Seroprevalencia de anticuerpos anti-Mycoplasma pneumoniae en niños menores de 12 años / Seroprevalence of anti-Mycoplasma pneumoniae antibodies in otherwise healthy children

Resumen: Introducción: La infección por Mycoplasma pneumoniae (Mypn) podría estar ocurriendo a edades más tempranas, debido a fenómenos sociales como concurrencia a centros de cuidado diurno en forma más frecuente y precoz. Objetivo: estimar la prevalencia de anticuerpos anti-Mypn en niños de 0-12 años, y explorar si la edad, asistencia a centro de cuidados diurnos/escuela, hacinamiento o convivencia con niños incrementan el riesgo de seropositividad. Pacientes y Método: Estudio transversal incluyendo niños de 0-12 años de edad que requirieron extracciones de sangre para control, por lo demás sanos. En todos los casos se consignaron las variables mencionadas y se determinó IgG anti-Mypn mediante enzimoinmunoanálisis. Se evaluó la asociación entre predictores y seropositividad en un modelo de regresión logística. Resultados: Se incluyeron 232 pacientes (edad promedio 56,4 ± 40,0 meses). El 56,9% concurría a centro de cuidado diurno/escuela, 63,8% convivían con menores de 12 años y 15,9% presentaban hacinamiento. El 14,6% presentaba anticuerpos anti-Mypn. Los niños seroposi- tivos no mostraron diferencias significativas con aquellos seronegativos en relación a edad (63,1 ± 40,7 vs. 55,4 ± 41,3 meses), escolaridad (64,7% vs 55,5%), hacinamiento (14,7% vs 14,9%), ni con vivencia con menores (64,7% vs 63,6%). La edad tampoco se mostró como predictor independiente de seropositividad en el modelo multivariado. Conclusión: La prevalencia de anticuerpos anti-Mypn fue 14,6%. La edad no fue predictor de seropositividad.

Abstract: Introduction: Mycoplasma pneumoniae (Mypn) infection could be occurring at an earlier age due to social pheno mena such as attending daycare centers more frequently and earlier than decades ago. Objective: to estimate the prevalence of anti-Mypn antibodies in children aged 0-12 years, and to explore whether age, attendance to daycare center/school, overcrowding or the presence of children aged below 12 years in the households increase the risk of seropositivity. Patients and Method: Cross-sectional stu dy including healthy children aged 0-12 years which required blood draws for routine laboratory tests. In all cases, the aforementioned variables were recorded and anti-Mypn IgG was determined by enzyme immunoassay. The association between predictors and seropositivity was assessed in a logistic regression model. Results: We included 232 patients (average age 56.4 ± 40.0 months). 56.9% attended a daycare center/school, 63.8% co-habited with children under 12 years old, and 15.9% lived in overcrowded households. The prevalence of anti-Mypn antibodies was 14.6%. There were no significant differences between seropositive and seronegative children regarding age (63.1 ± 40.7 vs. 55.4 ± 41.3 months), school/day-care attendance (64.7% vs. 55.5%), overcrowding (14.7% vs. 14.9%), or co-habiting with children (64.7% vs. 63.6%). Age was not an independent predictor of seropositivity in the multivariate model. Conclusion: The prevalence of anti-Mypn antibodies in children was 14.6% and age was not a predictor of seropositivity.

Hemólisis, exantema, serositis. Manifestaciones extrapulmonares del Mycoplasma pneumoniae: Reporte de un caso / Hemolysis, serositis and exanthema induced by Mycoplasma pneumoniae infection: Report of one case

Mycoplasma infections have extrapulmonary manifestations that may be associated with respiratory symptoms and may have skin, heart, gastrointestinal, rheumatologic, neurologic, hematologic involvement. Cold agglutinin mediated autoimmune hemolytic anemia is the most common hematological manifestation. We report a 27-year-old woman infected with Mycoplasma pneumoniae, who presented respiratory involvement with pneumonia, exanthema, serositis and acute hemolytic anemia that required transfusion. The key for the diagnosis were the extrapulmonary manifestations associated with respiratory involvement after five days of hospitalization.

Características clínico-radiológicas e hematológicas das pneumonias causadas pelo Mycoplasma pneumoniae / Clinical, radiographic and hematological characteristics of Mycoplasma pneumoniae pneumonia

OBJETIVO: Descrever as características clínicas, hematológicas e radiológicas de crianças hospitalizadas por pneumonia causada pelo Mycoplasma pneumoniae. MÉTODO: Participaram deste estudo, 190 crianças de 3 meses a 16 anos, hospitalizadas por pneumonia radiologicamente comprovada. Os pacientes foram divididos em dois grupos, a saber: 95 crianças com pneumonia por Mycoplasma pneumoniae, diagnosticada pelo método de ensaio imunoenzimático (ELISA); e 95 crianças com pneumonia causada por outros agentes etiológicos. A partir de um sistema de pontuação validado, os achados clínicos, hematológicos e radiológicos dos dois grupos foram comparados para diferenciar as pneumonias por Mycoplasma pneumoniae (grupo 1) das pneumonias causadas por outros agentes etiológicos (grupo 2), divididas em bactérias (n = 75) e vírus (n = 20). RESULTADOS: Pneumonia por Mycoplasma pneumoniae foi mais frequente em crianças do sexo feminino (p < 0,01), com média de idade maior (p < 0,01), tosse seca (p < 0,01) e manifestações extrapulmonares (p < 0,01). As variáveis clínicas, hematológicas e radiológicas da pneumonia por Mycoplasma pneumoniae (média do escore = 6,95) tiveram uma pontuação intermediária entre os escores obtidos para as pneumonias bacterianas (média do escore = 8,27) e virais (média do escore = 0,90). CONCLUSÃO: Os resultados sugerem que o sistema de pontuação empregado pode contribuir para o diagnóstico presuntivo de pneumonia por Mycoplasma pneumoniae e auxiliar na sua diferenciação dos quadros pneumônicos determinados por outros agentes etiológicos.

OBJECTIVE: To describe the clinical, hematological and radiographic characteristics of children hospitalized for Mycoplasma pneumoniae pneumonia. METHOD: The study population consisted of 190 children between 3 months and 16 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups, to wit: 95 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the enzyme-linked immunosorbent assay (ELISA) method; and 95 children with pneumonia caused by other etiologic agents. Using a validated scoring system, the clinical, hematological and radiographic findings of both groups were compared to differentiate Mycoplasma pneumoniae pneumonia (group 1) from pneumonia caused by other etiologic agents (group 2), itself divided into two groups, bacterial (n = 75) and viral (n = 20). RESULTS: Mycoplasma pneumoniae pneumonia was found most often in girls (p < 0.01), older children (p < 0.01), and patients with dry cough (p < 0.01) and extrapulmonary manifestations (p < 0.01). The clinical, hematological and radiographic variables of Mycoplasma pneumoniae pneumonia (mean score = 6.95) scored between those found in bacterial (mean score = 8.27) and viral pneumonia (mean score = 0.90). CONCLUSION: Results suggest that the scoring system can contribute to the presumptive diagnosis of Mycoplasma pneumoniae pneumonia and help differentiate pneumonic status caused by other etiologic agents.

A Case of Acute Hepatitis with Mycoplasma pneumoniae Infection and Transient Depression of Multiple Coagulation Factors

We report a case of acute severe hepatitis with Mycoplasma pneumoniae (M. pneumoniae) infection and transient depression of multiple coagulation factors. A 5-year-old boy, previously healthy, was admitted with pneumonia. M. pneumoniae infection was confirmed by serology testing. Liver enzymes were elevated on admission without any past medical history. After treatment with azithromycin for 3 days, pneumonia improved, but the hepatitis was acutely aggravated. Partial thromboplastin time (PTT) was prolonged and depression of multiple coagulation factors developed. Liver biopsy revealed features consistent with acute hepatitis. A week later, liver enzymes were nearly normalized spontaneously. Normalization of prolonged PTT and coagulation factors were also observed several months later. This may be the first case of transient depression of multiple coagulation factors associated with M. pneumoniae infection.

Multiple hypoechoic lesions in spleen and Mycoplasma pneumoniae infection.

An 8-year-old boy was admitted because of recurrent fever for 1 month with increased CRP and ESR. Ultrasound reviewed multiple, small, hypo-echoic, rounded and wedge-shaped nodules with diffuse blood flow in spleen and enlarged abdominal lymph nodes. The spleen was enlarged and no echoic space was found in the largest lesion on 5th day. After a positive mycoplasma pneumoniae (MP) IgM was reported on 6th day, azithromycin was used intravenously. The temperature returned to normal and CRP and ESR improved in a short period. The lesions and lymphadenopathy disappeared and MP IgM antibody became negative 6 months later.

Distributions of Antibody Titers to Mycoplasma pneumoniae in Korean Children in 2000-2003

The aim of study was to describe Mycoplasma pneumoniae epidemics in a hospital-based population. Special attention was paid to the relationship between antibody titer to M. pneumoniae and sex, age, and atopy. During the eight 6-month periods between January 2000 and December 2003, serum samples were obtained from 1,319 Korean children who presented with respiratory symptoms, and were examined for antibodies to M. pneumoniae using the indirect particle agglutination test. Geometric mean antibody titers peaked in the second half of 2000 and then decreased gradually, a second peak occurred in the second half of 2003. Likewise, the frequency of high antibody titers (>or=1:640) also peaked during these two periods. Antibody titers in children aged 0-3 yr were lower than in older children during both peak periods and for 2 yr after the first peak. Sex and atopy had no effect on antibody titers. During the years 2000-2003, geometric mean antibody titers and the frequencies of high antibody titers varied with time. These changes suggest a cyclic pattern of M. pneumoniae infection, with two epidemic peaks separated by 3 yr.

Prevalence of complement fixing antibody to Mycoplasma pneumoniae in Thai children.

The prevalence of antibodies to Mycoplasma pneumoniae was determined in normal Thai children by means of complement fixation. There were 445 children (243 boys and 202 girls) of different ages, ranging from newborn to 15 years. The lowest frequency of complement-fixing antibody was found in children age 1-3 months, and highest in children age 6-10 years which corresponds to the age distribution of symptomatic M. pneumoniae infection. The lowest and highest titers measured were less than 1:8 and 1:512 respectively. The prevalence of complement fixing antibody of titers more than or equal to 1:8, 1:32, 1:64 and 1:128 were 61.3, 31.7, 25.4 and 10.3 per cent of total children, respectively. Among children less than one month old, the frequency of complement fixing antibody of titers greater than or equal to 1:32 was 12.2 per cent and decreased to 1.3 per cent among children from the age 1-3 months. This decrease probably represented the disappearance of maternal antibody over this period. An increase in both the frequency and the geometric mean titer was seen thereafter. The peak frequency of high titers (greater than or equal to 1:32), 81.1 per cent, occurred in children 6-10 year of age. Paired sera were obtained from 72 children with high titers of greater than or equal to 1:64, 9.7 per cent had four fold changes of titer which indicated recent infection.(ABSTRACT TRUNCATED AT 250 WORDS)