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Emerging Microbes & Infections Dec 2022Although previous studies have reported the use of metabolomics for infectious diseases, little is known about the potential function of plasma metabolites in children...
Although previous studies have reported the use of metabolomics for infectious diseases, little is known about the potential function of plasma metabolites in children infected with (MP). Here, a combination of liquid chromatography-quadrupole time-of-flight mass spectrometry and random forest-based classification model was used to provide a broader range of applications in MP diagnosis. In the training cohort, plasma from 63 MP pneumonia children (MPPs), 37 healthy controls (HC) and 29 infectious disease controls (IDC) was collected. After multivariate analyses, 357 metabolites were identified to be differentially expressed among MPP, HC and IDC groups, and 3 metabolites (568.5661, 459.3493 and 411.3208) had high diagnostic values. In an independent cohort with 57 blinded subjects, samples were successfully classified into different groups, demonstrating the reliability of these biomarkers for distinguishing MPPs from controls. A metabolomic signature analysis identified major classes of glycerophospholipids, sphingolipids and fatty acyls were increased in MPPs. These markedly altered metabolites are mainly involved in glycerophospholipid and sphingolipid metabolism. As the ubiquitous building blocks of eukaryotic cell membranes, dysregulated lipid metabolism indicates damage of the cellular membrane and the activation of immunity in MPPs. Moreover, lipid metabolites, differentially expressed between severe and mild MPPs, were correlated with the markers of extrapulmonary complications, suggesting that they may be involved in MPP disease severity. These findings may offer new insights into biomarker selection and the pathogenesis of MPP in children.
Topics: Biomarkers; Humans; Metabolomics; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Reproducibility of Results
PubMed: 35094669
DOI: 10.1080/22221751.2022.2036582 -
Emerging Microbes & Infections Dec 2022The objective of this paper is to explore the characteristics of (MP) epidemics in Beijing, China. Patients with acute respiratory tract infection (ARTI) were enrolled...
The objective of this paper is to explore the characteristics of (MP) epidemics in Beijing, China. Patients with acute respiratory tract infection (ARTI) were enrolled from 35 sentinel hospitals in Beijing, 2015-2020. Their medical records were reviewed and respiratory specimens were collected for assay for nucleic acids of 24 respiratory pathogens, including MP. The genotypes of MP were analysed using a real-time PCR method. The domain V of 23s rRNA gene was sequenced to identify macrolide-resistant mutations. A total of 41,677 specimens of ARTI patients were included, with an MP positive rate of 6.16%. MP prevalence mainly occurred between August and January, and peaked in October. The increase in the MP detection rate was coincident with the elevation of the reported number of patients with pneumonia in the 35 sentinel hospitals. One or more respiratory pathogens were co-detected in 27.1% of the MP-positive patients. Type 1 MP remained predominant, and the macrolide-resistant rate of MP had exceeded over 90%. A2063G mutation accounted for 99.0% of macrolide-resistant MP infections. MP epidemic in Beijing mainly occurred between August and January with a remarkable high macrolide-resistant rate. MP is one of the important contributors to the pneumonia epidemic in autumn and winter in Beijing.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Epidemics; Epidemiologic Studies; Humans; Macrolides; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Respiratory Tract Infections
PubMed: 35582916
DOI: 10.1080/22221751.2022.2078228 -
The Clinical Respiratory Journal Jul 2023To compare the demographic and clinical features, laboratory and imaging findings in mycoplasma pneumoniae pneumonia (MPP) children with non-MPP (NMPP) children and...
BACKGROUND
To compare the demographic and clinical features, laboratory and imaging findings in mycoplasma pneumoniae pneumonia (MPP) children with non-MPP (NMPP) children and general MPP (GMPP) children with refractory MPP (RMPP) children and analysis the relationship with the severity of disease.
METHODS
The study included 265 children with MPP and 230 children with NMPP in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from 2020 to 2021. The children with MPP included RMPP (n = 85) and GMPP (n = 180). Demographic and clinical characteristics, laboratory and imaging findings of all children were measured as baseline data within 24 h after admission and the differences between MPP and NMPP, RMPP and GMPP patients were compared. ROC curves were used to evaluate the diagnostic and predictive value of different indicators for RMPP.
RESULTS
Fever duration and hospital stay in children with MPP were longer than those with NMPP. The number of patients with imaging features of pleural effusion, lung consolidation and bronchopneumonia in MPP group was significantly higher than that in NMPP group. Compared with NMPP group, the levels of C-reactive protein (CRP), procalcitonin (PCT), serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), lactic dehydrogenase (LDH), prothrombin time (PT), fibrinogen (FIB) and D-dimer and inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10 and IL-1β) in MPP group were significantly higher (P < 0.05). The clinical symptoms and pulmonary imaging findings were more severe in RMPP group. The levels of white blood cell (WBC), CRP, PCT, SAA, ESR, alanine aminotransferase (ALT), LDH, ferritin, PT, FIB, D-dimer and inflammatory cytokines in RMPP group were higher than those in GMPP group. There was no significant difference in the level of lymphocyte subsets between the RMPP and GMPP group. IL-6, IL-10, LDH, PT, D-dimer and lung consolidation were independent risk factors for RMPP. IL-6 levels and LDH activity were good predictors of RMPP.
CONCLUSION
In conclusion, there were differences in clinical characteristics and serum inflammatory markers between MPP group and NMPP group, RMPP group and GMPP group. IL-6, IL-10, LDH, PT and D-dimer can be used as predictive indicators for RMPP.
Topics: Humans; Child; Pneumonia, Mycoplasma; Interleukin-10; Interleukin-6; Retrospective Studies; Biomarkers; Mycoplasma pneumoniae; C-Reactive Protein; Cytokines; Procalcitonin
PubMed: 37142438
DOI: 10.1111/crj.13620 -
The Lancet. Microbe Dec 2022
Topics: Humans; Mycoplasma pneumoniae; COVID-19; Pandemics; Pneumonia, Mycoplasma; Antibodies, Bacterial
PubMed: 35964636
DOI: 10.1016/S2666-5247(22)00190-2 -
Frontiers in Cellular and Infection... 2023is an important pathogen causing upper and lower respiratory tract infections in children and other age groups. Macrolides are the recommended treatments of choice for...
is an important pathogen causing upper and lower respiratory tract infections in children and other age groups. Macrolides are the recommended treatments of choice for infections. However, macrolide resistance in is increasing worldwide, which complicates the treatment strategies. The mechanisms of macrolide resistance have been extensively studied focusing on the mutations in and ribosomal proteins. Since the secondary treatment choice for pediatric patients is very limited, we decided to look for potential new treatment strategies in macrolide drugs and investigate possible new mechanisms of resistance. We performed an selection of mutants resistant to five macrolides (erythromycin, roxithromycin, azithromycin, josamycin, and midecamycin) by inducing the parent strain M129 with increasing concentrations of the drugs. The evolving cultures in every passage were tested for their antimicrobial susceptibilities to eight drugs and mutations known to be associated with macrolide resistance by PCR and sequencing. The final selected mutants were also analyzed by whole-genome sequencing. Results showed that roxithromycin is the drug that most easily induces resistance (at 0.25 mg/L, with two passages, 23 days), while with midecamycin it is most difficult (at 5.12 mg/L, with seven passages, 87 days). Point mutations C2617A/T, A2063G, or A2064C in domain V of were detected in mutants resistant to the 14- and 15-membered macrolides, while A2067G/C was selected for the 16-membered macrolides. Single amino acid changes (G72R, G72V) in ribosomal protein L4 emerged during the induction by midecamycin. Genome sequencing identified sequence variations in , , , , and in one of the () genes in the mutants. Mutants induced by the 14- or 15-membered macrolides were resistant to all macrolides, while those induced by the 16-membered macrolides (midecamycin and josamycin) remained susceptible to the 14- and 15-membered macrolides. In summary, these data demonstrated that midecamycin is less potent in inducing resistance than other macrolides, and the induced resistance is restrained to the 16-membered macrolides, suggesting a potential benefit of using midecamycin as a first treatment choice if the strain is susceptible.
Topics: Humans; Child; Anti-Bacterial Agents; Mycoplasma pneumoniae; Macrolides; Roxithromycin; Josamycin; RNA, Ribosomal, 23S; Microbial Sensitivity Tests; Drug Resistance, Bacterial; Pneumonia, Mycoplasma
PubMed: 37284499
DOI: 10.3389/fcimb.2023.1186017 -
BMC Pulmonary Medicine Nov 2023We analyzed the clinical characteristics of children with plastic bronchitis (PB) caused by Mycoplasma pneumoniae (MP) and explored its risk factors.
BACKGROUND
We analyzed the clinical characteristics of children with plastic bronchitis (PB) caused by Mycoplasma pneumoniae (MP) and explored its risk factors.
METHODS
We prospectively analyzed clinical data of children with MP pneumonia (MPP) treated with fiberoptic bronchoscopy (FB). Patients were classified into a PB and non-PB group. General information, clinical manifestations, laboratory tests, results of computed tomography scan, and FB findings were compared between groups. We conducted statistical analysis of risk factors for developing PB.
RESULTS
Of 1169 children who had MPP and were treated with FB, 133 and 1036 were in the PB and non-PB groups, respectively. There were no significant differences in sex, age, and incident season between groups (P > 0.05). The number of children in the PB group decreased during the COVID-19 pandemic. Compared with children in the non-PB group, those in the PB group had longer duration of hospitalization, increased levels of neutrophil (N), C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH), alanine transaminase (ALT) and aspartate transaminase (AST); lower levels of lymphocyte (L) and platelet (PLT); and higher incidence of lack of appetite, decreased breath sounds, single lobar infiltrate, pleural effusion, pericardial effusion, mucosal erosion and/or necrosis, and bronchial embolization. L levels and pleural effusion were identified as risk factors in multivariate logistic regression.
CONCLUSIONS
Children with PB caused by MPP had a strong and local inflammatory response. L levels and pleural effusion were independent risk factors of PB with MPP in children. Our findings will help clinicians identify potential PB in pediatric patients for early and effective intervention.
Topics: Child; Humans; Mycoplasma pneumoniae; Pandemics; Retrospective Studies; Pneumonia, Mycoplasma; Pleural Effusion; Risk Factors; Bronchitis
PubMed: 37996853
DOI: 10.1186/s12890-023-02766-0 -
The Journal of Infection Mar 2023
Topics: Child; Humans; Mycoplasma pneumoniae; Prevalence; Pandemics; COVID-19; Pneumonia, Mycoplasma; China
PubMed: 36646141
DOI: 10.1016/j.jinf.2022.12.030 -
BMC Infectious Diseases Apr 2023Community-acquired pneumonia (CAP) is a major public health challenge worldwide. However, the aetiological and disease severity-related pathogens associated with CAP in...
BACKGROUND
Community-acquired pneumonia (CAP) is a major public health challenge worldwide. However, the aetiological and disease severity-related pathogens associated with CAP in adults in China are not well established based on the detection of both viral and bacterial agents.
METHODS
A multicentre, prospective study was conducted involving 10 hospitals located in nine geographical regions in China from 2014 to 2019. Sputum or bronchoalveolar lavage fluid (BALF) samples were collected from each recruited CAP patient. Multiplex real-time PCR and bacteria culture methods were used to detect respiratory pathogens. The association between detected pathogens and CAP severity was evaluated.
RESULTS
Among the 3,403 recruited eligible patients, 462 (13.58%) had severe CAP, and the in-hospital mortality rate was 1.94% (66/3,403). At least one pathogen was detected in 2,054 (60.36%) patients, with two or more pathogens were co-detected in 725 patients. The ten major pathogens detected were Mycoplasma pneumoniae (11.05%), Haemophilus influenzae (10.67%), Klebsiella pneumoniae (10.43%), influenza A virus (9.49%), human rhinovirus (9.02%), Streptococcus pneumoniae (7.43%), Staphylococcus aureus (4.50%), adenovirus (2.94%), respiratory syncytial viruses (2.35%), and Legionella pneumophila (1.03%), which accounted for 76.06-92.52% of all positive detection results across sampling sites. Klebsiella pneumoniae (p < 0.001) and influenza viruses (p = 0.005) were more frequently detected in older patients, whereas Mycoplasma pneumoniae was more frequently detected in younger patients (p < 0.001). Infections with Klebsiella pneumoniae, Staphylococcus aureus, influenza viruses and respiratory syncytial viruses were risk factors for severe CAP.
CONCLUSIONS
The major respiratory pathogens causing CAP in adults in China were different from those in USA and European countries, which were consistent across different geographical regions over study years. Given the detection rate of pathogens and their association with severe CAP, we propose to include the ten major pathogens as priorities for clinical pathogen screening in China.
Topics: Humans; Adult; Aged; Pneumonia, Bacterial; Prospective Studies; Pneumonia; Streptococcus pneumoniae; Mycoplasma pneumoniae; Respiratory Syncytial Viruses; Legionella pneumophila; Klebsiella pneumoniae; Community-Acquired Infections
PubMed: 37059987
DOI: 10.1186/s12879-023-08166-3 -
BMJ Case Reports Apr 2021A 9-year-old boy presented to the emergency department of a paediatric hospital with non-painful lesions on his lips and inside his mouth, associated with lip swelling....
A 9-year-old boy presented to the emergency department of a paediatric hospital with non-painful lesions on his lips and inside his mouth, associated with lip swelling. On examination, his oral mucosa and lips showed numerous blisters with yellowish serofibrinous content and lip oedema. An eye examination revealed bilateral conjunctival injection. Genitalia was unaffected and no other skin lesions were found. He was on day 4 of clarithromycin prescribed for atypical pneumonia caused by The patient was diagnosed with -associated mucositis and was started on topical treatment with fusidic acid and betamethasone, with gradual improvement of the oral lesions.
Topics: Child; Clarithromycin; Humans; Male; Mouth Mucosa; Mucositis; Mycoplasma pneumoniae; Pneumonia, Mycoplasma
PubMed: 33858884
DOI: 10.1136/bcr-2020-239086 -
JAAD Case Reports Mar 2021
PubMed: 33644281
DOI: 10.1016/j.jdcr.2021.01.004