Mycoplasma pneumoniae from the Respiratory Tract and Beyond

Waites, Ken B.; Xiao, Li; Liu, Yang; Balish, Mitchell F.; Atkinson, T. Prescott

doi:10.1128/cmr.00114-16

Cited by 455 publications

(682 citation statements)

References 485 publications

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“…The reliability of mutation analysis with the GENECUBE system and GENECUBE Mycoplasma detection kit has previously been demonstrated, showing results identical with those obtained with a conventional sequence method (absence of mutations 82/173, A2063G 90/173, A2064G 1/173). Our results revealed that the rate of M. pneumoniae with MRM varied remarkably from season to season within the same year, which was possibly because of the change in endemic strains 25. Therefore, determining the exact trend of prevalence of M. pneumoniae with MRM requires continuous monitoring, conducted locally throughout the year, which could be helpful for the antimicrobial stewardship in primary care settings.…”

Section: Discussionmentioning

confidence: 80%

Clinical features and seasonal variations in the prevalence of macrolide‐resistant Mycoplasma pneumoniae

Akashi

Hayashi

Suzuki

et al. 2018

J of Gen and Family Med

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Background Mycoplasma pneumoniae is a common pathogen causing pneumonia; macrolide‐resistant strains are rapidly spreading across Japan. However, the clinical features of macrolide‐resistant M. pneumoniae pneumonia have not been well established. Here, we evaluated the clinical characteristics and seasonal variations in the prevalence of M. pneumoniae with macrolide‐resistant mutations (MRM).MethodsThe monthly prevalence of MRM in M. pneumoniae strains isolated from May 2016 to April 2017 was retrospectively analyzed, and the clinical characteristics of pneumonia cases with MRM were compared to those of cases without MRM. The M. pneumoniae isolates and point mutations at site 2063 or 2064 in domain V of 23S rRNA were evaluated by the GENECUBE system and GENECUBE Mycoplasma detection kit.Results Mycoplasma pneumoniae infection was identified in 383 cases, including 221 cases of MRM (57.7%). The MRM prevalence was 86.3% (44/51) between May and July 2016, demonstrating an apparent decrease in September 2016, subsequently reaching 43.0% (34/79) in November 2016. Mycoplasma pneumoniae pneumonia was diagnosed in 275 cases, including 222 pediatric and 53 adult cases. Macrolide use preceding evaluation was found to be the only feature of MRM pneumonia cases both in children (odds ratio [OR] 3.86, 95% confidence interval [CI]:1.72–8.66) and in adults (OR 7.43, 95% CI: 1.67–33.1).ConclusionsThe determination rate of MRM varied widely throughout the year, and our study demonstrated the challenges in predicting M. pneumoniae with MRM based on clinical features at diagnosis. Therefore, continuous monitoring of the prevalence of MRM is warranted, which may help in selecting an effective treatment.

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Section: Discussionmentioning

confidence: 80%

Clinical features and seasonal variations in the prevalence of macrolide‐resistant Mycoplasma pneumoniae

Akashi

Hayashi

Suzuki

et al. 2018

J of Gen and Family Med

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“…9 En Japón se ha reportado una correlación entre el incremento de temperatura y las infecciones por M. pneumoniae, lo que puede explicar el incremento de casos en los meses cálidos del año. 10 En el mundo se reportan frecuencias que van desde 0.74 hasta 43.8% (Figura 1). La aparición de ciclos epidémicos puede deberse a la circulación de diferentes genotipos de M. pneumoniae (variación en la adhesina P1).…”

Section: Epidemiologíaunclassified

“…48 Además, hay una adecuada respuesta celular con linfocitos B y T. Al parecer, la respuesta humoral no condiciona protección contra reinfecciones; sin embargo, el efecto neutralizante de los anticuerpos podría ser importante para la contención en la infección aguda, ya que pacientes con deficiencias humorales pueden cursar con cuadros más graves o prolongados, además de tener más riesgo para manifestaciones extrapulmonares, particularmente a nivel neurológico. 10 El papel de los macrófagos parece ser vital en controlar la infección a nivel pulmonar, ya que interviene en la opsonización y depuración del patógeno. La activación de macrófagos depende de los receptores Toll-like, particularmente el TLR2.…”

Section: Inmunidad Contra M Pneumoniaeunclassified

“…49 En relación al perfil de citoquinas, no hay una clara polarización hacia una respuesta Th1 o Th2; 50 por una parte predomina la producción de IL-8 e IL-18, en donde la IL-8 es un potente reclutador de neutrófilos, mientras que la IL-18 se encarga de activar a los linfocitos T. Los mastocitos a su vez son productores de IL-4/IF-g, siendo inductor de la producción de citoquinas por los macrófagos, leucocitos periféricos y a nivel del epitelio respiratorio. 10 La producción de citoquinas y la activación linfocítica por una parte puede eliminar a M. pneumoniae, o bien, causar exacerbaciones por hipersensibilidad inmunológica, agravando el daño del epitelio respiratorio y espacio alveolar.…”

Section: Inmunidad Contra M Pneumoniaeunclassified

“…53 Habitualmente, el cuadro clínico por M. pneumoniae inicia como una infección de vía aérea superior que suele ser similar a la de un cuadro viral; sin embargo, son poco frecuentes los datos de rinitis, sinusitis y laringotraqueobronquitis. 10,53 La presencia de fiebre se ha documentado entre un 38-100%. 4,7,34 La faringitis por M. pneumoniae se reporta entre un 12-24% de las faringitis no-estreptocóccicas.…”

Section: Manifestaciones Clínicasunclassified

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Cambiando los paradigmas de la infección por M. pneumoniae en pediatría

et al. 2017

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CorrespondenciaDe Colsa-Ranero A agustin.decolsa@infecto.mx Este artículo debe citarse comoMerida-Vieyra J, Aquino-Andrade A, Ribas-Aparicio RM, De Colsa-Ranero A. Cambiando los paradigmas de la infección por M. pneumoniae en pediatría. Acta Pediatr Mex. 2017;38(6):412-426. ResumenLa neumonía atípica es un término que originalmente se utilizó en pacientes adultos que presentaban neumonías de curso atípico, generalmente leves y de evolución benigna, que eran causadas por agentes como: Mycoplasma pneumoniae, Chlamydophila pneumoniae y Legionella pneumophila.En población pediátrica la presentación, tanto clínica como epidemiológica, de las neumonías por M. pneumoniae merece una especial atención ya que no siempre son cursos benignos y pueden existir numerosos cuadros extrapulmonares asociados; el proceso diagnóstico es complejo y poco diferencial de otros agentes etiológicos.Recientemente ha llamado la atención la emergencia de la resistencia a macrólidos en algunos países del mundo, por lo que existen controversias respecto al tratamiento. Estudios numerosos realizados a nivel mundial, particularmente derivados de países asiáticos, han generado nueva información en relación al comportamiento biológico, clínico, epidemiológico, radiológico y respuesta terapéutica de M. pneumoniae en pacientes pediátricos. PALABRAS CLAVE:Mycoplasma pneumoniae, pacientes pediátricos, neumonía, diagnóstico. Changing the paradigms of M. pneumoniae infection in pediatrics.Acta Pediatr Mex. 2017 Nov;38 (6) AbstractAtypical pneumonia is a term that was used originally in adult patients who had atypical pneumonia symptoms, usually with mild and benign courses, and were caused by agents such as Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila. In pediatric patients, the clinical and epidemiological aspects of M. pneumoniae www.actapediatrica.org.mx

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Frequency and Clinical Presentation of Mucocutaneous Disease Due to Mycoplasma pneumoniae Infection in Children With Community-Acquired Pneumonia

et al. 2020

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The diagnosis of Mycoplasma pneumoniae infection as the cause of mucocutaneous disease is challenging because current diagnostic tests are not able to differentiate M pneumoniae infection from carriage. OBJECTIVE To examine the frequency and clinical presentation of M pneumoniae-induced mucocutaneous disease in children with community-acquired pneumonia (CAP) using improved diagnostics. DESIGN, SETTING, AND PARTICIPANTS This prospective, longitudinal cohort study included 152 children aged 3 to 18 years with CAP enrolled in a CAP study from May 1, 2016, to April 30, 2017, at the University Children's Hospital Zurich. Children were inpatients or outpatients with clinically defined CAP according to the British Thoracic Society guidelines. Data analysis was performed from July 10, 2017, to June 29, 2018. MAIN OUTCOMES AND MEASURES Frequency and clinical presentation of M pneumoniaeinduced mucocutaneous disease in childhood CAP. Mycoplasma pneumoniae infection was diagnosed by polymerase chain reaction (PCR) of oropharyngeal samples and confirmed with the measurement of specific peripheral blood IgM antibody-secreting cells by enzyme-linked immunospot assay to differentiate M pneumoniae-infected patients from carriers with CAP caused by other pathogens. Mucocutaneous disease was defined as any eruptive lesion that involved skin and/or mucous membranes occurring during the CAP episode. RESULTS Among 152 enrolled children with CAP (median [interquartile range] age, 5.7 [4.3-8.9] years; 84 [55.3%] male), 44 (28.9%) tested positive for M pneumoniae by PCR; of these, 10 children (22.7%) developed mucocutaneous lesions. All 10 patients with mucocutaneous eruptions tested positive for specific IgM antibody-secreting cells. Skin manifestations were found in 3 cases (2.8%) of M pneumoniae PCR-negative CAP (P < .001). The spectrum of M pneumoniae-induced mucocutaneous disease included M pneumoniae-induced rash and mucositis (3 cases [6.8%]), urticaria (2 cases [4.5%]), and maculopapular skin eruptions (5 cases [11.4%]). Two patients had ocular involvement as the sole mucosal manifestation (bilateral anterior uveitis and nonpurulent conjunctivitis). Patients with M pneumoniae-induced mucocutaneous disease had longer duration of prodromal fever (median [interquartile range], 10.5 [8.3-11.8] vs 7.0 [5.5-9.5] days; P = .02) and higher C-reactive protein levels (median [interquartile range], 31 vs 16 [7-23] mg/L; P = .04) than patients with CAP due to M pneumoniae without mucocutaneous manifestations. They were also more likely to require oxygen (5 [50%] vs 1 [5%]; P = .007), to require hospitalization (7 [70%] vs 4 [19%]; P = .01), and to develop long-term sequelae (3 [30%] vs 0; P = .03). CONCLUSIONS AND RELEVANCEMucocutaneous disease occurred significantly more frequently in children with CAP due to M pneumoniae than in children with CAP of other origins. Mycoplasma pneumoniae-induced mucocutaneous disease was associated with increased systemic inflammation, morbidity, and a higher risk of long-term sequelae.

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Mycoplasma pneumoniae from the Respiratory Tract and Beyond

Cited by 455 publications

References 485 publications

Clinical features and seasonal variations in the prevalence of macrolide‐resistant Mycoplasma pneumoniae

Clinical features and seasonal variations in the prevalence of macrolide‐resistant Mycoplasma pneumoniae

Cambiando los paradigmas de la infección por M. pneumoniae en pediatría

Frequency and Clinical Presentation of Mucocutaneous Disease Due to Mycoplasma pneumoniae Infection in Children With Community-Acquired Pneumonia

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