Abstract:SUMMARY
Fatal swine influenza A H1N1 and Mycoplasma pneumoniae coinfection in a child
One of the most common causes of death in influenza patients
“…In our study, the ratio of coinfection with multiple pathogens in MP-positive cases was 56.63%, which was higher than previous reports. In MP-positive cases, the co-infection rate with IFV was highest among all cases (24.1%) and this was consistent with the findings of Zheng, et al [27] and Kalenahalli, et al [28]. It has been reported that viral infection can make patients susceptible to MP infection, and that this interaction may lead to the aggravation of asthma [29].…”
Background
Among hospitalized children suffering from community-acquired pneumonia, Mycoplasma pneumoniae (MP) is one of the most common pathogens. MP often exists as a co-infection with bacteria or viruses, which can exacerbate the clinical symptoms. We investigated the pathogen spectrum in MP-positive and MP-negative samples from hospitalized children with respiratory tract infections in Beijing, China.
Method
This study included 1038 samples of nasopharyngeal aspirates obtained between April, 2017 and March, 2018 from hospitalized children under 6 years of age with respiratory tract infections. To explore the impact of MP infection on the composition of the pathogen spectrum, 185 nasopharyngeal aspirates (83 MP-positive/102 MP-negative) were randomly selected for next-generation sequencing and comprehensive metagenomics analysis. Real-time PCR was used to detect and verify common respiratory viruses.
Results
Of the 1038 samples, 454 (43.7%) were infected with MP. In children < 6 years of age, the MP infection rate gradually increased with age, with the highest rate of 74.2% in 5–6-year-olds. The results of metagenomics analysis revealed 11 human, animal and plant virus families, and bacteriophages, including common respiratory viruses, enteroviruses and anelloviruses. The virus family with the highest number of reads in both MP-positive and MP-negative samples was the Pneumoviridae, and the number of reads for human respiratory syncytial virus (HRSV) in MP-positive samples was higher than that in MP-negative samples. Among the 83 MP-positive samples, 47 (56.63%) were co-infected with viruses, the most common of which was influenza virus (IFV). The durations of hospitalization and fever were higher in patients with MP co-infection than MP single infection, but the difference was not statistically significant.
Conclusion
The viral family with the highest number of reads in both groups was Pneumoviridae, and the number of reads matched to HRSV in MP-positive samples was much higher than MP-negative samples. Co-infection of MP and IFV infection were the most cases.
“…In our study, the ratio of coinfection with multiple pathogens in MP-positive cases was 56.63%, which was higher than previous reports. In MP-positive cases, the co-infection rate with IFV was highest among all cases (24.1%) and this was consistent with the findings of Zheng, et al [27] and Kalenahalli, et al [28]. It has been reported that viral infection can make patients susceptible to MP infection, and that this interaction may lead to the aggravation of asthma [29].…”
Background
Among hospitalized children suffering from community-acquired pneumonia, Mycoplasma pneumoniae (MP) is one of the most common pathogens. MP often exists as a co-infection with bacteria or viruses, which can exacerbate the clinical symptoms. We investigated the pathogen spectrum in MP-positive and MP-negative samples from hospitalized children with respiratory tract infections in Beijing, China.
Method
This study included 1038 samples of nasopharyngeal aspirates obtained between April, 2017 and March, 2018 from hospitalized children under 6 years of age with respiratory tract infections. To explore the impact of MP infection on the composition of the pathogen spectrum, 185 nasopharyngeal aspirates (83 MP-positive/102 MP-negative) were randomly selected for next-generation sequencing and comprehensive metagenomics analysis. Real-time PCR was used to detect and verify common respiratory viruses.
Results
Of the 1038 samples, 454 (43.7%) were infected with MP. In children < 6 years of age, the MP infection rate gradually increased with age, with the highest rate of 74.2% in 5–6-year-olds. The results of metagenomics analysis revealed 11 human, animal and plant virus families, and bacteriophages, including common respiratory viruses, enteroviruses and anelloviruses. The virus family with the highest number of reads in both MP-positive and MP-negative samples was the Pneumoviridae, and the number of reads for human respiratory syncytial virus (HRSV) in MP-positive samples was higher than that in MP-negative samples. Among the 83 MP-positive samples, 47 (56.63%) were co-infected with viruses, the most common of which was influenza virus (IFV). The durations of hospitalization and fever were higher in patients with MP co-infection than MP single infection, but the difference was not statistically significant.
Conclusion
The viral family with the highest number of reads in both groups was Pneumoviridae, and the number of reads matched to HRSV in MP-positive samples was much higher than MP-negative samples. Co-infection of MP and IFV infection were the most cases.
“…As confirmed in previous studies, Streptococcus pneumoniae and Haemophilus influenza are main upper respiratory pathogens in children[4], and both increase almost from September to next March. The change trend may be affected by the flu season[4,5]. It has been reported that influenza virus is interacted with pathogenic bacteria, and confirmed the relation of influenza with Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenza, Neisseria meningitidis, respiratory syncytial virus (RSV), human rhinoviruses, and human parainfluenza viruses, etc [4,6]…”
Background To obtain the pathogenic spectrum of infectious diseases of different development phases of children from different regions of Shandong Province, we collected the data of pathogens from 40 hospitals in 17 cities of Shandong Province, and aimed at promoting the management and reasonable application of children's antibacterial agents. Methods We collected the bacterial drug resistance monitoring information from 26,778 strains isolated from children from 40 hospitals in 17 cities of Shandong Province (including 35 Grade 3A tertiary hospitals and 5 secondary hospitals) in 2017, and analyzed the variation pattern and the comparative distribution features of the pathogenic spectrum changing with age, season and gender. Results Pathogenic spectrum changes along with children's age. For example, Streptococcus pneumonia and Haemophilus influenza show a significant feature of normal distribution as the age increases. The distribution of pathogenic spectrum is significantly affected by season change. Infections reveal inequality between the sexes. Conclusion We first established a provincial-level pediatric antimicrobial surveillance system (Shandong Province Pediatric Antimicrobial Resistance Surveillance System, SPARSS) in China. Supported by the analysis of big data for the first time, we confirmed that the pathogenic spectrums for children from different development stages and seasons are completely different. Besides, we also found the evidence for facts that men in general live shorter lives than women, and boys are more easily to be infected compared with girls. In order to promote reasonable and standard application of antimicrobial drugs on children, clinical doctors should choose antibiotics according to the results of the variation pattern and the distribution comparative analysis of pathogenic spectrum for children from different age groups concluded by our study.
“…In humans, Streptococcus pneumoniae , Staphylococcus aureus and Haemophilus influenzae are the three most frequently reported bacteria secondary to influenza infection. Other less common bacteria include Nocardia [25], Mycoplasma pneumoniae [26], Mycobacterium tuberculosis [27], Legionella pneumophila [28], and Campylobacter jejuni [29] . Choi et al performed a retrospective analysis of 636 swine influenza virus (SIV) cases in pigs and found that Pasteurella multocida and Mycoplasma hyopneumoniae were the most common bacteria associated with SIV [30].…”
Background
In May 2017, 17 dogs in a German Shepherd breeding kennel in northern China developed respiratory clinical signs. The owner treated the dogs with an intravenous injection of Shuang-Huang-lian, a traditional Chinese medicine, and azithromycin. The respiratory signs improved 3 days post-treatment, however, cysts were observed in the necks of eight dogs, and three of them died in the following 2 days.
Case presentation
Quantitative real-time PCR was used to detect canine influenza virus (CIV). All of the dogs in this kennel were positive and the remaining 14 dogs had seroconverted. Two of the dogs were taken to the China Agricultural University Veterinary Teaching Hospital for further examination. Two strains of influenza virus (A/canine/Beijing/0512–133/2017 and A/canine/Beijing/0512–137/2017) isolated from the nasal swabs of these dogs were sequenced and identified as avian-origin H3N2 CIV. For the two dogs admitted to the hospital, hematology showed mild inflammation and radiograph results indicated pneumonia. Cyst fluid was plated for bacterial culture and bacterial 16 s rRNA gene PCR was performed, followed by Sanger sequencing. The results indicated an
Enterococcus faecalis
infection. Antimicrobial susceptibility tests were performed and dogs were treated with enrofloxacin. All 14 remaining dogs recovered within 16 days.
Conclusions
Coinfection of H3N2 CIV and
Enterococcus faecalis
was detected in dogs, which has not been reported previously. Our results highlight that CIV infection might promote the secondary infection of opportunistic bacteria and cause more severe and complicated clinical outcomes.
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