ABSTRACT
Mycoplasma pneumoniae infection is conventionally diagnosed using serum antibody testing, microbial culture, and genetic testing. Recently, immunochromatography-based rapid mycoplasma antigen test kits have been developed and commercialised for rapid diagnosis of M. pneumoniae infection. However, as these kits do not provide sufficient sensitivity and specificity, a rapid test kit with improved accuracy is desired. The present prospective study evaluated a rapid M. pneumoniae diagnostic system utilizing a newly developed silver amplification immunochromatography (SAI) system. We performed dilution sensitivity test and the prospective clinical study evaluating the SAI system. The subjects of the clinical study included both children and adults. All patients suspected to have mycoplasma pneumonia (169 patients) were sequentially enrolled. Twelve patients did not agree to participate and 157 patients were enrolled in the study. The results demonstrate excellent performance of this system with 90.4% sensitivity and 100.0% specificity compared with real-time polymerase chain reaction. When compared with loop-mediated isothermal amplification (LAMP) methods, the results also demonstrate a high performance of this system with 93.0% sensitivity and 100.0% specificity. The SAI system uses a dedicated device for automatic analysis and reading, making it highly objective, and requires less human power, supporting its usefulness in clinical settings.
Subject(s)
Antigens, Bacterial/analysis , Chromatography, Affinity/methods , Mycoplasma pneumoniae/immunology , Pneumonia, Mycoplasma/diagnosis , Silver/chemistry , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pneumonia, Mycoplasma/immunology , Prospective Studies , Reagent Kits, Diagnostic , Sensitivity and Specificity , Young AdultABSTRACT
The only oral penem antibiotic, faropenem (FRPM: Farom Dry Syrup for pediatrics), is one of the few antibiotics that exerts potent antibacterial activity against penicillin-resistant Streptococcus pneumoniae (PRSP), and the dosage and administration schedule has been established for children. We studied the efficacy and safety of the drug in 113 pediatric patients with mild-to-moderate bacterial infectious diseases: upper respiratory tract infection (pharyngitis or tonsillitis), acute bronchitis, otitis media and urinary tract infection (UTI). The patients were administered oral FRPM at the dose of 15-30 mg/kg/day three times a day for 3 to 8 days (or 5 to 14 days for group A streptococcal infection). The study drug was found to be clinically effective in 63/70 cases (90.0%) of upper respiratory tract infection, 6/7 cases of acute bronchitis, 16/17 cases (94.1%) of otitis media and 6/6 cases of UTI. FRPM was demonstrated to have very potent antibacterial activity against S. pneumoniae, with a high bacteriological eradication rate. No serious adverse drug reactions were observed. The only side effect was diarrhea in 12.5% of the patients (14/112 cases). There was little difference in the incidence of diarrhea between FRPM and other oral beta-lactam antibiotics. Compliance with FRPM was found to be very good in this study. These findings suggest that FRPM is as useful for the treatment of bacterial infectious diseases in children as oral penicillin and cephem antibiotics.
Subject(s)
Otitis Media/drug therapy , Otitis Media/microbiology , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/microbiology , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiology , beta-Lactams/administration & dosage , beta-Lactams/pharmacology , Child , Child, Preschool , Dosage Forms , Drug Resistance, Bacterial , Humans , Streptococcus pneumoniae/drug effects , Streptococcus pneumoniae/isolation & purification , Streptococcus pyogenes/drug effects , Streptococcus pyogenes/isolation & purification , Treatment Outcome , beta-Lactams/adverse effectsABSTRACT
A total of 141 children with community-acquired pneumonia (CAP) were studied prospectively to determine the causative microorganisms. Microbial investigations included examination of postnasal swabs, cultures, polymerase chain reaction (PCR), and serology. The atypical pathogens occurring most frequently were Mycoplasma pneumoniae (58 patients [41.1%]), Chlamydia pneumoniae (4 patients [2.8%]), and concurrent occurrence of both pathogens (1 patient [0.7%]). Patients aged under 4 years showed a relatively lower rate of atypical bacterial etiology compared with those aged 4 years or older. Major bacterial pathogens were detected in 89 patients (atypical pathogens were detected in 28 patients simultaneously), including Streptococcus pneumoniae in 34 patients, Haemophilus influenzae in 60, Moraxella catarrhalis in 48, and multiple pathogens in 42. In patients suspected of having atypical pneumonia, macrolides are recommended.
