Mycoplasma Research Articles

Influence of COVID-19 public health restrictions on community-acquired pneumonia pathogens in children in Henan, China: a multicenter retrospective study

ObjectiveTo investigate the distribution of pathogens and epidemiological changes in children hospitalized with community-acquired pneumonia (CAP) during and after the COVID-19 pandemic public health restrictive measures. aiming to provide a foundation for clinical diagnosis, treatment, and policy formulation.MethodsThis multicenter retrospective study spanned January 2019 to December 2023. The study included 78,256 children hospitalized for CAP in four hospitals in Henan, China, among which 27,580 cases (35.2%) were tested for pathogens using multiplex real-time fluorescent polymerase chain reaction (PCR). The pathogens detected include Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Haemophilus influenzae (HI), respiratory syncytial virus (RSV), influenza A virus (Flu A), influenza B virus (Flu B), and Mycoplasma pneumoniae (MP).ResultsPathogens were identified in 18,690 of the 27,580 children, resulting in a 67.8% positive detection rate. Of these cases, 15,105 (54.8%) were single pathogen infections and 3,585 (13%) were mixed pathogen infections. The pathogen positivity rate was lowest in the first year of the COVID-19 pandemic (2020), at 54.7%, and peaked at 79.1% in 2023, after public health restrictions were lifted. During the COVID-19 pandemic (2020–2022), seasonal variation in pathogen prevalence was disrupted. Post-restriction, there was a significant increase in RSV and MP cases. SP remained the leading bacterial cause of CAP, especially in young children. RSV was the predominant viral pathogen, particularly affecting infants. MP showed a rising trend with age, yet it also affected younger individuals.ConclusionThe COVID-19 pandemic altered the epidemiological characteristics of pathogens in children with CAP. This impact is likely to persist, necessitating enhanced surveillance of CAP pathogens to mitigate the healthcare burden in children.Clinical trial numberNot applicable.

Molecular detection and genetic characterization of hemotropic mycoplasmas in goats and fleas from Thailand

Arthropod vectors play a crucial role in the transmission of hemotropic mycoplasmas, small bacteria that infect red blood cells in a wide range of animals and humans globally, leading to intravascular infections. Traditional Giemsa-stained thin blood smears, used for diagnosing hemotropic mycoplasmas through microscopic examination, have low sensitivity and are effective only when bacteremia levels are high. This study aimed to employ molecular methods to detect and genetically characterize hemotropic mycoplasmas in goats as well as investigate the potential role of fleas as vectors. Blood and flea samples were collected concurrently from goats on 16 farms across seven provinces in Thailand from January 2017 to October 2023. The 16 S rRNA, 23 S rRNA, and rnpB genes of hemoplasmas were amplified and sequenced. All fleas were identified morphologically and molecularly through DNA barcoding of the cytochrome oxidase I gene. A total of 78 out of 500 goats (15.6%), three pooled flea samples (3/6, 50%), and one individual flea (1/49, 2.04%) tested positive for hemoplasmas and all fleas were identified as Ctenocephalides orientis. BLASTN searches utilizing the three genetic markers revealed that the hemoplasmas detected in this study showed 97.81–100% similarity to Mycoplasma ovis and Candidatus Mycoplasma haemovis, which have been previously reported in sheep, goats, and humans, suggesting their zoonotic potential. The sequences were grouped into 28 unique nucleotide sequence types (ntSTs) based on minor variations in the 16 S rRNA gene. Hemotropic mycoplasma infection was significantly associated with farm locations and seasonality of sample collection (p < 0.0001), indicating that farm management practices or environmental conditions may play a critical role in the epidemiology of these infections. This study represents the first report of hemotropic mycoplasmas in goats in Thailand, confirms their presence in fleas, and provides valuable insights for farm management, such as guiding the rational use of insecticides and antibiotics.

Preparation and Characterization of Tiamulin-Loaded Niosomes for Oral Bioavailability Enhancement in Mycoplasma-Infected Broilers

Mycoplasma infections pose significant challenges in the poultry industry, necessitating effective therapeutic interventions. Tiamulin, a veterinary antibiotic, has demonstrated efficacy against Mycoplasma species. However, the emergence of resistant Mycoplasma species could dramatically reduce the therapeutic potential, contributing to economic losses. Optimizing the tiamulin’s pharmacokinetic profile via nanocarrier incorporation could enhance its therapeutic potential and reduce the administration frequency, ultimately reducing the resistant strain emergence. Niosomes, a type of self-assembled non-ionic surfactant-based nanocarrier, have emerged as a promising drug delivery system, offering improved drug stability, sustained release, and enhanced bioavailability. In this study, niosomal nanocarriers encapsulating tiamulin were prepared, characterized and assessed in Mycoplasma-inoculated broilers following oral administration. Differential scanning colorimetry (DSC) confirmed the alterations in the crystalline state following components integration into the self-assembled structures formed during the formulation procedure. Transmission electron microscopy (TEM) showed the spherical nanostructure of the formed niosomes. The formulated nanocarriers exhibited a zeta potential and average hydrodynamic diameter of −10.65 ± 1.37 mV and 339.67 ± 30.88 nm, respectively. Assessment of the pharmacokinetic parameters following oral administration to Mycoplasma gallisepticum-infected broilers revealed the ability of the niosomal nanocarriers to increase the tiamulin’s bioavailability and systemic exposure, marked by significantly higher area under the curve (AUC) (p &lt; 0.01) and prolonged elimination half-life (T1/2) (p &lt; 0.05). Enhanced bioavailability and prolonged residence time are crucial factors in maintaining therapeutic concentrations at reduced doses and administration frequencies. This approach provides a viable strategy to decrease the risk of subtherapeutic levels, thereby mitigating the development of antibiotic resistance. The findings presented herein offer a sustainable approach for the efficient use of antibiotics in veterinary medicine.

Epidemiological characteristics of respiratory pathogens infections among children after the removal of non-pharmaceutical interventions in central China

BackgroundDuring the COVID-19 pandemic between 2020 and 2022 in China, various non-pharmaceutical interventions (NPIs) were implemented to reduce the spread of SARS-CoV-2 and other respiratory pathogens. From 2023, China downgraded the management of COVID-19, and compliance with NPIs was no longer mandatory. This study aimed to reveal the epidemiological characteristics of respiratory pathogens in 2023 after the removal of NPIs in central China.MethodsRespiratory specimens of children with acute respiratory infections (ARIs) were obtained to detect seven common respiratory pathogens, including influenza A (FluA), influenza B (FluB), adenovirus (ADV), human rhinovirus (HRV), human respiratory syncytial virus (HRSV), human metapneumovirus (HMPV), Mycoplasma pneumoniae (MP). From January 2022 to December 2023, a total of 5423 specimens were collected, including 1122 children in 2022 and 4301 children in 2023.ResultsOne or more pathogens were detected in 62.50% specimens in 2023, significantly higher than that in 2022 (44.12%). HRV (13.81%) was the most common pathogen in 2022, whereas MP (24.67%) was predominant in 2023. There was no significant difference in the overall prevalence of HRV, HRSV and HMPV between 2022 and 2023. HRSV was the most common pathogen in the < 1 years children both in 2022 and 2023. However in the ≥ 7 years group, FluB was the predominant pathogen in 2022 whereas MP ranked first in 2023. Co-detection were significantly more frequent in 2023 compared to 2022.ConclusionsThe removal of NPIs significantly increased the infection rates of the respiratory pathogens among children. Some NPIs, such as wearing mask and hand hygiene are necessary to decrease the prevalence of certain pathogens.

Significance of respiratory virus coinfection in children with Mycoplasma pneumoniae pneumonia

ObjectiveMycoplasma pneumoniae is a major causative pathogen in community-acquired pneumonia. Respiratory viral coinfections in children with Mycoplasma pneumoniae pneumonia (MPP) are not uncommon and cause severe clinical manifestations. This study aims to investigate the impacts of viral coinfection in MPP patients and hopes to offer novel insights for discriminating between MPP and MPP coinfection.MethodsThis study recruited 748 children hospitalized for MP pneumonia between January 2021 and October 2023. Patients were classified into two groups: MPP coinfected with respiratory virus group and MPP group. All children underwent polymerase chain reaction testing for respiratory pathogens. Baseline clinical features and demographic data were obtained retrospectively through medical records.ResultsThe retrospective study included 748 patients, with a viral coinfection rate of 38.75%. Patients in the MPP coinfected with respiratory virus group have a higher disease burden than those in the non-coinfection group. Our findings indicate that patients with Mycoplasma pneumonia co-infected with respiratory viruses had longer hospital stays and prolonged fever post-admission, as well as more severe conditions and a higher incidence of extrapulmonary complications. MPP coinfection was associated with the following factors: patients with extrapulmonary complications of gastroenteritis (OR = 4.474, 95%CI = 1.733–11.554, P = 0.002), longer hospital stay (OR = 1.109, 95%CI = 1.012–1.217, P = 0.027), longer days of fever after admission (OR = 1.215 95%CI = 1.006–1.469, P = 0.043), elevated white blood cell count (OR = 1.332 95%CI = 1.082–1.640, P = 0.007), decreased neutrophil count (OR = 0.768 95%CI = 0.602–0.981, P = 0.035), higher fibrinogen levels (OR = 1.652 95%CI = 1.138–2.398, P = 0.008), and raised lactate dehydrogenase levels (OR = 1.007 95%CI = 1.003–1.011, P = 0.001).ConclusionsWe determined the clinical significance of respiratory viral coinfection in children with MPP. Timely identification of MPP coinfection and provision of early and comprehensive therapeutic measures are vital in shortening the disease severity and improving prognosis.

Analysis of clinical characteristics and laboratory examination data of 112 cases of Mycoplasma pneumoniae pneumonia in children

The aim of this study was to analyze the clinical characteristics of Mycoplasma pneumoniae (MP) infection in children and provide a basis for the diagnosis and treatment of MP and refractory Mycoplasma pneumoniae pneumonia (MPP) in children. A total of 112 children with MPP admitted to Luoyang Maternal and Child Health Hospital between January 31, 2023 and December 31, 2023 were studied, and their clinical characteristics were retrospectively analyzed, including children’s general data, clinical symptoms, imaging changes, bronchoscopy, and laboratory data, including inflammatory factors such as C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), bacterial culture results of bronchoalveolar lavage or sputum, and results of MP culture and detection of MP drug resistance gene loci 23sRNA A2063G and A2064G. Among the 112 children with MPP included in the analysis, 48 were males (42.86%), 64 were females (57.14%), with an average age of 5.74 ± 2.62 years old, 55 cases were older than 6 years old (49.11%), 35 cases were 3 to 6 years old (31.25%), and 22 cases were &lt;3 years old (19.64%), with the older children being the most; 103 cases were fever (91.96%), 94 cases were cough (83.93%), and 46 cases were dyspnea (41.07%). Fiber bronchoscopy showed that 112 cases were mucosal congestion and edema (100.00%), 69 cases were sputum embolism (61.61%), and 19 cases were mucosal erosion (16.96%); the incidence of CRP, PCT, IL-6, and bacterial infection in the MPP group were lower than those in the RMPP group (P &lt; .05), and there was no significant difference in the mutation rate of 23sRNA A2063G and A2064G between the 2 groups (P &gt; .05); logistic regression analysis showed that CRP, PCT, IL-6, alanine aminotransferase, lactate dehydrogenase, immunoglobulin A, IgG, and immunoglobulin M were the main influencing factors of RMPP (P &lt; .05); the length of hospital stay, biochemical treatment of alanine aminotransferase, lactate dehydrogenase, cardiac troponin I, and inflammatory factors of CRP, PCT, and IL-6 in the bronchoalveolar lavage treatment group were lower than those in the general treatment group (P &lt; .05). Children with MPP have more fever, cough, and dyspnea as the starting point, and mucosal congestion, edema, sputum embolism are the most common in bronchoscopy. Children with RMPP may be accompanied by decreased immune function and increased inflammation.

Association between 25-hydroxy vitamin D, interleukin-4, and interferon-γ levels and asthma in children with Mycoplasma pneumonia infection

To explore the association between 25-hydroxy vitamin D [25-(OH)-D], interleukin-4 (IL-4), and interferon-γ (IFN-γ) in children with Mycoplasma pneumoniae (MP) infection-related asthma. Logistic analysis was conducted to compare general data in MP asthma and MP non-asthma groups. The level of 25-(OH)-D, IL-4, and IFN-γ were detected and compared between groups. Moreover, the receiver operating characteristic curve (ROC) was applied to test the predictive value of each variable. The results of logistic regression analysis demonstrated that recurrent upper respiratory tract infections and collective living are related to the incidence of MP infection whether with asthma or without asthma. IL-4 and IFN-γ in MP asthma group were significantly higher than those in MP non-asthma group and control group (p < 0. 05), whilst 25-(OH)-D and IFN-γ/IL-4 in MP asthma group were significantly lower than those in MP non-asthma group and control group (p < 0. 05). ROC curves indicated that the area under the curve (AUC) of 25-(OH)-D, IL-4, IFN-γ, IFN-γ/IL-4, and joint detection are 0.765, 0.780, 0.853, 0.638, and 0.912 in diagnosis of MP infection-related asthma, and sensitivity and specificity of joint detection are both greater than 95%. For children with MP infection-related asthma, the level of IL-4 and IFN-γ is upregulated, while 25-(OH)-D is downregulated. The joint detection of 25-(OH)-D, IL-4, IFN-γ, and IFN-γ/IL-4 may improve diagnostic capabilities of MP infection-related asthma.

Mycoplasma synoviae elongation factor thermo stable is an adhesion-associated protein that enters cells by endocytosis and stimulates DF-1 cell proliferation

Mycoplasma synoviae is an important avian pathogen that causes respiratory infections and arthritis symptoms in chickens and turkeys, resulting in significant economic damage to the poultry farming industry worldwide. Cell adhesion is a vital stage of Mycoplasma infection, and the proteins associated with this process play an important role in its pathogenesis. Elongation factor thermo stable (EF-Ts) is an important factor in prokaryotic biosynthesis that serves as a guanosine exchange factor for elongation factor thermo unstable (EF-Tu). To date, little is known about the role of EF-Ts in Mycoplasma infection. In this study, we identified EF-Ts as an immunogenic protein in M. synoviae through liquid chromatography with tandem mass spectrometry (LC–MS/MS) screening. We constructed an E. coli recombinant expression vector and prepared a highly efficient rabbit antiserum. Immunoblot analysis and suspension immunofluorescence revealed that the EF-Ts is located in both the cell membrane and cytoplasm. The prepared rabbit EF-Ts antiserum exhibited complement-dependent Mycoplasma-killing activity and inhibited the adhesion of rEF-Ts and M. synoviae to DF-1 cells. An in-vitro binding assay showed that EF-Ts could bind to fibronectin (Fn) and chicken plasminogen (cPlg) in a dose-dependent manner. In addition, EF-Ts could internalize into cells through lipid rafts and clathrin-dependent endocytosis and induce DF-1 cell proliferation. In conclusion, our studies demonstrated that MS EF-Ts is a potentially immunogenic, novel adhesion protein that acts as a critical virulence factor in M. synoviae adhesion to host cells during infection. These studies further deepen our understanding of the pathogenic mechanism of M. synoviae.

Efficacy of Pulmicort Respules Combined with Azithromycin in the Treatment of Children with Recurrent Respiratory Tract Infection Caused by Mycoplasmal Pneumonia.

Aims/Background The drug treatment of recurrent respiratory tract infection caused by mycoplasma pneumonia (MP) has a complex background, involving the characteristics of pathogens, drug resistance, and multiple treatment methods. This study aimed to analyze the therapeutic effect of pulmicort respules and azithromycin on children with recurrent respiratory tract infection caused by MP. Methods The clinical data of 106 children with recurrent respiratory tract infection caused by MP diagnosed in Huoqiu First People's Hospital from July 2021 to July 2023 were retrospectively analyzed. Based on different therapeutic methods, 56 children treated with azithromycin were included in the reference group, and 50 children treated with pulmicort respules and azithromycin were included in the observation group. The disappearance time of clinical symptoms, levels of inflammatory factors, immunoglobulin levels, and complications in both groups were observed and compared. Results After treatment, the disappearance time of fever, cough, pulmonary rales, and expectoration was shorter in the observation group, compared with the reference group (p < 0.001). No significant difference was observed in levels of tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), or interleukin-6 (IL-6) between the two groups on the first day of admission (p > 0.05). After 1 week of treatment, the observation group had significantly higher levels of TNF-α, IL-2, and IL-6 compared with the reference group (p < 0.05). No significant difference was observed in levels of immunoglobulin G (IgG), immunoglobulin A (IgA) and immunoglobulin M (IgM) between the two groups on the first day of admission (p > 0.05). After 1 week of treatment, the observation group had significantly lower levels of IgG, IgA, and IgM than the reference group (p < 0.01). This study revealed that the incidence of complications in the observation group was 16.00%, which was significantly lower than the 37.50% in the reference group (p < 0.05). Conclusion In the short-term clinical treatment, the combination application of pulmicort respules and azithromycin can effectively improve the immune function of children with recurrent respiratory tract infection caused by MP and relieve their clinical symptoms.

Hearing loss as the first symptom of pneumonia caused by Chlamydia psittaci: a case report and literature review

BackgroundThe typical clinical symptoms of psittacosis pneumonia include fever, dry cough, and chills. Sudden sensorineural hearing loss is a relatively uncommon condition in pneumonia caused by Chlamydia psittaci. In this study, we reported a rare case of Chlamydia psittaci pneumonia presented as hearing loss.Case presentationA 65-year-old man presented to our hospital with sudden hearing loss, cough with sputum, and fever for the last three days. Chest computed tomography revealed inflammation of the left lung and poor response to broad-spectrum antibiotics. The metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid identified the sequence of Chlamydia psittaci. Subsequently, antibiotic treatment was adjusted to doxycycline hydrochloride and moxifloxacin, resulting in significant improvement in both hearing loss and lung infection.ConclusionsSudden sensorineural hearing loss as an extrapulmonary feature of Chlamydia psittaci pneumonia is extremely rare. Although the exact mechanism remains unclear, this case report described a patient with sudden bilateral sensorineural hearing loss as a presenting feature of Chlamydia psittaci pneumonia, illustrating the importance of the extrapulmonary features of atypical pneumonia. The mNGS test could provide early diagnosis. Many patients had a good prognosis with prompt and effective treatment.

Characteristics of the respiratory season in 2022—23 and 2023—24 according to data from the city children's hospital

The end of the COVID-19 pandemic in the respiratory disease season of 2022—23 was characterized by an increase in the number of cases, a shift in the classic peaks of morbidity for various infections, and a predominance of influenza and respiratory syncytial virus infection (RSVI). Materials and methods. When compared with the last pandemic season, a later start of the 2023—24 respiratory season was noted with a gradual shift to the usual pre-pandemic period timing of viral morbidity increases. Results. The currently prevailing SARS-CoV-2 Omicron variant has acquired the properties of a common respiratory viral infection, currently all-season, with a mild course, without the need for hospitalization. The number of patients with influenza has decreased and there were no patients with a severe course of this infection. A feature of the first post-pandemic season was the outbreak of mycoplasma infection, which was a reason of large number of pneumonia cases.

A subunit vaccine based on P97R1, P46, P42, and P65 from Mycoplasma hyopneumoniae can induce significant immune response in piglets.

Mycoplasma pneumonia (MPS), caused by Mycoplasma hyopneumoniae (Mhp), is a chronic, airborne respiratory disease that poses a significant threat to the global swine industry. The P97 and P46 proteins are major antigens of Mhp, with the R1 region of P97 possessing full adhesive capability. Studies have shown that the main antigenic regions of Mhp P42 and P65 proteins exhibit strong immunogenicity. In this study, we first linked the genes encoding P97R1 and P46 proteins to form the P97R1P65 gene and subsequently constructed three shuttle plasmids: pFBD-P97R1P46, pFBD-P97R1P46-p65, and pFBD-P65-P42. These proteins were expressed using the Bac to Bac system and formulated into subunit vaccines for mouse immunization. Mouse experiments indicated that the P97R1P46 + P65-P42 protein combination elicited higher levels of specific antibodies, IL-2, IL-4, and CD8+ T cells compared to other subunit vaccine groups, a finding further validated in subsequent mouse challenge protection experiments. Therefore, we utilized the MultiBac expression system to co-express P97R1P46, P65, and P42 proteins in the pFastMultibacDual vector for immunization experiments in piglets. The piglet immunization experiments demonstrated that the Mhp subunit vaccine prepared in this study could induce specific antibodies against Mhp, with the combination of P97R1P46, P65, and P42 proteins inducing the highest level of humoral immunity. This study provides valuable insights for the development of Mhp subunit vaccines.

Reactive arthritis in children

One of the common childhood illnesses is reactive arthritis, which develops during or soon after an infection.Purpose. The aim of the study was to study the etiology, clinical and laboratory manifestations of arthritis in children.Material and methods. The study included 37 children with arthritis aged 1 year 10 months to 15 years who were hospitalized at Kazan City Children’s Hospital № 1.Results. Reactive arthritis was diagnosed in 26 children, and juvenile idiopathic arthritis in 11. In 20 patients, reactive arthritis manifested itself as monoarthritis with predominant damage to the hip or knee joints – in 11 and 9 cases, respectively. Two children had ankle arthritis. In 4 cases there was oligoarthritis. Markers of infectious diseases were identified in 10 out of 26 children with reactive arthritis (38%). In 5 children (19%) IgM to Mycoplasma pneumonia was detected, in two (8%) – IgM to capsid antigen of Epstein–Barr virus, in one child (4%) – IgM to Chlamydia pneumonia. Two children had elevated ASLO values (more than 400 IU/ml). Inflammatory in the blood in 33 cases (89%) were characterized by increased erythrocyte sedimentation rate, the median of which was 22 mm/hour. Increased level of C-reactive protein and leukocytes in the blood were observed only in 9 (24%) and 7 (19%) children, respectively.Conclusion. Reactive arthritis in children mainly manifests as monoarthritis, with predominant damage to the hip or knee joints and in most cases was associated with Mycoplasma pneumonia.

Clinical and Epidemiologic Features of Mycoplasma pneumoniae Infection Among Adults Hospitalized with Community-acquired Pneumonia.

Background/Purpose: The burden and epidemiology of Mycoplasma pneumoniae (Mp) community-acquired pneumonia (CAP) among hospitalized U. S. adults (≥ 18 years) are poorly understood. Methods: In the Etiology of Pneumonia in the Community (EPIC) study, we prospectively enrolled 2272 adults hospitalized with radiographically-confirmed pneumonia between January 2010-June 2012 and tested nasopharyngeal/oropharyngeal swabs for Mp by real-time polymerase chain reaction (PCR). Clinical and epidemiological features of Mp-PCR-positive and -negative adults were compared using logistic regression. Macrolide susceptibility was assessed by genotyping isolates. Results: Among 2272 adults, 43 (1.8%) were Mp-PCR-positive (median age: 45 years); 52% were male, and 56% were non-Hispanic white. Only one patient had Mp macrolide resistance. Four (9%) were admitted to the intensive care unit (ICU). No in-hospital deaths were reported. Of the 9 (21%) who received an outpatient antibiotic ≤5 days pre-admission, 2 (22%) received an antibiotic with Mp activity. Variables significantly associated with higher odds of Mp detection included age {18-29 years [(adjusted odds ratio (aOR): 11.7 (95% confidence interval (CI): 5.1- 26.6) versus ≥50 years]} and radiographic lymphadenopathy [aOR: 3.5 (95% CI: 1.2- 9.3)]. Conclusions: M. pneumoniae, commonly known to cause "walking pneumonia", was detected among hospitalized adults, with the highest prevalence among young adults. Although associated with clinically non-specific symptoms, approximately one out of every ten patients were admitted to the ICU. Increasing access to M. pneumoniae point-of-care testing could facilitate targeted treatment and avoid hospitalization.

The levels and clinical significance of serum miR-146a, miR-145, Th17/Treg in children with respiratory syncytial virus infection pneumonia

To investigate the levels and clinical significance of serum microRNA (miR)-146a, miR-145, T-helpertype17 (Th17)/regulatory T cell (Treg) in children with respiratory syncytial virus (RSV) infectious pneumonia. The clinical data of 200 children with RSV infectious pneumonia admitted to Nantong Maternal and Child Health Hospital from June 2020 to June 2023 were retrospectively collected as the study group. At the same time, 200 children with mycoplasma pneumonia were selected as the common pneumonia group and 200 healthy children were selected as the healthy group. The levels of serum inflammatory factors [interleukin-6 (IL-6), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α)] were detected by enzyme-linked immunosorbent assay. The expression levels of serum miR-146a and miR-145 were detected by RT-qPCR. The levels of Th17/Treg were detected by flow cytometry. The levels of miR-146a, miR-145, Th17/Treg and serum inflammatory factors were compared among the three groups. Pearson method was used to analyze the correlation between miR-146a, miR-145, Th17/Treg and serum inflammatory factors in children with RSV infectious pneumonia. The receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of miR-146a, miR-145, Th17/Treg in children with respiratory syncytial virus infection pneumonia. The results showed that in the study group, miR-146a (2.01±0.58), miR-145 (1.81±0.46), Th17/Treg (1.09±0.31), IL-6 (7.82±2.11) ng/L and TNF-α (9.82±2.96) ng/L were higher than those in the common pneumonia group miR-146a (1.49±0.42), miR-145 (1.43±0.31), Th17/Treg (0.77±0.24), IL-6 (5.89±1.32) ng/L, TNF-α (7.34±2.32) ng/L and healthy group miR-146a (1.25±0.19), miR-145 (1.19±0.16), Th17/Treg (0.38±0.09), IL-6 (4.52±1.04) ng/L, TNF-α (5.39±1.07)ng/L. The levels of the above indexes in the common pneumonia group were higher than those in the healthy group, and the differences were statistically significant (F=183.543, 175.938, 617.182, 226.657, 193.459, P<0.05). In the study group, IFN-γ (14.18±3.25) pg/ml was lower than that in the control group (19.52±5.13) pg/ml, but higher than that in the healthy group (9.77±2.40) pg/ml, and the difference was statistically significant (F=335.432, P<0.05). Pearson correlation analysis showed that miR-146a, miR-145 and Th17/Treg were positively correlated with IL-6 and TNF-α (P<0.05), but negatively correlated with IFN-γ (P<0.05). ROC curve results showed that the area under the curve (AUC) of miR-146a, miR-145 and Th17/Treg in the diagnosis of RSV infectious pneumonia was 0.767, 0.762 and 0.790, respectively, while the combined detection of the three was 0.904. In conclusion, the levels of miR-146a, miR-145 and Th17/Treg are highly expressed in children with RSV infectious pneumonia, and are closely related to the inflammatory response of children. The combined detection of the three may have certain application value in the auxiliary diagnosis of RSV infectious pneumonia.

Atypical Mycobacterial Pneumonia in 2 Siblings with a Novel Hypomorphic NEMO/IKBKG Mutation.

Atypical Mycobacterial Pneumonia in 2 Siblings with a Novel Hypomorphic NEMO/IKBKG Mutation.

Adverse events associated with azithromycin and clarithromycin in adults aged ≥65: a disproportionality analysis of the FDA Adverse Event Reporting System (FAERS) database

ABSTRACT Background Azithromycin and clarithromycin are commonly used to treat community-acquired pneumonia in adults aged ≥ 65, such as mycoplasma pneumonia. This study aims to evaluate adverse events (AEs) associated with azithromycin and clarithromycin in this age group by analyzing the FDA Adverse Event Reporting System (FAERS), providing insights for clinical use and management of AEs in this population. Research design and methods We retrieved reports of AEs related to azithromycin and clarithromycin from the FAERS database. Disproportionality analysis was conducted using the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Gamma Poisson Shrinkage (MGPS) to identify AEs associated with azithromycin and clarithromycin in adults aged ≥ 65. Results A total of 2,019 adverse event reports were retrieved for azithromycin, and 2,392 for clarithromycin. Off-label use (n = 349) and drug interactions (n = 487) were the most reported AEs in adults aged ≥ 65 for azithromycin and clarithromycin, respectively. Prolonged QT interval showed the strongest signal among AEs for azithromycin in this age group. Drug interaction-related medication errors had the strongest signal for clarithromycin. Seven signals not explicitly included in the azithromycin package insert were identified in adults aged ≥ 65. Fourteen signals not explicitly included in the clarithromycin package insert were identified. Conclusions Among adults aged ≥ 65, cardiac-related adverse events are more closely associated with azithromycin than with clarithromycin. Conversely, AEs related to drug interactions and psychiatric symptoms are more associated with clarithromycin. Additionally, clinicians should be vigilant regarding AEs not specified in the package inserts. The findings of this study may help optimize the selection of azithromycin and clarithromycin based on patient circumstances and assist clinicians in focusing on relevant AEs for early intervention.

Alterations in Gut Microbiota and Serum Metabolites in Children with Mycoplasma pneumoniae Pneumonia.

Over the past years, there has been a significant increase in the incidence of Mycoplasma pneumoniae (MP) infections, particularly among pediatric patients, nationwide. An emerging body of research has established a link between dysbiosis of the host microbiome and the metabolic functioning of the host, which contributes to the development of respiratory diseases. A total of 25 children were included in the study, comprising 15 pneumonia patients and 10healthy children. Stool samples were collected from all participants to analyze the 16S ribosomal RNA (16S rRNA) gene, while serum samples were prepared for untargeted metabolomics to qualitatively and quantitatively assess short-chain fatty acids. The gut microbial composition of individuals with Mycoplasma pneumoniae pneumonia (MPP) exhibited significant differences compared to healthy children. Notably, diseased children demonstrated higher microbial diversity and an enrichment of opportunistic pathogens, such as Erysipelatoclostridium and Eggerthella. Analysis revealed elevated levels of two specific short-chain fatty acids, namely acetic acid and isobutyric acid, in the MPP group, suggesting their potential as biomarkers for predicting MP infection. Metabolomic signature analysis identified a significant increase in major classes of glycerophospholipids in the MPP group. Moreover, we identified a total of 750 significant correlations between gut microbiota and circulating serum metabolites. MPP enriched genera Erysipelatoclostridium and Eggerthella, exhibited negative associations with indole-3-butyric acid. Additionally, Eggerthella showed a positive correlation with inflammatory metabolites LPC (18:0). Collectively, these findings provide novel insights into the selection of potential biomarkers and the pathogenesis of MPP in children based on the gut microbiota and systemic circulating metabolites.

Exploring high-risk factors for the prediction of severe mycoplasma pneumonia in children

Exploring high-risk factors for the prediction of severe mycoplasma pneumonia in children

Characterization of a Mycoplasma hyopneumoniae aerosol infection model in pigs

The purpose of the present study was to develop and characterize an experimental aerosol model for Mycoplasma hyopneumoniae (M. hyopneumoniae) infection and respiratory disease in pigs. The experiment was carried out to determine the pathogenicity, colonization, mucosal immune response, and clinical course of disease of dose-controlled aerosols of M. hyopneumoniae. Four groups of three M. hyopneumoniae-free gilts each were individually exposed to aerosols of diluted lung homogenate containing M. hyopneumoniae strain 232 in a chamber. Each group was exposed to different doses of viable organisms (105 to 106 color changing units/mL during 15-20 or 30-35min in two consecutive days). Nasal, laryngeal, and deep-tracheal secretions were collected from each gilt at 0, 7, 14, 21, and 28 days post-exposure (dpe). Blood samples were collected at 0 and 28 dpe. At necropsy, lung lesions were assessed, and bronchial secretions and bronchoalveolar lavage fluid (BALF) were collected from each lung set. Blood was used to assess seroconversion by means of an indirect ELISA, while BALF, deep-tracheal and nasal secretions were tested by modifying the ELISA to evaluate mucosal IgG and IgA production. Nasal, laryngeal, deep-tracheal, and bronchial secretions were tested by real-time PCR to evaluate bacterial load. Gilts became infected irrespective of the infectious dose, as determined by M. hyopneumoniae detection in deep-tracheal secretions from all gilts at 7 dpe. A specific local humoral immune response starting at 14 dpe was detected in all gilts. While all experimental groups presented gilts with some extent of mycoplasmal pneumonia, only the exposure of gilts to high-dose aerosols consistently reproduced typical clinical signs and severe lung lesions. These results showed that the reproduction of mycoplasmal pneumonia by means of infectious aerosols can be successfully achieved at experimental level, making this model a valuable alternative to evaluate preventive and treatment measures against M. hyopneumoniae.