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Liu M, Meng K, Jiang J, Zhang L, Sun S. Comparison of serodiagnosis methods for community-acquired Mycoplasma pneumoniae respiratory tract infections in children. Medicine (Baltimore) 2023; 102:e34133. [PMID: 37478238 PMCID: PMC10662900 DOI: 10.1097/md.0000000000034133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/07/2023] [Indexed: 07/23/2023] Open
Abstract
This study aimed to evaluate the diagnostic value of chemiluminescence immunoassay (CLIA), passive particle agglutination (PPA), and indirect immunofluorescence assay (IFA) in detecting Mycoplasma pneumoniae infection in children. Serum samples from 165 children with acute community-acquired respiratory tract infections were examined using CLIA, PPA, and IFA, and consistency coefficient, specificity, and sensitivity were analyzed. Compared with the PPA (titer ≥ 1:160), the consistency coefficients of the immunoglobulin(Ig)M-CLIA, immunoglobulin(Ig)G-CLIA and IgM-IFA methods were 93.94%, 75.76%, and 83.64%, respectively. The positive likelihood ratio (PLR) and specificity of IgM-CLIA was 19.40 and 95.49%, respectively. The consistency coefficient of (IgM+IgG)-CLIA and PPA (titer ≥ 1:160) was 89.1%, and the sensitivity and negative predictive value of (IgM+IgG)-CLIA were 96.88% and 98.94%, respectively. CLIA MP-IgM has high concordance with PPA, and its specificity and sensitivity are higher than those of CLIA MP-IgG and IFA MP-IgM, suggesting its better diagnosis of early MP infection. The sensitivity and negative predictive value of CLIA MP (IgM+IgG) were higher than those of PPA or IFA, indicating that it should be considered as a priority in the diagnosis of MP infection.
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Affiliation(s)
- Mengyang Liu
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
| | - Ke Meng
- Department of Physical Examination of Qilu Hospital (Qingdao), Shandong University, Qingdao, P.R. China
| | - Jun Jiang
- Department of Physical Examination of Qilu Hospital (Qingdao), Shandong University, Qingdao, P.R. China
| | - Li Zhang
- Department of Immunology, School of Basic Medicine, Qingdao University, Qingdao, P.R. China
| | - Shiying Sun
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
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Peng QY, Zhang L, Deng H, Ye YM, Huang RL, Liang YQ, Feng SS, Li J, Luo XQ, Peng YL. Poor accuracy of single serological IgM tests in children with suspected acute Mycoplasma pneumoniae infection in Guangzhou, China. J Med Microbiol 2023; 72. [PMID: 36920846 DOI: 10.1099/jmm.0.001673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Introduction. Early and accurate diagnosis of Mycoplasma pneumoniae (MP) infection of children with pneumonia is at the core of treatment in clinical practice.Gap Statement. Serological immunoglobulin M (IgM) tests for MP infection of children in south China have been rarely described.Aim. To assess the diagnostic performance and clinical application of serodiagnosis of MP infection in paediatric pneumonia patients.Methodology. Serum samples from 144 children diagnosed with MP pneumonia were subjected to a particle agglutination (PA)-based IgM assay. Meanwhile, we used an established suspension array as the reference standard method for the detection of MP DNA in bronchoalveolar lavage fluid (BALF) from all patients to assess the reliability of serological assays.Results. When running immunological testing in single serum samples, 80.6 %(79/98) of cases were diagnosed with MP infection, whereas only 55 (56.1 %) cases were positive in MP DNA analysis. Furthermore, single serum tests for IgM during acute MP infection resulted in 85.5 % (47/55) sensitivity and 25.6 % (11/43) specificity. Nevertheless, immunological testing and MP DNA analysis yielded the same results when paired sera were available for MP IgM antibody testing.Conclusion. Paired serological IgM assays are necessary for the determination of an acute MP infection, whereas single serological IgM testing is unreliable. Moreover, even a short interval of two MP serological tests works well.
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Affiliation(s)
- Qiu-Ying Peng
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Liang Zhang
- Maternal and Child Health Research Institute, Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, 511400, PR China
| | - Hua Deng
- Maternal and Child Health Research Institute, Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, 511400, PR China
| | - Yu-Ming Ye
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Rui-Lin Huang
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Yao-Qiong Liang
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Su-Shi Feng
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Juan Li
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Xue-Qun Luo
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
| | - Yan-Li Peng
- Department of Pediatrics, Guangzhou Panyu Maternal and Children Health Hospital, Guangzhou Panyu District He Xian Memorial Hospital, Guangzhou, 511499, PR China
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Zhang Z, Dou H, Tu P, Shi D, Wei R, Wan R, Jia C, Ning L, Wang D, Li J, Dong Y, Xin D, Xu B. Serum cytokine profiling reveals different immune response patterns during general and severe Mycoplasma pneumoniae pneumonia. Front Immunol 2022; 13:1088725. [PMID: 36618370 PMCID: PMC9813340 DOI: 10.3389/fimmu.2022.1088725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Mycoplasma pneumoniae (MP) is an important human pathogen that mainly affects children causing general and severe Mycoplasma pneumoniae pneumonia (G/SMPP). In the present study, a comprehensive immune response data (33 cytokines) was obtained in school-age children (3-9 years old) during MPP, aiming to analyze the immune response patterns during MPP. At acute phase, changes of cytokines were both detected in GMPP (24/33) and SMPP (23/33) groups compared to the healthy group (p < 0.05), with 20 identical cytokines. Between MPP groups, the levels of 13 cytokines (IL-2, IL-10, IL-11, IL-12, IL-20, IL-28A, IL-32, IL-35, IFN-α2, IFN-γ, IFN-β, BAFF, and TSLP) were higher and three cytokines (LIGHT, OPN and CHI3L1) were lower in the SMPP group than in the GMPP group (p < 0.05). Function analysis reveals that macrophage function (sCD163, CHI3L1) are not activated in both MPP groups; difference in regulatory patterns of T cells (IL26, IL27, OPN, LIGHT) and defective activation of B cells (BAFF) were detected in the SMPP group compared to the GMPP group. Besides, the level of osteocalcin; sIL-6Rβ and MMP-2 are both decreased in MPP groups at acute and convalescent phases compared to the healthy group, among which the levels of sIL-6Rβ and MMP-2 showed negative correlations (p < 0.1) to the application of bronchial lavage in SMPP group, indicating their roles in the development of MPP. At the convalescent phase, more cytokines recovered in GMPP (18) than SMPP (11), revealing better controlled immune response during GMPP. These results reveal different immune response patterns during GMPP and SMPP. In addition, the differentiated cytokines may serve as potential indicators of SMPP; early intervention on immune response regulations may be helpful in reducing the severity of SMPP.
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Affiliation(s)
- Zhikun Zhang
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haiwei Dou
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Peng Tu
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Dawei Shi
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ran Wei
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Ruijie Wan
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chunmei Jia
- Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Lihua Ning
- Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Dongmei Wang
- Department of Pediatric, Baotou Fourth Hospital, Baotou, Inner Mongolia, China
| | - Jing Li
- Department of Pediatric, Beijing Chang Ping District Hospital of Traditional Chinese Medicine and Western Medicine, Beijing, China
| | - Yan Dong
- Department of Pediatric, Beijing Chang Ping District Hospital of Traditional Chinese Medicine and Western Medicine, Beijing, China
| | - Deli Xin
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Baoping Xu
- Department of Respiratory, Beijing Children’s Hospital, Capital Medical University, Beijing, China
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Wang T, Sun H, Lu Z, Jiang W, Dai G, Huang L, Wang M, Zhu C, Wang Y, Hao C, Yan Y, Chen Z. The CARDS toxin of Mycoplasma pneumoniae induces a positive feedback loop of type 1 immune response. Front Immunol 2022; 13:1054788. [PMID: 36532054 PMCID: PMC9752573 DOI: 10.3389/fimmu.2022.1054788] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background Within the past 3-5 years, Mycoplasma pneumoniae has become a major pathogen of community-acquired pneumonia in children. The pathogenic mechanisms involved in M. pneumoniae infection have not been fully elucidated. Methods Previous protein microarray studies have shown a differential expression of CXCL9 after M. pneumoniae infection. Here, we conducted a hospital-based study to explore the clinical significance of the type 1 immune response inflammatory factors interferon (IFN)-γ and CXCL9 in patients with M. pneumoniae pneumonia (MPP). Then, through in vitro experiments, we explored whether CARDS toxin stimulated F-DCs (dendritic cells incubated with Flt3L) to promote Th-cell differentiation; we also investigated the IFN-γ-induced CXCL9 secretion pathway in macrophages and the role of CXCL9 in promoting Th1 cell migration. Results The CXCL9 expression level was upregulated among patients with a higher fever peak, fever duration of greater than 7 days, an imaging manifestation of lobar or segmental, or combined pleural effusion (P<0.05). The peripheral blood levels of IFN-γ and CXCL9, which were higher in patients than in the healthy control group, were positively correlated with each other (r=0.502, P<0.05). In patients, the CXCL9 expression level was significantly higher in the bronchoalveolar lavage fluid (BALF) than in the peripheral blood, and the BALF CXCL9 expression level was higher than that in the healthy control group (all P<0.05). Our flow cytometry analysis revealed that M1-phenotype macrophages (CD16 + CD64 + CD163-) were predominant in the BALF from children with MPP. In in vitro experiments, F-DCs stimulated with CARDS toxin promoted the differentiation of CD4 + IFN-γ + Th (Th1) cells (P<0.05). Moreover, IFN-γ induced high levels of CXCL9 expression in M1-type macrophages in a dose-dependent and time-dependent manner. Additionally, macrophages transfection with STAT1-siRNA-1 downregulated the expression of CXCL9 (P<0.05), and CXCL9 promoted Th1 cell migration (P<0.05). Conclusions Our findings suggest that CARDS toxin induces a type 1 immune response positive feedback loop during M. pneumoniae infection; this putative mechanism may be useful in future investigations of immune intervention approaches for M. pneumoniae pneumonia.
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Affiliation(s)
- Ting Wang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Huiming Sun
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Zhitao Lu
- Department of Pediatrics, Zhangjiagang No.1 People’s Hospital, Affiliated Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Ge Dai
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Li Huang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Canhong Zhu
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China,*Correspondence: Zhengrong Chen, ; Yongdong Yan,
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China,*Correspondence: Zhengrong Chen, ; Yongdong Yan,
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Manoharan A, Ramya M, Chandy S, Ranjitha P, Hameed A, Nachiyar GS, Balasubramanian S. Evaluation of real-time PCR with serology for diagnosis of community acquired pneumonia caused by Mycoplasma pneumoniae. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Sun H, Li S, Wang T, Chen Z. Mycoplasma Pneumoniae Infection and Persistent Wheezing in Young Children: A Retrospective Case-Control Study. Front Pediatr 2022; 10:811086. [PMID: 35321015 PMCID: PMC8935056 DOI: 10.3389/fped.2022.811086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/11/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND To investigate the clinical characteristics of children with persistent wheezing (PW) with Mycoplasma pneumoniae (MP) DNA in bronchoalveolar lavage fluid (BALF). METHODS This retrospective case-control study included consecutive admitted children under 3 years of age who were diagnosed with PW and had MP DNA detected in BALF. Patients with mycoplasma pneumoniae pneumonia (MPP) and foreign-body aspiration (FBA) were enrolled as controls. The clinical characteristics of the groups were compared. RESULTS During the study period, there were 89 patients diagnosed with PW without structural anomalies of the conductive airways, and 30 of these patients (33.7%, 30/89) with MP DNA detected in the BALF were selected as the study group. We included 44 patients with MPP and 44 patients with FBA as controls. Patients with MPP were older and had a higher occurrence of fever and C-reactive protein (CRP) than patients with PW (all P < 0.001). The median MP DNA copy number in patients with MPP was higher than that of patients with PW (P = 0.004). The median level of MP IgG in patients with PW was lower than that of patients with MPP and higher than that of patients with FBA (all P < 0.001). MP DNA copy number positively correlated with age (r = 0.392, P = 0.001) and CRP (r = 0.235, P = 0.048). CONCLUSIONS Our study reveals that MP was highly detected in the BALF of PW patients. In addition, young patients with a low load of MP infection showed lower amounts of antibody, and a weak inflammatory response might be associated with PW.
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Affiliation(s)
- Huiming Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Shuxiang Li
- Department of Nuclear Medicine, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, China
| | - Ting Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
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Esposito S, Argentiero A, Gramegna A, Principi N. Mycoplasma pneumoniae: a pathogen with unsolved therapeutic problems. Expert Opin Pharmacother 2021; 22:1193-1202. [PMID: 33544008 DOI: 10.1080/14656566.2021.1882420] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Despite the amount of new information, the most effective approach for the diagnosis and treatment of Mycoplasma pneumoniae infections is not established. In this narrative review the pharmacological options for macrolide-resistant (ML) M. pneumoniae infections in children are discussed. AREAS COVERED Despite significant improvement in the diagnosis and in the definition of diseases potentially associated with this pathogen, not all the problems related to M. pneumoniae infection are solved. True epidemiology of M. pneumoniae diseases and the real role of this pathogen in extra-respiratory manifestations is still unestablished. This reflects on therapy. It is not known whether antibiotics are really needed in all the cases, independently of severity and localization. The choice of antibiotic therapy is debated as it is not known whether ML resistance has clinical relevance. Moreover, not precisely defined is the clinical importance of corticosteroids for improvement of severe cases, including those associated with ML-resistant strains. EXPERT OPINION Improvement in M. pneumoniae identification is mandatory to reduce antibiotics overuse , especially in the presence of ML-resistant strains. Priority for future studies includes the evaluation of the true benefit of therapeutic approaches including corticosteroids in patients with severe CAP and in those with extra-respiratory M. pneumoniae diseases.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - Alberto Argentiero
- Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - Andrea Gramegna
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Nicola Principi
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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