Retinal vein and artery occlusion as the first manifestation of primary antiphospholipid syndrome in a pediatric patient / Oclusão arterial e venosa como primeira manifestação da síndrome antifosfolipide primária em criança

ABSTRACT Antiphospholipid syndrome is an acquired autoimmune disease characterized by hypercoagulability associated with recurrent venous and arterial thromboembolism in the presence of antiphospholipid antibodies. Herein, we report a case of rapid sequential retinal vein and artery occlusion as the first manifestation of a primary antiphospholipid syndrome triggered by an acute Mycoplasma infection in a previously healthy 11-year-old patient. On day 1, ophthalmoscopy revealed a central retinal vein occlusion. The patient developed temporal branch retinal artery occlusion the next day. On day 3, a central retinal artery occlusion was observed. Serum lupus anticoagulant, immunoglobulin (Ig) G anticardiolipin, IgG anti-β2-glycoprotein 1 antibody, and Mycoplasma pneumoniae IgM antibody levels were increased. Thus, retinal vascular occlusions can be the first manifestation of primary antiphospholipid syndrome. Although it may not improve visual prognosis, prompt diagnosis and treatment are essential to avoid further significant morbidity.

RESUMO A síndrome antifosfolipide é uma doença autoimune adquirida caracterizada por hipercoagulabilidade associada a tromboembolismo venoso e arterial recorrente na presença de anticorpos antifosfolipídicos. Aqui, relatamos um caso clínico de oclusão sequencial de veia e artéria da retina como primeira manifestação de uma síndrome antifosfolipíde primária desen­cadeada por uma infeção aguda por Mycoplasma num paciente de 11 anos previamente saudável. No primeiro dia, a oftalmoscopia revelou uma oclusão da veia central da retina. No dia seguinte, o paciente desenvolveu uma oclusão do ramo temporal da artéria central da retina. No terceiro dia, uma oclusão da artéria central da retina foi diagnosticada. Os níveis de anticoagulante lúpico sérico, anticorpos IgG anticardiolipina e IgG anti-β2-glicoproteína 1 e anticorpos IgM para Mycoplasma pneumoniae estavam aumentados. As oclusões vasculares retinianas podem ser a primeira manifestação da síndrome antifosfolipíde primária. Apesar do prognóstico visual ser reservado, o seu diagnóstico e o tratamento imediatos são essenciais para evitar outras morbilidades associadas.

Clinical significance of serum microRNA-146a and inflammatory factors in children with Mycoplasma pneumoniae pneumonia after azithromycin treatment

Abstract Objective This study aimed to investigate the clinical significance of serum microRNA-146a and pro-inflammatory factors in children with Mycoplasma pneumoniae pneumonia after azithromycin treatment. microRNA-146a is known to regulate inflammatory responses, and excessive inflammation is a primary characteristic of MPP. Methods Children with MPP received conventional symptomatic therapy along with intravenous administration of azithromycin for one week. Serum levels of microRNA-146a and pro-inflammatory factors were measured using RT-qPCR and ELISA kits, respectively. The correlation between microRNA-146a and pro-inflammatory factors was analyzed by the Pearson method. Pulmonary function indexes were assessed using a pulmonary function analyzer, and their correlation with microRNA-146a and pro-inflammatory factors after treatment was evaluated. Children with MPP were divided into effective and ineffective treatment groups, and the clinical significance of microRNA-146a and pro-inflammatory factors was evaluated using receiver operating characteristic curves and logistic multivariate regression analysis. Results Serum microRNA-146a was downregulated in children with MPP but upregulated after azithromycin treatment, contrasting with the trend observed for pro-inflammatory factors. MicroRNA-146a showed a negative correlation with pro-inflammatory cytokines. Pulmonary function parameters were initially reduced in children with MPP, but increased after treatment, showing positive/inverse associations with microRNA-146a and pro-inflammatory factors. Higher microRNA-146a and lower pro-inflammatory factors predicted better efficacy of azithromycin treatment. MicroRNA-146a, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) were identified as independent factors influencing treatment efficacy. Conclusion Azithromycin treatment in children with MPP upregulates microRNA-146a, downregulates pro-inflammatory factors, and effectively improves pulmonary function.

Association between chlamydia pneumoniae, mycoplasma infection and atherosclerosis / 公共卫生与预防医学

Objective To investigate the infection of Chlamydia pneumoniae and mycoplasma pneumoniae in adults and their association with atherosclerosis,and to provide theoretical guidance for the prevention of such diseases. Methods A case-control study was used to collect 362 patients who were diagnosed with atherosclerosis from January 2019 to December 2021 in Department of Sichuan Bazhong Central Hospital, and 370 cases who were admitted to the hospital during the same period of physical examination without any cardiovascular disease were selected as the control group, and whole blood samples of the two groups of study subjects were collected, and the infection of Chlamydia pneumoniae and mycoplasma pneumoniae was detected by PCR. Results The infection rate of Chlamydia pneumoniae was 35.49%, the infection rate of mycoplasma was 40.37%, and the co-infection rate was 11.37%；The infection rate of Chlamydia pneumoniae in the control group was 12.04%, the infection rate of mycoplasma was 15.83%, and the coinfection rate was 3.14%, and the difference between the two groups was statistically significant ( χ2=10.926, P=0.023). The effects of mycoplasma, chlamydia, and co-infection on atherosclerotic patients have sex differences, mainly manifested as higher infection rates in men; In addition, the effects of mycoplasma, chlamydia, and co-infection on atherosclerosis patients varied by age, mainly in the 55-70 years age group (P<0.05). Multivariate logistic regression results showed that Chlamydia pneumoniae infection was a risk factor for atherosclerosis (OR=1.303, 95%CI: 1.043-1.677) in the whole population, and chlamydia pneumoniae (OR=1.472, 95% CI: 1.037-1.556), mycoplasma (OR=2.003, 95%CI: 1.637-3.842) and co-infection in men (OR=1.937, 95%CI: 1.380-2.184) were risk factors for atherosclerosis, while co-infection in women (OR=1.699, 95%CI: 1.263-1.765) was a risk factor for atherosclerosis. Conclusion Chlamydia pneumoniae and mycoplasma infection are risk factors for atherosclerosis, and their impact on male groups is greater, and more attention needs to be paid to them.

PCR múltiplex para el diagnóstico de microorganismos atípicos transmitidos sexualmente / Multiplex PCR testing for the atypical microorganisms diagnosis sexually transmitted

Resumen Antecedentes: Las infecciones de transmisión sexual son un problema de salud pública mundial. El análisis rutinario incluye solo pruebas microbiológicas y serológicas para el diagnóstico de patógenos. Los microorganismos atípicos como Chlamydia trachomatis y micoplasmas no son identificados debido a los requerimientos. Además, no es incluida Gardnerella vaginalis, aunque se asocia a la vaginosis bacteriana. Objetivo: Desarrollar una PCR múltiplex para el diagnóstico de C. trachomatis, micoplasmas y G. vaginalis. Método: Se estandarizó la PCR múltiplex utilizando oligonucleótidos para C. trachomatis (gen ompA, orf6 plasmídico), Mycoplasma/Ureaplasma y G. vaginalis (genes rRNA16s). Resultados: Se estandarizaron pruebas de PCR múltiplex para los microorganismos estudiados, optimizándose las concentraciones y condiciones de las reacciones múltiplex. Se obtuvieron PCR dúplex para C. trachomatis (ompA, orf6), Chlamydia/Gardnerella y Chlamydia/micoplasmas y tríplex para Chlamydia/Mycoplasma/Ureaplasma. También un cuádruplex para Chlamydia/Mycoplasma/Ureaplasma/Gardnerella. Los resultados fueron verificados por PCR e hibridación automática (HybriSpot 12) y análisis in silico. Conclusión: Se desarrollaron pruebas de PCR múltiplex con una alta sensibilidad y especificidad para la identificación de C. trachomatis, micoplasmas y G. vaginalis.

Abstract Background: Sexually transmitted infections are a global public health problem. Routine analysis includes microbiological and serological tests for the diagnosis of pathogens. Atypical microorganisms such as Chlamydia trachomatis and mycoplasmas are not determined due to the requirements for their identification. Furthermore, Gardnerella vaginalis is not included despite being associated with bacterial vaginosis. Objective: To develop a multiplex PCR to diagnose Chlamydia, mycoplasmas, and Gardnerella. Method: Standardization of multiplex PCR tests was carried out using oligonucleotides for the identification of Chlamydia (ompA gene, plasmid orf6), Mycoplasma/Ureaplasma and Gardnerella (rRNA16s genes). Results: Multiplex PCR tests were standardized for the microorganisms studied, optimizing the concentrations and conditions of the multiplex reactions. Duplex PCR was obtained for Chlamydia (ompA, orf6), Chlamydia/Gardnerella, and Chlamydia/mycoplasmas, and triplex PCR for Chlamydia/mycoplasmas. Also, a quadruplex for Chlamydia, Mycoplasma/Ureaplasma and Gardnerella. PCR and automatic hybridization verified the results obtained (HybriSpot 12) and in silico analysis. Conclusion: Multiplex PCR tests with high sensitivity and specificity were developed to identify C. trachomatis, mycoplasmas, and G. vaginalis.

Ureaplasma diversum-Ureaplasma sp. alone or concomitantly with Mycoplasma hyopneumoniae in pig lungs with and without pneumonia: A descriptive exploratory study in abattoirs / Presencia de Ureaplasma diversum-Ureaplasma sp. solo o junto con Mycoplasma hyopneumoniae en pulmones de cerdos con y sin neumonía: un estudio exploratorio descriptivo en frigorífico

Abstract Occurrence of Ureaplasma diversum (U. diversum) has been associated with repro-ductive failures in cattle and detected in pigs with and without pneumonia. However, its rolein the porcine respiratory disease complex (PRDC) is unclear. A cross-sectional study was con-ducted in abattoirs, inspecting 280 pig lungs from eight herds. All the lungs were inspected,processed and classified according to the histopathological analysis. Moreover, bronchoalveolarlavage (BAL) specimens were collected and processed by PCR for detection of U. diversum andMycoplasma hyopneumoniae (M. hyopneumoniae). Ureaplasma sp.---U. diversum and M. hyop-neumoniae were detected in 17.1% and 29.3% of the analyzed BAL specimens, respectively. Theconcomitant presence of both microorganisms was detected in 12.5% of the inspected lungs.Both agents were found in lungs with and without pneumonia. M. hyopneumoniae was detectedin 31.8% of pig lungs with enzootic pneumonia-like lesions, while Ureaplasma sp.---U. diversumwas detected in 27.5% of lungs with these lesions. This descriptive exploratory study providesinformation for future experimental and field-based studies to better define the pathogenicrole of this organism within the PRDC.

Resumen La presencia de Ureaplasma diversum se ha asociado a fallas reproductivas en el ganado bovino y se ha detectado en cerdos con y sin neumonía. Sin embargo, su participación en el complejo de enfermedades respiratorias porcinas (CERP) no es clara. Se llevó a cabo un estudio transversal en matadero, inspeccionando 280 pulmones de cerdo provenientes de ocho piaras. Todos los pulmones fueron inspeccionados, procesados y clasificados según el análisis histopatológico. También se colectaron muestras de lavado broncoalveolar (LBA) y se procesaron mediante PCR para la detección de U. diversum y Mycoplasma hyopneumoniae. Ureaplasma sp.-U. diversum y M. hyopneumoniae se detectaron en el 17,1% y en el 29,3% de los LBA analizados, respectivamente. La presencia concomitante de ambos microorganismos se detectó en el 12,5% de los pulmones inspeccionados. Ambos agentes se encontraron en pulmones con y sin neumonía. M. hyopneumoniae se detectó en el 31,8% de los pulmones con lesiones compatibles con neumonía enzoótica, mientras que Ureaplasma sp.-U. diversum se detectó en el 27,5% de los pulmones con estas lesiones. Este estudio exploratorio descriptivo proporciona información para futuros estudios experimentales y de campo tendentes a definir mejor el papel patógeno de este organismo dentro del CERP.

Epidemiología y prevalencia de Mycoplasma genitalium y resistencia a azitromicina en el Área Norte de Tenerife, Islas Canarias

Introducción: La infección y resistencia antimicrobiana de Mycoplasma genitalium está infradiagnósticada en nuestra comunidad ya que no es una Enfermedad de Declaración Obligatoria y requiere técnicas de biología molecular, no siempre disponibles. Objetivo: Estudiar la epidemiología y prevalencia de M. genitalium y la tasa de resistencia frente a azitromicina en nuestra Área de Salud. Métodos: Estudio retrospectivo, desde abril de 2019 a julio de 2020, realizado en el Área de Salud del Norte de Tenerife, la cual atiende el Hospital Universitario Canarias. Para el diagnóstico de las infecciones de transmisión sexual (ITS) se utilizó la RT-PCR Allplex™ STI Essential Assay (Seegene, South Korea). Las muestras en las que se detectó M. genitalium fueron congeladas a −80°C para posteriormente realizar estudio de resistencia a azitromicina con la RT-PCR Allplex™ MG y AziR Assay (Seegene, South Korea). Resultados: Se identificaron 111/3.849 (prevalencia de 2,8%) pacientes con M. genitalium, de los cuales la mayoría, 59(53,1%) eran hombres con una mediana de 32 años (15-74) y cuyas muestras procedían principalmente de Atención Primaria: 55 (49,5%). Para la detección de resistencia a azitromicina, de los 111 pacientes solo se pudo analizar las muestras de 79, detectándose resistencia in vitro en 15(18,3%): 10 con A2059G, 4 con A2058G y 1 con ambas. La resistencia a azitromicina fue más frecuente en hombres 12 (15,8%). Discusión y Conclusiones: Con este estudio se pone de manifiesto la importancia de la prevalencia de M. genitalium en nuestro entorno, así como su alta tasa de resistencia a azitromicina por lo que se hace necesario vigilar dicha resistencia en nuestro Área de Salud para su adecuado tratamiento.

Background: Infection and antimicrobial resistance of Mycoplasma genitalium is under-diagnosed in our community as it is not a Notifiable Infectious Disease and requires for its detection molecular biology techniques, which are not always available. Aim: To study the epidemiology and prevalence of M. genitalium and the rate of resistance to azithromycin in our Health Care Area. Methods: We conducted a retrospective study from April 2019 to July 2020 in the Northern Health Care Area of Tenerife, which is attended to the Universitary Hospital Complex of the Canary Islands. The RT-PCR Allplex™ STI Essential Assay (Seegene, South Korea) to diagnose Sexually Transmitted Infections (STI) was used. Samples in which M. genitalium was detected were stored at −80°C for subsequent diagnosis of resistance to azithromycin with the RT-PCR Allplex™ MG and AziR Assay (Seegene, South Korea). Results: Of a total of 111/3,849 (2.8% prevalence) patients diagnosed with M. genitalium, 59 (53.1%) were male with a mean age of 30 (19-61) years and mainly from Primary Care 55 (49.5%). Only 79 samples of the 111 patients could be tested to detect azithromycin resistance, of which 15 (18.3%) were resistant in vitro: 10 with A2059G, 4 with A2058G and 1 with both. Azithromycin resistance was more frequent in men 12 (15.8%) and detected mainly in urine samples 6 (60%). Discussion and Conclusions: This study highlights the prevalence of M. genitalium in our setting as well as the high rate of resistance to azithromycin, making it necessary to detect resistance to azithromycin in M. genitalium for its appropriate treatment in our Health Care Area.

Laboratory detection of bacterial pathogens and clinical and laboratory response of syndromic management in patients with cervical discharge: A retrospective study

Background: Cervical discharge as part of cervicitis and pelvic inflammatory disease is a cause of significant morbidity in sexually active women worldwide. Non-gonococcal and non- chlamydial bacterial pathogens are becoming more prevalent. Aims: This study aims to determine bacterial pathogens causing cervical discharge using culture and/or polymerase chain reaction and assess the clinical and laboratory response to the conventional syndromic kit regimen established by the World Health Organisation. Methods: A retrospective review of records of women with cervical discharge over one year period. Culture and/or polymerase chain reaction results of endocervical swabs of various bacterial pathogens at baseline and after four weeks of treatment with syndromic kit regimen were recorded. Results: A total of 70 case records were reviewed for clinical details, out of which results of bacterial culture and polymerase chain reaction were available for 67 cases. Infectious aetiology was found in 30 (44.7%) patients with Ureaplasma species being the most common organism isolated on culture (18, 26.8%) and polymerase chain reaction (25, 37.3%), respectively. Polymerase chain reaction for Chlamydia trachomatis and Mycoplasma hominis was positive in ten (14.9%) and four (6%) cases, respectively. None of the patients showed positive culture for Neisseria gonorrhoeae. Coinfection was seen in eight (11.9%) patients with the majority showing Chlamydia trachomatis and Ureaplasma spp. coinfection (five patients). Forty one cases (58.5%) received tab. cefixime 400 mg and tab. azithromycin one gram stat (kit 1), while 29 cases (43.3%) received tab. cefixime 400 mg stat, tab. metronidazole 400 mg and cap. doxycycline 100 mg, both twice daily for 14 days (kit 6). Minimal to no clinical improvement with treatment was seen in 14 out of 32 cases (44%) at the end of four weeks with the conventional kit regimen. Post-treatment culture and/or polymerase chain reaction were positive in nine out of 28 cases (32.1%) with Ureaplasma spp. being the most common. Limitations: Retrospective study design, small sample size and fewer cases with follow-up data were the main limitations. Conclusion: Ureaplasma spp. was the most common infectious cause of cervical discharge in our patients. Treatment given as part of syndromic management led to a clinical and microbiological response in around half and two-third cases, respectively.

The immunogenic involvement of miRNA-492 in mycoplasma pneumoniae infection in pediatric patients

Abstract Objective: This study aimed to evaluate the role of miRNA-492 in the progression of mycoplasma pneumoniae (MP) infection in pediatric patients. Methods: Forty-six children admitted to the present study's hospital and diagnosed with mycoplasma pneumonia were recruited as the study group from March 2018 to August 2019, and 40 healthy children were selected as the control group. Results: The expression levels of miRNA-492, TNF-α, IL-6 and IL-18 in the study group were significantly higher than those in the control group (p < 0.05). There was no significant correlation between miRNA-492 and most of the immune-correlated indicators in the study group, except for IL-6, IL-18 and HMGB1. Meanwhile, overexpression of miRNA-492 increased IL-6 secretion in PMA-activated monocytes (p < 0.01). Conclusion: The present study's results suggested that miRNA-492 might play a role in the pathogenesis of mycoplasma pneumoniae pneumonia in children by regulating the secretion of immune-inflammatory factors such as IL-6 and IL-18 in the mononuclear macrophages.

A rare presentation of Mycoplasma pneumoniae with splenic nodules

Mycoplasma pneumoniae is a common respiratory pathogen that can cause a wide spectrum of extrapulmonary manifestations with neurological manifestations being the most common. Here, we report a rare case of splenic nodules in a 7-year-old girl with M. pneumoniae infection which responded well to macrolides. M. pneumoniae infection should be considered in children with extrapulmonary manifestations including splenic lesions

Mycoplasma Genitalium and Chlamydia Trachomatis Prevalence, Co-Infection and Relevant Factors in An Epidemiology Study (2016 - 2019) In Ho Chi Minh, Vietnam

Chlamydia trachomatis and Mycoplasma genitalium are two common types of sexually transmitted infections. However, currently in Vietnam, there is no report on the rate of patients infected by the two types of bacteria. In this study, there were 6194 patients visiting the STI clinic of the HCMC Hospital of Dermato-Venereology, Vietnam, from 2016 to 2019. The results show that the proportion of patients positive with CT and MG is in-dependent on time. The infection rate is mainly at the age of 21 - 30 (53.4%). The CT infection rate in female and male is equal (17.3% vs 17.4%) while the rate of MG in female is lower (5.1% vs 7, 8%). The rate of pa-tients co-infected with either CT or MG is 4.5%, 17% and 5.7% respectively, time independence. This study may give better understandings of the epidemiological characteristics of MG and CT in Vietnam.

Prevalence and association of mycoplasma infection in the development of coronary artery disease / Prevalência e associação de infecção por micoplasma no desenvolvimento de doença arterial coronariana

Abstract Coronary heart disease (CHD) has been associated with significant morbidity and mortality worldwide. Although remain controversial, several studies have demonstrated the association of M. pneumoniae infections with atherosclerosis. We evaluated the possible association of mycoplasma infections in patients diagnosed with atherosclerosis by ELISA and PCR methods. Atherosclerotic tissue samples and blood samples were collected for the detection of mycoplasma antibodies (IgA) by ELISA from the 97 patients with coronary artery disease (CAD). M. pneumoniae specific IgA, IgG and IgM were measured by using the Anti-M. pneumoniae IgA/IgG/IgM ELISA. Detection of M. pneumoniae targeting the P1 adhesion gene was performed by PCR Acute infection of M. pneumoniae was diagnosed in 43.3% (42) of patients by PCR. The M. pneumoniae specific antibodies were detected in 36.1% (35) of patients. Twenty-five (25.8%) cases had IgG antibodies, 15 (15.5%) cases had IgM antibodies, 3 (3.1%) cases had IgA antibodies, 10 (10.3%) cases had both IgM + IgG antibodies and 1 (1%) case of each had IgM + IgA and IgG + IgA antibodies. None of the cases was positive for all three antibodies. A Pearson correlation coefficient analysis revealed an excellent correlation between the PCR and the serological results (r=0.921, p<0.001). A majority (17, 40.5%) of the M. pneumoniae positive patients are within the 41-50 years of age group, followed by 10 (23.8%) patients in the age group of 61-70 years and 2 (4.8%) patients were >70 years of age. Our study reported an unusually higher prevalence of M. pneumoniae by serological tests (36.1%) and PCR (43.3%). Although the hypothesis of the association of M. pneumoniae and CAD is yet to be proven, the unusually high prevalence of M. pneumoniae in CAD patients indicates an association, if not, in the development of atherosclerosis.

Resumo A doença coronariana (DCC) tem sido associada a significativa morbidade e mortalidade em todo o mundo. Embora ainda sejam controversos, vários estudos têm demonstrado a associação de infecções por M. pneumoniae com aterosclerose. Avaliamos a possível associação de infecções por micoplasma em pacientes com diagnóstico de aterosclerose pelos métodos ELISA e PCR. Amostras de tecido aterosclerótico e amostras de sangue foram coletadas para a detecção de anticorpos contra micoplasma (IgA) por ELISA de 97 pacientes com doença arterial coronariana (DAC). IgA, IgG e IgM específicos para M. pneumoniae foram medidos usando o Anti-M. pneumoniae IgA / IgG / IgM ELISA. A detecção de M. pneumoniae visando o gene de adesão P1 foi realizada por PCR. A infecção aguda por M. pneumoniae foi diagnosticada em 43,3% (42) dos pacientes pela PCR. Os anticorpos específicos para M. pneumoniae foram detectados em 36,1% (35) dos pacientes. Vinte e cinco (25,8%) casos tinham anticorpos IgG, 15 (15,5%) casos tinham anticorpos IgM, 3 (3,1%) casos tinham anticorpos IgA, 10 (10,3%) casos tinham anticorpos IgM + IgG e 1 (1%) caso de cada um tinha anticorpos IgM + IgA e IgG + IgA. Nenhum dos casos foi positivo para os três anticorpos. A análise do coeficiente de correlação de Pearson revelou uma excelente correlação entre o PCR e os resultados sorológicos (r = 0,921, p < 0,001). A maioria (17, 40,5%) dos pacientes positivos para M. pneumoniae está na faixa etária de 41-50 anos, seguida por 10 (23,8%) pacientes na faixa etária de 61-70 anos e 2 (4,8%) pacientes tinham > 70 anos de idade. Nosso estudo relatou uma prevalência incomumente maior de M. pneumoniae por testes sorológicos (36,1%) e PCR (43,3%). Embora a hipótese da associação de M. pneumoniae e DAC ainda não tenha sido comprovada, a prevalência incomumente alta de M. pneumoniae em pacientes com DAC indica uma associação, se não, no desenvolvimento de aterosclerose.

Analysis of clinical characteristics and related risk factors of severe mycoplasma pneumoniae pneumonia in children / 中国小儿急救医学

Objective:To explore the clinical features and risk factors of severe mycoplasma pneumoniae pneumonia(SMPP) in children, and to provide guidance for early identification of SMPP.Methods:The clinical data of 263 children with mycoplasma pneumoniae pneumonia admitted to the Respiratory Department at Anhui Children′s Hospital from January 2019 to December 2021 were analyzed retrospectively.According to the severity of the disease, the patients were divided into severe group( n=88) and mild group( n=175). The general conditions, clinical manifestations, laboratory examination, imaging features and bronchoscopic findings between two groups were compared and statistically analyzed. Results:There was no significant difference in sex and onset season between two groups( P>0.05). The age of severe group was older than that of mild group( P<0.05). According to the age group, the incidence of SMPP in the infant group(14.10%) was lower than that in the preschool group (45.00%) and the school age group (37.65%) ( P<0.05), but there was no significant difference between preschool group and school age group ( P>0.05). The degree of fever and the proportion of extrapulmonary complications in severe group were higher than those in mild group, and the duration of fever, length of hospital stay and use of macrolides in severe group were longer than those in mild group ( P<0.05). There were significant differences in white blood cell count/lymphocyte count, C-reactive protein (CRP), prealbumin, glutamic pyruvic transaminase, lactate dehydrogenase (LDH), immunoglobulin G, immunoglobulin A, procalcitonin, erythrocyte sedimentation rate (ESR) and D-dimer between two groups(all P<0.05). There was significant difference in the copies of mycoplasma pneumoniae DNA in bronchoalveolar lavage fluid between two groups ( P<0.05). The proportion of large shadow, pleural thickening, atelectasis, pleural effusion, bronchoalveolar lavage and airway mucus thrombus blockage in severe group were higher than those in mild group ( P<0.05). Multivariate Logistic regression analysis showed that hot course ( OR=1.294, 95% CI: 1.127-1.485), CRP level( OR=1.027, 95% CI: 1.003-1.052), LDH level( OR=1.006, 95% CI: 1.002~1.011), D-dimer level( OR=1.406, 95% CI: 1.065~1.875), ESR( OR=1.042, 95% CI: 1.008-1.077), large shadow( OR=21.811, 95% CI: 6.205~76.664) and pleural effusion( OR=5.495, 95% CI: 1.604-18.826) were independent risk factors for SMPP.ROC curve analysis showed that thermal path, CRP level, LDH level, D-dimer level and ESR had high predictive value in the diagnosis of SMPP, and the best thresholds were 8.50 d, 25.625 mg/L, 412.50 IU/L, 0.98 mg/L and 36.5 mm/h, respectively. Conclusion:Children with SMPP had high degree of fever, long duration of fever, length of hospital stay, long use of macrolides, significantly increased inflammatory indexes, and severe changes in pulmonary imaging and bronchoscopy.Hot course, CRP level, LDH level, D-dimer level, ESR, large shadow and pleural effusion are risk factors for SMPP.It is helpful for early identification of SMPP when the hot course is >8.50 d, CRP>25.625 mg/L, LDH > 412.50 IU/L, D-dimer > 0.98 mg/L, ESR > 36.5 mm/h.

Progress on biomarkers of Mycoplasma pneumoniae pneumonia / 国际儿科学杂志

Mycoplasma pneumoniae pneumonia is an important component of community-acquired pneumonia, which can cause severe extrapulmonary complications of digestive, cardiovascular, blood, urinary and other systems.Accurate and effective biomarkers are significant for the diagnosis and treatment of Mycoplasma pneumoniae pneumonia.Recent studies have shown that new biomarkers such as IL-35, IL-17, neutrophil to lymphocyte ratio(NLR) and S100 protein are involved in the development of Mycoplasma pneumoniae pneumonia.In order to provide reference for the clinical diagnosis and treatment of Mycoplasma pneumoniae pneumonia, this paper reviews the progress of new biomarkers in Mycoplasma pneumoniae pneumonia.

Clinical characteristics of Mycoplasma pneumoniae infection in 20 299 children / 国际儿科学杂志

Objective:To explore the clinical features of Mycoplasma pneumoniae(MP)infection in children, and provide data support for the prevention and control of MP.Methods:In this study , a retrospective analysis was used to collect clinical data with respiratory tract infection from January 2018 to February 2022 in the Shenyang Children′s Hospital, and analyze the distribution characteristics of MP positive rate, season, age, sex.Results:In this study, the positive rate of MP was 17.12% (20 299/118 598), in 2018, 2019, 2020 and 2021 were 22.92% (7 732/33 738), 15.76% (5 736/36 388), 9.81% (1 313/13 379) and 16.60% (4 954/29 849) respectively.The highest positive rates of MP in 2018 and 2019 were 27.72% (1 809/6 527) and 23.45% (1 519/6 478) in summer, respectively, 2020 was spring (19.13%, 216/1 129) and 2021 was autumn (20.09%, 1 665/8 287).The MP positive rates of infancy, early childhood, preschool age and school age were 5.89% (605/10 265), 14.35% (4 639/32 333), 18.51% (10 961/59 203) and 24.37% (4 094/16 798), and MP positive rate increased with age, the difference was statistically significant ( χ2=1 790.971, P<0.05).The positive rate of boys was 14.70% (9 586/65 206), while that of girls was 20.06% (10 713/53 392), the difference was statistically significant ( χ2=594.937, P<0.05). Conclusion:MP can occur all years round, mainly in summer and autumn.Girls are susceptible, especially common in school-age and pre-school children.Prevention and control measures should be taken as soon as possible for susceptible individuals to reduce the infection rate of MP.

Investigation of an outbreak of Mycoplasma pneumoniae respiratory tract infection in a primary school in Huzhou City， Zhejiang Province / 上海预防医学

ObjectiveTo understand the epidemiological characteristics of an outbreak of respiratory tract infections caused by Mycoplasma pneumoniae （MP） in a primary school in Huzhou City， Zhejiang Province， and to provide scientific reference for future prevention and control of school outbreaks of upper respiratory tract infections caused by M. pneumoniae. MethodsAccording to the requirements for investigating respiratory infectious disease outbreaks， basic information， clinical history and epidemiological information were collected from the cases. Throat swab samples of cases for COVID-19 nucleic acid testing， influenza A and B virus antigen testing， and serum samples for detecting total antibody of mycoplasma were also collected. ResultsA total of 47 cases related to M. pneumoniae infection were identified. The first case occurred on May 4， 2022， and the cases were concentrated between May 22 and May 31， 2022. The last case occurred on June 21， marking a duration of 48 days for the outbreak. All cases were second-grade students， with an incidence rate of 35.07% （47/134） in the affected classes， with Class 206 at 53.330% （24/45）， Class 207 at 38.64% （17/44）， and Class 211 at 13.33% （6/45）. There was a statistically significant difference in the incidence rates among the classes （χ2=16.57，P<0.05）. The incidence rate was 32.39% （23/71） for boys and 38.10% （24/63） for girls， with no statistically significant difference by gender （χ2=0.48，P>0.05）. The main clinical manifestations included cough， fever， and sore throat， and some cases exhibited signs of pneumonia. Pharyngeal swabs and serum samples were collected from 27 patients. The results were negative for pharynx swab samples， and positive for total mycoplasma antibody in 12 serum samples， with a positive rate of 44.44%. ConclusionSymptoms caused by M. pneumoniae are diverse in clinical manifestations， with atypical signs and a slow progression. Early cases tend to exhibit mild symptoms. The onset of the disease is not detected in time when students are attending classes. The school morning health checks fail to promptly detect it and trigger home isolation control measures， which all contribute to the outbreak of the epidemic. Schools should conduct relevant prevention and control campaigns， improve morning and afternoon health checks， and prevent students from attending classes while sick.

Prognosis and correlation analysis of serum SAA, PCT and SF levels in children with severe mycoplasma pneumonia / 公共卫生与预防医学

Objective To analyze the prognosis of children with severe mycoplasma pneumonia (MPP) and its correlation with serum SAA, PCT and SF levels, so as to provide a basis for evaluating the prognosis of children with MPP. Methods A total of 273 children with MPP admitted to our hospital from January 2020 to December 2020 were divided into mild MPP children (n=187) and severe MPP children (n=86) according to the severity of their disease. According to the prognosis, children with severe MPP were divided into survival group (n=65) and death group (n=21). Serum SAA, PCT and SF levels were determined. Pearson correlation analysis was used to analyze the correlation between serum SAA, PCT and SF levels and APACHE ⅱ score. ROC curve was used to analyze the predictive value of serum SAA, PCT and SF levels for poor prognosis of children with severe MPP. Results The levels of serum SAA, PCT and SF and APACHE II score in children with severe MPP were significantly higher than those in children with mild MPP (P<0.05). Serum SAA, PCT and SF levels and APACHE II score in death group were significantly higher than those in survival group (P<0.05). Pearson correlation analysis showed that APACHE II score was positively correlated with serum SAA, PCT and SF levels (r =0.474,0.519,0.446,P<0.05). The AUC, sensitivity and specificity of combined ROC curve analysis to predict the prognosis of severe MPP were 0.871, 85.9% and 93.6% respectively, which were higher than those of SAA, PCT and SF alone. Conclusion SAA, PCT and SF are closely related to the prognosis of severe MPP, and can be used as potential markers to predict poor prognosis of severe MPP children.

An outbreak of school influenza complicated with mycoplasma pneumoniae infection / 中国学校卫生

Objective@#To describe the clinical features, causal agent and transmission mode of a fever outbreak in a school in Shanghai.@*Methods@#Field epidemiological approaches including case definition development, searching for contacts, distribution of diseases description, environmental sampling and laboratory testing.@*Results@#A total of 16 influenza like cases were included, all concentrated in the one class of grade two, including 15 students and 1 teacher. Among student cases, the incidence rate was 36.59% (15/41), the average age was 7.4 years, the incidence rate was 36.84%(7/19) for boys, 36.36%(8/22) for girls. The clinical course was 5-15 days, with the median of 9 days, and 18.75%(3/16) of the cases stayed studying while sick. The nasopharyngeal swab specimens in 16 cases all tested positive for influenza B, of which 11 tested positive for mycoplasma pneumoniae and 1 case also tested positive for coronavirus OC43. Body temperature, number of mononuclear cells, and treatment time of patients infected with Influenza B and mycoplasma pneumoniae were higher than those of patients infected with influenza B alone( P <0.05). The outbreak lasted for 12 days, all sick students were treated and discharged from hospital, with no severe cases or death, and the outbreak was effectively controlled.@*Conclusion@#This campus cluster outbreak caused by influenza B and mycoplasma pneumoniae. Patients with influenza B with mycoplasma pneumoniae have severe symptoms and a long course of illness, suggesting the importance of early management of the epidemic.

The influence of Mycoplasma species on human and canine semen quality: a review / 亚洲男科学杂志(英文版)

Mycoplasma species (spp.) are bacteria that are difficult to detect. Currently, the polymerase chain reaction (PCR) is considered the most effective diagnostic tool to detect these microorganisms in both human and veterinary medicine. There are 13 known species of human Mycoplasma and 15 species of canine Mycoplasma. Owing to the difficulties in identifying the individual species of Mycoplasma, there is a lack of information regarding which species are saprophytic and which are pathogenic. The prevalence of the individual species is also unknown. In addition, in both humans and dogs, the results of some studies on the impact of Mycoplasma are conflicting. The presence of Mycoplasma spp. on the epithelium of reproductive tract is often associated with infertility, although they are also detected in healthy individuals. The occurrence of Mycoplasma spp. is more common in dogs (even 89%) than in humans (1.3%-4%). This is probably because the pH of a dog's genital is more conducive to the growth of Mycoplasma spp. than that of humans. Phylogenetically, human and canine Mycoplasma are related, and majority of them belong to the same taxonomic group. Furthermore, 40% of canine Mycoplasma spp. are placed in common clusters with those of human. This suggests that species from the same cluster can play a similar role in the canine and human reproductive tracts. This review summarizes the current state of knowledge about the impact of Mycoplasma on canine and human male fertility as well as the prospects of further development in this field.

Dickkopf-1 inhibits the secretion of MUC5AC induced by Mycoplasma pneumoniae P1-C in mouse lung epithelial cells / 生物工程学报

Mycoplasma pneumoniae is the most common pathogen of respiratory tract infection in children and adults. Clinical observation shows that M. pneumoniae infection can cause massive mucus secretion in the respiratory tract, which makes the breathing of patients difficult. Studies have shown that M. pneumoniae infection can cause massive secretion of mucin 5AC (MUC5AC). Adhesin P1 plays an important role in the pathogenesis of M. pneumoniae infection by mediating the adhesion of pathogens to host cells, and the C-terminal residues of P1 (P1-C) are immunogenic. This study investigated the molecular mechanism of Wnt/β-catenin signaling pathway inhibitor Dickkopf-1 (DKK1) in the secretion of MUC5AC in mouse airway epithelial cells (MAECs) induced by P1-C. Scanning electron microscope and hematoxylin-eosin staining were used to observe the effect of P1-C on mucus secretion of MAECs. Protein chip was used to detect the secretion of cytokines and analyse the enrichment of related signaling pathways induced by P1-C in MAECs. Periodic acid schiff stain (PAS) staining, Tunel staining and Masson staining were used to detect the damage of the lungs of mouse exposed to P1-C. Immunohistochemistry was used to detect the secretion of MUC5AC expression, and Western blotting was used to reveal the molecular mechanism of DKK1-regulated secretion of MUC5AC induced by P1-C protein in MACES. The results showed that P1-C induced the massive secretion of mucus and inflammatory factors in MAECs. During P1-C infection, DKK1 down-regulated janus kinase 2 (JAK2), phosphorylation signaling and transcription activator 1 (p-STAT1) and phosphorylation signaling and activator of transcription 3 (p-STAT3) expression. Overexpression of DKK1 significantly up-regulated the expression of MUC5AC repressor transcription factor fork-head box protein A2 (FOXA2). At the same time, the expression of MUC5AC induced by P1-C was inhibited significantly. It is speculated that DKK1 can effectively reduce the secretion of MUC5AC in MAECs induced by P1-C by inhibiting the JAK/STAT1-STAT3 signaling pathway and up-regulating the expression of FOXA2.

Clinical Effect of Feining Paidu Decoction on Refractory Mycoplasma Pneumoniae Pneumonia in Child Patients / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of Feining Paidu decoction on refractory Mycoplasma pneumoniae pneumonia in child patients. MethodA randomized controlled trial （RCT） was conducted， with 96 child patients randomly divided into a control group and an observation group， each containing 48 cases. The control group received intravenous azithromycin （10 mg·kg-1·d-1） for 7 days， intravenous methylprednisolone （1 mg·kg-1·d-1） for 3 days， along with supportive treatments such as fluid infusion and antipyretics. The observation group received oral administration of Feining Paidu decoction once a day for 7 days. Changes in traditional Chinese medicine （TCM） syndrome scores， clinical efficacy， serum soluble B7-H3 （sB7-H3）， serum inflammatory factors， coagulation function， and lung imaging ［computer tomography（CT）］ scores were observed in both groups. Adverse reaction events were also recorded. ResultThe total effective rate in the observation group was 95.74% （45/47）， significantly higher than 80.43% （37/46） in the control group （Z=-3.702， P<0.01）. Compared with the results before treatment， TCM syndrome scores， lung imaging scores， sB7-H3， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， D-dimer （D-D）， and fibrinogen （FIB） levels in both groups all significantly decreased after treatment （P<0.05， P<0.01）. After treatment， the observation group showed significantly better results in these indicators than the control group （P<0.05， P<0.01）. There was no statistically significant difference in thrombin time （TT） in the control group before and after treatment， while the observation group showed a significant prolongation after treatment （P<0.05）. There were no statistically significant differences in activated partial thromboplastin time （APTT） and prothrombin time （PT） between the two groups before treatment， and no serious adverse reactions occurred in either group. ConclusionFeining Paidu decoction combined with conventional treatment can alleviate inflammatory responses， improve hypercoagulable states， promote the absorption of pulmonary inflammation， and enhance the clinical efficacy of refractory Mycoplasma pneumoniae pneumonia in children.