Mycoplasma pneumoniae: A significant but underrated pathogen in paediatric community-acquired lower respiratory tract infections

Abstract

Lower respiratory tract infections are considered a common cause responsible for morbidity and mortality among children, and Mycoplasma pneumoniae is identified to be responsible for up to 40 per cent of community-acquired pneumonia in children greater than five years of age. Extrapulmonary manifestations have been reported either due to spread of infection or autoimmune mechanisms. Infection by M. pneumoniae has high incidence and clinical importance but is still an underrated disease. Most widely used serologic methods are enzyme immunoassays for detection of immunoglobulin M (IgM), IgG and IgA antibodies to M. pneumoniae, though other methods such as particle agglutination assays and immunofluorescence methods are also used. Detection of M. pneumoniae by nucleic acid amplification techniques provides fast, sensitive and specific results. Utilization of polymerase chain reaction (PCR) has improved the diagnosis of M. pneumoniae infections. Besides PCR, other alternative amplification techniques include (i) nucleic acid sequence-based amplification, (ii) Qβ replicase amplification, (iii) strand displacement amplification, (iv) transcription-mediated amplification, and (v) ligase chain reaction. Macrolides are used as the first-line treatment in childhood for M. pneumoniae infections; however, emergence of macrolide-resistant M. pneumoniae is a cause of concern. Development of a safe vaccine is important that gives protective immunity and would be a major step in reducing M. pneumoniae infections.

Clinical, epidemiological and immunological characteristics of mycoplasma pneumonia (analytical review)

“…Комплекс цитоадгезинов M. pneumoniaе (особенно MRMP) вызывает мощное воспаление, напоминающее гиперчувствительность замедленного типа. Во время этого процесса может возникнуть дисбаланс цитокинов, что в свою очередь может усугубить повреждающее действие на легочную ткань [93,94] и вызывать острую системную воспалительную реакцию.…”

Epidemiology and mechanism of drug resistance of Mycoplasma pneumoniae in Beijing, China: A multi-center study

“…lacking the cell wall, which was first isolated from a patient with primary atypical pneumonia [1,2]. M. pneumoniae is one of the most common pathogens causing community-acquired respiratory tract infections (RTIs) and has been recognized as a worldwide cause of primary atypical pneumonia [3][4][5]. It can affect people of all ages, especially the most vulnerable groups children and adolescents [6][7][8].…”

Epidemiology and Molecular Identification of Mycoplasma pneumoniae associated respiratory tract, Zhejiang province, China, 2008-2017

“…The pathological changes of mycoplasma pneumonia were mainly interstitial pneumonia, and the incidence of mycoplasma pneumonia was the highest among adolescents. The clinical manifestations and chest X-ray examination of mycoplasma pneumonia are not characteristic [11][12][13] . Diagnosis cannot be made solely by clinical manifestations and chest X-ray examination.…”