RESUMO
Currently, there is a nationwide outbreak of Mycoplasma pneumoniae infections. M. pneumoniae is a bacterium that can cause atypical pneumonia, especially in children and young adults, and does not respond to the standard antibiotics prescribed for pneumonia. In addition, the bacterium regularly causes extra-pulmonary symptoms. In our hospitals, we have admitted 100 patients (including 20 children) with M. pneumoniae since the fall of 2023, many of which were young and had severe clinical symptoms. It is important to recognize the clinical picture to start effective antibiotic treatment. In this clinical lesson, we will provide two examples of recently admitted patients and discuss the characteristics of all inpatients who have presented to our hospitals during this epidemic. Finally, we pay attention to antibiotic policy and antibiotic resistance.
Assuntos
Antibacterianos , Mycoplasma pneumoniae , Pneumonia por Mycoplasma , Humanos , Países Baixos/epidemiologia , Antibacterianos/uso terapêutico , Mycoplasma pneumoniae/efeitos dos fármacos , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/história , Criança , Farmacorresistência Bacteriana , Surtos de Doenças , Masculino , Feminino , AdultoRESUMO
We report a large-scale outbreak of Mycoplasma pneumoniae respiratory infections encompassing 218 cases (0.8% of 26,449 patients tested) during 2023-2024 in Marseille, France. The bacterium is currently circulating and primarily affects children <15 years of age. High prevalence of co-infections warrants the use of a syndromic diagnostic strategy.
Assuntos
Surtos de Doenças , Mycoplasma pneumoniae , Pneumonia por Mycoplasma , Humanos , França/epidemiologia , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Pneumonia por Mycoplasma/história , Adolescente , Criança , Pré-Escolar , Masculino , Feminino , Adulto , Lactente , Adulto Jovem , Pessoa de Meia-Idade , História do Século XXI , Idoso , Prevalência , Coinfecção/epidemiologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologiaRESUMO
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.
Assuntos
Mutação , Mycoplasma pneumoniae , Pneumonia por Mycoplasma , RNA Ribossômico 23S , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/classificação , Humanos , Vietnã/epidemiologia , RNA Ribossômico 23S/genética , Pneumonia por Mycoplasma/microbiologia , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/história , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/epidemiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/genéticaRESUMO
The aim of this study was to assess which Mycoplasma pneumoniae genotypes were present in Moscow during the years 2015-2018 and whether the proportion between detected genotypes changed over time. We were also interested in the presence of macrolide resistance (MR)Mycoplasma pneumoniae. We performed multilocus variable-number tandem-repeat (VNTR) analysis (MLVA), SNP typing, and mutation typing in the 23S rRNA gene from 117 M. pneumoniae clinical isolates. Our analysis suggests two major MLVA types: 4572 and 3562. In 2017-2018, MLVA type 4572 gradually became predominant. In general, the SNP type range is the same as described earlier for European countries. The analysis of MR mutations showed that 7% of the isolates had an A2063G mutation in the 23S rRNA gene with no isolates carrying an A2064G mutation. In 2017-2018, MLVA type 4572 (SNP type 1) begins to spread in Moscow, which was widespread globally, especially in Asian countries. SNP typing of our sample showed higher discriminatory power than MLVA typing.
Assuntos
Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana , História do Século XXI , Humanos , Macrolídeos/farmacologia , Testes de Sensibilidade Microbiana , Moscou/epidemiologia , Tipagem de Sequências Multilocus , Mycoplasma pneumoniae/classificação , Mycoplasma pneumoniae/efeitos dos fármacos , Pneumonia por Mycoplasma/história , Polimorfismo de Nucleotídeo Único , Vigilância em Saúde Pública , RNA Ribossômico 23S/genéticaRESUMO
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.
Assuntos
Adesinas Bacterianas/genética , Variação Genética , Tipagem Molecular , Mycoplasma pneumoniae/classificação , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Adesinas Bacterianas/química , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sequência de Aminoácidos , Criança , Pré-Escolar , Feminino , História do Século XX , História do Século XXI , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Repetições Minissatélites , Tipagem de Sequências Multilocus , Pneumonia por Mycoplasma/história , Suécia/epidemiologia , Adulto JovemRESUMO
In Japan, Mycoplasma pneumoniae resistance to macrolides is high. To compare sequence types (STs) of susceptible and resistant isolates, we performed multilocus sequence typing for 417 isolates obtained in Japan during 2002-2016. The most prevalent ST overall was ST3, for macrolide-resistant was ST19, and for macrolide-susceptible were ST14 and ST7.
Assuntos
Mycoplasma pneumoniae/classificação , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Genes Fúngicos , Genótipo , História do Século XXI , Humanos , Japão/epidemiologia , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Mycoplasma pneumoniae/efeitos dos fármacos , Filogenia , Pneumonia por Mycoplasma/história , Vigilância em Saúde PúblicaRESUMO
During 2012-2015, we tested respiratory specimens from patients with severe respiratory illness (SRI), patients with influenza-like illness (ILI), and controls in South Africa by real-time PCR for Mycoplasma pneumoniae, followed by culture and molecular characterization of positive samples. M. pneumoniae prevalence was 1.6% among SRI patients, 0.7% among ILI patients, and 0.2% among controls (p<0.001). Age <5 years (adjusted odd ratio 7.1; 95% CI 1.7-28.7) and HIV infection (adjusted odds ratio 23.8; 95% CI 4.1-138.2) among M. pneumonia-positive persons were associated with severe disease. The detection rate attributable to illness was 93.9% (95% CI 74.4%-98.5%) in SRI patients and 80.7% (95% CI 16.7%-95.6%) in ILI patients. The hospitalization rate was 28 cases/100,000 population. We observed the macrolide-susceptible M. pneumoniae genotype in all cases and found P1 types 1, 2, and a type 2 variant with multilocus variable number tandem repeat types 3/6/6/2, 3/5/6/2, and 4/5/7/2.
Assuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/história , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Genótipo , História do Século XXI , Hospitalização , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Mycoplasma pneumoniae/classificação , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/história , Vigilância da População , Prevalência , Fatores de Risco , África do Sul/epidemiologia , Adulto JovemRESUMO
Mycoplasma pneumoniae (MP) is particularly prevalent in low-immunity school-age children. Few data have been reported on MP prevalence in Yunnan, China. This study was designed to investigate the prevalence and characterize genomic DNA of MP in a small outbreak in 2016, Southwest China. RepMP4 and RepMP2/3 genes of MP positive samples were amplified for molecular typing through sequence alignment and PCR-RFLP assay. Phylogenetic trees were constructed by MEGA5.0. The results showed that two distinct P1 types (type I and type II) were prevalent in this MP outbreak. Type I was the most prevalent type, and clustered in the same evolutionary branch of C26 (China, 2012). Only 1 MP isolate belonged to type II, and clustered in the branch of KCH405 (Japan, 2016). Fifty-nine nucleotide mutations were observed in P1 genes of type I isolates (51 in RepMP4, 8 in RepMP2/3). Ninety-five nucleotide mutations were observed in P1 genes of the type II isolates (33 in RepMP4, 62 in RepMP2/3). It is noteworthy that 31 mutation sites were clustered in an 84-bp fragment in the RepMP4 gene of type II isolates. One new fragment that appeared in two of the type I strains was not found in NCBI. Nucleotide diversity analyze results showed that RepMP4 was more likely to be genetically diverse than RepMP2/3. Two-tailed Z-test result of RepMP4 suggested positive selection between 6 P1 type I isolates and M29 (China, 2005). According to secondary structure prediction, 36 new possible protein binding sites were found and another 9 sites were lost, 2 helices were missed and 1 new helix appeared in type I isolates. As for type II isolates, 16 protein binding regions were gained and 31 were lost. This study may help to understand the intrinsic geographical relatedness and contributes further to the research of MP.
Assuntos
Genoma Bacteriano , Mycoplasma pneumoniae/classificação , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , China/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Surtos de Doenças , Evolução Molecular , Genes Bacterianos , Variação Genética , Genótipo , História do Século XXI , Humanos , Tipagem Molecular , Mutação , Mycoplasma pneumoniae/isolamento & purificação , Filogenia , Pneumonia por Mycoplasma/história , PrevalênciaRESUMO
Multiple-locus variable-number tandem-repeat analysis (MLVA) typing was performed for Mycoplasma pneumoniae strains isolated between 2004 and 2014 in Yamagata, Japan. The results were examined by considering the combination of the P1 type and prevalence of macrolide resistance-associated mutations. Four-locus (Mpn13-16) MLVA classified 347 strains into 9 MLVA types, including 3 major types: 3-5-6-2, 4-5-7-2, and 4-5-7-3. All type 3-5-6-2 strains (77 strains) were P1 type 2 variants (2a or 2c), while types 4-5-7-2 (181 strains) and 4-5-7-3 (75 strains) were P1 type 1. MLVA type 4-5-7-2 strains circulated and were dominant until 2010, accounting for 88.4% of the 121 strains isolated between 2004 and 2010. The prevalence of types 4-5-7-3 and 3-5-6-2 strains increased rapidly in 2011 and 2012, respectively, resulting in cocirculation of 3 MLVA types, including type 4-5-7-2, between 2011 and 2013. The prevalence of macrolide resistance-associated mutations in MLVA types 4-5-7-2, 4-5-7-3, and 3-5-6-2 strains was 59.7% (108/181), 25.3% (19/75), and 0% (0/77), respectively. Because the prevalence of macrolide resistance-associated mutations differed by current MLVA types in Yamagata, continued surveillance combined with molecular typing and identification of macrolide resistance-associated mutations is necessary.
Assuntos
DNA Bacteriano , Repetições Minissatélites , Tipagem de Sequências Multilocus , Mycoplasma pneumoniae/classificação , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , História do Século XXI , Humanos , Japão/epidemiologia , Macrolídeos/farmacologia , Testes de Sensibilidade Microbiana , Mutação , Mycoplasma pneumoniae/efeitos dos fármacos , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/história , Prevalência , Vigilância em Saúde PúblicaAssuntos
Surtos de Doenças/história , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/história , Criança , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/história , Infecção Hospitalar/microbiologia , História do Século XX , Hospitais Pediátricos , Humanos , Pediatria/história , Publicações Periódicas como Assunto/história , Philadelphia/epidemiologia , PrevalênciaRESUMO
Mycoplasma pneumoniae is a leading cause of encephalitis and pneumonia in children. Active surveillance identified a cluster of children with suspected encephalitis associated with M.pneumoniae in NSW during July, 2015. An investigation that cross validated encephalitis surveillance with ED pneumonia surveillance and senitenal reference laboratory data revealed probable epidemic M.pneumoniae disease activity in Sydney during 2015.
Assuntos
Encefalite Infecciosa/epidemiologia , Encefalite Infecciosa/microbiologia , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Adolescente , Austrália/epidemiologia , Criança , Pré-Escolar , Feminino , História do Século XXI , Humanos , Lactente , Recém-Nascido , Encefalite Infecciosa/diagnóstico , Encefalite Infecciosa/história , Masculino , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/história , Vigilância em Saúde Pública , Estações do Ano , Vigilância de Evento SentinelaAssuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Feminino , História do Século XX , Humanos , Índia , Lactente , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/história , Pneumonia por Mycoplasma/microbiologiaAssuntos
Surtos de Doenças , Mycoplasma pneumoniae/classificação , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , História do Século XXI , Humanos , Repetições de Microssatélites , Tipagem de Sequências Multilocus , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/história , Federação Russa/epidemiologiaRESUMO
Mycoplasma pneumoniae is a leading cause of respiratory infections, including community-acquired pneumonia (CAP). Currently, pathogen-specific testing is not routinely performed in the primary care setting, and the United States lacks a systematic surveillance program for M. pneumoniae. Documentation of individual cases and clusters typically occurs only when severe illness and/or failure to improve with empirical antibiotic therapy is observed. Outbreaks, some lasting for extended periods and involving a large number of cases, occur regularly. However, many more likely go unrecognized due to the lack of diagnostic testing and structured reporting. We reviewed data from 17 investigations of cases, small clusters, and outbreaks of M. pneumoniae infections that were supported by the Centers for Disease Control and Prevention (CDC) between 2006 and 2013. We examined 199 M. pneumoniae-positive specimens collected during this time period in order to identify trends in antimicrobial resistance and circulating types. Overall, macrolide resistance was identified in approximately 10% of M. pneumoniae infections occurring during this time period. Typing of strains revealed cocirculation of multiple multilocus variable-number tandem-repeat analysis (MLVA) and P1 types throughout this period, including diversity in types detected within individual outbreaks. Three MLVA types (4572, 3562, and 3662) accounted for 97% of the infections during the study period. A systematic surveillance program is necessary to understand the burden of M. pneumoniae disease in the United States, facilitate case and outbreak identification, and inform appropriate therapeutic and infection control strategies.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Macrolídeos/farmacologia , Mycoplasma pneumoniae/efeitos dos fármacos , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Adolescente , Adulto , Criança , Pré-Escolar , Surtos de Doenças , História do Século XXI , Humanos , Lactente , Recém-Nascido , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem Molecular , Mycoplasma pneumoniae/classificação , Pneumonia por Mycoplasma/história , Pneumonia por Mycoplasma/prevenção & controle , Vigilância da População , Estados Unidos/epidemiologia , Adulto JovemRESUMO
In 2011, Norway experienced a surge in community acquired Mycoplasma pneumoniae infections. Norway also has one of the highest rates of reported Bordetella pertussis infections, despite high vaccine coverage. We aimed to determine the prevalence of upper respiratory tract pathogens in patients attending primary care physicians for respiratory illness during the 2011 M. pneumoniae epidemic period. A retrospective analysis of data from 26,039 patients that have had nasopharyngeal swabs analysed by nucleic acid amplification testing (NAAT) for M. pneumoniae, C. pneumoniae and B. pertussis was performed. Subsets of samples were tested for additional pathogenic bacteria, including B. parapertussis and B. holmesii, as well as influenza virus. M. pneumoniae, C. pneumoniae and B. pertussis were detected in 2,484 (9.5 %), 261 (1.0 %) and 821 (3.2 %) patients, respectively. Co-infection of M. pneumoniae and B. pertussis was found in 50 (0.19 %) patients, C. pneumoniae and B. pertussis in 4 (0.02 %). Influenza virus was found in 899 (24.5 %) of 3,661 nasopharyngeal swabs. Co-infection of influenza virus and bacterial pathogens was common, although influenza virus co-infection with B. pertussis occurred significantly more often than with C. pneumoniae and M. pneumoniae (20.4 % versus 2.9 % and 9.1 %, respectively; p<0.005). Testing for Bordetella species genes IS1001, IS1002 and recA showed that B. holmesii was most likely misdiagnosed as B. pertussis in 5.8 % of cases. The most prevalent respiratory tract pathogen in the general population in 2011 was M. pneumoniae. B. pertussis was also found frequently as was B. pertussis and influenza virus co-infections.
Assuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bordetella pertussis/genética , Bordetella pertussis/isolamento & purificação , Criança , Pré-Escolar , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Coinfecção , Infecções Comunitárias Adquiridas , Epidemias , História do Século XXI , Humanos , Lactente , Recém-Nascido , Vírus da Influenza A/genética , Vírus da Influenza A/isolamento & purificação , Pessoa de Meia-Idade , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/isolamento & purificação , Noruega/epidemiologia , Pneumonia por Mycoplasma/história , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Estudos Retrospectivos , Adulto JovemAssuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma , Antibacterianos/uso terapêutico , Surtos de Doenças , Europa (Continente)/epidemiologia , Genótipo , História do Século XX , Humanos , Macrolídeos/uso terapêutico , Testes de Sensibilidade Microbiana , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/história , Saúde Pública , Reação em Cadeia da Polimerase em Tempo RealRESUMO
The subject of atypical pneumonias is of great medical and historical interest to modern physicians. Although these diseases have no doubt affected humans throughout our history, it is not until the mid-twentieth century that physicians first began to differentiate certain atypical pulmonary infectious processes from typical pneumonia. Physicians at the time were unclear as to the precise etiology of these infections. As time progressed and study of these organisms continued, physicians were better able to identify the causative agent and devise tests with which to detect the disease. This article focuses on the description and ultimate identification of Mycoplasma pneumoniae.
Assuntos
Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/etiologia , Pneumonia por Mycoplasma/história , História do Século XX , Humanos , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/patologiaRESUMO
A number of clinical and epidemiological factors permit the tentative identification of Mycoplasma pneumoniae infections. These selective factors can be considered the mainstay of diagnosis because they facilitate intelligent and efficient use of laboratory tests. The laboratory, in turn, through identification of the causative agent, augments both clinical and epidemiological data. The laboratory can better serve its purpose as more rapid, sensitive, and specific diagnostic methods come into use.
Assuntos
Pneumonia por Mycoplasma/diagnóstico , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/história , Diagnóstico Diferencial , História do Século XX , Humanos , Pneumonia/diagnóstico , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/históriaRESUMO
The three classical papers published in 1944 and 1945 by Monroe A. Eaton and colleagues deal with the etiology of primary atypical pneumonia (PAP) and with the properties of a filterable agent (subsequently and for a number of years known as Eaton agent) from the sputum or lung of patients with PAP using cotton rats, hamsters, and chick embryos as laboratory hosts. The present review is first and foremost a tribute to Monroe Eaton and his colleagues for their trail-blazing discovery of a major cause of the atypical pneumonia syndrome and their steadfast vision of its importance. The organism was finally identified and designated Mycoplasma pneumoniae some 20 years after their papers first appeared in the Journal of Experimental Medicine.