-
Alternative Therapies in Health and... Jun 2024This study aims to analyze the factors influencing the efficacy of budesonide (BUD) combined with N-acetylcysteine (NAC) treatment in children with Mycoplasma pneumoniae...
Influence Factors of the Therapeutic Effect of Budesonide Combined with N-Acetylcysteine in Children with Mycoplasma Pneumoniae Infection Analyzed by Lasso-Logistic and Construction of a Nomogram Prediction Model.
OBJECTIVE
This study aims to analyze the factors influencing the efficacy of budesonide (BUD) combined with N-acetylcysteine (NAC) treatment in children with Mycoplasma pneumoniae (MP) infection through Lasso-Logistic analysis, construct a Nomogram predictive model, and provide personalized treatment plans for clinicians. Additionally, it aims to fill the knowledge gap regarding the treatment of MP-infected children with BUD combined with NAC.
METHODS
We retrospectively analyzed clinical data from 96 children treated with BUD and NAC for MP infection at our hospital from January 2022 to May 2023. Treatment outcomes were categorized as good or poor. Logistic regression and Lasso-Logistic analysis were used to identify independent factors influencing outcomes and construct a predictive Nomogram model, which was validated through ROC curve analysis.
RESULTS
Logistic regression identified prolonged fever (≥7 days), high fever, and elevated levels of TNF-α, IL-6, and CRP as independent risk factors for poor outcomes. The Nomogram model, based on these factors, demonstrated excellent predictive accuracy with a C-index of 0.992 and AUC values of 0.987 and 0.948 in the modeling and validation cohorts, respectively.
CONCLUSION
The developed Nomogram model provides clinicians with a reliable tool to predict poor treatment outcomes in children with MP infection treated with BUD and NAC, supporting more personalized and effective treatment plans.
PubMed: 38836732
DOI: No ID Found -
Platelets Dec 2024Acquired disorders of platelet function are an underdiagnosed cause of bleeding tendency. A 14-year-old girl developed moderate mucocutaneous bleeding two weeks after a...
Acquired disorders of platelet function are an underdiagnosed cause of bleeding tendency. A 14-year-old girl developed moderate mucocutaneous bleeding two weeks after a infection successfully treated with clarithromycin. The patient was referred to us 7 months later for laboratory investigation of the persisting bleeding diathesis. The patient's personal and family histories were negative for bleeding disorders. Complete blood count, von Willebrand Factor levels and coagulation tests were normal; platelet aggregation, ATP secretion, δ-granules content and serum thromboxane B2 levels were defective. At follow-up visits, laboratory parameters and the bleeding diathesis progressively normalized within 2 years. The patient's condition is compatible with a diagnosis of acquired Storage Pool Deficiency (SPD), associated with defective thromboxane A2 production. To our knowledge, this is the first case of acquired, transient SPD with spontaneous remission. The pathogenic role of infection or clarithromycin is possible, albeit uncertain.
Topics: Humans; Female; Adolescent; Platelet Storage Pool Deficiency; Thromboxane A2; Blood Platelets; Hemorrhagic Disorders
PubMed: 38832819
DOI: 10.1080/09537104.2024.2358241 -
BMC Infectious Diseases Jun 2024Nonpharmaceutical interventions (NPIs) implemented to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have suppressed the spread...
BACKGROUND
Nonpharmaceutical interventions (NPIs) implemented to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have suppressed the spread of other respiratory viruses during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to explore the epidemiological trends and clinical characteristics of Mycoplasma pneumoniae (MP) infection among inpatient children with lower respiratory tract infection (LRTI) before and during the COVID-19 pandemic, and investigate the long-term effects of China's NPIs against COVID-19 on the epidemiology of MP among inpatient children with LRTI.
METHODS
Children hospitalised for LRTI at the Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine (Hangzhou, China) between January 2019 and December 2022 were tested for common respiratory pathogens, including Mycoplasma pneumoniae (MP), Chlamydia trachomatis (CT) and other bacteria. Clinical data on age, sex, season of onset, disease spectrum, and combined infection in children with MP-induced LRTI in the past 4 years were collected and analysed.
RESULTS
Overall, 15909 patients were enrolled, and MP-positive cases were 1971 (34.0%), 73 (2.4%), 176 (5.8%), and 952 (20.6%) in 2019, 2020, 2021, and 2022, respectively, with a significant statistical difference in the MP-positive rate over the 4 years (p <0.001). The median age of these children was preschool age (3-6 years), except for 2022, when they were school age (7-12 years), with statistical differences. Comparing the positive rates of different age groups, the school-age children (7-12 years) had the highest positive rate, followed by the preschoolers (3-6 years) in each of the 4 years. Compared among different seasons, the positive rate of MP in children with LRTI was higher in summer and autumn, whereas in 2020, it was highest in spring. The monthly positive rate peaked in July 2019, remained low from 2020 to 2021, and rebounded until 2022. Regarding the disease spectrum, severe pneumonia accounted for the highest proportion (46.3%) pre-pandemic and lowest (0%) in 2020.
CONCLUSION
Trends in MP detection in children with LRTIs suggest a possible correlation between COVID-19 NPIs and significantly reduced detection rates. The positivity rate of MP gradually rose after 2 years. The epidemic season showed some differences, but school-age children were more susceptible to MP before and during the COVID-19 pandemic.
Topics: Humans; China; COVID-19; Child; Child, Preschool; Male; Female; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Respiratory Tract Infections; Adolescent; Infant; SARS-CoV-2; Pandemics
PubMed: 38824572
DOI: 10.1186/s12879-024-09438-2 -
BMC Pediatrics May 2024Neurospecific Enolase (NSE), a multifunctional protein, is present in various tissues of the body and plays an important role in many disease processes, such as...
BACKGROUND
Neurospecific Enolase (NSE), a multifunctional protein, is present in various tissues of the body and plays an important role in many disease processes, such as infection, inflammation, tumours, injury, and immunity. In recent years, the application of NSE in respiratory diseases has become increasingly widespread and a research hotspot.
OBJECTIVE
This study aims to explore the relationship between NSE and childhood pneumonia, providing assistance for the diagnosis and assessment of pneumonia.
METHODS
Using prospective research and case-control methods, We selected 129 children with pneumonia hospitalised in Weifang People's Hospital from September 2020 to April 2022 as the case group. Among them were 67 cases of Mycoplasma pneumoniae pneumonia (MP+), 62 cases of non-Mycoplasma pneumoniae pneumonia (MP -), and 21 cases of severe pneumonia. At the same time, 136 children who underwent outpatient health examinations were selected as the control group. The levels of NSE, ESR, CRP in cases group and NSE in control group were measured separately.
RESULT
The NSE levels in the MP + group were 17.86 (14.29-22.54) ng/mL, while those in the MP- group were 17.89 (14.10-21.66) ng/mL, both of which were higher than the control group's NSE levels of 13.26(12.18,14.44) ng/mL (H = 46.92, P = 0.000). There was no statistically significant difference in NSE levels between the MP + and MP - groups (P > 0.05). The NSE level in the severe pneumonia group was 27.38 (13.95-34.06) ng/mL, higher than that in the mild pneumonia group, which was 17.68 (14.27-21.04) ng/mL, (P = 0.024). The AUC values for diagnosing pneumonia are NSE0.714, CRP0.539, and ESR0.535, with NSE having the highest diagnostic value.
CONCLUSION
Serum NSE can serve as an inflammatory indicator for paediatric pneumonia, which has important clinical guidance significance for the diagnosis, condition evaluation, and prognosis of paediatric pneumonia.
Topics: Humans; Phosphopyruvate Hydratase; Case-Control Studies; Female; Male; Child, Preschool; Child; Prospective Studies; Pneumonia, Mycoplasma; Pneumonia; Biomarkers; Infant; C-Reactive Protein; Clinical Relevance
PubMed: 38822291
DOI: 10.1186/s12887-024-04852-6 -
Emerging Infectious Diseases Jul 2024We report a large-scale outbreak of Mycoplasma pneumoniae respiratory infections encompassing 218 cases (0.8% of 26,449 patients tested) during 2023-2024 in Marseille,...
We report a large-scale outbreak of Mycoplasma pneumoniae respiratory infections encompassing 218 cases (0.8% of 26,449 patients tested) during 2023-2024 in Marseille, France. The bacterium is currently circulating and primarily affects children <15 years of age. High prevalence of co-infections warrants the use of a syndromic diagnostic strategy.
Topics: Humans; France; Disease Outbreaks; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Adolescent; Child; Child, Preschool; Male; Female; Adult; Infant; Young Adult; Middle Aged; History, 21st Century; Aged; Prevalence; Coinfection; Respiratory Tract Infections
PubMed: 38816344
DOI: 10.3201/eid3007.240315 -
Biosensors & Bioelectronics Sep 2024To address the limitations of the CRISPR/Cas12f1 system in clinical diagnostics, which require the complex preparation of single-stranded DNA (ssDNA) or in vitro...
To address the limitations of the CRISPR/Cas12f1 system in clinical diagnostics, which require the complex preparation of single-stranded DNA (ssDNA) or in vitro transcripts (RNA), we developed a fluorescent biosensor named PDTCTR (PAM-dependent dsDNA Target-activated Cas12f1 Trans Reporter). This innovative biosensor integrates Recombinase Polymerase Amplification (RPA) with the Cas12f_ge4.1 system, facilitating the direct detection of double-stranded DNA (dsDNA). PDTCTR represents a significant leap forward, exhibiting a detection sensitivity that is a hundredfold greater than the original Cas12f1 system. It demonstrates the capability to detect Mycoplasma pneumoniae (M. pneumoniae) and Hepatitis B virus (HBV) with excellent sensitivity of 10 copies per microliter (16.8 aM) and distinguishes single nucleotide variations (SNVs) with high precision, including the EGFR (L858R) mutations prevalent in non-small cell lung cancer (NSCLC). Clinical evaluations of PDTCTR have demonstrated its high sensitivity and specificity, with rates ranging from 93%-100% and 100%, respectively, highlighting its potential to revolutionize diagnostic approaches for infectious diseases and cancer-related SNVs.This research underscores the substantial advancements in CRISPR technology for clinical diagnostics and its promising future in early disease detection and personalized medicine.
Topics: Biosensing Techniques; Humans; CRISPR-Cas Systems; RNA, Guide, CRISPR-Cas Systems; Hepatitis B virus; DNA; Mycoplasma pneumoniae; CRISPR-Associated Proteins; Carcinoma, Non-Small-Cell Lung; Bacterial Proteins; Lung Neoplasms; Endodeoxyribonucleases; Pneumonia, Mycoplasma
PubMed: 38805891
DOI: 10.1016/j.bios.2024.116428 -
Zhongguo Dang Dai Er Ke Za Zhi =... May 2024To study the risk factors for embolism in children with refractory pneumonia (RMPP) and to construct a nomogram model for prediction of embolism.
OBJECTIVES
To study the risk factors for embolism in children with refractory pneumonia (RMPP) and to construct a nomogram model for prediction of embolism.
METHODS
This retrospective study included 175 children diagnosed with RMPP at Children's Hospital Affiliated toZhengzhou University from January 2019 to October 2023. They were divided into two groups based on the presence of embolism: the embolism group (=62) and the non-embolism group (=113). Multivariate logistic regression analysis was used to screen for risk factors of embolism in children with RMPP, and the R software was applied to construct the nomogram model for prediction of embolism.
RESULTS
Multivariate logistic regression analysis indicated that higher levels of D-dimer, interleukin-6 (IL-6) and neutrophil to lymphocyte ratio (NLR), lung necrosis, and pleural effusion were risk factors for embolism in children with RMPP (<0.05). The area under the curve of the nomogram model for prediction of embolism constructed based on the aforementioned risk factors was 0.912 (95%: 0.871-0.952, <0.05). The Hosmer-Lemeshow goodness-of-fit test showed that the model had a good fit with the actual situation (<0.05). Calibration and decision curve analysis indicated that the model had high predictive efficacy and clinical applicability.
CONCLUSIONS
Higher levels of D-dimer, IL-6 and NLR, lung necrosis, and pleural effusion are risk factors for embolism in children with RMPP. The nomogram model based on these risk factors has high clinical value for predicting embolism in children with RMPP.
Topics: Humans; Nomograms; Pneumonia, Mycoplasma; Female; Male; Child; Risk Factors; Retrospective Studies; Fibrin Fibrinogen Degradation Products; Interleukin-6; Child, Preschool; Logistic Models; Embolism; Neutrophils; Adolescent
PubMed: 38802909
DOI: 10.7499/j.issn.1008-8830.2311146 -
Infectious Diseases Now May 2024While sensitive molecular diagnostic tests enable accurate and rapid diagnosis of many respiratory viruses, their impact on antibiotic management remains uncertain. Our...
Real-life impact on antimicrobial prescription of Syndromic Molecular Testing in adults hospitalized in infectious disease departments. Respiratory Syndromic Molecular Testing panel: Is it worth it?
BACKGROUND
While sensitive molecular diagnostic tests enable accurate and rapid diagnosis of many respiratory viruses, their impact on antibiotic management remains uncertain. Our study aimed to evaluate the impact of respiratory syndromic molecular testing panel in real-life clinical practice.
METHOD
Retrospective descriptive study involving consecutive hospitalized patients in an infectious disease department who had been prescribed a respiratory syndromic molecular testing panel on nasopharyngeal swab samples (FilmArray Respiratory Panel 2 plus) during hospitalization from October 1st, 2021, to February 28th, 2023.
RESULTS
All in all, 94 out of 210 screened patients were included in the study. Syndromic molecular testing results influenced antibiotic treatment in seven cases: discontinuation in four cases (three virus identifications), changes in two (Mycoplasma pneumoniae positive cases), and initiation in two (negative viral PCRs and one positive bacterial culture).
CONCLUSION
In our study, respiratory syndromic molecular testing had low impact on antibiotic modification.
PubMed: 38801977
DOI: 10.1016/j.idnow.2024.104933 -
International Journal of Biometeorology May 2024Mycoplasma pneumoniae (M. pneumoniae) is a major cause of upper and lower respiratory tract infections and respiratory tract disease in humans. While accumulated pieces...
Mycoplasma pneumoniae (M. pneumoniae) is a major cause of upper and lower respiratory tract infections and respiratory tract disease in humans. While accumulated pieces of epidemiological evidence suggest an association between meteorological factors and the risk of M. pneumoniae pneumonia, comprehensive nationwide studies on this topic are lacking. We aimed to systematically assess the effect of meteorological factors such as mean temperature and relative humidity on the incidence of M. pneumoniae pneumonia in Japan over a 15-year period from 2005 to 2019. The exposure - response relationships between incidence of M. pneumoniae pneumonia, mean temperature, and relative humidity in all 47 Japanese prefectures (covering whole country) for 2005 - 2019 were quantified by using a distributed lag non-linear model for each prefecture and the estimates from all the prefectures were then pooled using a multivariate mete-regression model to derive nationwide average associations. The study encompassed a total of 162,845 M. pneumoniae pneumonia cases. Our findings indicate that seasonal variations in weekly mean temperature and relative humidity were positively associated with the incidence of M. pneumoniae pneumonia. Specifically, when considering - 1.3 °C as the reference, the relative risk (RR) peaked at 16.8 °C (with RRs of 1.50, 95% confidence interval (CI): 1.32-1.70). Similarly, when using 45.5% relative humidity as the reference, the RR reached its peak at 87.7% (with RRs of 1.49, 95% CI: 1.33-1.67). These results emphasize the necessity of implementing climate change adaptation strategies and public health interventions in regions vulnerable to M. pneumoniae pneumonia.
PubMed: 38801532
DOI: 10.1007/s00484-024-02712-7 -
IDCases 2024The case presented involves a 6-year-old boy admitted to the Department of Infectious Diseases with symptoms of fever, cough, and rash, ultimately diagnosed with...
The case presented involves a 6-year-old boy admitted to the Department of Infectious Diseases with symptoms of fever, cough, and rash, ultimately diagnosed with -induced rash and mucositis (MIRM). The patient exhibited typical MIRM rashes, characterized by severe damage to the oral mucosa and scattered rashes on his limbs and trunk.
PubMed: 38798827
DOI: 10.1016/j.idcr.2024.e01973