Survey of Mycoplasmal Bacteremia Detected in Children by Polymerase Chain Reaction

Abstract

To determine whether mycoplasmal bacteremia occurs during ordinary or complicated diseases due to M. pneumoniae (and if so, how frequently), we used polymerase chain reaction (PCR) to detect M. pneumoniae in serum samples. The PCR primers used were modified for nested amplification. The genome of this organism was detected in 1 of the 25 patients with pneumonia and 10 of the 17 patients without pneumonia (P < .001, chi test). The genome was detected more frequently in patients who had encephalitis of which the neurological onset was within 7 days of the onset of fever rather than later. We hypothesize that mycoplasmal bacteremia occurs more frequently than previously appreciated, specifically in the absence of pneumonia, and that certain types of complications (e.g., encephalitis of early onset) are associated with its occurrence.

Close Association between Pulmonary Disease Manifestation inMycoplasma pneumoniaeInfection and Enhanced Local Production of Interleukin-18 in the Lung, Independent of Gamma Interferon

“…They comprised 15 patients with early-onset encephalitis, 5 patients with late-onset encephalitis, and 4 patients with aseptic meningitis. Of these, serum and/or CSF samples from eight patients with early-onset encephalitis, two patients with late-onset encephalitis, and three patients with aseptic meningitis had already been included in previous studies concerning the PCR detection of M. pneumoniae DNA (22,23) or the determination of IL-6 levels (18). "Encephalitis" represented a clinical diagnosis which comprised encephalitis, meningoencephalitis, cerebellitis, and acute disseminated encephalomyelitis.…”

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

“…However, the availability of PCR has greatly enhanced understanding of how M. pneumoniae can disseminate throughout the body. The presence of M. pneumoniae in extrapulmonary sites such as blood, synovial fluid and cerebrospinal fluid, pericardial fluid, and skin lesions has been documented by PCR as well as culture, so direct invasion must always be considered (23,220,235,306,360). However, the frequency of direct invasion of these sites is unknown because the organism is rarely sought for clinical purposes.…”

Mycoplasma pneumoniae as an Under- Recognized Agent of Vasculitic Disorders

“…From this perspective, the activation of interleukin-8 by M. pneumoniae is one of the key steps in inducing the vasculitic disorders which are the main subject of this chapter. As regards the presence of pneumonia in relation to the development of extrapulmonary diseases, the author and coworkers have found, using polymerase chain reaction methodology [Narita et al, 1992], that the genome of M. pneumoniae can be detected more frequently in serum from patients without pneumonia than in serum from patients with pneumonia [Narita et al, 1996]. This means that pneumonia, which is a consequence of the local host immune response occurring on the respiratory surface, plays an important role as a kind of fire-wall preventing dissemination of the organism beyond the respiratory tract [Cartner et al, 1998;Tanaka et al, 1996].…”