-
Clinical Medicine Insights.... 2019is one of the primary cause of community-acquired pneumonia (CAP) worldwide. However, scant data are available on the prevalence of etiological organisms for CAP in...
BACKGROUND
is one of the primary cause of community-acquired pneumonia (CAP) worldwide. However, scant data are available on the prevalence of etiological organisms for CAP in adolescent and adult Indian population.
OBJECTIVE
We performed a systematic review and meta-analysis to determine the contribution of in the causation of CAP in Indian patients aged 12 years or above.
METHODOLOGY
We performed a systematic search of both indexed and non-indexed publications using PubMed, databases of National Institute of Science Communication and Information Resources (NISCAIR), Annotated Bibliography of Indian Medicine (ABIM), Google Scholar, and hand search including cross-references using key terms 'community acquired pneumonia AND India'. All studies, published between January 1990 and January 2017, that evaluated Indian patients aged above 12 years with a confirmed diagnosis of CAP were eligible for inclusion. Our search retrieved a total of 182 studies, of which only 17 and 12 qualified for inclusion in the systematic review of all etiological organisms, and meta-analysis of , respectively.
RESULTS
A total of 1435 patients met the inclusion criteria. The pooled proportion of patients with infection was 19% (95% confidence interval [CI]: 12%-26%; I = 94.5% where I represents heterogeneity, < .01). Other major etiological agents are (15.5% [1.1%-35.5%]), (10.5% [1.6%-24.0%]), and (7.3% [2.5%-23.8%]).
CONCLUSIONS
Analysis found approximately a one-fifth proportion of adult Indian patients of CAP with infection, suggesting it as a leading organism for causing CAP compared with other etiological organisms.
PubMed: 31391784
DOI: 10.1177/1179548419862790 -
Medicine Apr 2019Several clinical studies have reported that inflammation factors (IF) are associated with Mycoplasma pneumoniae in children. However, no study systematically... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several clinical studies have reported that inflammation factors (IF) are associated with Mycoplasma pneumoniae in children. However, no study systematically investigated the association between IF and M pneumoniae in pediatric population. Thus, this study will explore the association between IF and pediatric M pneumoniae systematically.
METHODS
This study will search following databases of PUBMED, PsycINFO, Scopus, Cochrane Library, EMBASE, Web of Science, and Chinese Biomedical Literature Database from inception to the February 28, 2019 without any language limitations. We will cover clinical studies of M pneumoniae that report associations between IF and M pneumoniae. In addition, reference lists of relevant studies will also be identified to avoid missing any eligible studies. Two investigators will independently screen and select studies, and will assess the methodological quality for each study, which is evaluated by using Newcastle Ottawa Scale. Any disagreements will be settled down through discussion with a third investigator until consensus is reached.
RESULTS
This study will explore the associations between IF and M pneumoniae by assessing the changes of IF, such as interleukin (IL)-4, IL-5, IL-6, IL-10, IL-13, and IL-17 at different stages of M pneumoniae.
CONCLUSION
The findings of this study may provide most recent evidence for the associations between IF and M pneumoniae in pediatric populations.
ETHICS AND DISSEMINATION
Ethical approval is not needed in this study, because no individual patient data will be utilized in this study. The findings of this study are expected to be published at peer-reviewed journal or will be presented at professional conference.
PROSPERO REGISTRATION NUMBER
PROSPERO CRD42019125359.
Topics: Child; Humans; Inflammation; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Research Design
PubMed: 30985670
DOI: 10.1097/MD.0000000000015118 -
Journal of Clinical Laboratory Analysis Jun 2019Mycoplasma pneumoniae (M pneumoniae) is a common human etiology of respiratory infections. Nuclear acid sequence-based amplification (NASBA) shows good value for the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mycoplasma pneumoniae (M pneumoniae) is a common human etiology of respiratory infections. Nuclear acid sequence-based amplification (NASBA) shows good value for the detection of M pneumoniae that surpasses PCR. However, the optimal detection technology still remains to be identified. The purpose of this meta-analysis was to systematically evaluate the overall accuracy of NASBA for diagnosing M pneumoniae infections.
METHODS
The databases PubMed, Cochrane Library, Google Scholar, CNKI, Wang Fang, and Baidu Scholar were comprehensively searched from their initiation date to December 2017 for NASBA in the diagnosis of M pneumoniae infection. Meta-DiSc 1.4 statistical software was used to evaluate the sensitivity (SEN), specificity (SPE), negative likelihood ratio (-LR), positive likelihood ratio (+LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC). RevMan 5.2 statistical software was used for quality evaluation of the included articles. Publication bias was evaluated by funnel plot.
RESULTS
Six articles with high quality, including 10 studies, were finally included in this meta-analysis. The combined statistics results for the diagnosis of M pneumoniae infection by NASBA were 0.77 (SEN, 95% CI: 0.71 to 0.82); 0.98 (SPE, 95% CI: 0.98 to 0.99); 0.22 (-LR, 95% CI: 0.13 to 0.39); 50.38 (+ LR, 95% CI: 21.85 to 116.17); 292.72 (DOR, 95% CI: 95.02 to 901.75); and 0.9875 (the area under the curve of SROC).
CONCLUSION
Nuclear acid sequence-based amplification is a reliable technique to diagnose M pneumoniae infection. However, whether it can replace PCR and serology need to be further studied.
Topics: Humans; Mycoplasma pneumoniae; Odds Ratio; Pneumonia, Mycoplasma; ROC Curve; Self-Sustained Sequence Replication; Sensitivity and Specificity
PubMed: 30843291
DOI: 10.1002/jcla.22879 -
BMC Infectious Diseases Feb 2019A novel method, termed loop-mediated isothermal amplification (LAMP), was developed by Notomi et al. (2000). Individually published results have been reported that this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A novel method, termed loop-mediated isothermal amplification (LAMP), was developed by Notomi et al. (2000). Individually published results have been reported that this technology has been successfully applied to the detection of a variety of pathogens. However, the overall diagnostic accuracy of LAMP for Mycoplasma pneumoniae (MP) remains unclear. A meta-analysis was therefore performed to review the accuracy of LAMP for Mycoplasma pneumoniae.
METHODS
Cochrane Library and PubMed were systematically searched and checked for studies using LAMP for detecting mycoplasma pneumoniae. We used PCR as a reference standard to evaluate the quality of the studies eligible for inclusion in the meta-analysis. Then, the data from the studies were extracted by two independent assessors. Meta-DiSc 1.4 software was utilized to test the heterogeneity of sensitivity (SEN), specificity (SP), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnosis odds ratio (DOR). The pooled analysis results were plotted, and the summary receiver operating characteristic (SROC) curve was plotted by calculating the area under the curve (AUC). Generated pooled summary estimates (95% CIs) were calculated for the overall accuracy, and a bivariate meta-regression model was used for the meta-analysis.
RESULTS
Seven studies with nine fourfold tables were included in this meta-analysis. The pooled SEN and SPE for diagnosing Mycoplasma pneumoniae were 0.90 (95% CI: 0.87-0.93) and 0.98 (95% CI: 0.96-0.99), respectively. The PLR was 31.25 (95% CI: 14.83-65.87), NLR 0.10 (95% CI: 0.05-0.22), DOR 399.32 (95% CI: 172.01-927.00), and AUC 0.9892.
CONCLUSIONS
In conclusion, compared with PCR, LAMP is a valuable alternative method for Mycoplasma pneumoniae diagnosis in clinic with high sensitivity and specificity. However, more evidence is required to confirm that LAMP can fully replace other methods in the clinical diagnosis of MP.
Topics: Area Under Curve; Humans; Mycoplasma pneumoniae; Nucleic Acid Amplification Techniques; Odds Ratio; Pneumonia, Mycoplasma; ROC Curve; Sensitivity and Specificity
PubMed: 30782134
DOI: 10.1186/s12879-019-3799-4 -
Frontiers in Neurology 2018An association between Mycoplasma pneumoniae (MP) infection and stroke has been described, especially in children. However, current knowledge on this rare potential... (Review)
Review
An association between Mycoplasma pneumoniae (MP) infection and stroke has been described, especially in children. However, current knowledge on this rare potential cause of stroke is scant. The purpose of this systematic review of all published cases was to help better understand the relationships between recent MP infection and ischemic stroke on a clinical, radiological and pathophysiological perspective. A PubMed and Embase search was performed in September 2018 to identify all published cases of stroke occurring within 4 weeks after MP infection. Twenty-eight patients with ischemic stroke associated with MP infection were identified. Median age was 8 years (range: neonate to 57). The middle cerebral artery territory was involved in 25 (89%) patients. Fifteen (54%) patients had at least one arterial occlusion. Elevated D-dimer and/or fibrinogen was reported in 8 (29%) patients. Four patients had transient anticardiolipin IgM antibodies. Cerebrospinal fluid analysis showed pleocytosis in 7/20 (35%) patients (median: 19 leucocytes/μL, range: 10 to 63) and MP PCR was positive in 3/8 (38%) patients. The etiological work-up was considered inconclusive in 25 (89%) patients. Three (11%) patients died during follow-up, all of early respiratory deterioration. Neurological functional outcome was good in 22/27 (81%) patients. The association between MP infection and ischemic stroke in children and young adults is rare. Underlying pathogenesis might include hypercoagulability and vasculitis. Most patients achieve a favorable recovery. Whether MP infection could be a long-term risk factor for stroke by promoting atherosclerosis is uncertain and deserves further investigation.
PubMed: 30622505
DOI: 10.3389/fneur.2018.01109 -
Canadian Respiratory Journal 2018pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children. The objective of this study was to explore potential changes in levels of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children. The objective of this study was to explore potential changes in levels of serum tumor necrosis factor- (TNF-) and interferon- (IFN-) associated with pediatric MPP.
METHODS
This protocol has been registered (PROSPERO 2017: CRD42017077979). A literature search was performed in October 2017 using PubMed, Embase, the Cochrane Library, and other Chinese medical databases to identify studies. The meta-analysis was performed using Review Manager 5.3 software. Random-effect models were used to estimate mean differences (MDs) and 95% confidence intervals (CIs) of cytokine levels.
RESULTS
Twelve studies were included in the meta-analysis, encompassing 2,422 children with MPP and 454 healthy control children. Serum TNF- levels were significantly higher in children with MPP compared with healthy children (MD = 22.5, 95% CI = 13.78-31.22, < 0.00001), and there was significant heterogeneity across studies ( = 100%, < 0.00001). Subgroup analyses showed no evidence for a difference in serum TNF- levels between children with refractory and nonrefractory MPP. Serum IFN- levels did not significantly differ in children with MPP compared with healthy children (MD = 4.83, 95% CI = -3.27-12.93, =0.24).
CONCLUSIONS
Our meta-analysis showed that serum TNF- and IFN- levels were significantly elevated and unchanged, respectively, in pediatric MPP. Because infection by different pathogens has variable effects on serum TNF- and IFN- levels, the finding could be helpful in developing novel diagnostic methods.
Topics: Child; Humans; Interferon-gamma; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Tumor Necrosis Factor-alpha
PubMed: 30275916
DOI: 10.1155/2018/8354892 -
Antimicrobial Agents and Chemotherapy Sep 2018The duration of therapy for community-acquired pneumonia (CAP) remains undefined. We sought to investigate whether short-course antibiotic treatment for CAP is... (Meta-Analysis)
Meta-Analysis
The duration of therapy for community-acquired pneumonia (CAP) remains undefined. We sought to investigate whether short-course antibiotic treatment for CAP is associated with favorable clinical outcomes in adult patients. We systematically searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for studies comparing the effectiveness and safety between treatment regimens administered for ≤6 days and ≥7 days. We defined treatment for ≤6 days as short-course treatment and treatment for ≥7 days as long-course treatment. Twenty-one clinical trials (4,861 clinically evaluable patients) were included, and 19 out of 21 trials were randomized. Clinical cure was similar between the compared groups (4,069 patients, risk ratio [RR] = 0.99 [95% confidence interval {CI}, 0.97 to 1.01]), irrespective of patient setting (RR = 0.98 [95% CI, 0.96 to 1.00] for the outpatient setting and RR = 1.00 [95% CI, 0.92 to 1.09] for the inpatient setting) or severity of pneumonia (RR = 1.05 [95% CI, 0.96 to 1.14]). Also, relapses were similar between the short- and long-course treatment groups (1,923 patients, RR = 0.67 [95% CI, 0.30 to 1.46]). Short-course treatment was associated with fewer serious adverse events (1,923 patients, RR = 0.73 [95% CI, 0.55 to 0.97]) and, importantly, resulted in lower mortality than long-course treatment (2,802 patients, RR = 0.52 [95% CI, 0.33 to 0.82]). In CAP, short-course antibiotic treatment (≤6 days) is as effective as and potentially superior to, in terms of mortality and serious adverse events, longer-course treatment.
Topics: Adult; Anti-Bacterial Agents; Clinical Trials as Topic; Community-Acquired Infections; Humans; Pneumonia; Randomized Controlled Trials as Topic
PubMed: 29987137
DOI: 10.1128/AAC.00635-18 -
Neuromuscular Disorders : NMD May 2018Acute benign calf myositis is a rare infection-associated syndrome presenting with calf pain that occurs in epidemics or sporadically. Epidemic cases are usually...
Acute benign calf myositis is a rare infection-associated syndrome presenting with calf pain that occurs in epidemics or sporadically. Epidemic cases are usually associated with influenza virus type B. Sporadic cases, however, might be associated with a large number of microorganisms. Furthermore, during an outbreak there is a great alertness that promotes earlier diagnosis. In contrast, there is likely a lower awareness regarding the sporadic form, compromising early and correct diagnosis. In order to characterize the sporadic form of acute calf myositis and increase the knowledge of this condition, we systematically reviewed the literature reporting sporadic cases. We identified 72 reports, including 451 patients, 325 males and 126 females. Sporadic acute benign calf myositis affected subjects ≤18 years of age (N = 450; 99%), who followed a prodromal flu-like illness (N = 411; 91%), presented with pain and tenderness affecting only the calves for ≤1½ weeks (N = 441; 99%) and was never complicated by kidney involvement. The creatine kinase ratio was ≥10 in 310 (70%) out of 444 cases. Microbiological studies identified an infectious trigger in 181 cases, mostly influenza virus (type B more frequently than type A), Dengue, Ebstein-Barr or Parainfluenza virus and Mycoplasma pneumoniae. Sporadic acute benign calf myositis is a self-limited condition that can usually be diagnosed on a clinical basis. Unlike the epidemic form, many cases are due to microorganisms other than influenza virus B or A.
Topics: Acute Disease; Humans; Leg; Muscle, Skeletal; Myositis
PubMed: 29653699
DOI: 10.1016/j.nmd.2018.02.005 -
Journal of Translational Internal... Mar 2018The prevalence and microbial pattern reported for Community-acquired pneumonia (CAP) differ considerably and contemporary situation remains changing over time. We...
The prevalence and microbial pattern reported for Community-acquired pneumonia (CAP) differ considerably and contemporary situation remains changing over time. We therefore searched both international and domestic databases for relevant references and pooled incidence of CAP and etiological distribution were estimated separately between children and adults groups. The results showed that CAP remained a major public health issue in China, with a relatively higher incidence than that reported in Western countries. Although pathogens were not detected in nearly half of patients, Mycoplasma pneumoniae remained to be the most frequently detected agent across age groups, the detection yield of which was lower than that reported from other countries. Notably, the incidence of influenza virus A in adults was almost four times higher than that in children while the prevalence of respiratory syncytial virus was much less common in adults than that in children. Despite some limitations, the value of this review, approaching to systematically review grey published data, is to sketch out the contemporary epidemiological and etiological situation of CAP in our country, which could be useful to help policymakers and clinicians make informed choices and to inspire future studies and surveillance.
PubMed: 29607301
DOI: 10.2478/jtim-2018-0006 -
Human Vaccines & Immunotherapeutics Nov 2017The aim of this systematic review was to examine the etiology of community-acquired pneumonia (CAP) among Chinese children younger than 5 y and provide evidence for... (Review)
Review
BACKGROUND
The aim of this systematic review was to examine the etiology of community-acquired pneumonia (CAP) among Chinese children younger than 5 y and provide evidence for further cost-effectiveness analyses for vaccine development, diagnostic strategies and empirical treatments.
METHODS
The literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were obtained by searching PubMed, Embase, Web-of Science, and the Chinese databases Wanfang Data and China National Knowledge Infrastructure. All CAP etiological studies on children under 5 y of age from China published in Chinese and English between the years of 2001 and 2015 were included. A total of 48 studies were included in the final review, comprising 100 151 hospitalized children with CAP episodes. Heterogeneity and the percentage of variation between studies was analyzed based on Q statistic and I indices, respectively. Random effect models were used to calculate the weighted average rate in all analyses.
RESULTS
The most frequently detected bacterial agents were Klebsiella pneumoniae (5.4%), Streptococcus pneumoniae (5.2%), Escherichia coli (5.2%), Staphylococcus aureus (3.9%), Haemophilus influenza (3.6%) and Haemophilus parainfluenzae (3.3%). The most frequently detected viruses were human rhinovirus (20.3%, in just 2 studies), respiratory syncytial virus (RSV, 17.3%), human bocavirus (9.9%), parainfluenza virus (5.8%), human metapneumovirus (3.9%) and influenza (3.5%). Mycoplasma pneumoniae and Chlamydophila pneumoniae were identified in 9.5% and 2.9%, respectively, of children under 5 y of age with CAP.
CONCLUSION
This article provides the most comprehensive analysis to date of the factors contributing to CAP in children under 5 y of age. S. pneumoniae, H. influenzae and influenza were the most common vaccine-preventable diseases in children. Corresponding, vaccines should be introduced into Chinese immunization programs, and further economic evaluations should be conducted. RSV is common in Chinese children and preventative measures could have a substantial impact on public health. These data also have major implications for diagnostic strategies and empirical treatments.
Topics: Child, Hospitalized; Child, Preschool; China; Community-Acquired Infections; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Immunization Programs; Infant; Male; Mycoplasma pneumoniae; Pneumonia; Pneumonia, Mycoplasma; Respiratory Syncytial Virus Infections; Respiratory Syncytial Virus, Human; Staphylococcus aureus; Streptococcus pneumoniae; Viruses
PubMed: 28922613
DOI: 10.1080/21645515.2017.1371381