Outbreak of macrolide-resistant mycoplasma pneumoniae in a primary school in Beijing, China in 2018.

BACKGROUND: On 7th June, 2018, a primary school in Beijing, China notified Shunyi CDC of an outbreak of acute respiratory disease characterized by fever and cough among students and resulting in nine hospitalization cases during the preceding 2 weeks. We started an investigation to identify the etiologic agent, find additional cases, develop and implement control measures. METHODS: We defined probable cases as students, teachers and other staffs in the school developed fever (T ≥ 37.5 °C) with cough or sore throat; or a diagnosis of pneumonia during May 1-June 31, 2018. Confirmed cases were probable cases with Mycoplasma pneumoniae detected in oropharyngeal (OP) swabs by quantitative real-time polymerase chain reaction (qPCR). We searched case by reviewing school absenteeism records and interviewing students, teachers and staff in this school. Oropharyngeal swabs were collected from symptomatic students. Two qPCR) assay, a duplex qPCR assay, and sequencing were performed to determine the pathogen, genotype and macrolide resistance at the gene level, respectively. RESULTS: From May 1st to June 31st, 2018, we identified 55 cases (36 probable and 19 confirmed), of whom 25 (45%) were hospitalized for complications. All cases were students, none of the teachers and other staffs in the school were with similar symptoms. The attack rate (AR) was 3.9% (55/1398) for all students. The cases were mainly male (58%), with an age range of 7-8 years (median: 7 years). 72% (18/25) of inpatients had radiograph findings consistent with pneumonia, and some cases were hospitalized for up to 4 weeks. Pathogen detection results indicated that Mycoplasma pneumonia (M. pneumoniae) P1 type 1 was the causative agent in this outbreak, and the strain harbored one point mutation of A to G at position 2063. CONCLUSIONS: The infections by macrolide-resistant M. pneumoniae are not always mild and pneumonia was common and M. pneumoniae could causes serious complications which require long-term hospitalization. In the future infectious disease prevention and control practice, M. pneumoniae should be paid more attention. It is necessary to establish and improve the pathogen and drug resistance surveillance system in order to prevent and control such mutated strains of M. pneumoniae from causing future outbreaks or epidemics in China.

[Analysis on the effects of hepatitis B vaccine to prevent mother-to-children transmission of hepatitis B virus in Shunyi District of Beijing Municipal].

OBJECTIVE: To evaluate the effects of immunization strategy about Hepatitis B vaccine preventing mother-to-children transmission (MTCT)of Hepatitis B virus (HBV) in Shun Yi District of Beijing. METHODS: The supervision data of blood serum of the children born from mothers who HBsAg carrier or HBsAg and HBeAg carrier were collected during the years of 2005-2008. The positive rate of HBsAg, anti-HBs, anti-HBc and the protective rate were analyzed. RESULTS: 223 children born from mothers of HBsAg and HBeAg carrier or HBsAg carrier were vaccinated according to the Hepatitis B vaccine immunigation strategy of Beijing. The infective rate of HBV was 1.18%, and protective rate of HepB was 98.61%. The infective rate of HBV of the children born from mothers of HBsAg and HBeAg carrier was higher than the rate of the children born from mothers of HBsAg carrier. The positive rate of anti-HBs was 84.71%. There were statistics significance in different years. The GMC of anti-HBs was 139.32 mIU per mL. The anti-HBs GMC of 2007 and 2008 were higher than those of 2005 and 2006. The anti-HBs GMC of the children who HBIG adopted was higher than that of the children who HBIG did not adopted. CONCLUSION: The Hepatitis B vaccine immunization strategy of Shun Yi District had good immunological and protective effects to prevent HBV perinatal transmission.