Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Metho...Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.展开更多
BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneu...BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.展开更多
Objective The aim of this study is to investigate the macrolide resistance rate and molecular type with multiple-locus variable-number tandem-repeat analysis(MLVA)of Mycoplasma pneumoniae of Beijing in 2016 in pediatr...Objective The aim of this study is to investigate the macrolide resistance rate and molecular type with multiple-locus variable-number tandem-repeat analysis(MLVA)of Mycoplasma pneumoniae of Beijing in 2016 in pediatric patients.Methods Real-time quantitative polymerase chain reaction(PCR)was used to identify M.pneumoniae,and MLVA was performed.The domain V of the 23 S rRNA was sequenced to detect macrolide-resistant point mutations.We also investigated the activities of antibiotics against M.pneumoniae isolates in vitro.Results The PCR detection rate of M.pneumoniae in children in Beijing was 40%,and the macrolide resistance rate was 66%.The A2063 G mutation in the 23 S rRNA V region is the dominant mutation(137/146,93.84%),whereas the A2064 G mutation is rare(9/146,6.16%).Seventy-three samples were typed successfully by MLVA typing,including 86.3%(63/73)were MLVA type 4-5-7-2,and 13.7%(10/73)were MLVA type 3-5-6-2.No other types were found.No strains were resistant to levofloxacin or tetracycline.Conclusion In 2016,a specific decrease in the macrolide resistance rate occurred in Beijing.The detection rate and macrolide resistance rate of outpatients are lower than those of inpatients.The A2063 G mutants M.pneumoniae have high levels of resistance to erythromycin and azithromycin.The primary MLVA type is 4-5-7-2,followed by 3-5-6-2.No other MLVA types were detected.No strains resistant to tetracycline or levofloxacin were found in vitro.展开更多
Objective Mutations in 23 S rRNA gene are known to be associated with macrolide resistance in Mycoplasma pneumoniae(M. pneumoniae). However, these mutations alone do not fully explain the high resistance rates in Asia...Objective Mutations in 23 S rRNA gene are known to be associated with macrolide resistance in Mycoplasma pneumoniae(M. pneumoniae). However, these mutations alone do not fully explain the high resistance rates in Asia. The aim of this study was to investigate other possible mutations involved in macrolide resistance in M. pneumoniae. Methods The whole genomes of 10 clinical isolates of M. pneumoniae with macrolide resistance were sequenced by Illumina Hi Seq2000 platform. The role of the macrolide-specific efflux transporter was assessed by efflux-pump inhibition assays with reserpine and carbonyl cyanide m-chlorophenyl-hydrazone(CCCP). Results A total of 56 single nucleotide polymorphisms(SNPs) were identified in 10 clinical isolates in comparison to the reference strains M129 and FH. Strikingly, 4 of 30 SNPs causing non-synonymous mutations were clustered in macrolide-specific efflux system gene mac B encoding macrolide-specific efflux pump protein of the ATP-binding cassette transporter family. In assays of the minimal inhibitory concentrations(MIC) of macrolide antibiotics in the presence of the efflux pump inhibitors caused a significant decrease of MICs, even under detectable levels in some strains. Conclusion Our study suggests that macrolide efflux pump may contribute to macrolide resistance in M. pneumoniae in addition to the common point mutations in 23 S r RNA gene.展开更多
Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth ...Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth Hospital of Baotou city,Inner Mongolia Autonomous Region,were collected and divided into general treatment(AF)and probiotic(AFY)groups,according to the treatment of“combined Bifidobacterium,Lactobacillus,Enterococcus,and Bacillus cereus tablets live”.Highthroughput 16S rDNA sequencing was used to identify intestinal flora.Results Intestinal flora abundance and diversity in children with MPP were decreased.Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls(P<.05).When compared with healthy controls,the proportion of Enterorhabdus was lower in the AF group,while the proportion of Lachnoclostridium was higher(P<0.05).The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus,Lachnoclostridium,Roseburia,and Erysipelatoclostridium proportions were higher.The proportion of Escherichia coli-Shigella in the AFY group after treatment was decreased(P<0.05).Conclusions The intestinal flora of children with MPP is disturbed,manifested as decreased abundance and diversity,and decreased Bifidobacteria.Our probiotic mixture partly improved intestinal flora disorders.展开更多
BACKGROUND To the best of our knowledge,cases of Kawasaki disease(KD)occurring at the age of 12 are rare,even in Asia where the incidence of KD is high.We report a case of lymph-node-first presentation of KD(NFKD)in a...BACKGROUND To the best of our knowledge,cases of Kawasaki disease(KD)occurring at the age of 12 are rare,even in Asia where the incidence of KD is high.We report a case of lymph-node-first presentation of KD(NFKD)in a 12-year-old girl with Mycoplasma pneumoniae(M.pneumoniae)infection who presented with prolonged fever and lymphadenitis refractory to macrolide antibiotics.CASE SUMMARY A previously healthy 12-year-old girl presented with fever,myalgia,sore throat,swelling,and tenderness on the right side of the neck.She was initially diagnosed with lymphadenitis caused by M.pneumoniae refractory to macrolide antibiotics.She had elevated brain natriuretic peptide(BNP)levels.Finally,the patient was diagnosed with KD.After receiving intravenous immunoglobulin,the fever resolved,and her symptoms improved.CONCLUSION NFKD should be differentiated from adolescent lymphadenitis presenting with prolonged fever by checking the BNP level early.展开更多
In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded en...In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic.展开更多
Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked ...Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked with coronary plaque rupture, in association with vessel dilatation and adventitial inflammation. Pathogens are recognized by Toll-like receptors (TLRs) development of the inflammatory process. Objective: Here, we studied whether co-infection by Cp and Mp was involved in the increased inflammation present in AAA and if it could be associated with deficient expression of TLRs. We compared human samples of AAA with non-dilated human aortic atherosclerotic lesions, regarding the amount of Cp and Mp antigens, and expression of TLR2 and TLR4. Methods: Two groups of aorta fragments were analyzed: G1 (n = 13) moderate atherosclerosis and G2 (n = 14) AAA samples, through immunohisto-chemistry and in situ hybridization methods. Results: Mp and Cp antigens in intima/medial layer were greater in G2 than G1, with no difference in adventitia. TLR2 and TLR4 were higher in G2 than G1 adventitia fat. There was a correlation between Mp versus TLR2 and of TLR4 in intima/medial layer and in adventitia of G1, but there was a lack of correlation in G2. In Cp adventitia, the correlation in G1 was high with TLR2 but not with TLR4, and in G2 the correlation was positive for both TLRs. Conclusion: This study favors the concept that symbiotic co-infection by Cp and Mp participates in the pathogenesis of AAA. It also emphasizes that adventitial fat is the initial site for colonization of these bacteria that probably reach the tissue through vasa vasorum. An exacerbated immune reaction is not efficient to control the infection that reaches and proliferates in high levels at the medial and intimal layer, contributing to the development of vessel dilatation.展开更多
Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagn...Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagnostic method.This study was performed to explore the relationship between the qPCR findings,clinical symptoms,and inflammatory markers in children with MPP.Four hundred children with MPP have been enrolled in this retrospective analysis.All clinical and analytical information,including mycoplasma pneumoniae(MP)PCR results,has been collected.Based on the PCR results,the patients were divided into groups with load values(copy number)<105(54 cases),2105 and<106(71 cases),2106 and<107(112 cases),>107 and<108(114 cases),and>108(49 cases).The clinical features(including symptoms and signs)and inflammatory indicators were compared among the groups.The incidence of high fever(above 39℃),thermal peak during the entire hospitalization period,fever duration,days of hospitalization,and plasma lactate dehydrogenase(LDH)levels were statistically correlated with the MP PCR load value in children with MPP.The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization>duration of fever>period of hospitalization>LDH value>C-reactive protein value.The host immune response was significantly greater in the complication group than in the non-complication group.展开更多
In order to investigate the role played by platelet derived growth factor-BB (PDGF-BB) in the pathogenesis of pulmonary interstitial fibrosis in rats repeatedly infected with mycoplasma pneumoniae (MP), a rat MP infec...In order to investigate the role played by platelet derived growth factor-BB (PDGF-BB) in the pathogenesis of pulmonary interstitial fibrosis in rats repeatedly infected with mycoplasma pneumoniae (MP), a rat MP infection model was developed by infecting rats with MP for 9 times during a period of 24 weeks with a technique of ultrasonic nebulizing inhalation. Then in situ hybridization was performed with PDGF-B chain cDNA probe and the results were quantitatively analyzed to measure the changes in PDGF-B chain mRNA expression in the lung tissue. The results showed that: (1) MP polymerase chain reaction (PCR) tests showed positive results in the bronchoalveotar lavage fluid (BALF) from all of the MP-infected rats (n=4) while they were all negative in BALF from the control animals (n=4, P【0.05) and in BALF from those rats both infected with MP and, at the same time, treated with erythromycin (n=4, P【0.05). Bacterial cultures of the bronchial and lung tissue were negative in all three groups. The展开更多
Objective To establish and evaluate a real-time PCR assay to detect Mycoplasma pneumoniae (M.pneumoniae) in clinical specimens.Methods By analysing the whole p1 gene sequence of 60 M.pneumoniae clinical isolates in Be...Objective To establish and evaluate a real-time PCR assay to detect Mycoplasma pneumoniae (M.pneumoniae) in clinical specimens.Methods By analysing the whole p1 gene sequence of 60 M.pneumoniae clinical isolates in Beijing of China,an optimized real-time PCR assay (MpP1) using p1 gene conserved region was designed.The specificity and sensitivity of this assay were evaluated and compared with other two reported assays (RepMp1 and Mp181) using 40 positive and 100 negative clinical specimens.Results The detection limit of the new assay was 8.1 fg (about 1～3CFU) M.pneumoniae DNA.The sensitivity of MpP1,RepMp1,and Mp181 assays appeared to be 100%,100%,and 85%,respectively.Conclusion MpP1 assay is suitable for the detection of M.pneumoniae in Chinese clinical specimens.展开更多
Kawasaki disease (KD) is an acute febrile systemic vasculitis occurring predominantly in young children less than 5 years of age. Although imperfectly known, the aetiopathogenesis of KD would be secondary to immunolog...Kawasaki disease (KD) is an acute febrile systemic vasculitis occurring predominantly in young children less than 5 years of age. Although imperfectly known, the aetiopathogenesis of KD would be secondary to immunological abnormalities that could constitute a favourable terrain for neoplasms. We report on a case in a 2-year-old girl who presented clinical manifestations compatible with Kawasaki disease complicated by coronary aneurysm. Aetiopathological investigations revealed M. pneumoniae infection as specific IgM were present in the serum (Elisa). The patient was initially treated by intravenous immunoglobulins (IVIG) and aspirin to anti-inflammatory dose. Following a few days of desquamation, resolution of the symptomatology occurred. Four weeks later she developed disseminated tumorous syndrome. Lymph node biopsy revealed massive infiltration by large cells lymphomatous proliferation. Histologic and immunophenotypic findings were characteristic of ALK-1+ anaplastic large cell lymphoma. Four weeks later, the patient died from a severe nosocomial infection complicated by septic shock. Our observation is the first cases describing the association between anaplastic large cell lymphoma, KD and M. pneumoniae. Immunologic disorder due to KD and M. pneumoniae infection may play probably a central role for malignancy.展开更多
In order to investigate the effect of vitamin A (VA) on the secretion of IFN-γ and IL-4 in Mycoplasma Pneumoniae (MP)-induced A549 cells, A549 cells were co-cultured with MP for different time lengths and then the le...In order to investigate the effect of vitamin A (VA) on the secretion of IFN-γ and IL-4 in Mycoplasma Pneumoniae (MP)-induced A549 cells, A549 cells were co-cultured with MP for different time lengths and then the levels of IFN-γ and IL-4 in the cell culture supernatants were detected before and after treatment with different concentrations of VA by using the enzyme-linked immu-nosorbent assay ( ELISA). The results showed that the level of IFN-γ and IL-4 in the supernatants of MP-induced A549 cells was much higher than that in non-induced cells (P<0.01). After application of VA, IL-4 level was not increased until the concentration of VA was up to 0.5×10-5 mol/L (P<0.01). However, with concentration of VA increased up to 1×10-4 mol/L, IL-4 was significantly suppressed (P<0.01). It was concluded that MP could induce the secretion of IFN-γ and IL-4 in A549 cells. VA could inhibit the secretion of IFN-γ and increase the IL-4 level in MP-induced A549 cells. However, high concentration of VA had an inhibitory effect on the secretion of IL-4 as well as on the IFN-γ. These data provided a theoretical basis for the application of VA in MP pneumonia in the clinical practice.展开更多
We established a diagnostic model to predict acute Mycoplasma pneumoniae(M.pneumonia)infection in elderly Community-acquired pneumonia(CAP)patients.We divided 456 patients into acute and non-acute M.pneumoniae infecti...We established a diagnostic model to predict acute Mycoplasma pneumoniae(M.pneumonia)infection in elderly Community-acquired pneumonia(CAP)patients.We divided 456 patients into acute and non-acute M.pneumoniae infection groups.Binary logistic regression and receiver operating characteristic(ROC)curves were used to establish a predictive model.The following independent factors were identified:age≥70 years;serum c TNT level≥0.05 ng/m L;lobar consolidation;mediastinal lymphadenopathy;and antibody titer in the acute phase≥1:40.The area under the ROC curve of the model was 0.923 and a score of≥7score predicted acute M.pneumoniae infection in elderly patients with CAP.The predictive model developed in this study has high diagnostic accuracy for the identification of elderly acute M.pneumoniae infection.展开更多
Objective: To confirm whether Mycoplasma pneumoniae(MP) are present in reproductive tract of STD patients in China. Methods: Application of nested PCR (nPCR) and DNA sequencing to test samples of urethral/vaginal swab...Objective: To confirm whether Mycoplasma pneumoniae(MP) are present in reproductive tract of STD patients in China. Methods: Application of nested PCR (nPCR) and DNA sequencing to test samples of urethral/vaginal swabs with MP culture confirmation of several nPCR positive patients. Results: 74 of 786 STD patients were positive for MP by nPCR, with a rate of 9.4%. Of the 484 male patients, 10.5%were positive, and among the 302 female patients, 7.6%were positive. There was no significant difference between them (P>0.05). Of 12 cases of MP positive samples by nPCR,4 cases were first generation culture-positive, and one ofthem passed to the next generation successfully. DNAsequencing was performed on the nPCR product of oneswab sample and one MP culture isolation. The determinedsequence was identical to the typical MP strain. Conclusion: In China, MP are present in reproductivetract of both male and female STD natients.展开更多
To analyze the bronchial epithelial cell damage induced by Mycoplasma pneumonia and the therapeutic effects of clarithromycin, we observed bronchial tissue damage by using a mouse model and performing immunostaining a...To analyze the bronchial epithelial cell damage induced by Mycoplasma pneumonia and the therapeutic effects of clarithromycin, we observed bronchial tissue damage by using a mouse model and performing immunostaining and scanning electron microscopy. The immunostaining study showed that M. pneumoniae-labeled fluorescence was found on the mucosal epithelium of mice, 6 days after inoculation. Clarithromycin treatment reduced the fluorescence. In this study, we demonstrated that the morphological alterations of bronchial mucosa, including the shortening and loss of ciliavisualized by scanning electron microscopy, and the inflammatory cell migration in the submucosal tissue visualized by differential interference contrast microscopy, were induced by mycoplasmal infection. We also showed that clarithromycin treatment, when administered from the first day of inoculation, attenuated both the bronchial epithelial damage and inflammatory cell migration in the submucosal tissue. These results suggest that the therapeutic effects of clarithromycin against mycoplasmal infection, may be due to its antibacterial and anti-inflammatory activities.展开更多
AIM To evaluate the increase in diagnostic yield, by using IgA in addition to IgM, instead of IgM alone, in relation to the age of the patients.METHODS The study considered 1067 blood samples from patients with clinic...AIM To evaluate the increase in diagnostic yield, by using IgA in addition to IgM, instead of IgM alone, in relation to the age of the patients.METHODS The study considered 1067 blood samples from patients with clinical signs of lower respiratory tract infections, tested for anti-Mycoplasma IgG, IgM and IgA antibody.RESULTS The increase in diagnostic yield with IgA, compared to IgM detection alone was of 3.5% with statistically significant differences between age groups(0.8% for those equal/under 50 years of age and 4.3% for those over 50).CONCLUSION Our findings demonstrate that IgA detection lead to a twofold increase in the number of diagnoses among the older age groups, but it did not result in relevant increase among the younger age groups.展开更多
As an important pathogen of respiratory tract infection, Mycoplasma pneumoniae (MP) may not only lead to primary atypical pneumonia but also cause systemic organ conditions.MP causes respiratory tract infection among ...As an important pathogen of respiratory tract infection, Mycoplasma pneumoniae (MP) may not only lead to primary atypical pneumonia but also cause systemic organ conditions.MP causes respiratory tract infection among school-age children and is also an important infectious agent for adult respiratory tract infection. Intensive studies on roles of MP infection on the innate immune system significantly aid development of targeted therapy drugs. Epidemic studies on associated symptoms also help in clinical prevention and diagnosis and show importance to personalized treatment utilizing different drugs for different patients. This study summarizes the abovementioned three points based on MP studies in recent years.展开更多
Objective: We present descriptive epidemiology of Mycoplasma infection using the (Nursery) School Absenteeism Surveillance System ((N)SASSy) in addition to national official sentinel surveillance for infectious diseas...Objective: We present descriptive epidemiology of Mycoplasma infection using the (Nursery) School Absenteeism Surveillance System ((N)SASSy) in addition to national official sentinel surveillance for infectious diseases (NOSSID). It is expected to be helpful for early detection and response to outbreak of Mycoplasma infection and also to be useful for antimicrobial resistance measures. Method: The study period was 2010-2014 seasons. The study area was the whole of Ibaraki prefecture, Japan. NOSSID reports the number of patients with Mycoplasma pneumonia from 13 sentinel hospitals. We compare the number of patients and the incidence rate of NOSSID with the same information in (N)SASSy. Result: In NOSSID, the largest number of patients by age was 27 patients of one year old in 2012. (N)SASSy showed that the incidence rate in the elementary schools is high in 2011 and 2012. Especially, the second grade students were the highest. Discussion: Even though Mycoplasma infection is well known as a pediatric disease, we showed that second grade was the highest in incidence at first. Because (N)SASSy is timely and real-time information collection, evaluation and sharing countermeasures with (nursery) schools, public health centers, and physicians are useful for students and nursery school children, and communities. Conclusion: Because mycoplasma infection is common pediatric infectious diseases and because some patients rarely develop severe infections, we must prevent larger outbreaks. (N)SASSy can provide timely intervention at the initial phase of outbreak by monitoring situations in (nursery) schools and comparing data to baseline information.展开更多
基金supported by the Evidence-based Capacity Building Project of Traditional Chinese medicine of the National Administration of Traditional Chinese Medicine(60102)the Fundamental Research Funds for the Central Public Welfare Research Institutes(49425).
文摘Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.
文摘BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.
基金supported by the National Natural Science Foundation of China[Grant No.81271890]Beijing Municipal Science&Technology Commission Grant[No.Z161100000116088 and Z1711000017081]
文摘Objective The aim of this study is to investigate the macrolide resistance rate and molecular type with multiple-locus variable-number tandem-repeat analysis(MLVA)of Mycoplasma pneumoniae of Beijing in 2016 in pediatric patients.Methods Real-time quantitative polymerase chain reaction(PCR)was used to identify M.pneumoniae,and MLVA was performed.The domain V of the 23 S rRNA was sequenced to detect macrolide-resistant point mutations.We also investigated the activities of antibiotics against M.pneumoniae isolates in vitro.Results The PCR detection rate of M.pneumoniae in children in Beijing was 40%,and the macrolide resistance rate was 66%.The A2063 G mutation in the 23 S rRNA V region is the dominant mutation(137/146,93.84%),whereas the A2064 G mutation is rare(9/146,6.16%).Seventy-three samples were typed successfully by MLVA typing,including 86.3%(63/73)were MLVA type 4-5-7-2,and 13.7%(10/73)were MLVA type 3-5-6-2.No other types were found.No strains were resistant to levofloxacin or tetracycline.Conclusion In 2016,a specific decrease in the macrolide resistance rate occurred in Beijing.The detection rate and macrolide resistance rate of outpatients are lower than those of inpatients.The A2063 G mutants M.pneumoniae have high levels of resistance to erythromycin and azithromycin.The primary MLVA type is 4-5-7-2,followed by 3-5-6-2.No other MLVA types were detected.No strains resistant to tetracycline or levofloxacin were found in vitro.
基金supported by the grants from National Nature Science Foundation of China(81601778 and 81672062)the Beijing Natural Science Foundation(7152025)Beijing Talents Fund(2015000021469G192)
文摘Objective Mutations in 23 S rRNA gene are known to be associated with macrolide resistance in Mycoplasma pneumoniae(M. pneumoniae). However, these mutations alone do not fully explain the high resistance rates in Asia. The aim of this study was to investigate other possible mutations involved in macrolide resistance in M. pneumoniae. Methods The whole genomes of 10 clinical isolates of M. pneumoniae with macrolide resistance were sequenced by Illumina Hi Seq2000 platform. The role of the macrolide-specific efflux transporter was assessed by efflux-pump inhibition assays with reserpine and carbonyl cyanide m-chlorophenyl-hydrazone(CCCP). Results A total of 56 single nucleotide polymorphisms(SNPs) were identified in 10 clinical isolates in comparison to the reference strains M129 and FH. Strikingly, 4 of 30 SNPs causing non-synonymous mutations were clustered in macrolide-specific efflux system gene mac B encoding macrolide-specific efflux pump protein of the ATP-binding cassette transporter family. In assays of the minimal inhibitory concentrations(MIC) of macrolide antibiotics in the presence of the efflux pump inhibitors caused a significant decrease of MICs, even under detectable levels in some strains. Conclusion Our study suggests that macrolide efflux pump may contribute to macrolide resistance in M. pneumoniae in addition to the common point mutations in 23 S r RNA gene.
文摘Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth Hospital of Baotou city,Inner Mongolia Autonomous Region,were collected and divided into general treatment(AF)and probiotic(AFY)groups,according to the treatment of“combined Bifidobacterium,Lactobacillus,Enterococcus,and Bacillus cereus tablets live”.Highthroughput 16S rDNA sequencing was used to identify intestinal flora.Results Intestinal flora abundance and diversity in children with MPP were decreased.Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls(P<.05).When compared with healthy controls,the proportion of Enterorhabdus was lower in the AF group,while the proportion of Lachnoclostridium was higher(P<0.05).The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus,Lachnoclostridium,Roseburia,and Erysipelatoclostridium proportions were higher.The proportion of Escherichia coli-Shigella in the AFY group after treatment was decreased(P<0.05).Conclusions The intestinal flora of children with MPP is disturbed,manifested as decreased abundance and diversity,and decreased Bifidobacteria.Our probiotic mixture partly improved intestinal flora disorders.
文摘BACKGROUND To the best of our knowledge,cases of Kawasaki disease(KD)occurring at the age of 12 are rare,even in Asia where the incidence of KD is high.We report a case of lymph-node-first presentation of KD(NFKD)in a 12-year-old girl with Mycoplasma pneumoniae(M.pneumoniae)infection who presented with prolonged fever and lymphadenitis refractory to macrolide antibiotics.CASE SUMMARY A previously healthy 12-year-old girl presented with fever,myalgia,sore throat,swelling,and tenderness on the right side of the neck.She was initially diagnosed with lymphadenitis caused by M.pneumoniae refractory to macrolide antibiotics.She had elevated brain natriuretic peptide(BNP)levels.Finally,the patient was diagnosed with KD.After receiving intravenous immunoglobulin,the fever resolved,and her symptoms improved.CONCLUSION NFKD should be differentiated from adolescent lymphadenitis presenting with prolonged fever by checking the BNP level early.
基金supported by the military medical innovation research project of PLAGH (CX19015)program for military medical innovation (18CXZ038)。
文摘In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic.
基金CNPQ (National Counsel of Technological and Scientific Development of Federal Government grant 132905/ 2006-0.) FAPESP (Foundation that supports research in the State of São Paulo, grant 562444/2007).
文摘Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked with coronary plaque rupture, in association with vessel dilatation and adventitial inflammation. Pathogens are recognized by Toll-like receptors (TLRs) development of the inflammatory process. Objective: Here, we studied whether co-infection by Cp and Mp was involved in the increased inflammation present in AAA and if it could be associated with deficient expression of TLRs. We compared human samples of AAA with non-dilated human aortic atherosclerotic lesions, regarding the amount of Cp and Mp antigens, and expression of TLR2 and TLR4. Methods: Two groups of aorta fragments were analyzed: G1 (n = 13) moderate atherosclerosis and G2 (n = 14) AAA samples, through immunohisto-chemistry and in situ hybridization methods. Results: Mp and Cp antigens in intima/medial layer were greater in G2 than G1, with no difference in adventitia. TLR2 and TLR4 were higher in G2 than G1 adventitia fat. There was a correlation between Mp versus TLR2 and of TLR4 in intima/medial layer and in adventitia of G1, but there was a lack of correlation in G2. In Cp adventitia, the correlation in G1 was high with TLR2 but not with TLR4, and in G2 the correlation was positive for both TLRs. Conclusion: This study favors the concept that symbiotic co-infection by Cp and Mp participates in the pathogenesis of AAA. It also emphasizes that adventitial fat is the initial site for colonization of these bacteria that probably reach the tissue through vasa vasorum. An exacerbated immune reaction is not efficient to control the infection that reaches and proliferates in high levels at the medial and intimal layer, contributing to the development of vessel dilatation.
基金This study was supported by the Chongqing Science and Health Joint Medical Research Project(No.8187011078)。
文摘Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia(MPP),quantitative polymerase chain reaction(qPCR)has become a useful diagnostic method.This study was performed to explore the relationship between the qPCR findings,clinical symptoms,and inflammatory markers in children with MPP.Four hundred children with MPP have been enrolled in this retrospective analysis.All clinical and analytical information,including mycoplasma pneumoniae(MP)PCR results,has been collected.Based on the PCR results,the patients were divided into groups with load values(copy number)<105(54 cases),2105 and<106(71 cases),2106 and<107(112 cases),>107 and<108(114 cases),and>108(49 cases).The clinical features(including symptoms and signs)and inflammatory indicators were compared among the groups.The incidence of high fever(above 39℃),thermal peak during the entire hospitalization period,fever duration,days of hospitalization,and plasma lactate dehydrogenase(LDH)levels were statistically correlated with the MP PCR load value in children with MPP.The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization>duration of fever>period of hospitalization>LDH value>C-reactive protein value.The host immune response was significantly greater in the complication group than in the non-complication group.
文摘In order to investigate the role played by platelet derived growth factor-BB (PDGF-BB) in the pathogenesis of pulmonary interstitial fibrosis in rats repeatedly infected with mycoplasma pneumoniae (MP), a rat MP infection model was developed by infecting rats with MP for 9 times during a period of 24 weeks with a technique of ultrasonic nebulizing inhalation. Then in situ hybridization was performed with PDGF-B chain cDNA probe and the results were quantitatively analyzed to measure the changes in PDGF-B chain mRNA expression in the lung tissue. The results showed that: (1) MP polymerase chain reaction (PCR) tests showed positive results in the bronchoalveotar lavage fluid (BALF) from all of the MP-infected rats (n=4) while they were all negative in BALF from the control animals (n=4, P【0.05) and in BALF from those rats both infected with MP and, at the same time, treated with erythromycin (n=4, P【0.05). Bacterial cultures of the bronchial and lung tissue were negative in all three groups. The
基金supported by the National Key Program for Infectious Diseases of China,No.2008ZX10004-002
文摘Objective To establish and evaluate a real-time PCR assay to detect Mycoplasma pneumoniae (M.pneumoniae) in clinical specimens.Methods By analysing the whole p1 gene sequence of 60 M.pneumoniae clinical isolates in Beijing of China,an optimized real-time PCR assay (MpP1) using p1 gene conserved region was designed.The specificity and sensitivity of this assay were evaluated and compared with other two reported assays (RepMp1 and Mp181) using 40 positive and 100 negative clinical specimens.Results The detection limit of the new assay was 8.1 fg (about 1～3CFU) M.pneumoniae DNA.The sensitivity of MpP1,RepMp1,and Mp181 assays appeared to be 100%,100%,and 85%,respectively.Conclusion MpP1 assay is suitable for the detection of M.pneumoniae in Chinese clinical specimens.
文摘Kawasaki disease (KD) is an acute febrile systemic vasculitis occurring predominantly in young children less than 5 years of age. Although imperfectly known, the aetiopathogenesis of KD would be secondary to immunological abnormalities that could constitute a favourable terrain for neoplasms. We report on a case in a 2-year-old girl who presented clinical manifestations compatible with Kawasaki disease complicated by coronary aneurysm. Aetiopathological investigations revealed M. pneumoniae infection as specific IgM were present in the serum (Elisa). The patient was initially treated by intravenous immunoglobulins (IVIG) and aspirin to anti-inflammatory dose. Following a few days of desquamation, resolution of the symptomatology occurred. Four weeks later she developed disseminated tumorous syndrome. Lymph node biopsy revealed massive infiltration by large cells lymphomatous proliferation. Histologic and immunophenotypic findings were characteristic of ALK-1+ anaplastic large cell lymphoma. Four weeks later, the patient died from a severe nosocomial infection complicated by septic shock. Our observation is the first cases describing the association between anaplastic large cell lymphoma, KD and M. pneumoniae. Immunologic disorder due to KD and M. pneumoniae infection may play probably a central role for malignancy.
文摘In order to investigate the effect of vitamin A (VA) on the secretion of IFN-γ and IL-4 in Mycoplasma Pneumoniae (MP)-induced A549 cells, A549 cells were co-cultured with MP for different time lengths and then the levels of IFN-γ and IL-4 in the cell culture supernatants were detected before and after treatment with different concentrations of VA by using the enzyme-linked immu-nosorbent assay ( ELISA). The results showed that the level of IFN-γ and IL-4 in the supernatants of MP-induced A549 cells was much higher than that in non-induced cells (P<0.01). After application of VA, IL-4 level was not increased until the concentration of VA was up to 0.5×10-5 mol/L (P<0.01). However, with concentration of VA increased up to 1×10-4 mol/L, IL-4 was significantly suppressed (P<0.01). It was concluded that MP could induce the secretion of IFN-γ and IL-4 in A549 cells. VA could inhibit the secretion of IFN-γ and increase the IL-4 level in MP-induced A549 cells. However, high concentration of VA had an inhibitory effect on the secretion of IL-4 as well as on the IFN-γ. These data provided a theoretical basis for the application of VA in MP pneumonia in the clinical practice.
基金supported by the Capital Medical Development and Scientific Research Fund(2009-1033)and the Science and Technology Plan of Beijing City(Z101107050210018)
文摘We established a diagnostic model to predict acute Mycoplasma pneumoniae(M.pneumonia)infection in elderly Community-acquired pneumonia(CAP)patients.We divided 456 patients into acute and non-acute M.pneumoniae infection groups.Binary logistic regression and receiver operating characteristic(ROC)curves were used to establish a predictive model.The following independent factors were identified:age≥70 years;serum c TNT level≥0.05 ng/m L;lobar consolidation;mediastinal lymphadenopathy;and antibody titer in the acute phase≥1:40.The area under the ROC curve of the model was 0.923 and a score of≥7score predicted acute M.pneumoniae infection in elderly patients with CAP.The predictive model developed in this study has high diagnostic accuracy for the identification of elderly acute M.pneumoniae infection.
文摘Objective: To confirm whether Mycoplasma pneumoniae(MP) are present in reproductive tract of STD patients in China. Methods: Application of nested PCR (nPCR) and DNA sequencing to test samples of urethral/vaginal swabs with MP culture confirmation of several nPCR positive patients. Results: 74 of 786 STD patients were positive for MP by nPCR, with a rate of 9.4%. Of the 484 male patients, 10.5%were positive, and among the 302 female patients, 7.6%were positive. There was no significant difference between them (P>0.05). Of 12 cases of MP positive samples by nPCR,4 cases were first generation culture-positive, and one ofthem passed to the next generation successfully. DNAsequencing was performed on the nPCR product of oneswab sample and one MP culture isolation. The determinedsequence was identical to the typical MP strain. Conclusion: In China, MP are present in reproductivetract of both male and female STD natients.
文摘To analyze the bronchial epithelial cell damage induced by Mycoplasma pneumonia and the therapeutic effects of clarithromycin, we observed bronchial tissue damage by using a mouse model and performing immunostaining and scanning electron microscopy. The immunostaining study showed that M. pneumoniae-labeled fluorescence was found on the mucosal epithelium of mice, 6 days after inoculation. Clarithromycin treatment reduced the fluorescence. In this study, we demonstrated that the morphological alterations of bronchial mucosa, including the shortening and loss of ciliavisualized by scanning electron microscopy, and the inflammatory cell migration in the submucosal tissue visualized by differential interference contrast microscopy, were induced by mycoplasmal infection. We also showed that clarithromycin treatment, when administered from the first day of inoculation, attenuated both the bronchial epithelial damage and inflammatory cell migration in the submucosal tissue. These results suggest that the therapeutic effects of clarithromycin against mycoplasmal infection, may be due to its antibacterial and anti-inflammatory activities.
文摘AIM To evaluate the increase in diagnostic yield, by using IgA in addition to IgM, instead of IgM alone, in relation to the age of the patients.METHODS The study considered 1067 blood samples from patients with clinical signs of lower respiratory tract infections, tested for anti-Mycoplasma IgG, IgM and IgA antibody.RESULTS The increase in diagnostic yield with IgA, compared to IgM detection alone was of 3.5% with statistically significant differences between age groups(0.8% for those equal/under 50 years of age and 4.3% for those over 50).CONCLUSION Our findings demonstrate that IgA detection lead to a twofold increase in the number of diagnoses among the older age groups, but it did not result in relevant increase among the younger age groups.
文摘As an important pathogen of respiratory tract infection, Mycoplasma pneumoniae (MP) may not only lead to primary atypical pneumonia but also cause systemic organ conditions.MP causes respiratory tract infection among school-age children and is also an important infectious agent for adult respiratory tract infection. Intensive studies on roles of MP infection on the innate immune system significantly aid development of targeted therapy drugs. Epidemic studies on associated symptoms also help in clinical prevention and diagnosis and show importance to personalized treatment utilizing different drugs for different patients. This study summarizes the abovementioned three points based on MP studies in recent years.
文摘Objective: We present descriptive epidemiology of Mycoplasma infection using the (Nursery) School Absenteeism Surveillance System ((N)SASSy) in addition to national official sentinel surveillance for infectious diseases (NOSSID). It is expected to be helpful for early detection and response to outbreak of Mycoplasma infection and also to be useful for antimicrobial resistance measures. Method: The study period was 2010-2014 seasons. The study area was the whole of Ibaraki prefecture, Japan. NOSSID reports the number of patients with Mycoplasma pneumonia from 13 sentinel hospitals. We compare the number of patients and the incidence rate of NOSSID with the same information in (N)SASSy. Result: In NOSSID, the largest number of patients by age was 27 patients of one year old in 2012. (N)SASSy showed that the incidence rate in the elementary schools is high in 2011 and 2012. Especially, the second grade students were the highest. Discussion: Even though Mycoplasma infection is well known as a pediatric disease, we showed that second grade was the highest in incidence at first. Because (N)SASSy is timely and real-time information collection, evaluation and sharing countermeasures with (nursery) schools, public health centers, and physicians are useful for students and nursery school children, and communities. Conclusion: Because mycoplasma infection is common pediatric infectious diseases and because some patients rarely develop severe infections, we must prevent larger outbreaks. (N)SASSy can provide timely intervention at the initial phase of outbreak by monitoring situations in (nursery) schools and comparing data to baseline information.
