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Epidemiology and Infection Apr 2024This paper retrospectively analysed the prevalence of macrolide-resistant (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145...
This paper retrospectively analysed the prevalence of macrolide-resistant (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
Topics: Mycoplasma pneumoniae; Humans; China; Macrolides; Retrospective Studies; Child; Anti-Bacterial Agents; Drug Resistance, Bacterial; Child, Preschool; Adolescent; Adult; Female; Male; Pneumonia, Mycoplasma; Middle Aged; Young Adult; Microbial Sensitivity Tests; Aged; Infant; Prevalence; RNA, Ribosomal, 23S; Aged, 80 and over
PubMed: 38634450
DOI: 10.1017/S0950268824000323 -
Health Informatics Journal 2024Mycoplasma pneumonia may lead to hospitalizations and pose life-threatening risks in children. The automated identification of mycoplasma pneumonia from electronic...
Mycoplasma pneumonia may lead to hospitalizations and pose life-threatening risks in children. The automated identification of mycoplasma pneumonia from electronic medical records holds significant potential for improving the efficiency of hospital resource allocation. In this study, we proposed a novel method for identifying mycoplasma pneumonia by integrating multi-modal features derived from both free-text descriptions and structured test data in electronic medical records. Our approach begins with the extraction of free-text and structured data from clinical records through a systematic preprocessing pipeline. Subsequently, we employ a pre-trained transformer language model to extract features from the free-text, while multiple additive regression trees are used to transform features from the structured data. An attention-based fusion mechanism is then applied to integrate these multi-modal features for effective classification. We validated our method using clinic records of 7157 patients, retrospectively collected for training and testing purposes. The experimental results demonstrate that our proposed multi-modal fusion approach achieves significant improvements over other methods across four key performance metrics.
Topics: Humans; Pneumonia, Mycoplasma; Electronic Health Records; Child; Retrospective Studies; Mycoplasma pneumoniae; Female; Male; Child, Preschool
PubMed: 38779978
DOI: 10.1177/14604582241255818 -
The Lancet. Microbe Jun 2024
Topics: Humans; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Disease Outbreaks
PubMed: 38342111
DOI: 10.1016/S2666-5247(23)00406-8 -
BMC Microbiology Jan 2024Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community-acquired pneumonia in children. The factors contributing to the severity of illness caused by...
BACKGROUND
Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community-acquired pneumonia in children. The factors contributing to the severity of illness caused by M. pneumoniae infection are still under investigation. We aimed to evaluate the sensitivity of common M. pneumoniae detection methods, as well as to analyze the clinical manifestations, genotypes, macrolide resistance, respiratory microenvironment, and their relationship with the severity of illness in children with M. pneumoniae pneumonia in Wuhan.
RESULTS
Among 1,259 clinical samples, 461 samples were positive for M. pneumoniae via quantitative polymerase chain reaction (qPCR). Furthermore, we found that while serological testing is not highly sensitive in detecting M. pneumoniae infection, but it may serve as an indicator for predicting severe cases. We successfully identified the adhesin P1 (P1) genotypes of 127 samples based on metagenomic and Sanger sequencing, with P1-type 1 (113/127, 88.98%) being the dominant genotype. No significant difference in pathogenicity was observed among different genotypes. The macrolide resistance rate of M. pneumoniae isolates was 96% (48/50) and all mutations were A2063G in domain V of 23S rRNA gene. There was no significant difference between the upper respiratory microbiome of patients with mild and severe symptoms.
CONCLUSIONS
During the period of this study, the main circulating M. pneumoniae was P1-type 1, with a resistance rate of 96%. Key findings include the efficacy of qPCR in detecting M. pneumoniae, the potential of IgM titers exceeding 1:160 as indicators for illness severity, and the lack of a direct correlation between disease severity and genotypic characteristics or respiratory microenvironment. This study is the first to characterize the epidemic and genomic features of M. pneumoniae in Wuhan after the COVID-19 outbreak in 2020, which provides a scientific data basis for monitoring and infection prevention and control of M. pneumoniae in the post-pandemic era.
Topics: Child; Humans; Mycoplasma pneumoniae; Anti-Bacterial Agents; Molecular Epidemiology; Macrolides; Drug Resistance, Bacterial; Pneumonia, Mycoplasma; RNA, Ribosomal, 23S; Pandemics
PubMed: 38229068
DOI: 10.1186/s12866-024-03180-0 -
Italian Journal of Pediatrics Oct 2023This study investigates the correlation between coagulation levels and the severity of Mycoplasma pneumoniae pneumonia (MPP) in children. In addition, the study analyses...
BACKGROUND
This study investigates the correlation between coagulation levels and the severity of Mycoplasma pneumoniae pneumonia (MPP) in children. In addition, the study analyses the predictive value of coagulation abnormalities in MPP combined with necrotising pneumonia (NP).
METHODS
A total of 170 children with MPP who underwent treatment between June 2021 and February 2022 were selected for this study. The study population was divided into groups according to the severity of the disease to compare differences in the incidence of coagulation abnormalities between the groups. The participants were also divided into groups according to imaging manifestations to compare the differences in coagulation function among the different groups. All data information was processed for statistical analysis using SPSS Statistics 25.0 and GraphPad Prism 7.0 statistical analysis software.
RESULTS
The incidence of coagulation abnormalities in the children in the severe MPP (SMPP) group was significantly higher than that in the normal MPP (NMPP) group (P < 0.05). The multi-factor logistic regression analysis revealed that the D-dimer level is an independent risk factor for the development of NP in SMPP (P < 0.05). The receiver operating characteristic curve analysis revealed statistically significant differences (P < 0.05) in D-dimer, fibrinogen degeneration products (FDP), neutrophils, lactate dehydrogenase and serum ferritin for predicting SMPP combined with NP. Bronchoscopic manifestations of coagulation indicators (D-dimer and FDP levels) were significantly higher in the mucus plug group than in the non-mucus plug group, while the activated partial thromboplastin time levels were lower in the former than in the latter (P < 0.05).
CONCLUSION
The degree of elevated D-dimer and FDP levels was positively correlated with the severity of MPP, with elevated serum D-dimer levels (> 3.705 mg/L) serving as an independent predictor of MPP combined with NP in children.
Topics: Child; Humans; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Fibrinogen; Neutrophils; Hemostatics; Retrospective Studies
PubMed: 37858230
DOI: 10.1186/s13052-023-01545-1 -
Italian Journal of Pediatrics Sep 2023There are relatively few studies investigating C-C motif chemokine ligand 2 (CCL2) level in bronchoalveolar lavage fluid (BALF) in children with Mycoplasma pneumoniae...
BACKGROUND
There are relatively few studies investigating C-C motif chemokine ligand 2 (CCL2) level in bronchoalveolar lavage fluid (BALF) in children with Mycoplasma pneumoniae pneumonia (MPP), and the relationship between CCL2 level in BALF and refractory mycoplasma pneumoniae pneumonia (RMPP) is unclear. This study aims to explore the relationship between chemokine CCL2 level in BALF and clinical characteristics and clinical outcome in children with MPP.
METHODS
A total of 51 children with confirmed acute MPP and requiring bronchoalveolar lavage in Department of Pediatrics, Huanghe Sanmenxia Hospital and The First Clinical College of Xinxiang Medical University from October 2021 to February 2023 were selected as the study group. And 11 children with bronchial foreign body were selected as the control group. The study group was divided into the non-refractory mycoplasma pneumoniae pneumonia (NRMPP) group and the RMPP group based on the response to treatment. BALF and clinical data of the patients were collected. And CCL2 levels were tested in the patients. Differences in CCL2 level in BALF and clinical characteristics were tested and compared.
RESULTS
The CCL2 level in BALF of the study group was higher than that of the control group, with significant difference (P < 0.05). With ROC curve, the area under the curve (AUC) of CCL2 in BALF predicting RMPP was 0.94, the cut-off value was 0.645 ng/ml, the sensitivity was 85%, and the specificity was 94%, and the diagnostic value was better than that of serum CRP and LDH. Logistic regression analysis was used to build the RMPP prediction model, and CCL2 showed good predictive value.
CONCLUSION
The level of CCL2 in BALF was high in children with MPP and had a high predictive value for RMPP. CCL2 can be used as one of the biomarkers for predicting RMPP.
Topics: Humans; Child; Bronchoalveolar Lavage Fluid; Pneumonia, Mycoplasma; Chemokines; Dimercaprol; Foreign Bodies
PubMed: 37740208
DOI: 10.1186/s13052-023-01528-2 -
Journal of Clinical Microbiology Jun 2021Factors leading to the wide range of manifestations associated with Mycoplasma pneumoniae infection are unclear. We investigated whether M. pneumoniae genotypes are...
Factors leading to the wide range of manifestations associated with Mycoplasma pneumoniae infection are unclear. We investigated whether M. pneumoniae genotypes are associated with specific clinical outcomes. We compared M. pneumoniae loads and genotypes of children with mucocutaneous disease to those of children with pneumonia, family members with upper respiratory tract infection (URTI), and carriers from a prospective cohort study (= 47; 2016 to 2017) and to those of other children with mucocutaneous disease from a case series (= 7; 2017 to 2020). Genotyping was performed using macrolide resistance determination, P1 subtyping, multilocus variable-number tandem-repeat analysis (MLVA), and multilocus sequence typing (MLST). Comparisons were performed with a pairwise Wilcoxon rank sum test and a Fisher exact test with corrections for multiple testing, as appropriate. M. pneumoniae loads did not statistically differ between patients with mucocutaneous disease and those with pneumonia or carriers. Macrolide resistance was detected in 1 (1.9%) patient with mucocutaneous disease. MLVA types from 2016 to 2017 included 3-5-6-2 (= 21 [46.7%]), 3-6-6-2 (= 2 [4.4%]), 4-5-7-2 (= 14 [31.1%]), and 4-5-7-3 (= 8 [17.8%]), and they correlated with P1 subtypes and MLST types. MLVA types were not associated with specific outcomes such as mucocutaneous disease, pneumonia, URTI, or carriage. They were almost identical within families but varied over geographic location. MLVA types in patients with mucocutaneous disease differed between 2016 to 2017 (3-5-6-2, = 5 [62.5%]) and 2017 to 2020 (4-5-7-2, = 5 [71.4%]) ( = 0.02). Our results suggest that M. pneumoniae genotypes may not determine specific clinical outcomes.
Topics: Anti-Bacterial Agents; Child; Drug Resistance, Bacterial; Genotype; Humans; Macrolides; Multilocus Sequence Typing; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Prospective Studies
PubMed: 33853838
DOI: 10.1128/JCM.00748-21 -
Immunity, Inflammation and Disease Oct 2023In recent years, there has been an increase in the number of patients diagnosed with pediatric diseases who have severe Mycoplasma pneumoniae (MP) pneumonia, and there...
BACKGROUND INTRODUCTION
In recent years, there has been an increase in the number of patients diagnosed with pediatric diseases who have severe Mycoplasma pneumoniae (MP) pneumonia, and there has also been an increased attention to serious extrapulmonary complications. However, cases with abdominal pain, acute abdomen, scrotal swelling and pain, and fever as the primary symptoms have been rarely reported.
CASE DESCRIPTION
A 3-years-and-8-months-old male patient diagnosed with pediatric disease was reported with abdominal pain, scrotal swelling and pain, and fever as the primary symptoms in the present study. No respiratory symptoms were observed throughout the disease. Through computed tomography (CT) scanning, the patient was diagnosed with severe MP pneumonia based on the symptoms of abdominal pain and fever, as well as pulmonary infection, pleural effusion, and retroperitoneal exudation. Laboratory tests supported the diagnosis of MP infection, and the diagnosis was confirmed by severe MP pneumonia. The therapeutic effects of azithromycin were poor, and the symptoms were quickly alleviated with the addition of gamma globulin and methylprednisolone. After discharge, azithromycin sequential therapy was administered. The chest CT was normal at the follow-up 1-month later.
CONCLUSION
Severe MP pneumonia in patients with pediatric diseases may include abdominal pain, scrotal swelling and pain, and fever as the primary symptoms. Care should be taken to avoid missed diagnoses and misdiagnoses in clinical practice.
Topics: Child; Humans; Male; Infant; Mycoplasma pneumoniae; Azithromycin; Abdomen, Acute; Pneumonia, Mycoplasma; Abdominal Pain
PubMed: 37904684
DOI: 10.1002/iid3.955 -
Neonatology 2018Mycoplasma pneumoniae is a significant cause of pneumonia in school-aged children and young adults. We report a case of neonatal M. pneumoniae pneumonia in a preterm... (Review)
Review
Mycoplasma pneumoniae is a significant cause of pneumonia in school-aged children and young adults. We report a case of neonatal M. pneumoniae pneumonia in a preterm child manifesting in the first hours of life. Vertical transmission was demonstrated by the detection of M. pneumoniae in inflamed placental tissue indicating chorioamnionitis.
Topics: Chorioamnionitis; DNA, Bacterial; Female; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Mycoplasma pneumoniae; Placenta; Pneumonia, Mycoplasma; Pregnancy; Radiography, Thoracic
PubMed: 30089291
DOI: 10.1159/000490610 -
Italian Journal of Pediatrics Sep 2023We investigated changes in microR-29c and microR-146a expression in the serum of children with Mycoplasma pneumoniae pneumonia, analysed their relationship with...
BACKGROUND
We investigated changes in microR-29c and microR-146a expression in the serum of children with Mycoplasma pneumoniae pneumonia, analysed their relationship with inflammatory factors and disease severity, and evaluated their diagnostic significance.
METHODS
Fifty-six children with Mycoplasma pneumoniae pneumonia were enrolled as the Mycoplasma pneumoniae pneumonia group; 37 healthy children were enrolled as the control group. The microR-29c or microR-146a serum expression levels were determined using real-time quantitative reverse transcription polymerase chain reaction. Interleukin-17, tumour necrosis factor-alpha, and interleukin-1 beta levels were detected using enzyme-linked immunosorbent assay. The correlation between serum microR-29c or microR-146a expression and inflammatory factors was analysed using the Pearson's method. Receiver operating characteristic curves were used to evaluate the diagnostic value of serum microR-29c, microR-146a, and their combined detection in Mycoplasma pneumoniae pneumonia.
RESULTS
Compared with that in healthy children, the microR-29c and microR-146a serum levels were significantly downregulated in children with Mycoplasma pneumoniae pneumonia; the decrease was more obvious in children with severe cases than that in those with mild cases. In addition, microR-29c and microR-146a were negatively correlated with increased expression of interleukin-17, tumour necrosis factor-alpha, and interleukin-1 beta. Receiver operating characteristic curves showed that a combination of microR-29c and microR-146a was highly suitable for diagnosing Mycoplasma pneumoniae pneumonia.
CONCLUSION
Serum microR-29c and microR-146a were underexpressed in children with Mycoplasma pneumoniae pneumonia, and diagnostic accuracy was significantly improved with combined microR-29c and microR-146a detection. Therefore, both microR-29c and microR-146a levels can be used as biomarkers for the diagnosis of Mycoplasma pneumoniae pneumonia.
Topics: Child; Humans; Interleukin-17; Interleukin-1beta; Mycoplasma pneumoniae; Tumor Necrosis Factor-alpha; Pneumonia, Mycoplasma
PubMed: 37705091
DOI: 10.1186/s13052-023-01500-0