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1.
Microbiol Spectr ; 10(2): e0002622, 2022 04 27.
Article in English | MEDLINE | ID: covidwho-1868712

ABSTRACT

Consolidation is one complication of pediatric severe community-acquired pneumonia (SCAP) that can respond poorly to conservative medical treatment. We investigated the pathogens that cause pediatric SCAP including cases with persistent consolidation that need bronchoscopy intervention. Alveolar lavage fluid (ALF) samples collected from cases admitted to Children's Hospital of Fudan University with SCAP during January 2019 to March in 2019 were retrospectively tested by the RespiFinder 2SMART multiplex PCR (multi-PCR) assay targeting 22 respiratory pathogens. A total of 90 cases and 91 samples were enrolled; 80.0% (72/90) of the cases had pulmonary consolidation and/or atelectasis. All samples were positive with targeted pathogens tested by multi-PCR, and 92.3% (84/91) of the samples were co-detected with pathogens. Mycoplasma pneumoniae (MP) and adenovirus (ADV) as the two dominant pathogens, with the positive rates of 96.7% (88/91) and 79.1% (72/91), respectively. Most of the samples were positive with MP and ADV simultaneously. As a control, 78.0% (71/91) of the samples were positive by conventional tests (CT), in which MP had the detection rate of 63.9% (55/86) by a traditional real-time PCR assay, while ADV were positive in 13.1% (12/91) of the samples by a direct immunofluorescence assay (DFA). In cases with persistent pulmonary consolidation, the positive rates of pathogens by multi-PCR and CT were 100% (72/72) and 81.9% (59/72), respectively. There were no significant differences of MP or ADV positive rates between cases with and without pulmonary consolidation. MP and ADV most prevalent in pediatric SCAP cases required fiberscope intervention, and presented with coinfections dominantly. IMPORTANCE Pathogens that cause pediatric severe community-acquired pneumonia (SCAP) requiring bronchoscopy intervention are understudied. Through this study, we explore the etiology of SCAP form alveolar lavage fluid (ALF) samples by the RespiFinder 2SMART multi-PCR assay. It is observed that high mixed detection rates of Mycoplasma pneumoniae and adenovirus in ALF samples collected from hospitalized SCAP children experienced bronchoscopy intervention. Eighty percent of the cases had pulmonary consolidation and/or atelectasis. The presence of possible coinfection of these two pathogens might contribute to poor clinical anti-infection response. The results of this study might be helpful for the selection of clinical strategies for the empirical treatment of such pediatric SCAP cases.


Subject(s)
Adenoviridae Infections , Coinfection , Community-Acquired Infections , Pneumonia , Pulmonary Atelectasis , Adenoviridae , Child , Coinfection/diagnosis , Community-Acquired Infections/diagnosis , Humans , Infant , Mycoplasma pneumoniae/genetics , Retrospective Studies
3.
BMJ Case Rep ; 15(4)2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1854260

ABSTRACT

A transgender man in his late teens presented with signs of multisystem disease, including hepatitis, mucositis and bone marrow suppression. He later developed dyspnoea, leucocytosis and bilateral pulmonary infiltrates on chest radiograph. He was treated for community-acquired pneumonia. After several days of treatment, he developed hypoxaemic respiratory failure due to bronchoscopy-confirmed diffuse alveolar haemorrhage (DAH). The differential diagnosis and workup were extensive, and he was ultimately treated with intravenous steroids and five sessions of plasmapheresis for a presumed autoimmune aetiology. Investigations were remarkable only for elevated IgM and IgG to Mycoplasma pneumoniae (MP). This case represents a rare presentation of multisystem disease secondary to MP in adults. Clinicians should consider Mycoplasma infection in cases of multisystem disease and observe for DAH even after initiation of appropriate therapy.


Subject(s)
Community-Acquired Infections , Lung Diseases , Adolescent , Adult , Bronchoscopy , Hemorrhage/etiology , Hemorrhage/therapy , Humans , Lung Diseases/diagnosis , Lung Diseases/etiology , Male , Mycoplasma pneumoniae
4.
Front Cell Infect Microbiol ; 12: 854505, 2022.
Article in English | MEDLINE | ID: covidwho-1847155

ABSTRACT

Objective: Mycoplasma pneumoniae (M. pneumoniae) is an important pathogen of community acquired pneumonia. With the outbreak of coronavirus disease 2019 (COVID-19), the prevalence of some infectious respiratory diseases has varied. Epidemiological features of M. pneumoniae in children from Beijing (China) before and during the COVID-19 pandemic were investigated. Methods: Between June 2016 and May 2021, a total of 569,887 children with respiratory infections from Children's Hospital Affiliated to Capital Institute of Pediatrics (Beijing, China) were included in this study. M. pneumoniae specific-IgM antibody in serum specimens of these patients was tested by a rapid immunochromatographic assay kit. The relevant clinical data of M. pneumoniae-positive cases were also collected, and analyzed by RStudio software. Results: The results showed that 13.08% of collected samples were positive for M. pneumoniae specific-IgM antibody. The highest annual positive rate was 17.59% in 2019, followed by 12.48% in 2018, 12.31% in 2017, and 11.73% in 2016, while the rate dropped to 8.9% in 2020 and 4.95% in 2021, with significant difference. Among the six years, the positive rates in summer and winter seasons were significantly higher than those in spring and autumn seasons (p < 0.001). The positive rate was the highest in school-age children (22.20%), and lowest in the infant group (8.76%, p < 0.001). The positive rate in boys (11.69%) was lower than that in girls (14.80%, p < 0.001). There were no significant differences in different seasons, age groups, or genders before and during the COVID-19 pandemic (p > 0.05). Conclusions: Our study demonstrated that an M. pneumoniae outbreak started from the summer of 2019 in Beijing. After the COVID-19 pandemic outbreak in the end of 2019, the M. pneumoniae positive rates dropped dramatically. This may be due to the restrictive measures of the COVID-19 pandemic, which effectively controlled the transmission of M. pneumoniae. The relationships between M. pneumoniae positive rates and season, age, and gender were not statistically significant before and during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pneumonia, Mycoplasma , Beijing/epidemiology , COVID-19/epidemiology , Child , Female , Humans , Immunoglobulin M , Infant , Male , Mycoplasma pneumoniae , Pandemics , Pneumonia, Mycoplasma/epidemiology , Prevalence
5.
Euro Surveill ; 27(19)2022 05.
Article in English | MEDLINE | ID: covidwho-1847113

ABSTRACT

BackgroundMycoplasma pneumoniae respiratory infections are transmitted by aerosol and droplets in close contact.AimWe investigated global M. pneumoniae incidence after implementation of non-pharmaceutical interventions (NPIs) against COVID-19 in March 2020.MethodsWe surveyed M. pneumoniae detections from laboratories and surveillance systems (national or regional) across the world from 1 April 2020 to 31 March 2021 and compared them with cases from corresponding months between 2017 and 2020. Macrolide-resistant M. pneumoniae (MRMp) data were collected from 1 April 2017 to 31 March 2021.ResultsThirty-seven sites from 21 countries in Europe, Asia, America and Oceania submitted valid datasets (631,104 tests). Among the 30,617 M. pneumoniae detections, 62.39% were based on direct test methods (predominantly PCR), 34.24% on a combination of PCR and serology (no distinction between methods) and 3.37% on serology alone (only IgM considered). In all countries, M. pneumoniae incidence by direct test methods declined significantly after implementation of NPIs with a mean of 1.69% (SD ± 3.30) compared with 8.61% (SD ± 10.62) in previous years (p < 0.01). Detection rates decreased with direct but not with indirect test methods (serology) (-93.51% vs + 18.08%; p < 0.01). Direct detections remained low worldwide throughout April 2020 to March 2021 despite widely differing lockdown or school closure periods. Seven sites (Europe, Asia and America) reported MRMp detections in one of 22 investigated cases in April 2020 to March 2021 and 176 of 762 (23.10%) in previous years (p = 0.04).ConclusionsThis comprehensive collection of M. pneumoniae detections worldwide shows correlation between COVID-19 NPIs and significantly reduced detection numbers.


Subject(s)
COVID-19 , Pneumonia, Mycoplasma , COVID-19/epidemiology , Communicable Disease Control , Humans , Macrolides , Mycoplasma pneumoniae/genetics , Pandemics , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/epidemiology
6.
Front Cell Infect Microbiol ; 12: 843463, 2022.
Article in English | MEDLINE | ID: covidwho-1779935

ABSTRACT

Background: Since the outbreak of COVID-19, a series of preventive and control measures in China have been used to effectively curb the spread of COVID-19. This study aimed to analyze the epidemiological characteristics of Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP) in hospitalized children with acute respiratory tract infection during the COVID-19 pandemic. Methods: MP IgM antibody and CP IgM antibody were detected in all hospitalized children due to acute respiratory tract infection in the Children's Hospital Affiliated to Zhejiang University from January 2019 to December 2020. These data were compared between 2019 and 2020 based on age and month. Results: The overall detection rate of MP and CP in 2020 was significantly lower than that in 2019 (MP: 21.5% vs 32.9%, P<0.001; CP: 0.3% vs 0.9%, P<0.001). This study found a 4-fold reduction in the number of children positive for MP and a 7.5-fold reduction in the number of children positive for CP from 2019 to 2020. The positive cases were concentrated in children aged >1 year old. In 2019, the positive rate of MP was detected more commonly in children 3 years of age or older than in younger children. In 2020, the higher positive rate of MP reached a peak in the 3- to 6-year age group (35.3%). CP was detected predominantly in children aged 6 years older in 2019 and 2020, with positive rates of 4.8% and 2.6%, respectively. Meanwhile, the positive rates of MP in 2019 were detected more commonly in July, August and September, with 47.2%, 46.7% and 46.3%, respectively. Nevertheless, the positive rates of MP from February to December 2020 apparently decreased compared to those in 2019. The positive rates of CP were evenly distributed throughout the year, with 0.5%-1.6% in 2019 and 0.0%-2.1% in 2020. Conclusions: A series of preventive and control measures for SARS-CoV-2 during the COVID-19 pandemic can not only contain the spread of SARS-CoV-2 but also sharply improve the infection of other atypical pathogens, including MP and CP.


Subject(s)
COVID-19 , Chlamydophila Infections , Chlamydophila pneumoniae , Pneumonia, Mycoplasma , Respiratory Tract Infections , Aged , COVID-19/epidemiology , Child , Child, Hospitalized , Chlamydophila Infections/epidemiology , Epidemiologic Studies , Humans , Immunoglobulin M , Infant , Mycoplasma pneumoniae , Pandemics , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/epidemiology , Respiratory Tract Infections/epidemiology , SARS-CoV-2
7.
Am J Emerg Med ; 54: 324.e5-324.e7, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1748330

ABSTRACT

Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a recently defined clinical entity characterized by pneumonia caused by M. pneumoniae with associated mucositis and frequent cutaneous lesions of a characteristic pattern. Although often similar in presentation, MIRM has distinct clinical and histologic features that are different from erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis. We report a case of MIRM in a nine-year-old boy.


Subject(s)
Erythema Multiforme , Exanthema , Mucositis , Pneumonia, Mycoplasma , Stevens-Johnson Syndrome , Child , Erythema Multiforme/diagnosis , Exanthema/etiology , Humans , Male , Mucositis/complications , Mycoplasma pneumoniae , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/diagnosis , Stevens-Johnson Syndrome/etiology
8.
Microbiol Spectr ; 10(1): e0155021, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1685499

ABSTRACT

Mycoplasma pneumoniae is a common pathogen causing respiratory disease in children. We sought to investigate the epidemiology of M. pneumoniae among outpatient children with mild respiratory tract infections (RTIs) during the coronavirus disease 2019 (COVID-19) pandemic. Eligible patients were prospectively enrolled from January 2020 to June 2021. Throat swabs were tested for M. pneumoniae RNA. M. pneumoniae IgM was tested by a colloidal gold assay. Macrolide resistance and the effect of the COVID-19 countermeasures on M. pneumoniae prevalence were assessed. Symptom scores, treatments, and outcomes were evaluated. Eight hundred sixty-two eligible children at 15 centers in China were enrolled. M. pneumoniae was detected in 78 (9.0%) patients. Seasonally, M. pneumoniae peaked in the first spring and dropped dramatically to extremely low levels over time until the next summer. Decreases in COVID-19 prevalence were significantly associated with decreases in M. pneumoniae prevalence (r = 0.76, P = 0.001). The macrolide resistance rate was 7.7%. The overall sensitivity and specificity of the colloidal gold assay used in determining M. pneumoniae infection were 32.1% and 77.9%, respectively. No more benefits for improving the severity of symptoms and outcomes were observed in M. pneumoniae-infected patients treated with a macrolide than in those not treated with a macrolide during follow-up. The prevalences of M. pneumoniae and macrolide resistance in outpatient children with mild RTIs were at low levels in the early stage of the COVID-19 pandemic but may have rebounded recently. The colloidal gold assay for M. pneumoniae IgM may be not appropriate for diagnosis of M. pneumoniae infection. Macrolides should be used with caution among outpatients with mild RTIs. IMPORTANCE This is the first and largest prospective, multicenter, active, population-based surveillance study of the epidemiology of Mycoplasma pneumoniae among outpatient children with mild respiratory tract infections (RTIs) during the COVID-19 pandemic. Nationwide measures like strict face mask wearing and restrictions on population movement implemented to prevent the spread of COVID-19 might also effectively prevent the spread of M. pneumoniae. The prevalence of M. pneumoniae and the proportion of drug-resistant M. pneumoniae isolates in outpatient children with mild RTIs were at low levels in the early stage of the COVID-19 pandemic but may have rebounded recently. The colloidal gold assay for M. pneumoniae IgM may be not appropriate for screening and diagnosis of M. pneumoniae infection. Macrolides should be used with caution among outpatients with mild RTIs.


Subject(s)
Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/microbiology , Respiratory Tract Infections/microbiology , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , COVID-19/epidemiology , Child , Child, Preschool , China/epidemiology , Drug Resistance, Bacterial , Female , Humans , Infant , Macrolides/therapeutic use , Male , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/physiology , Outpatients/statistics & numerical data , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Mycoplasma/epidemiology , Prospective Studies , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/epidemiology , Young Adult
9.
J Med Virol ; 94(1): 303-309, 2022 01.
Article in English | MEDLINE | ID: covidwho-1544346

ABSTRACT

Emerging evidence shows co-infection with atypical bacteria in coronavirus disease 2019 (COVID-19) patients. Respiratory illness caused by atypical bacteria such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila may show overlapping manifestations and imaging features with COVID-19 causing clinical and laboratory diagnostic issues. We conducted a prospective study to identify co-infections with SARS-CoV-2 and atypical bacteria in an Indian tertiary hospital. From June 2020 to January 2021, a total of 194 patients with laboratory-confirmed COVID-19 were also tested for atypical bacterial pathogens. For diagnosing M. pneumoniae, a real-time polymerase chain reaction (PCR) assay and serology (IgM ELISA) were performed. C. pneumoniae diagnosis was made based on IgM serology. L. pneumophila diagnosis was based on PCR or urinary antigen testing. Clinical and epidemiological features of SARS-CoV-2 and atypical bacteria-positive and -negative patient groups were compared. Of the 194 patients admitted with COVID-19, 17 (8.8%) were also diagnosed with M. pneumoniae (n = 10) or C. pneumoniae infection (n = 7). Confusion, headache, and bilateral infiltrate were found more frequently in the SARS CoV-2 and atypical bacteria co-infection group. Patients in the M. pneumoniae or C. pneumoniae co-infection group were more likely to develop ARDS, required ventilatory support, had a longer hospital length of stay, and higher fatality rate compared to patients with only SARS-CoV-2. Our report highlights co-infection with bacteria causing atypical pneumonia should be considered in patients with SARS-CoV-2 depending on the clinical context. Timely identification of co-existing pathogens can provide pathogen-targeted treatment and prevent fatal outcomes of patients infected with SARS-CoV-2 during the current pandemic.


Subject(s)
Atypical Bacterial Forms/isolation & purification , COVID-19/pathology , Chlamydophila Infections/epidemiology , Coinfection/epidemiology , Legionnaires' Disease/epidemiology , Pneumonia, Mycoplasma/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Chlamydophila pneumoniae/isolation & purification , Female , Humans , India , Legionella pneumophila/isolation & purification , Length of Stay , Male , Middle Aged , Mycoplasma pneumoniae/isolation & purification , Prospective Studies , SARS-CoV-2 , Severity of Illness Index , Young Adult
10.
Virol J ; 18(1): 202, 2021 10 09.
Article in English | MEDLINE | ID: covidwho-1463255

ABSTRACT

BACKGROUND: The effect of SARS-CoV-2 on existing respiratory pathogens in circulation remains uncertain. This study aimed to assess the impact of SARS-CoV-2 on the prevalence of respiratory pathogens among hospitalized children. METHODS: This study enrolled hospitalized children with acute respiratory infections in Shenzhen Children's Hospital from September to December 2019 (before the COVID-19 epidemic) and those from September to December 2020 (during the COVID-19 epidemic). Nasopharyngeal swabs were collected, and respiratory pathogens were detected using multiplex PCR. The absolute case number and detection rates of 11 pathogens were collected and analyzed. RESULTS: A total of 5696 children with respiratory tract infection received multiplex PCR examination for respiratory pathogens: 2298 from September to December 2019 and 3398 from September to December 2020. At least one pathogen was detected in 1850 (80.5%) patients in 2019, and in 2380 (70.0%) patients in 2020; the detection rate in 2020 was significantly lower than that in 2019.The Influenza A (InfA) detection rate was 5.6% in 2019, but 0% in 2020. The detection rates of Mycoplasma pneumoniae, Human adenovirus, and Human rhinovirus also decreased from 20% (460), 8.9% (206), and 41.8% (961) in 2019 to 1.0% (37), 2.1% (77), and 25.6% (873) in 2020, respectively. In contrast, the detection rates of Human respiratory syncytial virus, Human parainfluenza virus, and Human metapneumovirus increased from 6.6% (153), 9.9% (229), and 0.5% (12) in 2019 to 25.6% (873), 15.5% (530), and 7.2% (247) in 2020, respectively (p < 0.0001). CONCLUSIONS: Successful containment of seasonal influenza as a result of COVID-19 control measures will ensure we are better equipped to deal with future outbreaks of both influenza and COVID-19.Caused by virus competition, the detection rates of Human respiratory syncytial virus, Human parainfluenza virus, and Human metapneumovirus increased in Shenzhen,that reminds us we need to take further monitoring and preventive measures in the next epidemic season.


Subject(s)
Antibiosis , COVID-19/epidemiology , Respiratory Tract Diseases/epidemiology , SARS-CoV-2/isolation & purification , Adenoviruses, Human/genetics , Adenoviruses, Human/isolation & purification , Adolescent , COVID-19/virology , Child , Child, Hospitalized , Child, Preschool , China , Enterovirus/genetics , Enterovirus/isolation & purification , Female , Humans , Infant , Influenza A virus/genetics , Influenza A virus/isolation & purification , Male , Metapneumovirus/genetics , Metapneumovirus/isolation & purification , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/isolation & purification , Nasopharynx/microbiology , Nasopharynx/virology , Prevalence , Respiratory Syncytial Viruses/genetics , Respiratory Syncytial Viruses/isolation & purification , Respiratory Tract Diseases/microbiology , Respiratory Tract Diseases/virology , Respirovirus/genetics , Respirovirus/isolation & purification , SARS-CoV-2/genetics
11.
Pediatr Dermatol ; 38(5): 1222-1225, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1405194

ABSTRACT

Reactive infectious mucocutaneous eruption (RIME) was proposed as new terminology to encompass postinfectious mucocutaneous eruptions. The term includes all postinfectious mucocutaneous eruptions such as the widely reported Mycoplasma pneumoniae-induced rash and mucositis (MIRM). Very few reports in the literature regarding recurrent RIME are found. We present two adolescent cases of recurrent RIME that involve SARS-CoV-2 and influenza A where the latter is a newly reported infectious trigger; in both patients, the initial episode was likely triggered by Mycoplasma pneumoniae (MP) infection.


Subject(s)
COVID-19 , Exanthema , Influenza, Human , Pneumonia, Mycoplasma , Adolescent , Humans , Mycoplasma pneumoniae , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/diagnosis , SARS-CoV-2
12.
Future Microbiol ; 16(11): 769-776, 2021 07.
Article in English | MEDLINE | ID: covidwho-1308246

ABSTRACT

The current study presents two patients who lived in a rural family with close contact and suffered from rapidly progressive pneumonia. Chest computed tomography images and lymphocytopenia indicated the possibility of COVID-19 infection, but antibody and nucleic acid tests excluded this possibility. Negative results were obtained from corresponding tests for pneumococcal, adenovirus, fungal and legionella infection. Metagenomics analysis and subsequent antibody tests confirmed mycoplasma pneumonia. After treating with moxifloxacin, both patients recovered well and left the hospital. In terms of complicated infectious disease, consideration of atypical pathogens and medical and epidemiological history were important for differential diagnosis of COVID-19; metagenomics analysis was useful to provide direct references for diagnosis.


Subject(s)
Moxifloxacin/therapeutic use , Pneumonia, Mycoplasma/diagnosis , Adolescent , Adult , COVID-19 , DNA, Bacterial , Diagnosis, Differential , Feces/microbiology , Female , Humans , Male , Metagenomics , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/drug therapy , Sputum/microbiology , Young Adult
13.
J Infect Dev Ctries ; 15(6): 761-765, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1304764

ABSTRACT

INTRODUCTION: The aim of this study is to determine the coinfections with other respiratory pathogens in SARS-CoV-2 infected children patients in a pediatric unit in Istanbul. METHODOLOGY: This retrospective descriptive study was conducted in a 1000-bedded tertiary education and research hospital in Istanbul. All children hospitalized with the diagnosis of SARS-CoV-2 infection had been investigated for respiratory agents in nasopharyngeal secretions. Laboratory confirmation of SARS-CoV-2 and the other respiratory pathogens were performed using reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: A total of 209 hospitalized children with suspected SARS-CoV-2 infection between March 2020-May 2020 were enrolled in this study. Among 209 children, 93 (44.5%) were RT-PCR positive for SARS-CoV-2 infection, and 116 (55.5%) were RT-PCR negative. The most common clinical symptoms in all children with SARS-CoV-2 infection were fever (68.8%) and cough (57.0%). The other clinical symptoms in decreasing rates were headache (10.8%), myalgia (5.4%), sore throat (3.2%), shortness of breath (3.2%), diarrhea (2.2%) and abdominal pain in one child. In 7 (7.5%) patients with SARS-CoV-2 infection, coinfection was detected. Two were with rhinovirus/enterovirus, two were with Coronavirus NL63, one was with adenovirus, and one was with Mycoplasma pneumoniae. In one patient, two additional respiratory agents (rhinovirus/enterovirus and adenovirus) were detected. There was a significantly longer hospital stay in patients with coinfection (p = 0.028). CONCLUSIONS: Although the coinfection rate was low in SARS-CoV-2 infected patients in our study, we found coinfection as a risk factor for length of hospital stay in the coinfected patient group.


Subject(s)
COVID-19/microbiology , COVID-19/virology , Coinfection/microbiology , Coinfection/virology , Viruses/genetics , Adenoviridae/genetics , Adolescent , COVID-19/diagnosis , Child , Child, Preschool , Coinfection/diagnosis , Coinfection/epidemiology , Hospitalization/statistics & numerical data , Humans , Length of Stay/statistics & numerical data , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/isolation & purification , Nasopharynx/microbiology , Nasopharynx/virology , Qualitative Research , Respiratory System/microbiology , Respiratory System/virology , Retrospective Studies , SARS-CoV-2/genetics , Tertiary Care Centers/statistics & numerical data , Turkey/epidemiology , Viruses/classification , Viruses/isolation & purification
14.
Pediatrics ; 147(5)2021 05.
Article in English | MEDLINE | ID: covidwho-1256104

ABSTRACT

A male individual aged 18 years with no significant past medical history presented with fever, headache, dry cough, and chest pain. On clinical examination, he had tachycardia and hypotension needing intravenous fluid resuscitation and inotropic support. A chest radiograph revealed streaky lung opacities, and he was treated with antibiotics for suspected community-acquired pneumonia complicated by septic shock. Significant elevation of cardiac enzymes was noted, and there was a continued need for inotropes to maintain normotension. He also developed intermittent bradycardia, with serial electrocardiograms showing first-degree atrioventricular block, low-voltage QRS complexes, and ST-T wave changes and telemetry demonstrating junctional and ventricular escape rhythm. A complete workup for sepsis and acute myocarditis were performed to find the etiologic agent. Intravenous immunoglobulins were started to treat myocarditis, with eventual clinical improvement. He was eventually diagnosed with an unusual etiology for his illness. He was noted to still have intermittent ventricular escape rhythm on electrocardiograms on follow-up 2 weeks after discharge but continues to remain asymptomatic and in good health.


Subject(s)
Mycoplasma pneumoniae/isolation & purification , Myocarditis/microbiology , Pneumonia, Mycoplasma/diagnosis , Adolescent , Arrhythmias, Cardiac/etiology , Bradycardia/diagnosis , Bradycardia/physiopathology , COVID-19/diagnosis , COVID-19/therapy , Diagnosis, Differential , Fever/etiology , Humans , Hypotension/etiology , Immunoglobulins, Intravenous/therapeutic use , Male , Mycoplasma pneumoniae/immunology , Neutropenia/etiology , Pneumonia, Mycoplasma/complications , Shock, Septic/microbiology , Tachycardia/etiology
15.
BMC Pediatr ; 21(1): 202, 2021 04 28.
Article in English | MEDLINE | ID: covidwho-1207594

ABSTRACT

BACKGROUND: Following the outbreak of the COVID-19 pandemic, a change in the incidence and transmission of respiratory pathogens was observed. Here, we retrospectively analyzed the impact of COVID-19 on the epidemiologic characteristics of Mycoplasma pneumoniae infection among children in Chengdu, one of the largest cities of western China. METHOD: M. pneumoniae infection was diagnosed in 33,345 pediatric patients with respiratory symptoms at the Chengdu Women's & Children's Central Hospital between January 2017 and December 2020, based on a serum antibody titer of ≥1:160 measured by the passive agglutination assay. Differences in infection rates were examined by sex, age, and temporal distribution. RESULTS: Two epidemic outbreaks occurred between October-December 2017 and April-December 2019, and two infection peaks were detected in the second and fourth quarters of 2017, 2018, and 2019. Due to the public health response to COVID-19, the number of positive M. pneumoniae cases significantly decreased in the second quarter of 2020. The number of M. pneumoniae infection among children aged 3-6 years was higher than that in other age groups. CONCLUSIONS: Preschool children are more susceptible to M. pneumoniae infection and close contact appears to be the predominant factor favoring pathogen transmission. The public health response to COVID-19 can effectively control the transmission of M. pneumoniae.


Subject(s)
COVID-19 , Pneumonia, Mycoplasma , Child , Child, Preschool , China/epidemiology , Female , Humans , Infant , Mycoplasma pneumoniae , Pandemics , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/epidemiology , Retrospective Studies , SARS-CoV-2
16.
Mil Med Res ; 7(1): 60, 2020 12 03.
Article in English | MEDLINE | ID: covidwho-956635

ABSTRACT

In 2019, an outbreak of Mycoplasma 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.


Subject(s)
Military Personnel/statistics & numerical data , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/drug therapy , Academies and Institutes/organization & administration , Academies and Institutes/statistics & numerical data , Academies and Institutes/trends , China/epidemiology , Disease Outbreaks/statistics & numerical data , Humans , Mycoplasma pneumoniae/drug effects , Pneumonia, Mycoplasma/epidemiology
17.
Dermatology ; 238(1): 53-59, 2022.
Article in English | MEDLINE | ID: covidwho-1153758

ABSTRACT

BACKGROUND: Mycoplasma pneumoniae atypical pneumonia is frequently associated with erythema multiforme. Occasionally, a mycoplasma infection does not trigger any cutaneous but exclusively mucosal lesions. The term mucosal respiratory syndrome is employed to denote the latter condition. Available reviews do not address the possible association of mucosal respiratory syndrome with further atypical bacterial pathogens such as Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella species. We therefore performed a systematic review of the literature addressing this issue in the National Library of Medicine, Excerpta Medica, and Web of Science databases. SUMMARY: We found 63 patients (≤18 years, n = 36; >18 years, n = 27; 54 males and 9 females) affected by a mucosal respiratory syndrome. Fifty-three cases were temporally associated with a M. pneumoniae and 5 with a C. pneumoniae infection. No cases temporally associated with C. psittaci, C. burnetii, F. tularensis, or Legionella species infection were found. Two cases were temporally associated with Epstein-Barr virus or influenzavirus B, respectively.


Subject(s)
Mucositis/complications , Mucositis/microbiology , Respiratory Tract Infections/complications , Respiratory Tract Infections/microbiology , Chlamydophila pneumoniae , Humans , Mucositis/diagnosis , Mycoplasma pneumoniae , Respiratory Tract Infections/diagnosis , Syndrome
18.
Rev Esp Quimioter ; 34(2): 81-92, 2021 Apr.
Article in Spanish | MEDLINE | ID: covidwho-1145772

ABSTRACT

From a microbiological point of view, both empirical and targeted antimicrobial treatment in respiratory infection is based on the sensitivity profile of isolated microorganisms and the possible resistance mechanisms that they may present. The latter may vary in different geographic areas according to prescription profiles and vaccination programs. Beta-lactam antibiotics, fluoroquinolones, and macrolides are the most commonly used antimicrobials during the exacerbations of chronic obstructive pulmonary disease and community-acquired pneumonia. In their prescription, different aspects such as intrinsic activity, bactericidal effect or their ability to prevent the development of resistance must be taken into account. The latter is related to the PK/PD parameters, the mutant prevention concentration and the so-called selection window. More recently, the potential ecological impact has grown in importance, not only on the intestinal microbiota, but also on the respiratory one. Maintaining the state of eubiosis requires the use of antimicrobials with a low profile of action on anaerobic bacteria. With their use, the resilience of the bacterial populations belonging to the microbiota, the state of resistance of colonization and the collateral damage related to the emergence of resistance to the antimicrobials in pathogens causing the infections and in the bacterial populations integrating the microbiota.


Subject(s)
Anti-Bacterial Agents/pharmacology , COVID-19/epidemiology , Drug Resistance, Bacterial , Pulmonary Disease, Chronic Obstructive/drug therapy , Respiratory Tract Infections/drug therapy , Administration, Oral , Anti-Bacterial Agents/administration & dosage , Chlamydophila pneumoniae/drug effects , Community-Acquired Infections/drug therapy , Community-Acquired Infections/microbiology , Disease Progression , Gastrointestinal Microbiome/drug effects , Haemophilus influenzae/drug effects , Humans , Microbial Sensitivity Tests , Moraxella catarrhalis/drug effects , Mycoplasma pneumoniae/drug effects , Pseudomonas aeruginosa/drug effects , Pulmonary Disease, Chronic Obstructive/microbiology , Respiratory Tract Infections/microbiology , Staphylococcus aureus/drug effects , Streptococcus pneumoniae/drug effects
19.
PLoS One ; 16(3): e0248750, 2021.
Article in English | MEDLINE | ID: covidwho-1144198

ABSTRACT

BACKGROUND: Severe acute respiratory infection (SARI) results in a tremendous disease burden worldwide. Available research on active surveillance among hospitalized adult patients suffering from SARI in China is limited. This pilot study aimed to identify associated etiologies and describe the demographic, epidemiological and clinical profiles of hospitalized SARI patients aged over 16 years in Jinshan, Shanghai. METHODS: Active surveillance was conducted at 1 sentinel hospital in Jinshan district, Shanghai, from April 2017 to March 2018. Hospitalized SARI patients aged over 16 years old were enrolled, and nasopharyngeal swabs were collected within 24 hours of admission and tested for multiple respiratory viruses (including 18 common viruses) and Mycoplasma pneumoniae with real-time polymerase chain reaction. Demographic, epidemiological and clinical information was obtained from case report forms. RESULTS: In total, 397 SARI patients were enrolled; the median age was 68 years, and 194 (48.9%) patients were male. A total of 278 (70.0%) patients had at least one underlying chronic medical condition. The most frequent symptoms were cough (99.2%) and sputum production (88.4%). The median duration of hospitalization was 10 days. A total of 250 infection patients (63.0%) were positive for at least one pathogen, of whom 198 (49.9%) were positive for a single pathogen and 52 (13.1%) were positive for multiple pathogens. The pathogens identified most frequently were M. pneumoniae (23.9%, 95/397), followed by adenovirus (AdV) (11.6%, 46/397), influenza virus A/H3N2 (Flu A/H3N2) (11.1%, 44/397), human rhinovirus (HRhV) (8.1%, 32/397), influenza virus B/Yamagata (Flu B/Yamagata) (6.3%, 25/397), pandemic influenza virus A/H1N1 (Flu A/pH1N1) (4.0%, 16/397), parainfluenza virus (PIV) type 1 (2.0%, 8/397), human coronavirus (HCoV) type NL63 (2.0%, 8/397), HCoV 229E (1.5%, 6/397), HCoV HKU1 (1.5%, 6/397), PIV 3 (1.5%, 6/397), human metapneumovirus (HMPV) (1.5%, 6/397), PIV 4 (1.3%, 5/397), HCoV OC43 (1.0%, 4/397), influenza virus B/Victoria (Flu B/Victoria) (0.5%, 2/397), respiratory syncytial virus (RSV) type B (0.5%, 2/397), and human bocavirus (HBoV) (0.3%, 1/397). The seasonality of pathogen-confirmed SARI patients had a bimodal distribution, with the first peak in the summer and the second peak in the winter. Statistically significant differences were observed with respect to the rates of dyspnea, radiographically diagnosed pneumonia and the presence of at least one comorbidity in patients who were infected with only M. pneumoniae, AdV, HRhV, Flu A/H3N2, Flu A /pH1N1 or Flu B/Yamagata. The differences in the positivity rates of the above 6 pathogens among the different age groups were nonsignificant. CONCLUSIONS: M. pneumoniae, AdV and Flu A/H3N2 were the main pathogens detected in hospitalized SARI patients aged over 16 years old in Jinshan district, Shanghai. Our findings highlight the importance of sustained multipathogen surveillance among SARI patients in sentinel hospitals, which can provide useful information on SARI etiologies, epidemiology, and clinical characteristics.


Subject(s)
DNA Viruses/isolation & purification , Mycoplasma pneumoniae/isolation & purification , RNA Viruses/isolation & purification , Respiratory Tract Infections/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , China , Cough/etiology , Female , Glucocorticoids/therapeutic use , Hospitals , Humans , Male , Middle Aged , Nasopharynx/microbiology , Nasopharynx/virology , Pilot Projects , Prognosis , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology , Young Adult
20.
Medicine (Baltimore) ; 100(11): e24315, 2021 Mar 19.
Article in English | MEDLINE | ID: covidwho-1138005

ABSTRACT

ABSTRACT: Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, considerable attention has been paid on its epidemiology and clinical characteristics in children patients. However, it is also crucial for clinicians to summarize and investigate the co-infection of SARS-CoV-2 in children.We retrospectively reviewed the clinical manifestations, laboratory findings, and imaging characteristics of COVID-19 patients in co-infection group (CI, n = 27) and single infection group (SI, n = 54). Samples were tested for multiple pathogens.A high incidence (27/81, 33%) of co-infection in children with COVID-19 was revealed. The most frequent co-infected pathogen was mycoplasma pneumoniae (MP, 20/81, 25%), followed by virus (6/81, 7%), and bacteria (4/81, 5%). No significant difference in clinical characteristics, laboratory examinations, or hospital stay was observed between the patients with co-infections and those with monomicrobial, only lower in white blood cell counts (CI: 5.54 ±â€Š0.36 vs SI: 7.38 ±â€Š0.37, P = .002), neutrophil counts (CI: 2.20 ±â€Š0.20 vs SI: 2.92 ±â€Š0.23, P = .024) and lymphocyte counts (CI: 2.72 ±â€Š0.024 vs SI: 3.87 ±â€Š0.28, P = .006). Compared with the patients with monomicrobial, chest imaging of those with co-infections showed consolidation in more cases (CI: 29.6% vs SI: 11.1%, P = .038) and duration of positive in nucleic acid was shorter (CI: 6.69 ±â€Š0.82 vs SI: 9.69 ±â€Š0.74, P = .015).Co-infection was relatively common in children with COVID-19, almost 1/3 had co-infection, most commonly caused by MP. Co-infection did not cause a significant exacerbation in clinical manifestations.


Subject(s)
COVID-19/epidemiology , Coinfection/epidemiology , Adenoviridae Infections/epidemiology , Child , Child, Preschool , China/epidemiology , Coinfection/microbiology , Coinfection/virology , Female , Humans , Influenza, Human/epidemiology , Leukocyte Count , Lymphocyte Count , Male , Moraxellaceae Infections/epidemiology , Mycoplasma pneumoniae , Pneumococcal Infections/epidemiology , Pneumonia, Mycoplasma/epidemiology , Respiratory Syncytial Virus Infections/epidemiology , Retrospective Studies , SARS-CoV-2
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