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European Journal of Clinical... May 2024To investigate the clinical characteristics and risk factors for pneumonia in children co-infected with influenza A virus (IAV) and Mycoplasma pneumoniae (MP).
OBJECTIVE
To investigate the clinical characteristics and risk factors for pneumonia in children co-infected with influenza A virus (IAV) and Mycoplasma pneumoniae (MP).
METHODS
Children who were diagnosed with IAV and MP infection between January and December, 2023 were enrolled and divided into a non-pneumonia group and a pneumonia group. Univariate analysis and logistic regression analysis were used to evaluate each index, and the risk factors for pneumonia caused by coinfection in the two groups were explored.
RESULTS
A total of 209 patients were enrolled, of which 107 and 102 patients were in the pneumonia and non-pneumonia groups, respectively. The patients in the pneumonia group were older and had a longer duration of fever (P < 0.05). Univariate analysis revealed that the median age, duration of fever, and CD3, CD4, CD8 and IL-10 levels were significantly correlated with pneumonia (P < 0.05). Multivariate logistic regression analysis revealed that the median age, duration of fever, and CD4, CD8 and IL-10 levels were independent risk factors for pneumonia. Area under the curve of the five combined indicators in the ROC (receiver operator characteristic) analysis was 0.883, was higher than single factor.
CONCLUSION
Children with IAV and MP infection whose age older than 6.08 years, had a fever longer than 4 days, had a CD4 count < 22.12%, had a CD8 count < 35.21%, had an IL-10 concentration > 22.08 ng/ml were more likely to develop pneumonia.
PubMed: 38789887
DOI: 10.1007/s10096-024-04854-3 -
Marine Drugs May 2024, a notable pathogen behind respiratory infections, employs specialized proteins to adhere to the respiratory epithelium, an essential process for initiating infection....
, a notable pathogen behind respiratory infections, employs specialized proteins to adhere to the respiratory epithelium, an essential process for initiating infection. The role of glycosaminoglycans, especially heparan sulfate, is critical in facilitating pathogen-host interactions, presenting a strategic target for therapeutic intervention. In this study, we assembled a glycan library comprising heparin, its oligosaccharide derivatives, and a variety of marine-derived sulfated glycans to screen the potential inhibitors for the pathogen-host interactions. By using Surface Plasmon Resonance spectroscopy, we evaluated the library's efficacy in inhibiting the interaction between adhesion proteins and heparin. Our findings offer a promising avenue for developing novel therapeutic strategies against infections.
Topics: Mycoplasma pneumoniae; Heparin; Polysaccharides; Aquatic Organisms; Humans; Adhesins, Bacterial; Bacterial Adhesion; Pneumonia, Mycoplasma; Anti-Bacterial Agents; Animals; Host-Pathogen Interactions; Sulfates
PubMed: 38786623
DOI: 10.3390/md22050232 -
Journal of Clinical Virology : the... Aug 2024Community-acquired pneumonia (CAP) is a major global cause of death and hospitalization. Bacteria or community-acquired viruses (CARVs) cause CAP. COVID-19 associated...
BACKGROUND
Community-acquired pneumonia (CAP) is a major global cause of death and hospitalization. Bacteria or community-acquired viruses (CARVs) cause CAP. COVID-19 associated restrictions effectively reduced the circulation of CARVs.
OBJECTIVES
The aim of this study was to analyze the proportion of CARVs in adult patients with CAP from mid-2020 to mid-2023. Specifically, we aimed to compare the rate of influenza virus, SARS-CoV-2, and RSV detections in patients aged 18-59 years and ≥60 years.
STUDY DESIGN
We analyze the proportion of 21 community-acquired respiratory viruses (CARVs) and three atypical bacteria (Bordetella pertussis, Legionella pneumophila, and Mycoplasma pneumoniae) in nasopharyngeal swab samples using molecular multiplex methods within the prospective, multicentre, multinational study of the German study Group CAPNETZ. We used stringent inclusion criteria throughout the study.
RESULTS
We identified CARVs in 364/1,388 (26.2 %) patients. In detail, we detected SARS-CoV-2 in 210/1,388 (15.1 %), rhino-/enterovirus in 64/1,388 (4.6 %), influenza virus in 23/1,388 (1.6 %) and RSV in 17/1,388 (1.2 %) of all patients. We detected RSV and influenza more frequently in patients ≥60 years, especially in 22/23 compared to the previous season. None of the atypical bacteria were detected.
CONCLUSIONS
Beginning in 2023, we demonstrate a re-emergence of CARVs in CAP patients. Effective vaccines or specific antiviral therapies for more than two thirds of the detected viral infections are currently available. High detection rates of vaccine-preventable viruses in older age groups support targeted vaccination campaigns.
Topics: Humans; Community-Acquired Infections; Middle Aged; Adult; Prospective Studies; Male; Female; Young Adult; Adolescent; Aged; COVID-19; Mycoplasma pneumoniae; SARS-CoV-2; Pneumonia, Viral; Influenza, Human; Germany; Viruses; Nasopharynx; Legionella pneumophila
PubMed: 38781632
DOI: 10.1016/j.jcv.2024.105694 -
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 -
Infection and Drug Resistance 2024To explore the clinical characteristics, treatment, and long-term prognosis of mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in children.
PURPOSE
To explore the clinical characteristics, treatment, and long-term prognosis of mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in children.
PATIENTS AND METHODS
The medical records of 16 children who were diagnosed with MPP associated with PE between January 2016 and January 2023 at Children's Hospital, Zhejiang University School of Medicine were retrospectively reviewed.
RESULTS
The average age patients were 8.24 ± 1.99 years. All cases were diagnosed with refractory mycoplasma pneumoniae pneumonia (RMPP) and presented complications in the form of necrotizing pneumonia (NP). The main symptoms observed were cough and fever (n = 16, 100%), chest pain (n = 8, 50%), dyspnea (n = 8, 50%), and hemoptysis (n = 4, 25%). In these cases, 12 patients had involvement of the pulmonary artery, 3 patients experienced issues with the pulmonary vein, and 1 patient had simultaneous involvement of both the pulmonary artery and pulmonary vein. Among the 12 pulmonary artery embolism cases, 6 involved the right pulmonary artery, 4 involved the left pulmonary artery, and 2 involved both the right and left pulmonary arteries. The mean D-dimer level was 8.50 ± 4.76 mg/L. All patients received anticoagulant therapy, and after treatment, there was a significant improvement in their symptoms and lung lesions.
CONCLUSION
Children with RMPP, chest pain, hemoptysis, and elevated D-dimer levels should be closely monitored for the potential development of PE. The co-occurrence of MPP and PE often involves the presence of NP. In cases of confirmed PE, anticoagulation therapy may be a suitable consideration. PE and NP resulting from MPP generally had a favorable overall prognosis.
PubMed: 38779350
DOI: 10.2147/IDR.S459626 -
Cureus Apr 2024The syndromic nature of infections caused by pneumonia-causing pathogens including necessitates detection via multiplex PCR for accurate and timely diagnosis to...
The syndromic nature of infections caused by pneumonia-causing pathogens including necessitates detection via multiplex PCR for accurate and timely diagnosis to control the infection spread. In this study, we demonstrate an increase in the detection of in the outpatient population, during 2023, as compared to the previous two years (2021-2022). In this aggregated survey, respiratory samples collected within the continental United States were tested for the presence of and other respiratory bacterial and viral pathogens using a multiplex PCR assay. Patient data was analyzed on the basis of age, gender and geographical location. The positive detection of in 2021 and 2022 was 0.004% and 0.006%, respectively. The positivity rate of in 2023 increased to 0.21%. The highest proportion of cases were detected from Georgia with the outbreak generally concentrated in large urban settings. Median age of the patients testing positive for was 10 (interquartile range [IQR] 8-18) years with an almost equal distribution between male and female patients. Other respiratory, viral and bacterial, pathogens detected in samples positive for were similar in proportion to the negative population. A survey of the ICD-10 codes submitted in conjunction with the samples suggests that the current outbreak is mostly associated with upper respiratory tract infections. The present study is the first detailed report in the United States that shows an unprecedented increase in the detection of in the outpatient population during 2023. Our analysis suggests that this outbreak was not associated with any other bacterial or viral respiratory pathogen. The outbreak of this atypical pathogen was concentrated in the pediatric population in large urban areas. The 2023 outbreak could be a return of the cyclical outbreaks witnessed prior to the COVID-19 pandemic. Our study highlights the importance of performing continuous surveillance of respiratory pathogens, especially in the altered epidemiological landscape of the post-COVID world.
PubMed: 38779270
DOI: 10.7759/cureus.58757 -
BMC Pulmonary Medicine May 2024Mycoplasma pneumoniae pneumonia (MPP) is prevalent in paediatric patients and can progress to refractory mycoplasma pneumoniae pneumonia (RMPP).
INTRODUCTION
Mycoplasma pneumoniae pneumonia (MPP) is prevalent in paediatric patients and can progress to refractory mycoplasma pneumoniae pneumonia (RMPP).
OBJECTIVE
To assess the predictive value of bronchoscopy combined with computed tomography (CT) score in identifying RMPP in children.
METHODS
A retrospective analysis was conducted on 244 paediatric patients with MP, categorising them into RMPP and general mycoplasma pneumoniae pneumonia (GMPP) groups. A paired t-test compared the bronchitis score (BS) and CT score before and after treatment, supplemented by receiver operating characteristic (ROC) analysis.
RESULTS
The RMPP group showed higher incidences of extrapulmonary complications and pleural effusion (58.10% and 40%, respectively) compared with the GMPP group (44.60%, p = 0.037 and 18.71%, p < 0.001, respectively). The CT scores for each lung lobe were statistically significant between the groups, except for the right upper lobe (p < 0.05). Correlation analysis between the total CT score and total BS yielded r = 0.346 and p < 0.001. The ROC for BS combined with CT score, including area under the curve, sensitivity, specificity, and cut-off values, were 0.82, 0.89, 0.64, and 0.53, respectively.
CONCLUSION
The combined BS and CT score method is highly valuable in identifying RMPP in children.
Topics: Humans; Pneumonia, Mycoplasma; Male; Female; Retrospective Studies; Child; Bronchoscopy; Tomography, X-Ray Computed; Child, Preschool; ROC Curve; Mycoplasma pneumoniae; Predictive Value of Tests; Anti-Bacterial Agents; Adolescent; Sensitivity and Specificity; Lung; Bronchitis
PubMed: 38778338
DOI: 10.1186/s12890-024-02996-w -
Vaccine Jul 2024Community-acquired pneumonia often stems from the macrolide-resistant strain of Mycoplasma pneumoniae, yet no effective vaccine exists against it.
BACKGROUND
Community-acquired pneumonia often stems from the macrolide-resistant strain of Mycoplasma pneumoniae, yet no effective vaccine exists against it.
METHODS
This study proposes a vaccine-immunoinformatics strategy for Mycoplasma pneumoniae and other pathogenic microbes. Specifically, dominant B and T cell epitopes of the Mycoplasma pneumoniae P30 adhesion protein were identified through immunoinformatics method. The vaccine sequence was then constructed by coupling with CTLA-4 extracellular region, a novel molecular adjuvant for antigen-presenting cells. Subsequently, the vaccine's physicochemical properties, antigenicity, and allergenicity were verified. Molecular dynamics modeling was employed to confirm interaction with TLR-2, TLR-4, B7-1, and B7-2. Finally, the vaccine underwent in silico cloning for expression.
RESULTS
The vaccine exhibited both antigenicity and non-allergenicity. Molecular dynamics simulation, post-docking with TLR-2, TLR-4, B7-1, and B7-2, demonstrated stable interaction between the vaccine and these molecules. In silico cloning confirmed effective expression of the vaccine gene in insect baculovirus vectors.
CONCLUSION
This vaccine-immunoinformatics approach holds promise for the development of vaccines against Mycoplasma pneumoniae and other pathogenic non-viral and non-bacterial microbes.
Topics: Mycoplasma pneumoniae; Epitopes, T-Lymphocyte; Bacterial Vaccines; Epitopes, B-Lymphocyte; Humans; Computational Biology; Pneumonia, Mycoplasma; CTLA-4 Antigen; Molecular Dynamics Simulation; Molecular Docking Simulation; Toll-Like Receptor 2; Immunoinformatics
PubMed: 38777697
DOI: 10.1016/j.vaccine.2024.04.098 -
Archives of Rheumatology Mar 2024This study aimed to clarify the relationship between and Kawasaki disease by conducting an updated systemic review and meta-analysis of published studies. (Review)
Review
OBJECTIVES
This study aimed to clarify the relationship between and Kawasaki disease by conducting an updated systemic review and meta-analysis of published studies.
MATERIALS AND METHODS
Studies mentioning and Kawasaki disease before October 2022 were included in this meta-analysis. The pooled prevalence was calculated, and the log odds ratio in the random effects model was applied to estimate the pooled prevalence of infection in pediatric patients with Kawasaki disease. In addition, the clinical parameters, such as hemoglobin and erythrocyte sedimentation rate, were analyzed. Six studies with a total of 1,859 pediatric patients with Kawasaki disease were enrolled. The focused outcome was the pooled prevalence and clinical parameters.
RESULTS
The pooled prevalence of infection was statistically significant in pediatric patients with Kawasaki disease. In addition, the values of hemoglobin and erythrocyte sedimentation rate were significantly different between -infected and non--infected patients with Kawasaki disease. Other clinical parameters were not significantly different between -infected and non--infected patients with Kawasaki disease.
CONCLUSION
The results suggest that infection is significantly prevalent in pediatric patients with Kawasaki disease. The lower values of hemoglobin and erythrocyte sedimentation rate in -infected patients with Kawasaki disease might be needed to investigate further.
PubMed: 38774705
DOI: 10.46497/ArchRheumatol.2023.10149 -
Academic Radiology May 2024The mutations in the 23S ribosomal RNA (rRNA) gene are associated with an increase in resistance to macrolides in children with Mycoplasma pneumoniae pneumonia (MPP)....
Chest Computed Tomography Radiomics for Determining Macrolide Resistance-Associated Gene Mutation Status in Children with Mycoplasma pneumoniae Pneumonia: A Two-Center Study.
RATIONALE AND OBJECTIVES
The mutations in the 23S ribosomal RNA (rRNA) gene are associated with an increase in resistance to macrolides in children with Mycoplasma pneumoniae pneumonia (MPP). This study aimed to develop and validate a chest computed tomography (CT) radiomics model for determining macrolide resistance-associated gene mutation status in MPP.
MATERIALS AND METHODS
A total of 258 MPP patients were retrospectively included from two institutions (training set: 194 patients from the first institution; external test set: 64 patients from the second). The 23S rRNA gene mutation status was tested by nasopharyngeal swab polymerase chain reaction. Radiomics features were extracted from chest CT images of pulmonary lesions segmented with semi-automatic delineation. Subsequently, radiomics feature reduction was applied to identify the most relevant features. Logistic regression and random forest algorithms were employed to establish the radiomics models, which were five-fold cross-validated in the training set and validated in the external test set.
RESULTS
The radiomics feature selection resulted in eight features. After five-fold cross-validation in the training set, the mean areas under the receiver operating characteristic curve (AUCs) of the logistic regression and random forest models were 0.868 (95% confidence interval (CI): 0.813-0.923) and 0.941 (95% CI: 0.907-0.975), respectively. In the external test set, the corresponding AUCs were 0.855 (95% CI: 0.758-0.952) and 0.815 (95% CI: 0.705-0.925).
CONCLUSION
Chest CT radiomics is a promising diagnostic tool for determining macrolide resistance gene mutation status in MPP.
AVAILABILITY OF DATA AND MATERIAL
The datasets generated or analyzed during the study are available from the corresponding author on reasonable request.
PubMed: 38772798
DOI: 10.1016/j.acra.2024.05.008