Comparison of different detection methods for Mycoplasma pneumoniae infection in children with community-acquired pneumonia

Tang, Mingyu; Wang, Dong; Tong, Xing; Wu, Yulian; Zhang, Jing; Zhang, Lei; Yin, Yong; Cao, Qing

doi:10.1186/s12887-021-02523-4

Cited by 24 publications

(30 citation statements)

References 37 publications

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“…For the detection of M. pneumoniae , it has been reported that combined detection methods can improve the specificity and sensitivity of diagnosis and reduce false-negative and false-positive rates. M. pneumoniae cannot be reliably diagnosed using only a single test ( Loens and Ieven, 2016 ; Tang et al., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of bronchoalveolar lavage fluid metagenomic next-generation sequencing in pediatric pneumonia

Deng¹,

Wu³

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectivesThe aim of this study was to evaluate the diagnostic value of bronchoalveolar lavage fluid (BALF) metagenomic next-generation sequencing (mNGS) versus conventional microbiological tests (CMTs) for pediatric pneumonia.MethodsThis retrospective observational study enrolled 103 children who were diagnosed with pneumonia and hospitalized at Hubei Maternity and Child Health Care Hospital between 15 October 2020 and 15 February 2022. The pneumonia diagnosis was based on clinical manifestations, lung imaging, and microbiological tests. Pathogens in the lower respiratory tract were detected using CMTs and BALF mNGS (of DNA and RNA). The diagnostic performance of BALF mNGS was compared with that of CMTs.ResultsIn 96 patients, pathogens were identified by microbiological tests. The overall pathogen detection rate of mNGS was significantly higher than that of CMTs (91.3% vs. 59.2%, p = 0.000). The diagnostic performance of mNGS varied for different pathogens; however, its sensitivity and accuracy for diagnosing bacterial and viral infections were both higher than those of CMTs (p = 0.000). For the diagnosis of fungi, the sensitivity of mNGS (87.5%) was higher than that of CMTs (25%); however, its specificity and accuracy were lower than those of CMTs (p < 0.01). For the diagnosis of Mycoplasma pneumoniae, the specificity (98.8%) and accuracy (88.3%) of mNGS were high; however, its sensitivity (42.1%) was significantly lower than that of CMTs (100%) (p = 0.001). In 96 patients with definite pathogens, 52 cases (50.5%) were infected with a single pathogen, while 44 cases (42.7%) had polymicrobial infections. Virus–bacteria and virus–virus co-infections were the most common. Staphylococcus aureus, Haemophilus influenzae, rhinovirus, cytomegalovirus, parainfluenza virus, and fungi were more likely to be associated with polymicrobial infections.ConclusionsBALF mNGS improved the detection rate of pediatric pneumonia, especially in mixed infections. The diagnostic performance of BALF mNGS varies according to pathogen type. mNGS can be used to supplement CMTs. A combination of mNGS and CMTs may be the best diagnostic strategy.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of bronchoalveolar lavage fluid metagenomic next-generation sequencing in pediatric pneumonia

Deng¹,

Wu³

et al. 2022

Front. Cell. Infect. Microbiol.

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“…Given antibodies against M. pneumoniae could be affected by co-infection and patients' immune state [31,32], and results of PCR could be affected by antibiotics, techniques, and asymptomatic carriage [33,34], a combination of multiplex-PCR and serology helps to reduce each other's 'false positive' and 'false negative' rates and was considered to have the highest specificity and sensitivity [31]. However, paired serum samples are difficult to obtain in pediatric, and study demonstrated that titer of 1:160 had a high sensitivity and the highest Youden index and Kappa value using PCR as the standard indicating that it was conducive to screening for M. pneumoniae infection [35], coupled with that multiplex-PCR is expensive, therefore, our retrospective study relied mainly on clinical manifestations of respiratory infection combined with a single antibody titer ≥ 1:160. Another, we have to make longer observation and get more systematic surveillance data for better understanding of the epidemiology of M. pneumoniae in COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Effect of COVID-19 on childhood Mycoplasma pneumoniae infection in Chengdu, China

Zhang

Huang

et al. 2021

BMC Pediatr

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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.

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“…However, it has some limitations. First, it is time-consuming (24-72 h) and the second is low bacterial growth in people who have received antibiotics [ 11 , 12 ]. Hence, using molecular techniques such as polymerase chain reaction (PCR) that are rapid and sensitive, can improve the speed and accuracy of detection of CAP pathogens [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Multiplex polymerase chain reaction detection of Streptococcus pneumoniae and Haemophilus influenzae and their antibiotic resistance in patients with community-acquired pneumonia from southwest Iran

et al. 2021

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Background This study aimed to evaluate the occurrence of Streptococcus pneumoniae and Haemophilus influenzae in sputum of patients with community-acquired pneumonia (CAP) using culture and multiplex polymerase chain reaction (M-PCR) methods and to survey the antibiotic resistance patterns of aforesaid isolates. Result In total, 23.9 % (n = 22/92) of sputum samples showed positive results in the culture method. S. pneumoniae and H. influenzae were isolated from 15 (16.3 %) and 7 (7.6%) samples, respectively. Using M-PCR, 44 (47.8 %) samples were positive for S. pneumoniae and H. influenzae. Of these, S. pneumoniae and H. influenzae were detected in 33 (35.8%) and 11 (11.9%) of the sputum samples, respectively. The sensitivity, specificity, and accuracy rates of PCR in detection of S. pneumoniae in comparison with culture method were 100, 76.6, and 83.6%, respectively. While, the sensitivity, specificity, and accuracy rates of PCR in detection of H. influenzae in comparison with culture method were 100, 95.3, and 95.8%, respectively. Out of 11 isolates of H. influenzae, two strains confirmed as H. influenzae type b (Hib) and 3 isolates were type f. However, 6 isolates were non-typable. The co-trimoxazole and amoxicillin/clavulanate were the less effective antibiotics against S. pneumonia and H. influenzae, respectively. Ceftriaxone with 13.3% resistance rates was the most effective antibiotic against S. pneumoniae, while, clarithromycin, ceftriaxone, and gentamicin with resistance rates of 28.6% for each one were the most effective chemicals against H. influenzae isolates. Conclusion In this study, the prevalence of S. pneumoniae was more than H. influenzae using culture and M-PCR methods. The M-PCR provided better efficiency in detecting the bacterial agents in CAP patients compared to culture method. This method can improve the early detection of pathogens contributed to CAP. The drug resistant S. pneumoniae and H. influenzae indicated the need to develop a codified monitoring program to prevent further spread of these strains.

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Comparison of different detection methods for Mycoplasma pneumoniae infection in children with community-acquired pneumonia

Cited by 24 publications

References 37 publications

Diagnostic value of bronchoalveolar lavage fluid metagenomic next-generation sequencing in pediatric pneumonia

Diagnostic value of bronchoalveolar lavage fluid metagenomic next-generation sequencing in pediatric pneumonia

Effect of COVID-19 on childhood Mycoplasma pneumoniae infection in Chengdu, China

Multiplex polymerase chain reaction detection of Streptococcus pneumoniae and Haemophilus influenzae and their antibiotic resistance in patients with community-acquired pneumonia from southwest Iran

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