[Epidemiological and clinical analysis of community-acquired Mycoplasma pneumonia in children from a Spanish population, 2010-2015]

The Diagnostic Value of High-Resolution Computed Tomography Features Combined with Mycoplasma Pneumoniae Ribonucleic Acid Load Detection for Refractory Mycoplasma Pneumonia

The aim of this study was to investigate the value of high-resolution computed tomography (CT) images and mycoplasma pneumoniae (MP) ribonucleic acid (RNA) load detection in the early diagnosis of refractory mycoplasma pneumoniae (RMP) and provide more methods for the diagnosis and treatment of RMP. Seventy children with MP were divided into the RMP group (H1 group, 31 cases) and the MP group (H2 group, 39 cases) according to pathological findings, and all of them underwent CT scanning. MP-RNA load and genotype distribution were analyzed in both groups, and the diagnostic efficacy of CT combined with MP-RNA load for RMP was calculated. The sensitivity of children in the H1 group to erythromycin (59.17% vs 71.56%) and clarithromycin (53.21% vs 67.03%) was lower than that in the H2 group, and the resistance rate of children in the H1 group to erythromycin (71.43% vs 67.53%) and clarithromycin (64.24% vs 50.37%) was higher than that in the H2 group (P < 0.05); the regression coefficients between lactate dehydrogenase (LDH) and the MPLI value of RMP were −0.064 and −0.413, respectively, which were significantly negatively correlated (P < 0.05); the accuracy (96.5%), sensitivity (92.5%), and specificity (88%) of CT + MP-RNA in the diagnosis of RMP were significantly higher than those of CT alone (91%, 88%, and 82%) and MP-RNA alone (88%, 84.5%, and 74%), which were significantly different (P < 0.05). The results of high MP-RNA load detection can be used as an indicator to predict RMP, and the diagnostic efficacy is significantly improved after combination with high-resolution CT, with high clinical application value.

Etiology and efficacy of anti-microbial treatment for community-acquired pneumonia in adults requiring hospital admission in Ukraine

BACKGROUND AND AIM

Empiric therapy of community-acquired pneumonia (CAP) remains the standard care and guidelines are mostly based on published data from the United States or Europe. In this study, we determined the bacterial etiology of CAP and evaluated the clinical outcomes under antimicrobial treatment of CAP in Ukraine.

METHODS

A total of 98 adult subjects with CAP and PORT risk II-IV were recruited for the study. The sputum diagnostic samples were obtained from all patients for causative pathogen identification. Subjects were randomly assigned in a 1:1 ratio to receive delafloxacin 300 mg (n=51) or moxifloxacin 400 mg (n=47) with blinding placebo. The switch to oral treatment was after a minimum of 6 IV doses according to clinical criteria. The total duration of antibacterial treatment was 5-10 days. In vitro susceptibility of pathogens to delafloxacin and other comparator antibiotics was determined.

RESULTS

The most frequently isolated pathogens in adults with CAP were S. pneumoniae - 19.5%, M. pneumoniae - 15.3%, H. influenzae - 13.2%, S. aureus - 10.5%, K. pneumoniae - 10.1%, and H. parainfluenzae - 6.4%. All isolates of S. pneumoniae, S. aureus, M. pneumoniae had sufficient susceptibility to appropriate antibiotics. 9.0% of H. influenzae strains were susceptible to azithromycin. 94.8 % of patients had a successful clinical response to delafloxacin at the end of treatment and 93.9 % - at test-of-cure.

CONCLUSIONS

In Ukraine, the major bacterial agents that induced CAP in adults were S. pneumoniae, M. pneumoniae, H. influenzae, S. aureus, K. pneumoniae, H. parainfluenzae, E. cloacae, L. pneumophila. Delafloxacin is a promising effective antibiotic for monotherapy for CAP in adults and could be used in cases of antimicrobial-resistant strains.

Pulmonary and Extrapulmonary Manifestations in Hospitalized Children with Mycoplasma Pneumoniae Infection

Mycoplasma pneumoniae (MP) is one of the main causes of both upper and lower respiratory infections in school-aged children, accounting for up to 40% of community-acquired pneumonia. Younger children are also affected, and extrapulmonary manifestations have been recently reported in the pediatric population. We carried out a retrospective analysis of MP-positive patients admitted to the Pediatric Emergency Unit of S. Orsola Malpighi University Hospital in Bologna, the largest tertiary pediatric referral center in the Emilia–Romagna region, Northern Italy, between 2012 and 2020. We identified 145 patients with MP infection (82 males and 63 females), 27% of which were younger than 2 years; the median age was 5 years (interquartile range 1–9). The clinical presentation partially differed between age groups. School-aged children were more likely to have a chest X-ray-confirmed pneumonia (p = 0.013), while younger children required oxygen therapy more often (p = 0.048). Seventy-four children (51%) showed extrapulmonary manifestations, mainly gastrointestinal (30%) and dermatological (14%). Neurological symptoms were more frequent in children older than 6 years (p = 0.006). The rate of other extrapulmonary manifestations did not differ significantly between age groups. This study shows that MP infection is a frequent cause of pediatric hospitalization, including of children younger than 2 years. Clinicians should be aware of the variable clinical expressions of MP, including extrapulmonary manifestations, to achieve a correct diagnosis and determine appropriate treatment.

Epidemiology and molecular identification of mycoplasma pneumoniae associated with respiratory infections in Zhejiang province, China, 2008-2017

Introduction

Mycoplasma pneumoniae is a common cause of respiratory infections in humans. The aim of this study was to investigate the infection of Mycoplasma pneumoniae (MP) in patients with acute respiratory tract infections in Zhejiang Province from 2008 to 2017, and to provide evidence for the early diagnosis and prevention of MP pneumonia.

Methods

MP‐DNA was detected in nasopharyngeal swabs of patients with acute respiratory tract infection by real‐time fluorescent PCR (TaqMan probe). Statistical analysis and epidemiological investigation were carried out on the test results.

Results

There were 10 296 patients with acute respiratory tract infection in Zhejiang Provincial People's Hospital from 2008 to 2017, including 4387 females and 5909 males. A total of 1251 MP‐DNA–positive patients were detected, with a total positive rate of 12.2% (1251/10296). Among 1251 patients with MP infection, 571 were female positive, with an average positive rate of 13.0% (571/4387), and 680 were male positive, with a positive rate of 11.5% (680/5909). From 2008 to 2017, the positive rates were 22.8% (33 cases), 20.9% (211 cases), 20.9% (350 cases), 5.5% (70 cases), 11.7% (136 cases), 15.2% (190 cases), 7.8% (94 cases), 5.9% (62 cases), 7.8% (56 cases), and 6.0% (49 cases), respectively. Of 1251 MP‐DNA–positive patients, 1243 (99.4%) were younger than 18 years old.

Conclusions

Mycoplasma pneumoniae infection mainly occurs from late summer to autumn and in the age below 18 years, suggesting that early diagnosis and prevention of MP infection in adolescents should be emphasized.

Immunoglobulin M profile of viral and atypical pathogens among children with community acquired lower respiratory tract infections in Luzhou, China

Background

Community-acquired lower respiratory tract infections (CA-LRTIs) are the primary cause of hospitalization among children globally. A better understanding of the role of atypical pathogen infections in native conditions is essential to improve clinical management and preventive measures. The main objective of this study was to detect the presence of 7 respiratory viruses and 2 atypical pathogens among hospitalized infants and children with community-acquired lower respiratory tract infections in Luzhou via an IgM test.

Methods

Overall, 6623 cases of local hospitalized children with 9 pathogen-IgM results from 1st July 2013 to 31st Dec 2016 were included; multidimensional analysis was performed.

Results

1) Out of 19,467 hospitalized children with lower respiratory tract infections, 6623 samples were collected, for a submission ratio of 33.96% (6623 /19467). Of the total 6623 serum samples tested, 5784 IgM stains were positive, for a ratio of 87.33% (5784 /6623). Mycoplasma pneumoniae (MP) was the dominant pathogen (2548 /6623, 38.47%), with influenza B (INFB) (1606 /6623, 24.25%), Legionella pneumophila serogroup 1 (LP1) (485 /6623, 7.32%) and parainfluenza 1, 2 and 3(PIVs) (416 /6623, 6.28%) ranking second, third and fourth, respectively.

2) The distribution of various pathogen-IgM by age group was significantly different (χ² = 455.039, P < 0.05).

3) Some pathogens were found to be associated with a certain age of children and seasons statistically.

Conclusions

The dominant positive IgM in the area was MP, followed by INFB, either of which prefers to infect children between 2 years and 5 years in autumn. The presence of atypical pathogens should not be underestimated clinically as they were common infections in the respiratory tract of children in the hospital.