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International Journal of Infectious... Aug 2024The prevalence of respiratory infectious diseases has changed in the post-COVID-19 epidemic era, and mycoplasma pneumoniae (MP) infection in children has attracted wide...
OBJECTIVES
The prevalence of respiratory infectious diseases has changed in the post-COVID-19 epidemic era, and mycoplasma pneumoniae (MP) infection in children has attracted wide attention.
METHODS
Children hospitalized for pneumonia in Wuhan, China, in 2023 were enrolled. Respiratory secretions were obtained for the targeted next-generation sequencing (tNGS) including mutation of MP. Pulmonary inflammation was divided into bronchopneumonia and pulmonary consolidation/atelectasis according to lung computed tomography imaging.
RESULTS
Of the 667 pediatric pneumonia, 478 were MP positive (72%). The positive rate of MP detected by tNGS increased from April, and MP had become the primary pathogen of pneumonia in children in 2023. The 23S rRNA mutations were all A2063G, accounting for 85% of detected MP. The clinical symptoms of the mutant and wild-type strains were similar, with half of them experiencing atelectasis and lung consolidation. Early bronchoscopic lavage combined with azithromycin in pediatric pulmonary consolidation was an effective therapy strategy, which could be an alternative selection to MP pneumonia treatment.
CONCLUSIONS
A2063G mutant strain MP was the primary pathogen of mycoplasma pneumoniae in children recently, which was often complicated by extra-pulmonary symptoms and complications.
Topics: Humans; Pneumonia, Mycoplasma; China; Mycoplasma pneumoniae; Female; Child; Male; Child, Preschool; Mutation; Infant; RNA, Ribosomal, 23S; Anti-Bacterial Agents; Azithromycin; COVID-19; High-Throughput Nucleotide Sequencing; Adolescent
PubMed: 38734057
DOI: 10.1016/j.ijid.2024.107074 -
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 -
Clinical Case Reports May 2024Mycoplasma myocarditis is a rare but potentially serious condition that can cause inflammation of the heart muscle, leading to arrhythmia and heart failure. It is...
KEY CLINICAL MESSAGE
Mycoplasma myocarditis is a rare but potentially serious condition that can cause inflammation of the heart muscle, leading to arrhythmia and heart failure. It is important to consider this condition in the differential diagnosis of young patients presenting with unexplained signs of heart failure and SVT, even in the absence of signs of myocardiocytolysis and extra-cardiac disease.
ABSTRACT
infections are often underdiagnosed as a great proportion of patients remain asymptomatic, pauci-symptomatic, or exhibit varying presentations. manifestations can affect different systems, including the heart, with the potential to lead to high degree of morbidity and debilitating sequelae. Here we present an atypical case of associated myocarditis which presented with sustained refractory SVT, symptoms of heart failure, and with no signs of myocardiocytolysis, pulmonary involvement, or systemic infection. Given the lack of signs of myocardial inflammation, the patient was initially misdiagnosed with tachycardia induced cardiomyopathy (TIC), but later correctly diagnosed after showing signs of pneumonia during the hospitalization. The patient received the appropriate antibiotic treatment in addition to corticosteroids, was discharged on the 15th day of hospitalization, and completely recovered after 1 month with no arrhythmia recurrence and normalization of ventricular function.
PubMed: 38721564
DOI: 10.1002/ccr3.8851 -
La Revue de Medecine Interne May 2024
PubMed: 38719670
DOI: 10.1016/j.revmed.2024.04.441 -
Italian Journal of Pediatrics May 2024To explore the alterations of inflammatory markers and immune-related cytokines in children infected with Mycoplasma pneumoniae (MP) combined with Adenovirus (ADV).
BACKGROUND
To explore the alterations of inflammatory markers and immune-related cytokines in children infected with Mycoplasma pneumoniae (MP) combined with Adenovirus (ADV).
METHODS
The study population consisted of 201 children with MPP, and they were grouped according to whether they were coinfected with ADV infection and critically ill. Additionally, comparative analyses were performed. The diagnostic value of different indicators and combined indicators for SMPP combined with ADV was assessed using ROC curves.
RESULTS
There was no difference between group A1 and group A2, group B1 and group B2 in terms of age, gender, duration of hospitalisation and fever. The levels of calcitoninogen(PCT), lactate dehydrogenase concentration(LDH), interleukin(IL)-6, IL-8, IL-10, IL-4, IL-12P70, and IFN-γ in group A were higher than group B. The severe group (A1, B1) was significantly higher than the mild group (A2, B2) in terms of D-dimer, CRP, PCT, LDH, IL-6, IL-8, IL-10, IL-17a and number of patients with pleural effusion, solid lung changes. Among the individual indexes of D-dimer, CRP, N%,LDH, and PCT, the AUC of the combined test was 0.977, which was higher than that of the individual indicators. Among IL-6, IL-8, IL-10, and IL-17a, the AUC of the combined assay was 0.802, which was higher than that of the individual indicators.
CONCLUSION
MP combined with ADV infection was associated with increased expression levels of IL-6, IL-8, IL-10, IL-4, IL-12P70, IFN-γ, and LDH. IL-6, IL-8, IL-10, IL-17a, LDH, PCT, CRP, and D-dimer could be used as predictors of SMPP and the combined test can improve the diagnostic value.
Topics: Humans; Male; Female; Pneumonia, Mycoplasma; Cytokines; Child; Child, Preschool; Biomarkers; Adenoviridae Infections; Severity of Illness Index; Coinfection; ROC Curve; Retrospective Studies
PubMed: 38715105
DOI: 10.1186/s13052-024-01661-6 -
Biochemical and Biophysical Research... Jul 2024Mycoplasma pneumoniae (MP),as the most commonly infected respiratory pathogen in community-acquired pneumonia in preschool children,has becoming a prominent factor...
Mycoplasma pneumoniae (MP),as the most commonly infected respiratory pathogen in community-acquired pneumonia in preschool children,has becoming a prominent factor affecting children's respiratory health.Currently, there is a lack of easy, rapid, and accurate laboratory testing program for MP infection, which causes comparatively difficulty for clinical diagnostic.Here,we utilize loop-mediated isothermal amplification (LAMP) to amplify and characterize the P1 gene of MP, combined with nucleic acid lateral flow (NALF) for fast and visuallized detection of MP.Furthermore, we evaluated and analyzed the sensitivity, specificity and methodological consistency of the method.The results showed that the limit of detection(LoD) of MP-LAMP-NALF assay was down to 100 copys per reaction and there was no cross-reactivity with other pathogens infected the respiratory system. The concordance rate between MP-LAMP-NALF assay with quantitative real-time PCR was 94.3 %,which exhibiting excellent testing performance.We make superior the turnaround time of the MP-LAMP-NALF assay, which takes only about 50 min. In addition, there is no need for precision instruments and no restriction on the laboratory site.Collectively, LAMP-NALF assay targeting the P1 gene for Mycoplasma pneumoniae detection was a easy, precise and visual test which could be widely applied in outpatient and emergency departments or primary hospitals.When further optimized, it could be used as "point-of-care testing" of pathogens or multiple testing for pathogens.
Topics: Mycoplasma pneumoniae; Nucleic Acid Amplification Techniques; Humans; Pneumonia, Mycoplasma; Molecular Diagnostic Techniques; Sensitivity and Specificity; Limit of Detection; DNA, Bacterial
PubMed: 38714016
DOI: 10.1016/j.bbrc.2024.150028 -
The Pediatric Infectious Disease Journal Apr 2024
PubMed: 38710004
DOI: 10.1097/INF.0000000000004386 -
Pediatric Pulmonology Jun 2024Mycoplasma pneumoniae causes community-acquired pneumonia in children and increases asthma risk, but large studies are lacking.
BACKGROUND
Mycoplasma pneumoniae causes community-acquired pneumonia in children and increases asthma risk, but large studies are lacking.
OBJECTIVE
To assess the link between M. pneumoniae infection and to asthma exacerbation, in children with allergies, and age of infection impact.
METHODS
This retrospective cohort study analyzed medical records of South Korean children between January 2002 and December 2017. The study's exposure was hospitalization with an M. pneumoniae-related diagnosis, and the outcome was defined as asthma exacerbation, confirmed by hospitalization at least 6 months after M. pneumoniae infection, with alternative validation using asthma diagnosis and systemic steroid prescription records. Hazard ratios (HRs) for asthma exacerbation risk were estimated for the matched cohort using a Cox proportional hazards model stratified by allergic comorbidities. Time-dependent covariates and age-stratified exposure groups were used to calculate odds ratios.
RESULTS
The study included 84,074 children with M. pneumoniae infection and 336,296 unexposed children. Follow-up for 12.2 ± 2.3 years found the exposed group had a significant risk of asthma exacerbation (HR 2.86, 95% confidence interval [CI] 2.67-3.06) regardless of allergic comorbidities. The risk was highest (over threefold) in children infected between 24 and 71 months. Sensitivity analysis using an alternative definition of the outcome showed an HR of 1.38 (95% CI 1.35-1.42), further supporting the association between M. pneumoniae infection and asthma exacerbation.
CONCLUSION
M. pneumoniae infection was significantly associated with an increased risk of subsequent asthma exacerbation regardless of allergic comorbidities. Further research needed for understanding and confirmation.
Topics: Humans; Asthma; Pneumonia, Mycoplasma; Female; Retrospective Studies; Male; Child; Republic of Korea; Child, Preschool; Mycoplasma pneumoniae; Infant; Age Factors; Adolescent; Disease Progression; Hospitalization; Risk Factors; Proportional Hazards Models
PubMed: 38708969
DOI: 10.1002/ppul.26907 -
BMC Pediatrics May 2024Acute gastroenteritis (AGE) causes significant morbidity in children worldwide; however, the disease burden of children hospitalized with viral gastroenteritis in China...
Changes in the epidemiology and clinical characteristics of viral gastroenteritis among hospitalized children in the Mainland of China: a retrospective study from 2016 to 2020.
BACKGROUND
Acute gastroenteritis (AGE) causes significant morbidity in children worldwide; however, the disease burden of children hospitalized with viral gastroenteritis in China has been rarely described. Through this study, we analyzed the data of hospitalized children with viral gastroenteritis to explore the changes in the epidemiology and clinical characteristics of viral gastroenteritis in the mainland of China.
METHODS
Data were extracted from Futang Children's Medical Development Research Center (FRCPD), between 2016 and 2020, across 27 hospitals in 7 regions. The demographics, geographic distribution, pathogenic examination results, complications, hospital admission date, length of hospital stays, hospitalization charges and outcomes were collected and analyzed.
RESULTS
Viral etiological agents included rotavirus (RV), adenovirus (ADV), norovirus (NV) and coxsackievirus (CV) that were detected in 25,274 (89.6%), 1,047 (3.7%), 441 (1.5%) and 83 (0.3%) cases. There was a higher prevalence of RV and NV infection among children younger than 3 years of age. RV and NV had the highest detection rates in winter, while ADV in summer. Children with viral gastroenteritis were often accompanied by other diseases, such as myocardial diseases (10.98-31.04%), upper respiratory tract diseases (1.20-20.15%), and seizures (2.41-14.51%). Among those cases, the co-infection rate with other pathogens was 6.28%, with Mycoplasma pneumoniae (M. pneumoniae), Epstein-Barr virus (EBV), and influenza virus (FLU) being the most common pathogens. The median length of stay was 5 days, and the median cost of hospitalization corresponded to587 US dollars.
CONCLUSIONS
This finding suggests that viral gastroenteritis, especially those caused by RV, is a prevalent illness among younger children. Co-infections and the presence of other diseases are common. The seasonality and regional variation of viral etiological agents highlight the need for targeted prevention and control measures. Although viral gastroenteritis rarely leads to death, it also results in a significant economic burden on healthcare systems.
Topics: Humans; Gastroenteritis; China; Child, Preschool; Retrospective Studies; Infant; Male; Female; Child; Hospitalization; Length of Stay; Adolescent; Prevalence; Seasons; Infant, Newborn; Child, Hospitalized; Acute Disease; Rotavirus Infections
PubMed: 38704530
DOI: 10.1186/s12887-024-04776-1 -
Alternative Therapies in Health and... May 2024Metagenomic sequencing (mNGS) is a promising technique for pathogen detection. However, the use of mNGS in pediatric lung infections is still rarely reported.
OBJECTIVE
Metagenomic sequencing (mNGS) is a promising technique for pathogen detection. However, the use of mNGS in pediatric lung infections is still rarely reported.
METHODS
A total of 59 cases were included between January 2019 and December 2021. To compare the performance of mNGS and routine detection in diagnosing pulmonary infection and identifying pathogenic bacteria.
RESULTS
59 children (33.90%) were infected with Mycoplasma pneumoniae, 15 were infected with adenovirus type 7 (25.42%), 11 were infected with Streptococcus pneumoniae (18.64%), 6 were infected with Staphylococcus aureus (10.17%), 5 were infected with Klebsiella pneumoniae, Acinetobacter baumannii, pertussis, and oral streptococcus (8.47%), 3 were infected with Haemophilus influenzae (5.08%), and 3 were infected with Pseudomonas aeruginosa (5.08%). Among 59 patients, 41 were co-infected with multiple pathogens and 18 were infected with independent pathogens. Mycoplasma pneumoniae infection was most common in 6 out of 18 independent pathogen patients (33%). Among them were 3 cases of type 7 adenovirus, 53 cases of human herpesvirus (16.7%), and 2 cases of pertussis bacillus (11.1%). One case (5.6%) was infected with Streptococcus pneumoniae, Proteus albicans, Mycobacterium tuberculosis, Staphylococcus aureus, and Klebsiella pneumoniae. In cases where routine testing results are negative, mNGS improves the diagnostic efficiency of mixed pulmonary infections. 17 cases (17/59=28.81%) were diagnosed as single infection through routine testing, and the mNGS results of 4 cases were consistent with routine testing, all of which were Mycoplasma pneumoniae infections. Three cases were tested for partial mNGS matching, of which one case tested positive for Mycoplasma pneumoniae antibody and tested positive for Mycoplasma pneumoniae infection and human infection γ Herpes virus type 4, one case tested positive for antibodies and tested for infection with Mycoplasma pneumoniae and Streptococcus pneumoniae. The routine examination results of the remaining 11 patients were inconsistent with the mNGS examination results. Two patients tested positive for Mycoplasma antibodies. Patient 17 presented with mNGS infection of Haemophilus, Neisseria, and adenovirus type 7, while another patient 18 presented with herpes virus type 5 infection.
CONCLUSION
mNGS is a promising technique for detecting co-pathogens in mixed pediatric lung infections, with potential benefits in terms of speed and sensitivity.
PubMed: 38702151
DOI: No ID Found