-
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 -
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 -
Experimental and Therapeutic Medicine Jul 2024Mycoplasmas, the smallest self-replicating prokaryotes without a cell wall, are the most prevalent and extensively studied species in humans. They significantly... (Review)
Review
Mycoplasmas, the smallest self-replicating prokaryotes without a cell wall, are the most prevalent and extensively studied species in humans. They significantly contribute to chronic respiratory tract illnesses and pneumonia, with children and adolescents being particularly vulnerable. () infections typically tend to be self-limiting and mild but can progress to severe or even life-threatening conditions in certain individuals. Extrapulmonary effects often occur without pneumonia, and both intrapulmonary and extrapulmonary complications operate through separate pathological mechanisms. The indirect immune-mediated damage of the immune system, vascular blockages brought on by vasculitis or thrombosis and direct harm from invasion or locally induced inflammatory cytokines are potential causes of extrapulmonary manifestations due to . Proteins associated with adhesion serve as the primary factor crucial for the pathogenicity of , relying on a specialized polarized terminal attachment organelle. The type and density of these host receptors significantly impact the adhesion and movement of , subsequently influencing the pathogenic mechanism and infection outcomes. Adjacent proteins are crucial for the proper assembly of the attachment organelle, with variations in the genetic domains of P1, P40 and P90 surfaces contributing to the variability of clinical symptoms and offering new avenues for developing vaccines against infections. causes oxidative stress within respiratory tract epithelial cells by adhering to host cells and releasing hydrogen peroxide and superoxide radicals. This oxidative stress enhances the vulnerability of host cells to harm induced by oxygen molecules. The lack of superoxide dismutase and catalase of bacteria allows it to hinder the catalase activity of the host cell, leading to the reduced breakdown of peroxides. Lung macrophages play a significant role in managing infection, identifying it via Toll-like receptor 2 and initiating the myeloid differentiation primary response gene 88-nuclear factor κΒ signaling cascade. However, the precise mechanisms enabling to evade intracellular host defenses remain unknown, necessitating further exploration of the pathways involved in intracellular survival. The present comprehensive review delves into the pathogenesis of infection within the pulmonary system and into extrapulmonary areas, outlining its impact.
PubMed: 38765654
DOI: 10.3892/etm.2024.12559 -
Alternative Therapies in Health and... May 2024Mycoplasma pneumoniae (MP) infection is a common respiratory illness in children, but the factors associated with its severity remain unclear.
Correlation and Clinical Significance of Changes in Serum Soluble P-selectin, D- dimer and Platelet Levels with the Severity of Mycoplasma Pneumoniae Infection in Children.
OBJECTIVE
Mycoplasma pneumoniae (MP) infection is a common respiratory illness in children, but the factors associated with its severity remain unclear.
METHODS
The clinical data of 136 children aged 5 to 12 years with MP infection in our hospital from March 2021 to March 2022 were retrospectively analyzed. According to the severity of the disease, they were divided into a mild group (74 cases) and a severe group (62 cases), and 80 healthy children who underwent physical examination in our hospital during the same period were selected as the control group. The general data, lung function indexes and laboratory examination indexes of the three groups of children were compared. Multivariate Logistic regression was used to analyze the factors affecting the development of severe MP infection in children. Pearson test was used to analyze the correlation between each influencing factor and mild and severe MP infection. The predictive Value of ROC curve analysis for the development of severe MP infection in children.
RESULTS
Univariate analysis showed that levels of white blood cell (WBC), neutrophil (Neu), sedimentation rate (ESR), fibrinogen (Fib), interleukin -5 (IL-5), interleukin -6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), lactate dehydrogenase (LDH), alanine aminotransferase (GPT), soluble P-selectin, and D-dimer were higher in the group with mild and severe MP pneumonia. Conversely, levels of interferon-γ(IFN-γ), serum calcium, serum phosphorus, 25-(OH)D3, and PLT were lower.. In addition, Multivariate analysis showed that the increase of Neu, IL-5, CRP, LDH, GPT, soluble P-selectin, D- dimer and the decrease of PLT were the risk factors for the development of severe MP infection in children (P < .05). Meanwhile, the AUC of soluble P-selectin, D- dimer level, PLT and their combination were 0.796 (95% CI: 0.729~0.860, sensitivity=82.95%, specificity=80.16%), 0.721 (95% CI: 0.648~0.788, sensitivity=76.21%, specificity=73.65%), 0.820 (95% CI: 0.860, sensitivity=88.36%, specificity=96.42%), and 0.872 (95% CI: 0.823 ~ 0.920, sensitivity=96.42%, specificity=93.28%) respectively.
CONCLUSION
The levels of serum soluble P-selectin, D- dimer, and PLT had high predictive Value for the development of MP infection. These findings can help clinicians better understand MP and focus on children with elevated p-selectin, d-dimer, and platelet levels, emphasizing the importance of timely treatment and appropriate interventions to prevent complications.
PubMed: 38758155
DOI: No ID Found -
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 May 2024With the atypical rise of ycoplasma neumoniae infection (MPI) in 2023, prompt studies are needed to determine the current epidemic features and risk factors with...
With the atypical rise of ycoplasma neumoniae 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 pediatric patients in Southern China. Clinical data was collected from 133674 patients admitted into investigational hospitals from June 1, 2017, to November 30, 2023. Metagenomic next-generation sequencing (mNGS) data were retrieved based on sequence positive samples from 299 pediatric patients for macrolide resistance-associated mutations analysis. Pearson's chi-squared test was used to compare categorical variables between different time frames. The monthly average cases of pediatric common respiratory infection diseases were 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 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 ongoing surveillance is necessary to understand the impact of post pandemic on transmission disruption on epidemic season and severity of clinical outcomes in different scenarios.
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 -
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 -
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