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1.
J Med Virol ; 94(1): 303-309, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34491594

RESUMO

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 Jovem
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(8): 1466-1474, 2021 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814569

RESUMO

Objective: To analyze the epidemiological characteristics of Chlamydia pneumoniae infection among patients with acute respiratory infection in Beijing from 2015 to 2019. Methods: The epidemiological data of acute respiratory infection patients from 35 sentinel hospitals in Beijing were collected by the respiratory pathogen surveillance system in Beijing. The clinical samples were collected to detect Chlamydia pneumoniae, and the sequence of the VD4 region of the ompA gene in positive samples was analyzed. Results: From January 2015 to December 2019, the overall positive rate of Chlamydia pneumoniae among patients with acute respiratory infection in Beijing was 0.34% (129/37 460). The positive rate of Chlamydia pneumoniae generally increased in March, reaching the peak in May, and started to drop in July, with a duration of about 5-8 months. The epidemic season in different years fluctuated by 1-2 months. The positive monthly rate of Chlamydia pneumoniae was no less than 0.30% in every epidemic season. The positive rate of Chlamydia pneumoniae was the highest in the 5-44 years old group and the highest in 10-14 year-olds. The risk of Chlamydia pneumoniae infection increased with age in patients younger than 25 years old and decreased in those older one aged than 25 years of age. The positive rates in male and female patients were 0.33% (68/20 830) and 0.37% (61/16 528), respectively, and there was no significant difference between the two groups (χ2=0.486, P=0.486). The positive rate of Chlamydia pneumoniae in patients with common pneumonia was higher than that in patients with upper pneumonia and severe pneumonia (χ2=36.797, P<0.01). Other respiratory pathogens were also detected in the Chlamydia pneumoniae samples, and the top four pathogens appeared as Haemophilus influenzae (15 cases), Streptococcus pneumoniae (13 cases), Rhinovirus (8 cases), and Stenotrophomonas maltophilia (7 cases). 101 strains of 129 Chlamydia pneumoniae positive samples were identified as type A by sequencing. Conclusions: The annual epidemic pattern of Chlamydia pneumoniae in Beijing, is unimodal, and the epidemic season generally appears from March to July. The seasonal characteristics of Chlamydia pneumoniae in Beijing can be used for the differential diagnosis of Chlamydia pneumoniae from other respiratory pathogens. Chlamydia pneumoniae is most common in people aged 5-44 years, and the primary genotype is type A. People aged 10-44 years old suffer the highest incidence. If the nucleic acid positive rate of Chlamydia pneumoniae exceeds 0.30% for two consecutive months, the high prevalence period of Chlamydia pneumoniae can be preliminarily expected. Chlamydia pneumoniae infection has a higher probability of progressing to severe pneumonia from general pneumonia.


Assuntos
Chlamydophila pneumoniae , Pneumonia , Infecções Respiratórias , Adolescente , Adulto , Criança , Pré-Escolar , Chlamydophila pneumoniae/genética , Feminino , Humanos , Masculino , Mycoplasma pneumoniae , Infecções Respiratórias/epidemiologia , Rhinovirus , Adulto Jovem
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(10): 1033-1037, 2021 Oct 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34719419

RESUMO

OBJECTIVES: To study the clinical features of Mycoplasma pneumoniae pneumonia (MPP) with adenovirus (ADV) infection in children. METHODS: A retrospective analysis was performed on the medical data of 228 children with MPP alone and 28 children with MPP and ADV infection. The two groups were compared in terms of clinical features, laboratory results, and treatment outcome. RESULTS: Compared with the MPP group, the MPP+ADV group had significantly longer duration of fever and length of hospital stay, a significantly higher proportion of patients with severe lesions (erosion and exfoliation) of the airway mucosa under bronchoscopy, a significantly higher clinical pulmonary infection score, and a significantly higher proportion of patients requiring oxygen therapy (P<0.05). There were no significant differences between the two groups in white blood cell count, C-reactive protein, Mycoplasma pneumoniae DNA copy number in bronchoalveolar lavage fluid, and the incidence rates of pleural effusion and extrapulmonary complications (P>0.05). CONCLUSIONS: Compared with children with MPP alone, children with MPP and ADV infection tend to have more severe clinical manifestations and airway mucosal lesions and are more likely to require oxygen therapy, but most of the laboratory markers lack specificity.


Assuntos
Infecções por Adenoviridae , Pneumonia por Mycoplasma , Líquido da Lavagem Broncoalveolar , Criança , Humanos , Mycoplasma pneumoniae , Estudos Retrospectivos
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(11): 1127-1131, 2021 Nov 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34753544

RESUMO

OBJECTIVES: To study the consistency between nasopharyngeal aspirates (NPA) and bronchoalveolar lavage fluid (BALF) in pathogen detection in children with pneumonia. METHODS: A retrospective analysis was performed on the data of pathogens detected in 533 children with pneumonia from February 2017 to March 2020. The paired McNemar's test was used to compare the difference in pathogen detection between NPA and BALF groups. The Kappa coefficient was used to analyze the consistency in pathogen detection between the two groups. RESULTS: NPA had a sensitivity of 28%, a specificity of 74%, a positive predictive value of 14%, and a negative predictive value of 91% in detecting bacteria, and a Kappa coefficient of 0.013 suggested poor consistency between NPA and BALF. NPA had a sensitivity of 52%, a specificity of 81%, a positive predictive value of 24%, and a negative predictive value of 94% in detecting viruses, and a Kappa coefficient of 0.213 suggested poor consistency between NPA and BALF. NPA had a sensitivity of 78%, a specificity of 71%, a positive predictive value of 49%, and a negative predictive value of 90% in detecting Mycoplasma pneumoniae, and a Kappa coefficient of 0.407 suggested moderate consistency between NPA and BALF. CONCLUSIONS: There is poor consistency between NPA and BALF in the detection of bacteria and viruses, and clinicians should be cautious in diagnosing lower respiratory tract infection based on bacteria or viruses detected in NPA. There is moderate consistency between NPA and BALF in the detection of Mycoplasma pneumoniae, suggesting that it may be reliable to diagnose lower respiratory tract infection based on Mycoplasma pneumoniae detected in NPA, while comprehensive judgment in combination with clinical conditions is needed.


Assuntos
Pneumonia por Mycoplasma , Pneumonia , Infecções Respiratórias , Líquido da Lavagem Broncoalveolar , Criança , Humanos , Mycoplasma pneumoniae , Estudos Retrospectivos
5.
BMC Res Notes ; 14(1): 412, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758882

RESUMO

OBJECTIVE: This study aimed to determine the prevalence of A. baumannii in children aged less than 1 year admitted with a clinical diagnosis of whooping cough. RESULTS: A total of 225 nasopharyngeal samples from children under 1 year old hospitalized with clinical diagnosis of whooping cough were studied from January 2010 to July 2012. The presence of A. baumannii was detected in 20.89% (47/225) of the nasopharyngeal swab samples. Among the 47 patients with A. baumannii: 5 were diagnosed with A. baumannii monoinfection, 17 co-infection with bacteria, 7 co-infection with virus and 18 co-infection with bacteria + virus. It was observed that 51.6% (116/225) were children between 29 days and 3 months old, this same group had the highest overall prevalence with 53.3%. The most common co-infecting pathogens were Bordetella pertussis in 55.3%, Adenovirus in 42.6% and Mycoplasma pneumoniae in 23.4%.


Assuntos
Acinetobacter baumannii , Coqueluche , Bordetella pertussis , Criança , Pré-Escolar , Humanos , Lactente , Mycoplasma pneumoniae , Peru/epidemiologia , Coqueluche/diagnóstico , Coqueluche/epidemiologia
6.
PLoS One ; 16(10): e0258694, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34648603

RESUMO

OBJECTIVES: Macrolides are generally considered to be the drugs of choice for treatment of patients with Mycoplasma pneumoniae infection. However, macrolide-resistant M. pneumoniae has been emerging since about 2000. The Smart Gene® system (MIZUHO MEDY Co., Ltd., Tosu, Japan) is a novel fully automated system for detection of pathogens using the method of quantitative polymerase chain reaction (qPCR) with QProbe (QProbe PCR). The entire procedure is completed within 50 min and the size of the instrument is small (15 x 34 x 30 cm). The purpose of this study was to evaluate the usefulness of the Smart Gene® system for detection of M. pneumoniae and detection of a point mutation at domain V of the 23S rRNA gene of M. pneumoniae. MATERIALS: Pharyngeal swab samples were collected from 154 patients who were suspected of having respiratory tract infections associated with M. pneumoniae. RESULTS: Compared with the results of qPCR, the sensitivity and specificity of the Smart Gene® system were 98.7% (78/79) and 100.0% (75/75), respectively. A point mutation at domain V of the 23S rRNA gene was detected from 7 (9.0%) of 78 M. pneumoniae-positive samples by the Smart Gene® system and these results were confirmed by direct sequencing. The minimum inhibitory concentrations of clarithromycin among the 5 isolates of M. pneumoniae with a point mutation at domain V of the 23S rRNA gene were >64 µg/ml and those among the 33 isolates without a mutation in the 23S rRNA gene were <0.0625 µg/ml. CONCLUSION: The Smart Gene® system is a rapid and accurate assay for detection of the existence of M. pneumoniae and a point mutation at domain V of the 23S rRNA gene of M. pneumoniae at the same time. The Smart Gene® system is suitable for point-of-care testing in both hospital and outpatient settings.


Assuntos
Claritromicina/farmacologia , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/diagnóstico , Mutação Puntual , RNA Ribossômico 23S/genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , DNA Bacteriano/genética , DNA Ribossômico/genética , Feminino , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Pessoa de Meia-Idade , Mycoplasma pneumoniae/efeitos dos fármacos , Mycoplasma pneumoniae/genética , Faringe/microbiologia , Testes Imediatos , Kit de Reagentes para Diagnóstico , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade , Adulto Jovem
7.
Virol J ; 18(1): 202, 2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627307

RESUMO

BACKGROUND: The effect of SARS-CoV-2 on existing respiratory pathogens in circulation remains uncertain. This study aimed to assess the impact of SARS-CoV-2 on the prevalence of respiratory pathogens among hospitalized children. METHODS: This study enrolled hospitalized children with acute respiratory infections in Shenzhen Children's Hospital from September to December 2019 (before the COVID-19 epidemic) and those from September to December 2020 (during the COVID-19 epidemic). Nasopharyngeal swabs were collected, and respiratory pathogens were detected using multiplex PCR. The absolute case number and detection rates of 11 pathogens were collected and analyzed. RESULTS: A total of 5696 children with respiratory tract infection received multiplex PCR examination for respiratory pathogens: 2298 from September to December 2019 and 3398 from September to December 2020. At least one pathogen was detected in 1850 (80.5%) patients in 2019, and in 2380 (70.0%) patients in 2020; the detection rate in 2020 was significantly lower than that in 2019.The Influenza A (InfA) detection rate was 5.6% in 2019, but 0% in 2020. The detection rates of Mycoplasma pneumoniae, Human adenovirus, and Human rhinovirus also decreased from 20% (460), 8.9% (206), and 41.8% (961) in 2019 to 1.0% (37), 2.1% (77), and 25.6% (873) in 2020, respectively. In contrast, the detection rates of Human respiratory syncytial virus, Human parainfluenza virus, and Human metapneumovirus increased from 6.6% (153), 9.9% (229), and 0.5% (12) in 2019 to 25.6% (873), 15.5% (530), and 7.2% (247) in 2020, respectively (p < 0.0001). CONCLUSIONS: Successful containment of seasonal influenza as a result of COVID-19 control measures will ensure we are better equipped to deal with future outbreaks of both influenza and COVID-19.Caused by virus competition, the detection rates of Human respiratory syncytial virus, Human parainfluenza virus, and Human metapneumovirus increased in Shenzhen,that reminds us we need to take further monitoring and preventive measures in the next epidemic season.


Assuntos
Antibiose , COVID-19/epidemiologia , Doenças Respiratórias/epidemiologia , SARS-CoV-2/isolamento & purificação , Adenovírus Humanos/genética , Adenovírus Humanos/isolamento & purificação , Adolescente , COVID-19/virologia , Criança , Criança Hospitalizada , Pré-Escolar , China , Enterovirus/genética , Enterovirus/isolamento & purificação , Feminino , Humanos , Lactente , Vírus da Influenza A/genética , Vírus da Influenza A/isolamento & purificação , Masculino , Metapneumovirus/genética , Metapneumovirus/isolamento & purificação , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/isolamento & purificação , Nasofaringe/microbiologia , Nasofaringe/virologia , Prevalência , Vírus Sinciciais Respiratórios/genética , Vírus Sinciciais Respiratórios/isolamento & purificação , Doenças Respiratórias/microbiologia , Doenças Respiratórias/virologia , Respirovirus/genética , Respirovirus/isolamento & purificação , SARS-CoV-2/genética
8.
Medicine (Baltimore) ; 100(42): e27585, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34678908

RESUMO

BACKGROUND: Mycoplasma pneumoniae (MP) is a common infectious respiratory disease in pediatrics, and macrolide antibiotics are the optimal treatment option. In recent years, there is a significant increase in the resistance of this pathogen to macrolide antibiotics, which makes the clinical treatment of this disease increasingly complex. Shenfu injection (SFI), a herbal extract injection, has advantages of improving immune function, reducing inflammatory reaction, improving curative effect and shortening the course of disease in the treatment of pediatric MP. However, there is a lack of rigorous clinical studies to evaluate the effects of SFI on inflammatory factors and immune function in children with MP. METHODS: This study is a prospective, randomized, double-blind, placebo-controlled clinical trial protocol. The objective of this study is to evaluate the effect of SFI on inflammatory factors and immune function in children with MP. Patients meeting the inclusion criteria were randomized in a ratio of 1:1 to either the treatment group (azithromycin + 100 mL 5% glucose injection + 50 mL SFI) or the control group (azithromycin + 150 mL 5% glucose injection). Patients in both groups received the standard treatment for 7 days. The levels of inflammatory factor indexes (C-reactive protein, interleukin-6, interleukin-10, tumor necrosis factor-α) and immune function indexes (immunoglobulin G, immunoglobulin A, immunoglobulin M) in both groups were measured at the beginning of treatment, on the 3rd day of treatment and at the end of treatment. Besides, the time of improvement in clinical symptoms (duration of cough, time of disappearance of lung rales, time of fever reduction, and time of disappearance of lung X-ray infiltrative shadow) and adverse effects in both groups were recorded. Finally, the data were statistically analyzed by SPSS 20.0 software. DISCUSSION: In this study, an evaluation was conducted on the effects of SFI on inflammatory factors and immune function in pediatric MP. The results of this experiment will provide a clinical basis for the adjuvant treatment of pediatric MP with SFI. TRIAL REGISTRATION: OSF Registration number.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Imunidade/efeitos dos fármacos , Inflamação/tratamento farmacológico , Pneumonia por Mycoplasma/tratamento farmacológico , Criança , Pré-Escolar , Método Duplo-Cego , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Humanos , Lactente , Masculino , Mycoplasma pneumoniae , Estudos Prospectivos , Projetos de Pesquisa
9.
BMC Infect Dis ; 21(1): 1085, 2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34674642

RESUMO

BACKGROUND: Early prediction of bronchitis obliterans (BO) is of great significance to the improvement of the long-term prognosis of children caused by refractory Mycoplasma pneumoniae pneumonia (RMPP). This study aimed to establish a nomogram model to predict the risk of BO in children due to RMPP. METHODS: A retrospective observation was conducted to study the clinical data of children with RMPP (1-14 years old) during acute infection. According to whether there is BO observed in the bronchoscope, children were divided into BO and the non-BO groups. The multivariate logistic regression model was used to construct the nomogram model. RESULTS: One hundred and forty-one children with RMPP were finally included, of which 65 (46.0%) children with RMPP were complicated by BO. According to the multivariate logistic regression analysis, WBC count, ALB level, consolidation range exceeding 2/3 of lung lobes, timing of macrolides, glucocorticoids or fiber bronchoscopy and plastic bronchitis were independent influencing factors for the occurrence of BO and were incorporated into the nomogram. The area under the receiver operating characteristic curve (AUC-ROC) value of nomogram was 0.899 (95% confidence interval [CI] 0.848-0.950). The Hosmer-Lemeshow test showed good calibration of the nomogram (p = 0.692). CONCLUSION: A nomogram model found by seven risk factor was successfully constructed and can use to early prediction of children with BO due to RMPP.


Assuntos
Bronquite , Pneumonia por Mycoplasma , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Mycoplasma pneumoniae , Nomogramas , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/epidemiologia , Estudos Retrospectivos , Fatores de Risco
10.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(5): 855-858, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34622605

RESUMO

Objective: To investigate the clinical features of pediatric patients who had plastic bronchitis (PB) and to explore the risk factors for respiratory support in the pediatric patients with PB in order to improve the ability to identify PB in children. Methods: The basic information and clinical manifestations of 86 children diagnosed with PB at West China Second University Hospital of Sichuan University from March 2014 to December 2019 were collected and analyzed retrospectively. The patients were divided into the respiratory support (RS) group and non-respiratory support (NRS) group as per their need for respiratory support. Logistic regression was conducted to analyze the risk factors for respiratory support in PB patients. Results: A total of 86 children with PB were included in the study, including 62 (72.1%) who were over 3 years old. 57 patients (66.3%) had complications. 56 patients were given respiratory support after admission. All the 86 children had a history of fever and cough, and 76 (88.4%) experienced fever peaks≥39.5°C. Chest imaging showed large lung consolidation or atelectasis in 82 cases (95.3%) and pleural effusion in 63 cases (73.3%). 70 cases (81.4%) were tested positive for pathogens, with the highest infection rate of 68.6% for mycoplasma pneumoniae. There were 30 patients (34.9%) in the NRS group and 56 patients (65.1%) in the RS group. Logistic regression analysis showed that patient being younger than 3 years old ( OR=4.99) and having complications ( OR=7.22) were independent risk factors for respiratory support in children with PB (all P<0.05). Conclusions: Clinically, severe clinical symptoms combined with other systemic complications, large lung consolidation or atelectasis, pleural effusion, and positive lab results for mycoplasma pneumoniae should be an alert indicating the possibility of having PB. Young age and complications were independent risk factors for respiratory support in PB patients.


Assuntos
Bronquite , Derrame Pleural , Bronquite/epidemiologia , Criança , Pré-Escolar , Humanos , Mycoplasma pneumoniae , Plásticos , Estudos Retrospectivos
12.
BMC Infect Dis ; 21(1): 1003, 2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34563128

RESUMO

BACKGROUND: Mycoplasma pneumoniae is a common pathogen that causes community-acquired pneumonia in school-age children. Macrolides are considered a first-line treatment for M. pneumoniae infection in children, but macrolide-refractory M. pneumoniae (MRMP) strains have become more common. In this study, we assessed the efficacy of tetracyclines and fluoroquinolones in MRMP treatment in children through a systematic review and meta-analysis. METHODS: Two reviewers individually searched 10 electronic databases (Medline/Pubmed, Embase, the Cochrane Library, and core Korean, Chinese, and Japanese journals) for papers published from January 1, 1990 to March 8, 2018. The following data for each treatment group were extracted from the selected studies: intervention (tetracyclines and fluoroquinolones/comparator), patient characteristics (age and sex), and outcomes (fever duration, hospital stay length, treatment success rate, and defervescence rates 24, 48, and 72 h after starting treatment). RESULTS: Eight studies involving 537 participants were included. Fever duration and hospital stay length were shorter in the tetracycline group than in the macrolide group (weighted mean difference [WMD] = - 1.45, 95% confidence interval [CI]: - 2.55 to - 0.36, P = 0.009; and WMD = - 3.33, 95% CI: - 4.32 to - 2.35, P < 0.00001, respectively). The therapeutic efficacy was significantly higher in the tetracycline group than in the macrolide group (odds ratio [OR]: 8.80, 95% CI: 3.12-24.82). With regard to defervescence rate, patients in the tetracycline group showed significant improvement compared to those in the macrolide group (defervescence rate after 24 h, OR: 5.34, 95% CI: 1.81-15.75; after 48 h, OR 18.37, 95% CI: 8.87-38.03; and after 72 h, OR: 40.77, 95% CI: 6.15-270.12). There were no differences in fever improvement within 24 h in patients in the fluoroquinolone group compared to those in the macrolide group (OR: 1.11, 95% CI: 0.25-5.00), although the defervescence rate was higher after 48 h in the fluoroquinolone group (OR: 2.78, 95% CI: 1.41-5.51). CONCLUSION: Tetracyclines may shorten fever duration and hospital stay length in patients with MRMP infection. Fluoroquinolones may achieve defervescence within 48 h in patients with MRMP infection. However, these results should be carefully interpreted as only a small number of studies were included, and they were heterogeneous.


Assuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Criança , Farmacorresistência Bacteriana , Fluoroquinolonas/farmacologia , Fluoroquinolonas/uso terapêutico , Humanos , Macrolídeos/farmacologia , Macrolídeos/uso terapêutico , Pneumonia por Mycoplasma/tratamento farmacológico , Tetraciclinas/farmacologia , Tetraciclinas/uso terapêutico
13.
Braz J Biol ; 83: e246385, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34524372

RESUMO

Coronary heart disease (CHD) has been associated with significant morbidity and mortality worldwide. Although remain controversial, several studies have demonstrated the association of M. pneumoniae infections with atherosclerosis. We evaluated the possible association of mycoplasma infections in patients diagnosed with atherosclerosis by ELISA and PCR methods. Atherosclerotic tissue samples and blood samples were collected for the detection of mycoplasma antibodies (IgA) by ELISA from the 97 patients with coronary artery disease (CAD). M. pneumoniae specific IgA, IgG and IgM were measured by using the Anti-M. pneumoniae IgA/IgG/IgM ELISA. Detection of M. pneumoniae targeting the P1 adhesion gene was performed by PCR Acute infection of M. pneumoniae was diagnosed in 43.3% (42) of patients by PCR. The M. pneumoniae specific antibodies were detected in 36.1% (35) of patients. Twenty-five (25.8%) cases had IgG antibodies, 15 (15.5%) cases had IgM antibodies, 3 (3.1%) cases had IgA antibodies, 10 (10.3%) cases had both IgM + IgG antibodies and 1 (1%) case of each had IgM + IgA and IgG + IgA antibodies. None of the cases was positive for all three antibodies. A Pearson correlation coefficient analysis revealed an excellent correlation between the PCR and the serological results (r=0.921, p<0.001). A majority (17, 40.5%) of the M. pneumoniae positive patients are within the 41-50 years of age group, followed by 10 (23.8%) patients in the age group of 61-70 years and 2 (4.8%) patients were >70 years of age. Our study reported an unusually higher prevalence of M. pneumoniae by serological tests (36.1%) and PCR (43.3%). Although the hypothesis of the association of M. pneumoniae and CAD is yet to be proven, the unusually high prevalence of M. pneumoniae in CAD patients indicates an association, if not, in the development of atherosclerosis.


Assuntos
Doença da Artéria Coronariana , Infecções por Mycoplasma , Adulto , Idoso , Anticorpos Antibacterianos , Doença da Artéria Coronariana/epidemiologia , Humanos , Imunoglobulina M , Pessoa de Meia-Idade , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/epidemiologia , Mycoplasma pneumoniae , Prevalência
14.
BMC Pediatr ; 21(1): 372, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465285

RESUMO

BACKGROUND: Although M. pneumoniae (M. pneumoniae) infections have been associated with various extrapulmonary manifestations, there have been very few documented cases of thrombotic events in pediatrics, and none to our knowledge with such extensive involvement as the patient described here. We aim to contribute to the urgency of discovering the mechanism of the coagulopathy associated with M. pneumoniae infections. CASE PRESENTATION: This 10-year-old boy was admitted after 2 weeks of fever, sore throat, worsening cough, and progressive neck and back pain. During hospitalization, he developed clots in several different organs: bilateral pulmonary emboli, cardiac vegetations, multiple splenic infarcts, and deep venous thromboses in three of four extremities. He was treated with long-term antibiotics and anticoagulation, and fully recovered. CONCLUSIONS: This is the first case known to us of a child with an extensive number of thrombotic events in multiple anatomic sites associated with M. pneumoniae infection. The mechanism by which M. pneumoniae infection is related to thrombotic events is not fully understood, but there is evidence that the interplay between the coagulation pathways and the complement cascade may be significant. This patient underwent extensive investigation, and was found to have significant coagulopathy, but minimal complement abnormalities. By better understanding the mechanisms involved in complications of M. pneumoniae infection, the clinician can more effectively investigate the progression of this disease saving time, money, morbidity, and mortality.


Assuntos
Pediatria , Pneumonia por Mycoplasma , Antibacterianos/uso terapêutico , Criança , Humanos , Infarto/tratamento farmacológico , Masculino , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/tratamento farmacológico
15.
BMC Infect Dis ; 21(1): 902, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479483

RESUMO

BACKGROUND: Airway malacia is an important cause of noisy breathing, recurrent wheezing and respiratory infections, chronic coughing, and episodes of respiratory distress in young children. As the clinical manifestations of airway malacia are not common, many clinicians have insufficient understanding of this disease. So the purpose of this study is to summarize the pathogenic bacteria and clinical manifestations of airway softening complicated with pneumonia in children. METHODS: Children hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results. RESULTS: A total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3-10) months. The most commonly detected pathogen were Mycoplasma pneumoniae (25/164, 15.24%), Streptococcus pneumoniae (18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p < 0.05). CONCLUSION: The median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia was Mycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.


Assuntos
Pneumonia por Mycoplasma , Pneumonia , Infecções Respiratórias , Criança , Pré-Escolar , Tosse , Feminino , Humanos , Lactente , Masculino , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/epidemiologia , Sons Respiratórios
16.
BMC Infect Dis ; 21(1): 909, 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34481469

RESUMO

BACKGROUND: How to early distinguish the severity of Mycoplasma pneumoniae pneumonia (MPP) is a worldwide concern in clinical practice. We therefore conducted this study to assess the relationship between levels of serum inflammatory chemokines and the severity of MPP. METHODS: In this prospective study, we enrolled 39 children with MPP, whose clinical information was collected, blood samples were assayed for cytokines and chemokines by ELISA. RESULTS: The levels of serum CXCL10 in children with severe MPP were significantly higher than those in children with mild MPP (2500.0 [1580.9-2500.0] vs. 675.7 [394.7-1134.9], P < 0.001). Measurement of CXCL10 levels in serum enabled the differentiation of children with severe MPP with an area under the curve (AUC) of 0.885 (95 % CI 0.779-0.991, P < 0.001), with a sensitivity of 81.0 % and a specificity of 83.3 %. CONCLUSIONS: Serum CXCL10 level may be a potential biomarker for severe MPP in children.


Assuntos
Mycoplasma pneumoniae , Pneumonia por Mycoplasma , Biomarcadores , Quimiocina CXCL10 , Criança , Humanos , Pneumonia por Mycoplasma/diagnóstico , Estudos Prospectivos
18.
Pediatr Dermatol ; 38(5): 1222-1225, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34515364

RESUMO

Reactive infectious mucocutaneous eruption (RIME) was proposed as new terminology to encompass postinfectious mucocutaneous eruptions. The term includes all postinfectious mucocutaneous eruptions such as the widely reported Mycoplasma pneumoniae-induced rash and mucositis (MIRM). Very few reports in the literature regarding recurrent RIME are found. We present two adolescent cases of recurrent RIME that involve SARS-CoV-2 and influenza A where the latter is a newly reported infectious trigger; in both patients, the initial episode was likely triggered by Mycoplasma pneumoniae (MP) infection.


Assuntos
COVID-19 , Exantema , Influenza Humana , Pneumonia por Mycoplasma , Adolescente , Humanos , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/diagnóstico , SARS-CoV-2
19.
Hosp Pediatr ; 11(7): 760-763, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34583319

RESUMO

OBJECTIVES: To describe testing and treatment practices for Mycoplasma pneumoniae (Mp) among children hospitalized with community-acquired pneumonia (CAP). METHODS: We conducted a retrospective cohort study using the Pediatric Health Information Systems database. We included children 3 months to 18 years old hospitalized with CAP between 2012 and 2018 and excluded children who were transferred from another hospital and those with complex chronic conditions. We examined the proportion of patients receiving Mp testing and macrolide therapy at the hospital level and trends in Mp testing and macrolide prescription over time. At the patient level, we examined differences in demographics, illness severity (eg, blood gas, chest tube placement), and outcomes (eg, ICU admission, length of stay, readmission) among patients with and without Mp testing. RESULTS: Among 103 977 children hospitalized with CAP, 17.3% underwent Mp testing and 31.1% received macrolides. We found no correlation between Mp testing and macrolide treatment at the hospital level (R 2 = 0.05; P = .11). Patients tested for Mp were more likely to have blood gas analysis (15.8% vs 12.8%; P < .1), chest tube placement (1.4% vs 0.8%; P < .1), and ICU admission (3.1% vs 1.4%; P < .1). Mp testing increased (from 15.8% to 18.6%; P < .001), and macrolide prescription decreased (from 40.9% to 20.6%; P < .001) between 2012 and 2018. CONCLUSIONS: Nearly one-third of hospitalized children with CAP received macrolide antibiotics, although macrolide prescription decreased over time. Clinicians were more likely to perform Mp testing in children with severe illness, and Mp testing and macrolide treatment were not correlated at the hospital level.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia por Mycoplasma , Antibacterianos/uso terapêutico , Criança , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Humanos , Macrolídeos/uso terapêutico , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/diagnóstico , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/epidemiologia , Estudos Retrospectivos
20.
Ann Clin Lab Sci ; 51(4): 540-545, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34452893

RESUMO

OBJECTIVE: Mycoplasma pneumoniae (M. pneumoniae), an extracellular pathogen lacking a cell wall, causes respiratory infection in adults and children and has been implicated in asthma exacerbation; immunoglobulin (Ig) E may be involved in these exacerbations. Specific IgM and IgG immune response to M. pneumoniae has been reported, but less is known about IgE M. pneumoniae antibody (Ab) responses in asthma. Previous studies in our laboratory demonstrated that asthmatic children have increased IgM M. pneumoniae levels, but not IgE. Thus, we sought to investigate whether past M. pneumoniae infection triggers production of M. pneumoniae-specific IgE Abs in adult subjects with/without asthma. METHODS: M. pneumoniae- IgE and -IgM Ab responses were studied in adult asthmatic (N=22) and non-asthmatic (N=22) subjects (ELISA). Data are reported as antibody index. Threshold detection levels: IgE, IgM: 0.2, 0.9, respectively. RESULTS: M. pneumoniae-IgE Ab levels were low and below the threshold of detection in both asthmatic and non-asthmatics (0.002±0.008 vs. 0.02±0.03; P=0.021). However, specific-IgM levels were slightly higher in non-asthmatics compared with asthmatics (0.96±0.37 vs. 0.79±0.31; P=0.054). M. pneumoniae-IgM Ab positivity was similar in both groups (P=1.0). CONCLUSION: IgM M. pneumoniae Abs may play an important role in non-asthma and persist for months after acute infection. IgE M. pneumoniae Abs may play a less important role in both groups.


Assuntos
Anticorpos Antibacterianos/sangue , Asma/imunologia , Imunoglobulina E/imunologia , Imunoglobulina M/sangue , Mycoplasma pneumoniae/imunologia , Pneumonia por Mycoplasma/imunologia , Adulto , Anticorpos Antibacterianos/imunologia , Asma/sangue , Asma/complicações , Asma/epidemiologia , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , New York/epidemiologia , Pneumonia por Mycoplasma/sangue , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/etiologia , Prognóstico
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