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Journal of Immunology Research 2021() is implicated in several immune-mediated extrapulmonary manifestations, including reactive arthritis. Recently, increased total serum IgE were reported in children... (Observational Study)
Observational Study
BACKGROUND
() is implicated in several immune-mediated extrapulmonary manifestations, including reactive arthritis. Recently, increased total serum IgE were reported in children developing -related extrapulmonary diseases (MpEPDs). Here, we aimed at analyzing these aspects in children affected with rheumatic disorders and, in detail, Juvenile Idiopathic Arthritis (JIA).
METHODS
serology (IgG and IgM) and total serum IgE were concomitantly analyzed in 139 pediatric patients diagnosed with: JIA (Group 1, = 85), or any rheumatic disease other than JIA (Group 2, = 27), or non-inflammatory endocrinological disorders (Group 3, = 27).
RESULTS
Overall, 19.4% seroprevalence was observed in this hospitalized pediatric population, without signicant differences among the three groups. No significant differences in total serum IgE levels were noted among these groups; however, a second analysis excluding children with very high (and clearly abnormal) IgE levels suggested that JIA patients and, in detail, those with oligopolyarticular forms may have higher serum IgE concentrations. This relative difference among groups in serum IgE level seems to be more pronounced in seropositive children.
CONCLUSIONS
infection should be actively sought in children developing immune-mediated diseases, including patients affected with JIA and, especially, in oligopolyarticular forms. There is some evidence that total serum IgE levels may tend to be increased in patients with oligopolyarticular JIA subtype and especially in those resulting as seropositive. However, further and focused research is needed to confirm these preliminary results and to clarify the relation between infection, atopic status, and immune-mediated arthritis.
Topics: Antibodies, Bacterial; Arthritis, Juvenile; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Immunoglobulin E; Infant; Infant, Newborn; Male; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Seroepidemiologic Studies
PubMed: 34660816
DOI: 10.1155/2021/6596596 -
Emerging Microbes & Infections Dec 2024With the atypical rise of infection (MPI) in 2023, prompt studies are needed to determine the current epidemic features and risk factors with emerging trends of MPI to...
With the atypical rise of infection (MPI) in 2023, prompt studies are needed to determine the current epidemic features and risk factors with emerging trends of MPI to furnish a framework for subsequent investigations. This multicentre, retrospective study was designed to analyse the epidemic patterns of MPI before and after the COVID-19 pandemic, as well as genotypes and the macrolide-resistance-associated mutations in sampled from paediatric patients in Southern China. Clinical data was collected from 1,33,674 patients admitted into investigational hospitals from 1 June 2017 to 30 November 2023. Metagenomic next-generation sequencing (mNGS) data were retrieved based on sequence positive samples from 299 paediatric patients for macrolide-resistance-associated mutations analysis. was used to compare categorical variables between different time frames. The monthly average cases of paediatric common respiratory infection diseases increased without enhanced public health measures after the pandemic, especially for influenza, respiratory syncytial virus infection, and MPI. The contribution of MPI to pneumoniae was similar to that in the outbreak in 2019. Compared to mNGS data between 2019-2022 and 2023, the severity of did not grow stronger despite higher rates of macrolide-resistance hypervariable sites, including loci 2063 and 2064, were detected in childhood samples of 2023. Our findings indicated that ongoing surveillance is necessary to understand the impact of post pandemic on transmission disruption during epidemic season and the severity of clinical outcomes in different scenarios.
Topics: Humans; Pneumonia, Mycoplasma; Mycoplasma pneumoniae; China; COVID-19; Child; Retrospective Studies; Child, Preschool; Male; Female; Infant; Macrolides; Drug Resistance, Bacterial; SARS-CoV-2; Adolescent; High-Throughput Nucleotide Sequencing; Anti-Bacterial Agents; Pandemics
PubMed: 38721691
DOI: 10.1080/22221751.2024.2353298 -
BMJ Open Apr 2023We aimed to summarise the prevalence of atypical pathogens in patients with severe pneumonia to understand the prevalence of severe pneumonia caused by atypical... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
We aimed to summarise the prevalence of atypical pathogens in patients with severe pneumonia to understand the prevalence of severe pneumonia caused by atypical pathogens, improve clinical decision-making and guide antibiotic use.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed, Embase, Web of Science and Cochrane Library were searched through November 2022.
ELIGIBILITY CRITERIA
English language studies enrolled consecutive cases of patients diagnosed with severe pneumonia, with complete aetiological analysis.
DATA EXTRACTION AND SYNTHESIS
We conducted literature retrieval on PubMed, Embase, Web of Science and The Cochrane Library to estimate the prevalence of , and in patients with severe pneumonia. After double arcsine transformation of the data, a random-effects model was used for meta-analyses to calculate the pooled prevalence of each pathogen. Meta-regression analysis was also used to explore whether the region, different diagnostic method, study population, pneumonia categories or sample size were potential sources of heterogeneity.
RESULTS
We included 75 eligible studies with 18 379 cases of severe pneumonia. The overall prevalence of atypical pneumonia is 8.1% (95% CI 6.3% to 10.1%) In patients with severe pneumonia, the pooled estimated prevalence of , and was 1.8% (95% CI 1.0% to 2.9%), 2.8% (95% CI 1.7% to 4.3%) and 4.0% (95% CI 2.8% to 5.3%), respectively. We noted significant heterogeneity in all pooled assessments. Meta-regression showed that the pneumonia category potentially influenced the prevalence rate of . The mean age and the diagnostic method of pathogens were likely moderators for the prevalence of and , and contribute to the heterogeneity of their prevalence.
CONCLUSIONS
In severe pneumonia, atypical pathogens are notable causes, especially . The diagnostic method, regional difference, sample size and other factors contribute to the heterogeneity of prevalence. The estimated prevalence and relative heterogeneity factors can help with microbiological screening, clinical treatment and future research planning.
PROSPERO REGISTRATION NUMBER
CRD42022373950.
Topics: Humans; Pneumonia, Bacterial; Prevalence; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Legionella; Chlamydia
PubMed: 37041056
DOI: 10.1136/bmjopen-2022-066721 -
Journal of the Formosan Medical... Nov 2022Mycoplasma pneumoniae is a pathogen that causes respiratory diseases in children. Infections caused by M. pneumoniae are usually self-limited but occasionally can be...
BACKGROUND
Mycoplasma pneumoniae is a pathogen that causes respiratory diseases in children. Infections caused by M. pneumoniae are usually self-limited but occasionally can be severe. We observed emerging cases of severe mycoplasma infection requiring extracorporeal membrane oxygenation (ECMO). Thus, we investigated chronological changes in the molecular features of the M. pneumoniae and its clinical impacts among the pediatric population.
METHODS
From 2011 to 2019, respiratory samples were collected from patients younger than 18 years old with pneumonia in a tertiary children's hospital. Focused multiple-locus variable number of tandem repeats analysis (MLVA) typing was performed on samples positive for M. pneumoniae in 2016 and 2019. Clinical data from the patients' electronic medical records were collected. We described the annual trend of macrolide resistance and MLVA type and analyzed the associations between clinical manifestations and MLVA types.
RESULTS
The percentage of macrolide-resistant (ML) M. pneumoniae gradually increased from 22% (27/122) in 2015 to 70% (82/117) in 2019. Among the MLM. pneumoniae, the predominant strain shifted from type P (31% [13/42]) to type A (40% [19/46]). The demographics, initial presentations, and clinical courses of the subjects with MLM. pneumoniae did not differ significantly between 2011 and 2019. However, in 2019, two fulminant cases requiring venovenous ECMO were observed, which indicates that more attention to the clinical severity of MLM. pneumoniae infections is warranted.
CONCLUSION
Obtaining accurate information on macrolide susceptibility is crucial for physicians to initiate appropriate antibiotic treatment in a timely fashion. Although we could not identify significant differences among mycoplasma pneumonias caused by different MLVAs over a span of 9 years, the emergence of severe mycoplasma infections requiring ECMO was clinically significant, and further monitoring was required.
Topics: Adolescent; Anti-Bacterial Agents; Child; Drug Resistance, Bacterial; Humans; Macrolides; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Taiwan
PubMed: 35599105
DOI: 10.1016/j.jfma.2022.05.001 -
Nature Structural & Molecular Biology Mar 2023Mycoplasma pneumoniae, responsible for approximately 30% of community-acquired human pneumonia, needs to extract lipids from the host environment for survival and...
Mycoplasma pneumoniae, responsible for approximately 30% of community-acquired human pneumonia, needs to extract lipids from the host environment for survival and proliferation. Here, we report a comprehensive structural and functional analysis of the previously uncharacterized protein P116 (MPN_213). Single-particle cryo-electron microscopy of P116 reveals a homodimer presenting a previously unseen fold, forming a huge hydrophobic cavity, which is fully accessible to solvent. Lipidomics analysis shows that P116 specifically extracts lipids such as phosphatidylcholine, sphingomyelin and cholesterol. Structures of different conformational states reveal the mechanism by which lipids are extracted. This finding immediately suggests a way to control Mycoplasma infection by interfering with lipid uptake.
Topics: Humans; Cryoelectron Microscopy; Mycoplasma pneumoniae; Adhesins, Bacterial; Lipids; Cholesterol
PubMed: 36782049
DOI: 10.1038/s41594-023-00922-y -
American Journal of Hematology Jun 2020
Topics: Adult; Antibodies, Bacterial; Betacoronavirus; COVID-19; Coinfection; Coronavirus Infections; Humans; Male; Mycoplasma pneumoniae; Pandemics; Pneumonia, Mycoplasma; Pneumonia, Viral; SARS-CoV-2
PubMed: 32173883
DOI: 10.1002/ajh.25785 -
Dermatology (Basel, Switzerland) 2022Mycoplasma pneumoniae atypical pneumonia is frequently associated with erythema multiforme. Occasionally, a mycoplasma infection does not trigger any cutaneous but...
BACKGROUND
Mycoplasma pneumoniae atypical pneumonia is frequently associated with erythema multiforme. Occasionally, a mycoplasma infection does not trigger any cutaneous but exclusively mucosal lesions. The term mucosal respiratory syndrome is employed to denote the latter condition. Available reviews do not address the possible association of mucosal respiratory syndrome with further atypical bacterial pathogens such as Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella species. We therefore performed a systematic review of the literature addressing this issue in the National Library of Medicine, Excerpta Medica, and Web of Science databases.
SUMMARY
We found 63 patients (≤18 years, n = 36; >18 years, n = 27; 54 males and 9 females) affected by a mucosal respiratory syndrome. Fifty-three cases were temporally associated with a M. pneumoniae and 5 with a C. pneumoniae infection. No cases temporally associated with C. psittaci, C. burnetii, F. tularensis, or Legionella species infection were found. Two cases were temporally associated with Epstein-Barr virus or influenzavirus B, respectively.
Topics: Chlamydophila pneumoniae; Humans; Mucositis; Mycoplasma pneumoniae; Respiratory Tract Infections; Syndrome
PubMed: 33774629
DOI: 10.1159/000514815 -
JAAD Case Reports Dec 2020
PubMed: 33912639
DOI: 10.1016/j.jdcr.2020.09.029 -
Microbiology Spectrum Aug 2023Mycoplasma pneumoniae (MP) is an important respiratory pathogen, the prevalence of macrolide-resistant MP (mainly containing A2063G mutation in 23S rRNA) increased in...
Proteomic and Phenotypic Studies of Mycoplasma pneumoniae Revealed Macrolide-Resistant Mutation (A2063G) Associated Changes in Protein Composition and Pathogenicity of Type I Strains.
Mycoplasma pneumoniae (MP) is an important respiratory pathogen, the prevalence of macrolide-resistant MP (mainly containing A2063G mutation in 23S rRNA) increased in recent years. Epidemiological studies suggest a higher prevalence of type I resistant (IR) strains than corresponding sensitive (IS/IIS) strains, but not type II resistant (IIR) strains. Here, we aimed to analyze the factors underlying the altered prevalence of IR strains. First, proteomic analyses exhibit the protein compositions were type specific, while more differential proteins were detected between IS and IR (227) than IIS and IIR strains (81). mRNA level detection suggested posttranscriptional regulation of these differential proteins. Differential protein-related phenotypic changes were also detected: (i) P1 abundance was different between genotypes (I < II, IR < IS), the adhesion of MPs showed accordance to P1 abundance within IS and IIS strains; (ii) type I, especially IR, strains had a higher proliferation rate, which is potentially associated with differential proteins participating in glycolysis and one carbon pool metabolisms; (iii) A549 cells infected with IR strains had lower activity of caspase-3 and higher levels IL-8, but the differences were not significant between groups ( > 0.05). Correlations of P1 abundance to caspase-3 activity and proliferation rate to the level of IL-8 were obtained. These results suggest changes in protein composition influenced the pathogenicity of MP, especially in IR strains, which may impact the prevalence of MP strains of different genotypes. The prevalence of macrolide-resistant MPs increased the difficulty in treatment of MP infections and posed potential threats to children's health. Epidemiological studies showed a high prevalence of IR-resistant strains (mainly A2063G in 23S rRNA) in these years. However, the trigger mechanisms for this phenomenon are not clear. In this paper, proteomic and phenotypic studies suggest that IR strains have reduced levels of multiple adhesion proteins and increased proliferation rate, which may lead to higher transmission rate of IR strains in the population. This suggests that we should pay attention to the prevalence of IR strains.
Topics: Child; Humans; Mycoplasma pneumoniae; Macrolides; Caspase 3; RNA, Ribosomal, 23S; Virulence; Interleukin-8; Proteomics; Drug Resistance, Bacterial; Microbial Sensitivity Tests; Anti-Bacterial Agents; Mutation
PubMed: 37378520
DOI: 10.1128/spectrum.04613-22 -
Frontiers in Immunology 2023pneumonia (MPP) may lead to various significant outcomes, such as necrotizing pneumonia(NP) and refractory MPP (RMPP). We investigated the potential of the...
INTRODUCTION
pneumonia (MPP) may lead to various significant outcomes, such as necrotizing pneumonia(NP) and refractory MPP (RMPP). We investigated the potential of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) to predict outcomes in patients with MPP.
METHODS AND MATERIALS
This was a prospective study of patients with MPP who were admitted to our hospital from 2019 to 2021. Demographic and clinical data were collected from patient records and associated with the development of NP and RMPP and other outcome measures.
RESULTS
Of the 1,401 patients with MPP included in the study, 30 (2.1%) developed NP. The NLR was an independent predictor of NP (odds ratio 1.153, 95% confidence interval 1.022-1.300, =0.021). The probability of NP was greater in patients with a high NLR (≥1.9) than in those with a low NLR (<1.9) (<0.001). The NLR was also an independent predictor of RMPP (odds ratio 1.246, 95% confidence interval 1.102-1.408, <0.005). Patients with a high NLR were more likely to develop NP and RMPP and require intensive care, and had longer total fever duration, longer hospital stays, and higher hospitalization expenses than those with a low NLR (all <0.005).
DISCUSSION
The NLR can serve as a predictor of poor prognosis in patients with MPP. It can predict the occurrence of NP, RMPP, and other poor outcomes. The use of this indicator would allow the simple and rapid prediction of prognosis in the early stages of MPP, enabling the implementation of appropriate treatment strategies.
Topics: Humans; Mycoplasma pneumoniae; Neutrophils; Prospective Studies; Retrospective Studies; Pneumonia, Mycoplasma; Lymphocytes
PubMed: 38169689
DOI: 10.3389/fimmu.2023.1302702