assuntos
Infecções por Chlamydophila/diagnóstico , Chlamydophila pneumoniae/isolamento & purificação , Pericardite/microbiologia , Adulto , Infecções por Chlamydophila/complicações , Feminino , Humanos , Pericardite/diagnósticoRESUMO
BACKGROUND: An association between chronic infectious diseases and development of dementia has been suspected for decades, based on the finding of pathogens in postmortem brain tissue and on serological evidence. However, questions remain regarding confounders, reverse causality, and how accurate, reproducible and generalizable those findings are. OBJECTIVE: Investigate whether exposure to Herpes simplex (manifested as herpes labialis), Chlamydophila pneumoniae (C. pneumoniae), Helicobacter pylori (H. pylori), and cytomegalovirus (CMV) modifies the risk of dementia in a populational cohort. METHODS: Questionnaires regarding incidence of herpes infections were administered to Original Framingham Study participants (nâ=â2,632). Serologies for C. pneumoniae, H. pylori, and CMV were obtained in Original (nâ=â2,351) and Offspring cohort (nâ=â3,687) participants. Participants are under continuous dementia surveillance. Brain MRI and neuropsychological batteries were administered to Offspring participants from 1999-2005. The association between each infection and incident dementia was tested with Cox models. Linear models were used to investigate associations between MRI or neuropsychological parameters and serologies. RESULTS: There was no association between infection serologies and dementia incidence, total brain volume, and white matter hyperintensities. Herpes labialis was associated with reduced 10-year dementia risk (HR 0.66, CI 0.46-0.97), but not for the duration of follow-up. H. pylori antibodies were associated with worse global cognition (ß -0.14, CI -0.22, -0.05). CONCLUSION: We found no association between measures of chronic infection and incident dementia, except for a reduction in 10-year dementia risk for patients with herpes labialis. This unexpected result requires confirmation and further characterization, concerning antiviral treatment effects and capture of episodes.
Assuntos
Doença de Alzheimer , Chlamydophila pneumoniae/isolamento & purificação , Infecções por Citomegalovirus , Citomegalovirus/isolamento & purificação , Infecções por Helicobacter , Helicobacter pylori , Herpes Labial , Herpesvirus Humano 1/isolamento & purificação , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/imunologia , Encéfalo/diagnóstico por imagem , Causalidade , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/psicologia , Feminino , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/psicologia , Helicobacter pylori/imunologia , Helicobacter pylori/isolamento & purificação , Herpes Labial/diagnóstico , Herpes Labial/psicologia , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética/métodos , Masculino , Testes Neuropsicológicos , Modelos de Riscos Proporcionais , Medição de Risco , Testes Sorológicos/métodosRESUMO
Early detection of the family Chlamydiaceae as pathogens is essential worldwide for the rapid and sufficient management of atypical pneumonia. GENECUBE (TOYOBO) is a novel fully automated gene analyzer capable of amplifying and detecting target DNAs within 50 min. In this study, we developed a new PCR assay with a specific quenching probe (PCR-QC assay) for rapidly distinguishing between Chlamydia pneumoniae (CPN) and Chlamydia psittaci (CPS). The PCR-QC assay enabled us to precisely and simultaneously detect the 2 different types of DNA fragments even in a mixed sample by identifying unique melting temperatures. Next, we examined a total of 300 frozen samples from patients with respiratory tract infection using the PCR-QC assay and the cell culture method as the gold standard. Kappa index for agreement between the PCR-QC assay and the culture method was 0.43 (95% confidential interval (CI): 0.08-0.78). The sensitivity and specificity of the PCR-QC assay were 36.3% (4/11; 95% CI: 10.9-69.2%)) and 99.0% (286/289; 95% CI: 97.0-99.8%), respectively. The samples positive for CPN (n = 13) or CPS (n = 1) by either method were also examined by a conventional PCR TaqMan assay, which produced the same results as those from the PCR-QC assay. Furthermore, the PCR-QC assay using GENECUBE shortened the full detection time for CPN or CPS (within 50 min vs. more than 2 to 3 h) compared with conventional PCR TaqMan assays. Therefore, the new PCR-QC assay system equipped with GENECUBE is useful for rapidly detecting CPN or CPS pathogens in clinical laboratory, and may improve the management of atypical pneumonia.
Assuntos
Chlamydophila pneumoniae/isolamento & purificação , Chlamydophila psittaci/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Infecções por Chlamydia/microbiologia , Chlamydophila pneumoniae/genética , Chlamydophila psittaci/genética , DNA Bacteriano/química , DNA Bacteriano/genética , Análise Discriminante , Humanos , Sensibilidade e Especificidade , Temperatura de TransiçãoRESUMO
OBJECTIVE: Epicardial fat thickness (EFT) and chlamydia infection are independent cardiovascular risk factors in coronary artery disease (CAD). We aimed to evaluate the effect of coexistence of EFT and chlamydia infection on the presence and severity of CAD in patients with stable angina pectoris (SAP). PATIENTS AND METHODS: The study included 208 patients with SAP, divided into a CAD group (n=112) and a control group (n=96). The presence of Chlamydia pneumoniae-IgG (CP-IgG), EFT, and left ventricular ejection fraction (LVEF) were compared between groups. RESULTS: CP-IgG, LVEF, and EFT were found to be independent predictors of CAD (CP-IgG, OR=1.559, p=0.021; LVEF, OR=0.798, p<0.001; EFT, OR=3.175, p=0.026). Moreover, a statistically significant interaction was detected between CP-IgG and EFT for predicting the presence of CAD (p<0.001). A good positive correlation was found between EFT and Gensini score (r=0.684, p<0.001). CONCLUSIONS: We found that there was an interaction between CP-Ig and EFT for CAD development. This finding suggests that the interaction of CP-IgG and EFT plays a prominent role in the inflammatory process.
Assuntos
Angina Estável/diagnóstico por imagem , Infecções por Chlamydia/diagnóstico por imagem , Chlamydophila pneumoniae/isolamento & purificação , Doença da Artéria Coronariana/diagnóstico por imagem , Pericárdio/diagnóstico por imagem , Angina Estável/microbiologia , Infecções por Chlamydia/microbiologia , Doença da Artéria Coronariana/microbiologia , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pericárdio/microbiologiaRESUMO
Infection with Leptospira spp. is common in Réunion, a tropical island in the Indian Ocean. However, respiratory coinfections between strains of Leptospira spp. and other microorganisms are rarely described. Here, we describe the first reported case of coinfection between Leptospira spp. and Chlamydia pneumoniae, responsible for refractory acute respiratory distress syndrome requiring extracorporeal membrane oxygenation with a favorable outcome. In a case of leptospirosis with severe respiratory illness, testing for respiratory coinfection, especially with atypical pathogens, could explain the seriousness of the clinical condition and lead to specific treatment.
Assuntos
Antibacterianos/uso terapêutico , Infecções por Chlamydophila/complicações , Coinfecção , Leptospirose/complicações , Síndrome do Desconforto Respiratório/tratamento farmacológico , Síndrome do Desconforto Respiratório/terapia , Adulto , Chlamydophila pneumoniae/isolamento & purificação , Oxigenação por Membrana Extracorpórea , Humanos , Leptospira/isolamento & purificação , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/fisiopatologia , Reunião , Resultado do TratamentoRESUMO
OBJECTIVES: The contribution of intracellular and fastidious bacteria in Cystic fibrosis (CF) pulmonary exacerbations, and progressive lung function decline remains unknown. This project aimed to explore their impact on bacterial microbiota diversity over time in CF children. METHODS: Sixty-one children enrolled in the MUCOVIB multicentre prospective cohort provided 746 samples, mostly nasopharyngeal swabs, throat swabs and sputa which were analysed using culture, specific real-time qPCRs and 16S rRNA amplicon metagenomics. RESULTS: Chlamydia pneumoniae (n = 3) and Mycoplasma pneumoniae (n = 1) were prospectively documented in 6.6% of CF children. Microbiota alpha-diversity in children with a documented C. pneumoniae was highly variable, similarly to children infected with Staphylococcus aureus or Pseudomonas aeruginosa. The transition from routine follow-up visits to pulmonary exacerbation (n = 17) yielded variable changes in diversity indexes with some extreme loss of diversity. CONCLUSIONS: The high rate of C. pneumoniae detection supports the need for regular screenings in CF patients. A minor impact of C. pneumoniae on the microbial community structure was documented. Although detected in a single patient, M. pneumoniae should also be considered as a possible aetiology of lung infection in CF subjects.
Assuntos
Chlamydophila pneumoniae/isolamento & purificação , Fibrose Cística/microbiologia , Microbiota , Mycoplasma pneumoniae/isolamento & purificação , Sistema Respiratório/microbiologia , Biodiversidade , Criança , Pré-Escolar , Infecções por Chlamydophila/microbiologia , Chlamydophila pneumoniae/genética , DNA Bacteriano , Humanos , Metagenômica , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/microbiologia , Estudos Prospectivos , RNA Ribossômico 16S , Escarro/microbiologiaRESUMO
Multiple potential pathogens are frequently co-detected among children with lower respiratory tract infection (LRTI). Evidence indicates that Bordetella pertussis has an important role in the aetiology of LRTI. We aimed to study the association between B. pertussis and other respiratory pathogens in children hospitalised with severe LRTI, and to assess clinical relevance of co-detection. Nasopharyngeal (NP) swabs and induced sputa (IS) were tested with a B. pertussis specific PCR; additionally, IS was tested for other pathogens using a multiplex PCR. We included 454 children, median age 8 months (IQR 4-18), 31 (7%) of whom tested positive for B. pertussis. Children with B. pertussis had more bacterial pathogens detected (3 versus 2; P < 0.001). While B. pertussis showed no association with most pathogens, it was independently associated with Chlamydia pneumoniae, Mycoplasma pneumoniae and parainfluenza viruses with adjusted risk ratios of 4.01 (1.03-15.64), 4.17 (1.42-12.27) and 2.13 (1.03-4.55), respectively. There was a consistent increased risk of severe disease with B. pertussis. Patterns indicated even higher risks when B. pertussis was co-detected with any of the three organisms although not statistically significant. Improving vaccine coverage against B. pertussis would impact not only the incidence of pertussis but also that of severe LRTI generally.
Assuntos
Bordetella pertussis/isolamento & purificação , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Bordetella pertussis/genética , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Feminino , Hospitalização , Humanos , Incidência , Lactente , Masculino , Reação em Cadeia da Polimerase Multiplex/métodos , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/isolamento & purificação , Respirovirus/genética , Respirovirus/isolamento & purificação , Escarro/microbiologia , Coqueluche/microbiologiaRESUMO
Purpose: Mycoplasma pneumoniae (M. pneumoniae) and Chlamydophila pneumoniae (C. pneumoniae) play a significant role in children of all ages with lower respiratory tract infections (LRTIs). This study was conducted to detect M. pneumoniae and C. pneumoniae in children with community-acquired LRTIs employing serology, polymerase chain reaction (PCR) and nested PCR analysis. Material and Methods: This study included 75 children with acute LRTIs for detection of M. pneumoniae and C. pneumoniae. Blood was obtained for M. pneumoniae and C. pneumoniae antibodies and nasopharyngeal aspirates for M. pneumoniae PCR and C. pneumoniae nested PCR. Results: M. pneumoniae infection was positive in 9 (64.21%) children aged 2-6 months and in 5 (35.79%) aged 7 months-12 years, and this difference was statistically significant (P = 0.002). C. pneumoniae infection was comparable within the age group and statistically insignificant (P = 0.43). Clinical and radiological profiles of M. pneumoniae- and C. pneumoniae-positive and negative patients were numerically comparable. Serology and PCR together detected M. pneumoniae infection in 14 (18.6%) children. The sensitivity, specificity and positive and negative predictive values of serology were 77.78%, 92.42%, 58.33% and 96.83%, respectively. C. pneumoniae infection was positive in 11 (14.6%) children by serology and nested PCR with 50% sensitivity, 87.67% specificity, 10% positive predictive value and 98.46% negative predictive value. Conclusions: Our study confirms that M. pneumoniae and C. pneumoniae play a significant role in community-acquired LRTIs and a combination of serology and nested PCR is useful for its diagnosis.
Assuntos
Infecções por Chlamydophila/diagnóstico , Chlamydophila pneumoniae , Infecções Comunitárias Adquiridas/diagnóstico , Pneumonia por Mycoplasma/diagnóstico , Infecções Respiratórias/diagnóstico , Anticorpos Antibacterianos/sangue , Criança , Pré-Escolar , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/imunologia , Chlamydophila pneumoniae/isolamento & purificação , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Masculino , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/imunologia , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia Bacteriana/diagnóstico , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Testes SorológicosRESUMO
BACKGROUND: Molecular diagnostic methods have recently gained widespread use, and consequently, the importance of viral pathogens in community-acquired pneumonia (CAP) has undergone re-evaluation. Under these circumstances, the role of Chlamydophila pneumoniae as a pathogen that causes CAP also needs to be reviewed. METHODS: We reviewed articles that contained data on the frequency of identification of C. pneumoniae pneumonia as a causative pathogen for CAP. The articles were identified by performing a search in PubMed with the keywords "community-acquired pneumonia" and "pathogen". RESULTS: Sixty-three articles were identified. The reviewed articles demonstrated that the rates of identification of C. pneumoniae as the causative pathogen for CAP were significantly lower in assessments based on polymerase chain reaction (PCR) methods than in those based on serological methods. In some studies, it was possible to compare both serological and PCR methods directly using the same set of samples. CONCLUSIONS: The use of PCR methods, including multiplex PCR assays, has revealed that C. pneumoniae may play a limited role as a pathogen for CAP.
Assuntos
Infecções por Chlamydophila , Chlamydophila pneumoniae/isolamento & purificação , Chlamydophila pneumoniae/patogenicidade , Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/microbiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos , Masculino , Reação em Cadeia da Polimerase Multiplex/métodos , Testes Sorológicos/métodosRESUMO
CHLAMYDOPHILA PNEUMONIAE: , a common cause of respiratory tract infections, rarely leads to serious conditions. A 13-year-old boy with serologically confirmed C. pneumoniae infection presented with pneumonia complicated by pericardial and bilateral pleural effusions. He had a large haemorrhagic pericardial effusion from which 1000 ml of fluid was aspirated over 10 days and a right haemorrhagic pleural effusion which required a chest drain and the removal of 700 ml over 5 days. The addition of clarithromycin to ceftriaxone appeared to enhance recovery. As far as we are aware, this is the first report in the English literature of massive haemorrhagic pericardial and pleural effusions in children owing to C. pneumoniae infection.
Assuntos
Ceftriaxona/uso terapêutico , Pneumonia por Clamídia/complicações , Pneumonia por Clamídia/microbiologia , Claritromicina/uso terapêutico , Pericardite/microbiologia , Pericardite/patologia , Adolescente , Ceftriaxona/administração & dosagem , Chlamydophila pneumoniae/imunologia , Chlamydophila pneumoniae/isolamento & purificação , Claritromicina/administração & dosagem , Humanos , Imunoglobulina G/química , Imunoglobulina G/metabolismo , Imunoglobulina M/química , Imunoglobulina M/metabolismo , Masculino , Escarro/químicaRESUMO
This study was performed as a contribution for a better understanding of Chlamydia pneumoniae frequency in children with respiratory infections. A total of 416 children were recruited from two clinical centers in Sao Luis, Brazil. Of these patients, 165 children had upper respiratory tract infections (URTI), 150 had community-acquired pneumonia (CAP), and 101 were asymptomatic volunteer children. Clinical and epidemiological data from the participants were recorded. Nasopharyngeal swab samples were collected to extract DNA. C. pneumoniae DNA positivity and copy numbers were obtained by an absolute quantitative real-time PCR method. RESULTS: Positivity for C. pneumoniae DNA was higher in samples from URTI children (38.2%) and from CAP children (18.0%) than in those from the control group (7.9%; p < 0.001). Moreover, C. pneumoniae DNA was denser in children with URTI than in asymptomatic children. Considering the cutoff, the highest value of C. pneumoniae DNA found in asymptomatic children of the 3.98 log10 copies/mL, 8.5% (14/165) of the children with URTI, and 3.3% (5/150) with CAP presented high copy numbers of C. pneumoniae DNA. CONCLUSION: Taken together, these results revealed a high frequency of C. pneumoniae in both children with URTI and CAP.
Assuntos
Infecções por Chlamydophila/epidemiologia , Chlamydophila pneumoniae/isolamento & purificação , Nasofaringe/microbiologia , Pneumonia Bacteriana/epidemiologia , Doença Aguda , Brasil/epidemiologia , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , DNA Bacteriano/genética , Humanos , Lactente , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Fatores de RiscoRESUMO
OBJECTIVES: To assess the prevalence of Chlamydia psittaci, Chlamydia pneumoniae, and Chlamydia trachomatis in ocular adnexa lymphoma (OAL) determined by molecular testing in different countries and the potential association of Chlamydia infection with mucosa-associated lymphoid tissue (MALT) histotype by performing a systematic review and meta-analysis. METHODS: Electronic databases were searched for studies assessing the presence of Chlamydia in OAL. Pooled prevalence of the three Chlamydia species was calculated in each country. An odds ratio was calculated for the association between Chlamydia and MALT histotype, with a significant P < .05. RESULTS: Thirty-seven studies with 1,188 OALs were included. Pooled prevalence of C psittaci, C pneumoniae, and C trachomatis by country was done. Chlamydia infection was significantly associated with MALT histotype (odds ratio, 2.183; P = .027). CONCLUSIONS: The involvement of C psittaci in OAL is highly variable, with the highest prevalence in Italy and Korea. Chlamydia is associated with MALT histotype.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/isolamento & purificação , Chlamydophila pneumoniae/isolamento & purificação , Chlamydophila psittaci/isolamento & purificação , Neoplasias Oculares/microbiologia , Linfoma/microbiologia , HumanosRESUMO
Background: Acute chest syndrome (ACS) is an acute complication of sickle cell disease (SCD). Historically, the most common pathogens were Chlamydophila pneumoniae, Mycoplasma pneumoniae, and respiratory syncytial virus. Pediatric patients receiving guideline-adherent therapy experienced fewer ACS-related and all-cause 30-day readmissions compared with those receiving nonadherent therapy. This has not been evaluated in adults. Objectives: The primary objectives were to characterize antibiotic use and pathogens. The secondary objective was to assess the occurrence of readmissions associated with guideline-adherent and clinically appropriate treatment compared with regimens that did not meet those criteria. Methods: A retrospective cohort analysis was conducted for adults with SCD hospitalized between August 1, 2014, and July 31, 2017, with pneumonia (PNA) or ACS. The study was approved by the institutional review board. Results: A total of 139 patients with 255 hospitalizations were reviewed. Among 41 respiratory cultures, 3 organisms were isolated: Cryptococcus neoformans, Pseudomonas aeruginosa, and budding yeast. Respiratory panels were collected on 121 admissions, with 17 positive for 1 virus; all were negative for Chlamydophila pneumoniae and M pneumoniae. There were significantly more ACS-/PNA-related 7-day readmissions from patients on guideline-adherent regimens compared with nonadherent regimens (3.7% vs 0%; P = 0.04). Conclusion and Relevance: These findings challenge existing knowledge regarding the most common pathogens in adults with SCD with ACS or PNA. Routine inclusion of a macrolide may not be necessary. Future studies focused on pathogen characterization with standardized assessment are necessary to determine appropriate empirical therapy in this population.
Assuntos
Síndrome Torácica Aguda/tratamento farmacológico , Anemia Falciforme/complicações , Antibacterianos/uso terapêutico , Adulto , Chlamydophila pneumoniae/isolamento & purificação , Estudos de Coortes , Feminino , Humanos , Masculino , Readmissão do Paciente/estatística & dados numéricos , Estudos RetrospectivosRESUMO
BACKGROUND: Atypical pathogen infections played an important role in community-acquired pneumonia (CAP) in children. Pathogen-specific clinical symptoms are often lacking, and it is difficult to detect atypical pathogens by culture methods. The use of multiplex polymerase chain reaction (PCR) methods enables testing for many pathogens simultaneously in a single analysis. AIM: To determine the role of atypical pathogens in children hospitalized with CAP. PATIENTS AND METHODS: This cross-sectional study was conducted throughout a 2-year period from August 2015 to September 2017. It included 400 Egyptian children hospitalized with clinical diagnosis of CAP at a tertiary hospital in Cairo, Egypt. Sputum samples were collected from lower respiratory tract of all enrolled patients by mucus trap catheter for identification of Bordetella pertussis, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophilia by using multiplex real-time PCR. RESULTS: Among the 400 CAP patients enrolled in this study, atypical pathogens were detected in 12/400 (3%) patients. Bordetella pertussis was detected in 2% of cases, and it was responsible for CAP in 8/104 (7.69%) infants in the age stratum ≤ 4 months; compared with pertussis-negative cases, pertussis-positive cases were younger and incompletely vaccinated (P values were 0.001 and 0.007, respectively). Mycoplasma pneumoniae was detected in 1% of cases, all were among the age stratum > 4 months ≤ 59 months in 4/272 (1.47%) children. CONCLUSION: In early infancy, Bordetella pertussis causes a significant proportion of hospitalized CAP cases; all were ≤ 4 months old and incompletely vaccinated. This finding could suggest the role of maternal immunization in developing countries.
Assuntos
Bordetella pertussis/isolamento & purificação , Reação em Cadeia da Polimerase Multiplex/métodos , Pneumonia Bacteriana/diagnóstico , Criança , Pré-Escolar , Chlamydophila pneumoniae/isolamento & purificação , Infecções Comunitárias Adquiridas , Estudos Transversais , Egito/epidemiologia , Feminino , Humanos , Lactente , Legionella pneumophila/isolamento & purificação , Masculino , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia Bacteriana/microbiologiaRESUMO
BACKGROUND: Acute respiratory infections (ARIs) represent an important cause of morbidity and mortality in children, remaining a major public health concern, especially affecting children under 5 years old from low-income countries. Unfortunately, information regarding their epidemiology is still limited in Peru. METHODS: A secondary data analysis was performed from a previous cross-sectional study conducted in children with a probable diagnosis of Pertussis from January 2010 to July 2012. All samples were analyzed via Polymerase Chain Reaction (PCR) for the following etiologies: Influenza-A, Influenza-B, RSV-A, RSV-B, Adenovirus, Parainfluenza 1 virus, Parainfluenza 2 virus, Parainfluenza 3 virus, Mycoplasma pneumoniae and Chlamydia pneumoniae. RESULTS: A total of 288 patients were included. The most common pathogen isolated was Adenovirus (49%), followed by Bordetella pertussis (41%) from our previous investigation, the most prevelant microorganisms were Mycoplasma pneumonia (26%) and Influenza-B (19.8%). Coinfections were reported in 58% of samples and the most common association was found between B. pertussis and Adenovirus (12.2%). CONCLUSIONS: There was a high prevalence of Adenovirus, Mycoplasma pneumoniae and other etiologies in patients with a probable diagnosis of pertussis. Despite the presence of persistent cough lasting at least two weeks and other clinical characteristics highly suspicious of pertussis, secondary etiologies should be considered in children under 5 years-old in order to give a proper treatment.
Assuntos
Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Coqueluche/etiologia , Infecções por Adenoviridae/epidemiologia , Infecções por Adenoviridae/etiologia , Bordetella pertussis/genética , Bordetella pertussis/isolamento & purificação , Pré-Escolar , Infecções por Chlamydophila/epidemiologia , Infecções por Chlamydophila/etiologia , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Tosse/microbiologia , Estudos Transversais , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/etiologia , Masculino , Mycoplasma pneumoniae/isolamento & purificação , Vírus da Parainfluenza 3 Humana/genética , Vírus da Parainfluenza 3 Humana/isolamento & purificação , Peru/epidemiologia , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Infecções Respiratórias/epidemiologia , Infecções por Respirovirus/epidemiologia , Infecções por Respirovirus/etiologia , Coqueluche/diagnóstico , Coqueluche/epidemiologiaRESUMO
The in vitro activities of omadacycline, azithromycin, doxycycline, moxifloxacin, and levofloxacin were tested against 15 isolates of Chlamydia pneumoniae The minimum inhibitory concentration at which 90% of the isolates of C. pneumoniae were inhibited by omadacycline was 0.25 µg/ml (range, 0.03 to 0.5 µg/ml).
Assuntos
Antibacterianos/farmacologia , Chlamydophila pneumoniae/efeitos dos fármacos , Tetraciclinas/farmacologia , Azitromicina/farmacologia , Linhagem Celular , Pneumonia por Clamídia/tratamento farmacológico , Pneumonia por Clamídia/microbiologia , Chlamydophila pneumoniae/isolamento & purificação , Doxiciclina/farmacologia , Humanos , Levofloxacino/farmacologia , Testes de Sensibilidade Microbiana , Moxifloxacina/farmacologiaRESUMO
OBJECTIVE: Osteoarthritis (OA) is a common cause of disability affecting millions of people of all ages worldwide. The pathogenesis involves an inflammatory component, but the cause of the inflammation remains incompletely understood. The intracellular bacteria Chlamydia trachomatis and C. pneumoniae have been demonstrated in patients with reactive arthritis. Both of these microorganisms can cause chronic and persistent infections, with C. trachomatis being the most common cause of reactive arthritis. This study was performed to investigate the presence of C. pneumoniae in a large number of patients with primary OA. METHODS: The study included 75 patients who underwent total knee arthroplasty. During surgery, a synovial biopsy was performed and synovial fluid drawn. Real-time polymerase chain reaction (PCR) of C. pneumoniae was run on all patients, and real-time PCR of bacterial 16S rDNA was conducted on 30 of the 75 patients to screen for the presence of other bacteria. RESULTS: Real-time PCR showed no evidence of the presence of C. pneumoniae in the patients' specimens, nor were other bacteria detected. CONCLUSIONS: Although an inflammatory component is part of the pathogenesis of OA, we found no evidence indicating that C. pneumoniae is a stimulator of that inflammation.