Search

Background: X-linked agammaglobulinemia (XLA), also referred to as Bruton's tyrosine kinase deficiency, is a rare genetic disorder that affects the immune system. We conducted genetic analysis on patients suffering from immunodeficiency by utilizing Next-Generation Sequencing techniques, as well as their closest relatives, to facilitate accurate diagnosis, offer genetic counseling services, and enhance our comprehension of XLA. [ABSTRACT FROM AUTHOR]

Abstract The purpose of this study is to develop a nomogram model for early prediction of the severe mycoplasma pneumoniae pneumonia (SMPP) in Pediatric and Adult Patients. A retrospective analysis was conducted on patients with MPP, classifying them into SMPP and non-severe MPP (NSMPP) groups. A total of 550 patients (NSMPP 374 and SMPP 176) were enrolled in the study and allocated to training, validation cohorts. 278 patients (NSMPP 224 and SMPP 54) were retrospectively collected from two institutions and allocated to testing cohort. The risk factors for SMPP were identified using univariate analysis. For radiomic feature selection, Spearman’s correlation and the least absolute shrinkage and selection operator (LASSO) were utilized. Logistic regression was used to build different models, including clinical, imaging, radiomics, and integrated models (combining clinical, imaging, and radiomics features selected). The model’s discrimination was evaluated using a receiver operating characteristic curve, its calibration with a calibration curve, and the results were visualized using the Hosmer–Lemeshow goodness-of-fit test. Thirteen clinical features and fourteen imaging features were selected for constructing the clinical and imaging models. Simultaneously, a set of twenty-five radiomics features were utilized to build the radiomics model. The integrated model demonstrated good calibration and discrimination in the training cohorts (AUC, 0.922; 95% CI: 0.900, 0.942), validation cohorts (AUC, 0.879; 95% CI: 0.806, 0.920), and testing cohorts (AUC, 0.877; 95% CI: 0.836, 0.916). The discriminatory and predictive efficacy of the clinical model in testing cohorts increased further after clinical and radiological features were incorporated (AUC, 0.849 vs. 0.922, P = 0.002). The model demonstrated exemplary predictive efficacy for SMPP by leveraging a comprehensive set of inputs, encompassing clinical data, quantitative and qualitative radiological features, along with radiomics features. The integration of these three aspects in the predictive model further enhanced the performance of the clinical model, indicating the potential for extensive clinical applications.

Abstract Background X-linked agammaglobulinemia (XLA), also referred to as Bruton’s tyrosine kinase deficiency, is a rare genetic disorder that affects the immune system. We conducted genetic analysis on patients suffering from immunodeficiency by utilizing Next-Generation Sequencing techniques, as well as their closest relatives, to facilitate accurate diagnosis, offer genetic counseling services, and enhance our comprehension of XLA.

Abstract Objectives Influenza and Mycoplasma pneumoniae infections often present concurrent and overlapping symptoms in clinical manifestations, making it crucial to accurately differentiate between the two in clinical practice. Therefore, this study aims to explore the potential of using peripheral blood routine parameters to effectively distinguish between influenza and Mycoplasma pneumoniae infections. Methods This study selected 209 influenza patients (IV group) and 214 Mycoplasma pneumoniae patients (MP group) from September 2023 to January 2024 at Nansha Division, the First Affiliated Hospital of Sun Yat-sen University. We conducted a routine blood-related index test on all research subjects to develop a diagnostic model. For normally distributed parameters, we used the T-test, and for non-normally distributed parameters, we used the Wilcoxon test. Results Based on an area under the curve (AUC) threshold of ≥ 0.7, we selected indices such as Lym# (lymphocyte count), Eos# (eosinophil percentage), Mon% (monocyte percentage), PLT (platelet count), HFC# (high fluorescent cell count), and PLR (platelet to lymphocyte ratio) to construct the model. Based on these indicators, we constructed a diagnostic algorithm named IV@MP using the random forest method. Conclusions The diagnostic algorithm demonstrated excellent diagnostic performance and was validated in a new population, with an AUC of 0.845. In addition, we developed a web tool to facilitate the diagnosis of influenza and Mycoplasma pneumoniae infections. The results of this study provide an effective tool for clinical practice, enabling physicians to accurately diagnose and differentiate between influenza and Mycoplasma pneumoniae infection, thereby offering patients more precise treatment plans.

Objectives: Influenza and Mycoplasma pneumoniae infections often present concurrent and overlapping symptoms in clinical manifestations, making it crucial to accurately differentiate between the two in clinical practice. Therefore, this study aims to explore the potential of using peripheral blood routine parameters to effectively distinguish between influenza and Mycoplasma pneumoniae infections. Methods: This study selected 209 influenza patients (IV group) and 214 Mycoplasma pneumoniae patients (MP group) from September 2023 to January 2024 at Nansha Division, the First Affiliated Hospital of Sun Yat-sen University. We conducted a routine blood-related index test on all research subjects to develop a diagnostic model. For normally distributed parameters, we used the T-test, and for non-normally distributed parameters, we used the Wilcoxon test. Results: Based on an area under the curve (AUC) threshold of ≥ 0.7, we selected indices such as Lym# (lymphocyte count), Eos# (eosinophil percentage), Mon% (monocyte percentage), PLT (platelet count), HFC# (high fluorescent cell count), and PLR (platelet to lymphocyte ratio) to construct the model. Based on these indicators, we constructed a diagnostic algorithm named IV@MP using the random forest method. Conclusions: The diagnostic algorithm demonstrated excellent diagnostic performance and was validated in a new population, with an AUC of 0.845. In addition, we developed a web tool to facilitate the diagnosis of influenza and Mycoplasma pneumoniae infections. The results of this study provide an effective tool for clinical practice, enabling physicians to accurately diagnose and differentiate between influenza and Mycoplasma pneumoniae infection, thereby offering patients more precise treatment plans. [ABSTRACT FROM AUTHOR]

Recently, the treatment of bacterial infection has been very worrisome as a decline in antibiotic sensitivity is hitting a majority of the world population. Among many bacterial infection's causing agents, Enterococcus species and Mycoplasma pneumonia are highly threatening because of their resistance to powerful antibiotics such as vancomycin, erythromycin, and azithromycin. Herein, effect of polar (DMSO, EtOH, MeOH, H2O) solvation on the quantum chemical parameters, molecular structure, spectroscopy, and the antimicrobial potential of p-phenylenediamine-thiosemicarbazide-formaldehyde (PTSF) terpolymer is presented within the framework of density functional theory (DFT), solvation molecular dynamics, and molecular docking approach. Herein, ethanol was keenly observed with the most insightful properties across all analyses specifically by its high energy gap (4.6344 eV) which accounted for the stability of compound. The molecular docking revealed the binding affinities for PSTF with respect to the best docking modes are −4.6 kcal/mol with LYS 288 and bond distance of 2.82 Å for 5V2M and −5.1 kcal/mol with ASN 770 at 2.27 Å, GLU 767 at 2.61 Å, ARG 777 at 3.69 Å, GLU 775 at 2.57 Å, and ALA 763 at 2.86 Å for 6rj1. From the result obtained, the studied compound has higher binding affinity at the active site of 6RJ1 than that of 5V2M. This suggests that PSTF has greater efficacy for inhibiting the growth of M. pneumoniae than vancomycin resistant Enterococcus faecalis. Hence, further in vitro and in vivo studies should delve into the more exploration of the reported ligand. [ABSTRACT FROM AUTHOR]

"Objective To systematically evaluate the clinical efficacy of bronchoscopic lavage-assisted treatment of Mycoplasma pneumonia (MP) in children, providing references for clinical treatment. Methods China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine disc (CBM), PubMed, Embase and Web of Science were searched for randomized controlled trials of bronchoscopic lavage-assisted treatment of MP in children. Studies meeting inclusion criteria were evaluated according to the Cochrane Review manual, and Meta-analysis was performed using Stata 16.0 software. Results A total of 22 randomized controlled trials were included, all in Chinese, with a tolal of 1 774 children. Meta-analysis showed that bronchoscopic lavage-assisted treatment of MP in children significantly increased the effective rates ［RR=1.22, 95%CI(1.17, 1.26), P＜0.01］, and shortened the hospital stay ［WMD=-3.23, 95%CI (-3.64, -2.82), P＜0.01］, time to disappearance of rales ［WMD=-2.67, 95%CI (-3.12, -2.21), P＜0.01］, time to return to normal temperature ［WMD=-1.57, 95%CI (-1.84, -1.29), P＜0.01］, time to disappearance of cough ［WMD=-2.75, 95%CI (-3.40, -2.11), P＜0.01］. Conclusion Bronchoscopic lavage-assisted treatment of MP in children can significantly improve the clinical effective rate and the symptoms of children."

BackgroundTraditional Chinese medicine (TCM) is used to treat mycoplasma pneumonia (MP) in children with favorable treatment outcome in China. In the present study, we evaluated the clinical efficacy of TCM combined with azithromycin (AZM) for the treatment of MP among children, providing high evidence-based reference for clinical treatment.MethodWe retrieved eligible randomized controlled trials (RCTs) from CQVIP, CNKI, WanFang, NSTL, PubMed, Embase, and Embase databases from January 2000 to November 2023. Data extraction and quality assessment of the enrolled studies were independently by two reviewers. Review Manager 5.3 was used for meta-analysis.ResultA total of 51 RCTs involving 5,799 children aged 1–14 enrolled. Meta-analysis demonstrated that TCM combined with AZM improved the cure rate (odds ratio [OR] = 2.34, 95% CI: 2.06 to 2.64) and the effective rate (OR = 5.21, 95% CI: 4.22 to 6.43), shorted the disappearance duration of cough (WMD = −1.62, 95% CI: −1.90 to −1.34), the duration of fever (WMD = −1.62, 95% CI: −1.96 to −1.29), and the disappearance time of lung rales (WMD = −1.15, 95% CI: −1.32 to −0.98), improved CRP levels (WMD = −2.06, 95% CI: −2.57 to −1.55), IL-6 levels (WMD = −1.92,95% CI: −2.51 to −1.34), and TNF-α levels (WMD = −1.59, 95% CI: −2.14 to −1.04), and reduced adverse reactions (OR = 0.37, 95% CI: 0.32 to 0.44).ConclusionTCM combined with AZM in the treatment of MP among children has favorable clinical efficacy and safety.

Objective: The aim of this study was to investigate the epidemiological trend of respiratory pathogens infections among children after the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: This study enrolled 575,373 children who came to our hospital for relevant respiratory pathogen antigen/antibody testing due to respiratory symptoms such as fever and cough. The demographic and laboratory data, including age, gender, testing time, and influenza A virus (IAV), influenza B virus (IBV), respiratory syncytial virus (RSV), adenovirus (ADV), and Mycoplasma pneumonia (MP) results, were collected from electronic medical records. SPSS (version 21.0) and GraphPad Prism 9 software were used for statistical analysis and figure creation. Results: 79,746 children tested positive for IAV IgM, and 3196 children tested positive for IBV IgM, with an overall positive rate of 28.5 % for IAV and 1.1 % for IBV. IAV infections peaked at 21,502 cases in March 2023. 80,699 children underwent RSV IgM testing from April to October 2023, with 5726 (7.1 %) testing positive. The apex of RSV infections occurred in May 2023, with 2140 cases. Regarding ADV, 100,460 children underwent testing from April to October 2023, with 1981 (11.9 %) testing positive. The pinnacle of ADV infections reached 4546 cases in November 2023. Concerning MP, 474,913 children underwent MP testing, with 73,833 (15.5 %) testing positive. The zenith of MP infections occurred in November 2023, with 25,291 cases. Further analysis revealed that the outbreaks of these pathogens are occurring earlier than in previous years. Additionally, our data showed that children aged >3 years accounted for 79.6 %, 87.8 %, 88.6 %, and 77.8 % of the total IAV‐positive, IBV‐positive, ADV-positive, and MP-positive children, respectively. Conversely, RSV primarily infected children

Abstract Background To explore the alterations of inflammatory markers and immune-related cytokines in children infected with Mycoplasma pneumoniae (MP) combined with Adenovirus (ADV). Methods The study population consisted of 201 children with MPP, and they were grouped according to whether they were coinfected with ADV infection and critically ill. Additionally, comparative analyses were performed. The diagnostic value of different indicators and combined indicators for SMPP combined with ADV was assessed using ROC curves. Results There was no difference between group A1 and group A2, group B1 and group B2 in terms of age, gender, duration of hospitalisation and fever. The levels of calcitoninogen(PCT), lactate dehydrogenase concentration(LDH), interleukin(IL)-6, IL-8, IL-10, IL-4, IL-12P70, and IFN-γ in group A were higher than group B. The severe group (A1, B1) was significantly higher than the mild group (A2, B2) in terms of D-dimer, CRP, PCT, LDH, IL-6, IL-8, IL-10, IL-17a and number of patients with pleural effusion, solid lung changes. Among the individual indexes of D-dimer, CRP, N%,LDH, and PCT, the AUC of the combined test was 0.977, which was higher than that of the individual indicators. Among IL-6, IL-8, IL-10, and IL-17a, the AUC of the combined assay was 0.802, which was higher than that of the individual indicators. Conclusion MP combined with ADV infection was associated with increased expression levels of IL-6, IL-8, IL-10, IL-4, IL-12P70, IFN-γ, and LDH. IL-6, IL-8, IL-10, IL-17a, LDH, PCT, CRP, and D-dimer could be used as predictors of SMPP and the combined test can improve the diagnostic value.

Background: To explore the alterations of inflammatory markers and immune-related cytokines in children infected with Mycoplasma pneumoniae (MP) combined with Adenovirus (ADV). Methods: The study population consisted of 201 children with MPP, and they were grouped according to whether they were coinfected with ADV infection and critically ill. Additionally, comparative analyses were performed. The diagnostic value of different indicators and combined indicators for SMPP combined with ADV was assessed using ROC curves. Results: There was no difference between group A1 and group A2, group B1 and group B2 in terms of age, gender, duration of hospitalisation and fever. The levels of calcitoninogen(PCT), lactate dehydrogenase concentration(LDH), interleukin(IL)-6, IL-8, IL-10, IL-4, IL-12P70, and IFN-γ in group A were higher than group B. The severe group (A1, B1) was significantly higher than the mild group (A2, B2) in terms of D-dimer, CRP, PCT, LDH, IL-6, IL-8, IL-10, IL-17a and number of patients with pleural effusion, solid lung changes. Among the individual indexes of D-dimer, CRP, N%,LDH, and PCT, the AUC of the combined test was 0.977, which was higher than that of the individual indicators. Among IL-6, IL-8, IL-10, and IL-17a, the AUC of the combined assay was 0.802, which was higher than that of the individual indicators. Conclusion: MP combined with ADV infection was associated with increased expression levels of IL-6, IL-8, IL-10, IL-4, IL-12P70, IFN-γ, and LDH. IL-6, IL-8, IL-10, IL-17a, LDH, PCT, CRP, and D-dimer could be used as predictors of SMPP and the combined test can improve the diagnostic value. [ABSTRACT FROM AUTHOR]

Objective To investigate the expression and clinical significance of serum soluble programmed cell death ligand-2 (sPD-L2) and hyaluronic acid receptor Layilin (LAYN) in children with Mycoplasma pneumoniae pneumonia (MPP) complicated by airway mucus plug. Methods A total of 184 children with MPP from January 2018 to January 2022 were selected as the MPP group, and 60 children undergoing elective inguinal hernia repair in the same period were selected as the control group. According to whether airway mucus plug was combined under bronchoscopy, the MPP group was divided into the simple MPP group (130 cases) and the MPP combined with mucus plug group (54 cases) . Enzyme-linked immunosorbent assay was used to detect serum sPD-L2 and LAYN levels. Multivariate logistic regression analysis was used to analyze the risk factors affecting the formation of airway mucus plug in children with MPP. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum sPD-L2 and LAYN for MPP combined with airway mucus plug. Results The serum levels of sPD-L2 and LAYN in the MPP group were significantly higher than those in the control group, and the differences were statistically significant (all P＜0.05) . In the MPP group with airway mucus plug, the fever duration, serum C-reactive protein, pleural effusion, lung collapse, involvement of ≥2 lung lobes, sPD-L2, and LAYN levels were higher than those in the simple MPP group, and the differences were statistically significant (all P＜0.05) . The serum levels of sPD-L2 and LAYN in children with MPP combined with airway mucus plug were significantly positively correlated with white blood cell count, C-reactive protein, and percentage of neutrophils (all P＜0.05) . Fever duration, elevated serum sPD-L2, and LAYN were independent risk factors for the formation of airway mucus plug in MPP. The combined ROC curve for fever duration, sPD-L2, and LAYN predicting MPP combined with airway mucus plug had an area under the curve of 0.893, higher than the single indicator detection of 0.820, 0.721, and 0.789, with statistically significant differences (Z=4.302, 5.618, 4.518, all P＜0.001) . Conclusion The elevated serum levels of sPD-L2 and LAYN in children with MPP combined with airway mucus plug, along with prolonged fever duration, indicate independent risk factors for the formation of airway mucus plug. The combination of these three factors helps assess the presence of MPP combined with airway mucus plug. [ABSTRACT FROM AUTHOR]

Objective To investigate the diagnostic and prognostic value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in children with mycoplasma pneumonia (MP) infection. Methods The retrospective analysis was adopted. One hundred children patients with MP-IgM positive from January to June 2023 served as the case group, and other 100 healthy children during the same period were extracted as the control group; the results of the first re-examination in the case group served as the standard, the children patients in the case group were divided into the unrecovered group (MP-IgM positive) and the recovered group (MP-IgM negative); the levels of NLR and PLR were compared among the groups, and the logistic regression model was established, then the receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the two. Results The levels of NLR and PLR in the case group were significantly higher than those in the control group (P<0.05); the areas under the curve (AUC) of single detection and combined detection of NLR and PLR in the diagnosis of the children patients with MP infection were 0.749, 0.701 and 0.758 respectively. AUC of the combined detection was maximal, the corresponding sensitivity was 83.00% and the specificity was 61.00% (P<0.001). The levels of NLR and PLR in the unrecovered group were also significantly increased compared with those in the recovered group (P<0.05). Conclusion NLR and PLR are closely correlated to MP infection, and their combined detection has the higher sensitivity for MP infection and the both also have a certain prompt effect on the prognosis in the children patients. [ABSTRACT FROM AUTHOR]

As SARS-CoV-2 transitions from a pandemic to an endemic presence, a significant rise in respiratory diseases such as influenza and Mycoplasma pneumonia is challenging healthcare systems weakened by the impact of COVID-19. This commentary examines the global resurgence of respiratory pathogens, heightened by the post-pandemic "immunity debt", through an analysis of WHO surveillance data and national health reports. Findings reveal a substantial increase in respiratory illnesses, notably among children, compounded by a shortage of pediatricians and growing antimicrobial resistance. This underscores the need to improve hospital preparedness, optimize clinical responses, and enhance public health strategies to effectively navigate the impending peak of concurrent respiratory infections. [ABSTRACT FROM AUTHOR]

PurposeThis study aims to explore the value of clinical features, CT imaging signs, and radiomics features in differentiating between adults and children with Mycoplasma pneumonia and seeking quantitative radiomic representations of CT imaging signs.Materials and methodsIn a retrospective analysis of 981 cases of mycoplasmal pneumonia patients from November 2021 to December 2023, 590 internal data (adults:450, children: 140) randomly divided into a training set and a validation set with an 8:2 ratio and 391 external test data (adults:121; children:270) were included. Using univariate analysis, CT imaging signs and clinical features with significant differences (p

Abstract Objective To investigate the etiological characteristics of plastic bronchitis (PB) caused by pulmonary infections in children and to identify any differences in the clinical features of PB cases caused by different pathogens. Method We collected data on children diagnosed with PB and admitted to the Respiratory Department at Soochow University Children’s Hospital between July 2021 and March 2023 utilizing electronic bronchoscopy. We analyzed clinical characteristics and the species of pathogens causing the illness in these children. Result A total of 45 children were enrolled. The main clinical symptoms observed were cough (100%), fever (80%), shortness of breath (28.9%), and wheezing (20.0%). Pathogens were identified in 38 (84.4%) patients. Mycoplasma pneumoniae (MP) had the highest detection rate at 53.3%, followed by the Boca virus at 26.7%. MP-induced PB typically occurs in older children with an average age of 7.46 ± 2.36 years, with the main symptoms including high fever (85.7%) and local hyporespiration (42.9%). In contrast, Boca virus-induced PB tends to occur in younger children, with the main symptoms of moderate fever (54.5%), and wheezing (54.5%). The MP group exhibited a higher incidence of both internal and external pulmonary complications, including pleural effusion (42.9%), elevated aspartate aminotransferase (52.4%), lactic dehydrogenase (76.2%), and D-D dimer (90.5%). Conversely, the Boca virus group primarily showed pulmonary imaging of atelectasis (81.8%), with no pleural effusion. The average number of bronchoscopic interventions in the MP group was 2.24 ± 0.62, which was significantly higher than that required in the Boca virus group (1.55 ± 0.52). During the second bronchoscopy, 57.1% of children in the MP group still had visible mucus plugs, while none were observed in the Boca virus group. Conclusion MP and Boca virus are the primary pathogens responsible for PB among children. The clinical manifestations of PB typically vary significantly based on the pathogen causing the condition.

Mycoplasma pneumoniae (MP) is a prominent etiological agent of bronchitis and community-acquired pneumonia. MP, the smallest prokaryotes that are wall-less, free-living, and capable of self-replication, are present in more than 200 species of arthropods, animals, and humans. The swift advancement of nanotechnology has facilitated the utilization of a wide range of nanomaterials in constructing effective biosensing platforms that can detect a variety of target analytes. Nanomaterials possess unique magnetic, optical, and electronic properties and a high ratio of surface area to volume. These attributes enable the manipulation and control of these materials through the covalent or noncovalent attachment of recognition moieties. This has generated possibilities for detecting pathogenic microbes that were hitherto unattainable. Regulating the dimensions and composition of the nanomaterials' surfaces can substantially enhance the analytical capabilities of nanomaterials used in assays. As a result, the identification of pathogenic bacteria at the location of the incident can be accomplished swiftly and with minimal sample volumes required to ensure public safety. Assays utilizing nanomaterials offer numerous advantages over traditional pathogen detection methods. These include cost-effectiveness, rapidity, and exceptional precision, mainly when applied to high-throughput screening processes. Furthermore, these assays do not require labels and provide real-time responses. Moreover, they adhere to the standards and regulations set forth by regulatory agencies, hospitals, and the food industry. Nonetheless, obstacles exist in the detection of MP. The persistent difficulty in diagnosing pneumonia caused by MP is attributable to the absence of a sensitive, specific, and rapid detection method. Early-stage MP infections are frequently misdiagnosed due to the absence of distinct clinical and imaging features and atypical symptoms. In addition to serological tests, PCR and rapid culture derived from pharynx samples are the principal laboratory diagnostic techniques. Rapid antigen assays are another example. In this review, various nanotechnology-based methods for detecting MP are examined. Although applying nanotechnology to the detection of MP has yielded encouraging results, obstacles remain to be resolved. Further research is necessary to optimize these nanotechnology-based detection methods' sensitivity, specificity, and velocity.

Objective: To investigate the etiological characteristics of plastic bronchitis (PB) caused by pulmonary infections in children and to identify any differences in the clinical features of PB cases caused by different pathogens. Method: We collected data on children diagnosed with PB and admitted to the Respiratory Department at Soochow University Children's Hospital between July 2021 and March 2023 utilizing electronic bronchoscopy. We analyzed clinical characteristics and the species of pathogens causing the illness in these children. Result: A total of 45 children were enrolled. The main clinical symptoms observed were cough (100%), fever (80%), shortness of breath (28.9%), and wheezing (20.0%). Pathogens were identified in 38 (84.4%) patients. Mycoplasma pneumoniae (MP) had the highest detection rate at 53.3%, followed by the Boca virus at 26.7%. MP-induced PB typically occurs in older children with an average age of 7.46 ± 2.36 years, with the main symptoms including high fever (85.7%) and local hyporespiration (42.9%). In contrast, Boca virus-induced PB tends to occur in younger children, with the main symptoms of moderate fever (54.5%), and wheezing (54.5%). The MP group exhibited a higher incidence of both internal and external pulmonary complications, including pleural effusion (42.9%), elevated aspartate aminotransferase (52.4%), lactic dehydrogenase (76.2%), and D-D dimer (90.5%). Conversely, the Boca virus group primarily showed pulmonary imaging of atelectasis (81.8%), with no pleural effusion. The average number of bronchoscopic interventions in the MP group was 2.24 ± 0.62, which was significantly higher than that required in the Boca virus group (1.55 ± 0.52). During the second bronchoscopy, 57.1% of children in the MP group still had visible mucus plugs, while none were observed in the Boca virus group. Conclusion: MP and Boca virus are the primary pathogens responsible for PB among children. The clinical manifestations of PB typically vary significantly based on the pathogen causing the condition. [ABSTRACT FROM AUTHOR]

Yonghan Luo, Yanchun Wang Second Department of Infectious Disease, Kunming Children’s Hospital, Kunming, Yunnan, People’s Republic of ChinaCorrespondence: Yanchun Wang, Second Department of Infectious Disease, Kunming Children’s Hospital, Kunming, Yunnan, 650000, People’s Republic of China, Email wangyanchun0204@163.comObjective: To analyze the predictive factors for necrotizing pneumonia (NP) in children with Mycoplasma pneumoniae pneumonia (MPP) and construct a prediction model.Methods: The clinical data with MPP at the Children’s Hospital of Kunming Medical University from January 2014 to November 2022 were retrospectively analyzed. Eighty-four children with MPP who developed NP were divided into the necrotizing group, and 168 children who did not develop NP were divided into the non-necrotizing group by propensity-score matching. LASSO regression was used to select the optimal factors, and multivariate logistic regression analysis was used to establish a clinical prediction model. The receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the discrimination and calibration of the nomogram. Clinical decision curve analysis was used to evaluate the clinical predictive value.Results: LASSO regression analysis showed that bacterial co-infection, chest pain, LDH, CRP, duration of fever, and D-dimer were the influencing factors for NP in children with MPP (P < 0.05). The results of ROC analysis showed that the AUC of the prediction model established in this study for predicting necrotizing MPP was 0.870 (95% CI: 0.813– 0.927, P < 0.001) in the training set and 0.843 (95% CI: 0.757– 0.930, P < 0.001) in the validation set. The Bootstrap repeated sampling for 1000 times was used for internal validation, and the calibration curve showed that the model had good consistency. The Hosmer-Lemeshow test showed that the predicted probability of the model had a good fit with the actual probability in the training set and the validation set (P values of 0.366 and 0.667, respectively). The clinical decision curve showed that the model had good clinical application value.Conclusion: The prediction model based on bacterial co-infection, chest pain, LDH, CRP, fever duration, and D-dimer has a good predictive value for necrotizing MPP.Keywords: mycoplasma pneumonia, necrotizing pneumonia, nomogram, children

Abstract Background Mycoplasma pneumoniae is one of the leading causes of community-acquired pneumonia. Due to its microbiological variation, clinical presentations of mycoplasma infections are atypical and diverse. Multiple pulmonary and extrapulmonary manifestations of Mycoplasma pneumoniae have been documented. Among pulmonary, common manifestations are fever, malaise, lymphadenopathy, pneumonia, upper respiratory tract infections, sinusitis, etc. Necrotising pneumonia leading to cavitation as a manifestation is rather an uncommon presentation. Case presentation We are reporting a rare case of a 5-year-old female child who presented with bilateral haemorrhagic pleural effusion and necrotising pneumonia with cavitation along with extrapulmonary manifestation in the form of maculo-papular rash, Coombs-positive haemolytic anaemia and serositis. The child was started on azithromycin and symptomatic management, but she did not respond to it; she had clinical worsening and evidence of radiological necrotising pneumonia. The child was treated as macrolide-resistant mycoplasma pneumonia with levofloxacin, steroids and rigorous physiotherapy. Conclusions Accurate clinical acumen along with timely radiological imaging is the need of the hour for early diagnosis of macrolide-resistant mycoplasma pneumonia (MRMP). This case also emphasises role of fluoroquinolones and steroids in treatment of macrolide-resistant mycoplasma pneumonia.

Background: Coronary artery dilation (CAD) had rarely been described as a cardiac complication of febrile disease other than Kawasaki disease (KD). There are rare cases complicated by CAD reported in patients with Mycoplasma pneumoniae (MP) infection. Case presentation: A 6-year-old boy with severe Mycoplasma pneumoniae pneumonia (MPP) was transferred to our hospital due to significant respiratory distress on the 11th day from disease onset. Nadroparin, levofloxacin, and methylprednisolone followed by oral prednisone were aggressively prescribed. His clinical condition gradually achieved remission, and the drugs were withdrawn on the 27th day. Regrettably, the recurrent fever attacked him again in the absence of infection-toxic manifestations. Necrotizing pneumonia (NP) was found on chest CT. And echocardiography revealed right CAD (diameter, 3.40mm; z-score, 3.8), however, his clinical and laboratory findings did not meet the diagnostic criteria of KD. CAD was proposed to result from MP infection, and aspirin was prescribed. Encouragingly, the CAD regressed one week later (diameter, 2.50mm; z-score, 1.4). Additionally, the child defervesced seven days after the initiation of prednisone and Nadroparin treatment. The patient was ultimately discharged home on the 50th day. During follow-up, the child was uneventful with normal echocardiography and fully resolved chest CT lung lesions. Conclusions: CAD can develop in patients with severe MP infection. Pediatricians should be alert to the possibility of CAD in patients with severe MP infection and recognize that CAD might also develop in febrile disease rather than KD.

With the growing frequency of Mycoplasma pneumoniae infections linked to respiratory asthma (MP-RA), particularly in children, the quest for novel diagnostic molecular markers has become critical. We examined the link between serum immunoglobulin, inflammatory variables, vitamin A, and vitamin D levels in MP-RA patients and then found markedly diagnostic indicators. From January 2015 to March 2020, our hospital screened 55 cases of healthy control children (HC), 53 instances of mycoplasma pneumonia infection complicated with respiratory asthma (MP-RA), and 58 cases of non-respiratory asthma children for pneumonia mycoplasma infection (MP). Serum immunoglobulins, inflammatory markers, vitamin D, and vitamin A levels were analyzed, and a predictive model including the feature chosen in the least absolute shrinkage and selection operator regression model was developed. Serum TNF- and IL-1b levels were greater in MP-RA children than in MP children, but 25(OH)D, IgG, and IgA levels were lower. Our findings verified the link between IgA, TNF-a, 25(OH)D, and vitamin A with MP-RA. In addition, TNF-a, IL-1b, 25(OH)D (Vit-D), IgG, and IgA were the predictors in the prediction nomogram, showing the combined influence of serum inflammation in MP-RA. C-index of 0.985 (95% CI: −1.25 to 1.68) shows high scaling ability and the model exhibits good discriminative capacity. With range validation, the high C-index value of 0.96 is still possible. TNF-a, IL-1b, 25(OH)D (Vit-D), IgG, and IgA were considered as predictors in children with MP-RA was investigated in this research. [ABSTRACT FROM AUTHOR]

We present a previously healthy female who presented with life-threatening bilateral pneumonia causing respiratory failure associated with severe hemolysis. Because of their endemicity in India, malaria, dengue, and leptospirosis top the list of differential diagnosis in such cases. However, we found an alternate cause.

In this study, copper nanoparticles were synthesised according to green chemistry rules using the aqueous extract of Alhagi maurorum. The green-synthesised CuNPs were characterised using different techniques such as EDX, FE-SEM, XRD and FT-IR. The FE-SEM results confirm spherical morphology for the nanoparticles with a size of 42.68–68.87 nm. In vivo, the Mycoplasma pneumonia injection was applied for inducing pneumonia in the BALB/c mice, also the treatment was with CuNPs. The serum parameters such as inflammatory mediators (IL-6, TNF-α, IL-8, TGF and IL-1), total cell counts, and total protein content levels were evaluated. CuNPs regulated the levels of the inflammatory mediators in the infected mice. The cellular arrangements at the histopathological images were ameliorated with the administration of CuNPs. At the antioxidant test, the CuNPs and BHT removed 50% of free radicals at the concentrations of 181 and 110 µg/ml. In conclusion, the results revealed the ameliorative property of CuNPs green-formulated by A. maurorum aqueous extract on M. pneumoniae infected pneumonia mice model.

Abstract Background To explore the efficacy and safety of minocycline as adjuvant therapy for refractory mycoplasma pneumonia in Chinese children. Methods PubMed, EMBASE, Cochrane Library, CNKI, Wanfang database and VIP database were systematically searched. Studies where minocycline was used as adjuvant therapy for refractory mycoplasma pneumonia in Chinese children were included. The effect of numeration data and the measurement data were represented by odds ratios (OR) and weighted mean differences (MD), respectively. Review Manager version 5.3 was used to compare the treatment efficacy, time for the cough to subside, defervescence time, hospitalisation time, adverse events and other indicators. Results Ten studies involving 857 patients were included in the final analysis. Compared with the conventional treatment of refractory mycoplasma pneumonia in children, the addition of minocycline as adjuvant therapy was found to improve the treatment efficacy (OR: 5.45; 95% CI: 3.46, 8.57, p

Background: Mycoplasma pneumoniae is one of the leading causes of community-acquired pneumonia. Due to its microbiological variation, clinical presentations of mycoplasma infections are atypical and diverse. Multiple pulmonary and extrapulmonary manifestations of Mycoplasma pneumoniae have been documented. Among pulmonary, common manifestations are fever, malaise, lymphadenopathy, pneumonia, upper respiratory tract infections, sinusitis, etc. Necrotising pneumonia leading to cavitation as a manifestation is rather an uncommon presentation. Case presentation: We are reporting a rare case of a 5-year-old female child who presented with bilateral haemorrhagic pleural effusion and necrotising pneumonia with cavitation along with extrapulmonary manifestation in the form of maculo-papular rash, Coombs-positive haemolytic anaemia and serositis. The child was started on azithromycin and symptomatic management, but she did not respond to it; she had clinical worsening and evidence of radiological necrotising pneumonia. The child was treated as macrolide-resistant mycoplasma pneumonia with levofloxacin, steroids and rigorous physiotherapy. Conclusions: Accurate clinical acumen along with timely radiological imaging is the need of the hour for early diagnosis of macrolide-resistant mycoplasma pneumonia (MRMP). This case also emphasises role of fluoroquinolones and steroids in treatment of macrolide-resistant mycoplasma pneumonia. [ABSTRACT FROM AUTHOR]

Objective: To identify factors influencing mycoplasma pneumonia and respiratory diseases as a function of yearly seasons. Methods: Records of respiratory disease cases, as obtained from the respiratory laboratory of the First Affiliated Hospital of China Medical University over the period from November 2013 to October 2018, were retrospectively analyzed. Susceptible factors, as related to the general data from mycoplasma pneumonia cases, included season of the year along with the age and gender of the patients. Results: Statistically significant differences in mycoplasma pneumonia were obtained among the different seasons (2 = 496.24, P <0.05), ages (P < 0.05) and gender (2 = 300.10, P < 0.05). The rate and number of mycoplasma pneumonia cases were highest in the winter and lowest in the summer, with the difference between these two seasons being statistically significant (P < 0.05). Among confirmed positive cases, infection rates of mycoplasma pneumonia in young and middle-aged patients were significantly greater than that in the elderly (P < 0.05) and the incidence in women was significantly greater than that in men (2 = 300.10, P < 0.05). Among the total of all lung diseases sampled, the largest numbers were observed in pediatric cases and the peak period of disease occurrence was over the period from October to January. Conclusion: The incidence of pneumonia shows significant differences as a function of the season of the year, effects which are observed in all ages. [ABSTRACT FROM AUTHOR]

In this study, copper nanoparticles were synthesised according to green chemistry rules using the aqueous extract of Alhagi maurorum. The green-synthesised CuNPs were characterised using different techniques such as EDX, FE-SEM, XRD and FT-IR. The FE-SEM results confirm spherical morphology for the nanoparticles with a size of 42.68–68.87 nm. In vivo, the Mycoplasma pneumonia injection was applied for inducing pneumonia in the BALB/c mice, also the treatment was with CuNPs. The serum parameters such as inflammatory mediators (IL-6, TNF-α, IL-8, TGF and IL-1), total cell counts, and total protein content levels were evaluated. CuNPs regulated the levels of the inflammatory mediators in the infected mice. The cellular arrangements at the histopathological images were ameliorated with the administration of CuNPs. At the antioxidant test, the CuNPs and BHT removed 50% of free radicals at the concentrations of 181 and 110 µg/ml. In conclusion, the results revealed the ameliorative property of CuNPs green-formulated by A. maurorum aqueous extract on M. pneumoniae infected pneumonia mice model. [ABSTRACT FROM AUTHOR]

Abstract Objective The purpose of this study was to compare imaging features between COVID-19 and mycoplasma pneumonia (MP). Materials and methods The data of patients with mild COVID-19 and MP who underwent chest computed tomography (CT) examination from February 1, 2020 to April 17, 2020 were retrospectively analyzed. The Pneumonia-CT-LKM-PP model based on a deep learning algorithm was used to automatically quantify the number, volume, and involved lobes of pulmonary lesions, and longitudinal changes in quantitative parameters were assessed in three CT follow-ups. Results A total of 10 patients with mild COVID-19 and 13 patients with MP were included in this study. There was no difference in lymphocyte counts at baseline between the two groups (1.43 ± 0.45 vs. 1.44 ± 0.50, p = 0.279). C-reactive protein levels were significantly higher in MP group than in COVID-19 group (p

BackgroundThe relationship between vitamin D nutritional status and the formation of bronchial mucus plugs (BMPs) is unclear. The aims of the current study were to investigate associations between serum 25(OH)D levels, serum inflammatory factors, and clinical characteristics in children with mycoplasma pneumonia (MPP), and to summarize the risk factors for BMPs in children with MPP.MethodsClinical data from 175 children with MPP were collected and analyzed, the children were divided into a BMP group and a non-BMP group. Serum 25(OH)D levels, IL-8, and various inflammatory factors were compared in the two groups. Associations between 25(OH)D levels and IL-8, various inflammatory factors, and clinical characteristics were analyzed, and the diagnostic value of serum 25(OH)D levels was assessed.ResultsSerum 25(OH)D level was significantly lower in the BMP group (p < 0.05). Serum IL-8 level, percentages of neutrophils, and some inflammatory factors were significantly higher in the BMP group (p < 0.05). Serum 25(OH)D level was negatively correlated with IL-8, neutrophil percentage, various inflammatory factors (all p < 0.05). It was also associated with lobular infection, pleural effusion, mechanical ventilation, and mycoplasma 2,063/2,064 mutation (all p < 0.05). In multivariate regression analysis 25(OH)D [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.97–0.99, p = 0.003], IL-8 (OR 1.02, 95% CI 1.00–1.04, p = 0.002), polylobular infection (OR 1.75, 95% CI 1.17–2.64, p = 0.007), and MP DNA copies (OR 0.98, 95% CI 1.04–1.01, p = 0.022) were independent risk factors for BMPs, and the area under the curve value was 0.915 (95% CI 0.895–0.935). If the serum 25(OH)D level was

Objective: To elucidate the clinical usefulness of lactate dehydrogenase (LDH) levels in children with Mycoplasma pneumoniae (MP) pneumonia and identify cut-off levels in various clinical conditions. Methods: The study was retrospectively performed in 145 children who were hospitalized with MP pneumonia. Laboratory findings, including LDH levels at admission and clinical features were retrospectively reviewed from patients' electronic medical records. Results: The mean age of the study population was 5.9 y, and the mean value of LDH was 809.7 U/L. Poor response to treatment for MP pneumonia, respiratory virus coinfection, severe MP pneumonia, development of postinfectious bronchiolitis obliterans (PIBO) after MP pneumonia, pleural effusion, and oxygen need during illness were significantly associated with serum LDH levels. The cutoff levels of LDH for predicting poor response to treatment for MP pneumonia and respiratory virus coinfection were 1058 U/L [area under the curve (AUC), 0.729] and 803 U/L (AUC, 0.682), respectively. Those for pneumonic lesions involving at least one-third of the total lung volume, prediction of PIBO development, and extrapulmonary manifestations were 1098 U/L (AUC, 0.715), 676 U/L (AUC, 0.714), and 859 U/L (AUC, 0.710), respectively. The cutoff levels for pleural effusion during illness and for the prediction of oxygen need were 894 U/L (AUC, 0.699) and 1114 U/L (AUC, 0.771), respectively. Conclusion: LDH levels are elevated in diverse clinical conditions in children with MP pneumonia and may be useful in the identification of severe clinical courses of MP pneumonia in children. [ABSTRACT FROM AUTHOR]

Background: To explore the efficacy and safety of minocycline as adjuvant therapy for refractory mycoplasma pneumonia in Chinese children. Methods: PubMed, EMBASE, Cochrane Library, CNKI, Wanfang database and VIP database were systematically searched. Studies where minocycline was used as adjuvant therapy for refractory mycoplasma pneumonia in Chinese children were included. The effect of numeration data and the measurement data were represented by odds ratios (OR) and weighted mean differences (MD), respectively. Review Manager version 5.3 was used to compare the treatment efficacy, time for the cough to subside, defervescence time, hospitalisation time, adverse events and other indicators. Results: Ten studies involving 857 patients were included in the final analysis. Compared with the conventional treatment of refractory mycoplasma pneumonia in children, the addition of minocycline as adjuvant therapy was found to improve the treatment efficacy (OR: 5.45; 95% CI: 3.46, 8.57, p < 0.001); shorten the duration of cough (MD: -3.61; 95%CI: -4.25, -2.97, p < 0.001), fever time (MD: -4.77; 95% CI: -6.30, -3.23, p < 0.001) and hospitalisation time (MD: -5.53 (95% CI: -7.19, -3.88, p < 0.001); and decrease the concentration of C-reactive protein (MD: -13.95; 95%CI: -18.61, -9.29; p < 0.001) and the erythrocyte sedimentation rate (MD: -10.88; 95% CI: -14.05, -7.72, p < 0.001). The use of minocycline did not lead to significant adverse events (OR = 0.63; 95% CI: 0.39, 1.01, p = 0.05). Conclusion: The use of minocycline as adjuvant treatment of refractory mycoplasma pneumonia in Chinese children has good efficacy and safety and may be promoted in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: Mycoplasma pneumoniae is one of the major causes of upper and lower respiratory tract infection in childhood. Neurological diseases are among the most common extrapulmonary manifestations.This study aimed to share our center's experience regarding the treatment characteristics and clinical and radiological course of patients with M. pneumoniae-related neurological symptoms in light of the available evidence. Material and Methods: The study included in hospitalized patients with positive primary M. pneumoniae serology M. pneumoniae serology was examined in serum from the acute period and, if possible, convalescent serum (1-4 weeks after disease onset) using M. pneumoniae-specific immunoglobulin M (IgM) and IgG enzyme-linked immunoassay. A 4-fold or greater increase in IgG titer between acute and convalescent serum samples was considered diagnostic for M. pneumoniae infection. The clinical, laboratory, and imaging results and demographic data of patients with CNS involvement were evaluated. Results: Review of the patients' charts showed that 13 (25%) of the 52 patients with confirmed M. pneumoniae infection had neurological symptoms and findings. When evaluated together with clinical, laboratory, and imaging results, 6 patients were diagnosed with acute cerebellar ataxia, 4 patients with encephalitis, and 1 patient each with GBS, optic neuritis, and longitudinally extensive transverse myelitis. Conclusion: Although M. pneumoniae is known as mainly a respiratory pathogen, it also causes various neurological disorders. Although all of our patients had symptoms of respiratory tract infection, it has been shown that that M. pneumoniae can also cause neurological disease without respiratory symptoms. Further studies are needed to evaluate the most appropriate methods for early diagnosis and treatment of neurological involvement, considering the long-term burden of the disease. [ABSTRACT FROM AUTHOR]

Background: Traditional Chinese medicine (TCM) is used to treat mycoplasma pneumonia (MP) in children with favorable treatment outcome in China. In the present study, we evaluated the clinical efficacy of TCM combined with azithromycin (AZM) for the treatment of MP among children, providing high evidence-based reference for clinical treatment., Method: We retrieved eligible randomized controlled trials (RCTs) from CQVIP, CNKI, WanFang, NSTL, PubMed, Embase, and Embase databases from January 2000 to November 2023. Data extraction and quality assessment of the enrolled studies were independently by two reviewers. Review Manager 5.3 was used for meta-analysis., Result: A total of 51 RCTs involving 5,799 children aged 1-14 enrolled. Meta-analysis demonstrated that TCM combined with AZM improved the cure rate (odds ratio [OR] = 2.34, 95% CI: 2.06 to 2.64) and the effective rate (OR = 5.21, 95% CI: 4.22 to 6.43), shorted the disappearance duration of cough (WMD = -1.62, 95% CI: -1.90 to -1.34), the duration of fever (WMD = -1.62, 95% CI: -1.96 to -1.29), and the disappearance time of lung rales (WMD = -1.15, 95% CI: -1.32 to -0.98), improved CRP levels (WMD = -2.06, 95% CI: -2.57 to -1.55), IL-6 levels (WMD = -1.92,95% CI: -2.51 to -1.34), and TNF-α levels (WMD = -1.59, 95% CI: -2.14 to -1.04), and reduced adverse reactions (OR = 0.37, 95% CI: 0.32 to 0.44)., Conclusion: TCM combined with AZM in the treatment of MP among children has favorable clinical efficacy and safety., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lyu, Fan, Li, Wang, Tian, Xu, Zhang and Wang.)

Lemierre syndrome is an uncommon condition that typically presents with oropharyngeal infection and subsequent thrombophlebitis of the internal jugular veins. The syndrome is associated with septic emboli, frequently of the lungs, as well as Fusobacterium necrophorum bacteremia. Here, we report a case of Lemierre syndrome in the setting of an atypical pulmonary pathology. During the patient's clinical course, a peritonsillar abscess was identified, as well as associated septic emboli and superimposed Mycoplasma pneumoniae in the setting of  F. necrophorum bacteremia. Prompt imaging and antibiotic treatment, in addition to an incision and drainage of the peritonsillar abscess, allowed for the patient to be medically optimized for discharge home with intravenous and oral antibiotics. Early recognition of this rare syndrome can help guide treatment and promote positive outcomes for patients affected by Lemierre syndrome., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Walizada et al.)

Mycoplasma pneumoniae (MPP) induced pneumonia is a common disease of children. Sinomenine (SIN) is an isoquinoline mainly sequestered from Sinomenium acutum. It is a promising drug for treating arthritis, lung, colon, liver and gastric cancer. Hence, the present study investigated the role and mechanism of SIN treatment in MPP induced pneumonia in experimental in-vivo mice model. The BALB/c male mice were separated into four groups (n = 6 mice/group): normal, MPP, MPP + SIN (20 mg/kg bw), and SIN (20 mg/kg bw) alone. Results were expressed as mean ± SD. Data were analyzed using one way Analysis of Variance (ANOVA) with the Dunnett’s post hoc test using SPSS v 18.0. P value < 0.05 was considered significant. The total protein, cell count, inflammatory cytokines, MP–IgM, Monocyte chemo attractant protein-1 (MCP-1), and MP–DNA were measured. The protein expressions of Bax/Bcl–2, ERK, JNK, NF-κB were analyzed and histopathology of lungs was examined. SIN treatment significantly (p < 0.05) reduced the total proteins, cell counts in BALF, inflammatory cytokines, MP–IgM, MCP-1, MP–DNA and reversed the histological alterations. SIN attenuated the apoptotic pathway through the modulation of Bax/Bcl-2 expression. SIN alleviated pulmonary inflammatory mediators and apoptosis in MPP-infected mice via suppression of ERK/JNK/NF-κB signaling. SIN administration diminished inflammation and lung fibrosis by inhibiting apoptosis in MPP mice. Hence, SIN is a potential natural protective remedy for MPP. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the combined diagnostic value of multi-slice spiral computerized tomography (MSCT) and serum C-reactive protein (CRP) levels in children with mycoplasma pneumonia (MPP) after azithromycin treatment. Methods: Clinical data for 60 children with MPP who were treated in The First People's Hospital of Chenzhou, Chenzhou from February 2019 to February 2020, were retrospectively analyzed. All children were treated with azithromycin. Serum CRP levels were measured using immunoturbidimetric endpoint assay, while MSCT examination was done before and after treatment. This was a self-control clinical study in which the 60 patients served as their own controls. Thus, results obtained before treatment (control group, CG) were compared with those obtained after treatment (study group, EG). Within the same period, 60 healthy subjects were selected as the healthy group (HG), and were subjected to MSCT examination and serum CRP assay. The diagnostic results of CT were analyzed, and the responsiveness, selectivity, and positive and negative predictive values of the combination of MSCT and serum CRP levels were calculated. Results: Pre-treatment serum CRP level was higher in CG than in EG and HG, and CRP level was higher in EG than in HG (p < 0.001). The MSCT imaging features of EG were significantly different from those of CG (p < 0.05). The probabilities of bronchial wall thickening, hilar and mediastinal lymphadenopathy and pleural effusion were significantly higher in CG than in EG (p < 0.05). The responsiveness, selectivity, and positive and negative predictive values of combination of MSCT and serum CRP in MPP children after azithromycin treatment were 70.0, 66.7, 67.7 and 69.0 %, respectively. Conclusion: The combination of MSCT examination and serum CRP levels resulted in high diagnostic efficiency, and it may be useful for monitoring MPP in children after azithromycin treatment. Therefore, the combined procedure may reduce the burden on families of MPP children by enhancing efficiency of diagnosis of the disease. [ABSTRACT FROM AUTHOR]

Background: Mycoplasma pneumoniae is one of the major pathogens causing community-acquired pneumonia in children. Although usually self-limited, Mycoplasma pneumoniae pneumonia (MPP) may lead to complicated morbidity that can even be life-threatening. Upon MPP infection, alveolar macrophage becomes attracted and activated and will induce subsequent cytokine and chemokine reaction. Refractory Mycoplasma pneumoniae pneumonia (RMPP) is manifested by clinical or radiological deterioration despite proper antibiotic therapy. RMPP is characterized with excessive inflammation and may need subsequent glucocorticoid treatment. Aim: The aim of this study was to investigate the change of plasma chemokines in non-refractory Mycoplasma pneumoniae pneumonia (NRMPP) and RMPP before and after antibiotic or methylprednisolone treatment. Method: A total of 42 children with MPP were enrolled in this study. Plasma specimens were collected at admission and one to two weeks after antibiotic or methylprednisolone treatment with declined fever. Plasma specimens were then indicated to chemokines detection. Results: Mycoplasma pneumoniae pneumonia altered the chemokine profile through the observation of decreased plasma M1 related chemokines (CCL2, CCL8 and CXCL10) and increased M2 related chemokines (CCL17 and CCL22) after treatment.When the patients were divided into RMPP and NRMPP groups and the chemokines before treatment were compared, the RMPP group showed higher CXCL10 but lower CCL3 and CCL11 than the NRMPP group. Conclusion: Unique changes in macrophage related chemokines is observed in the course of MPP infection. NRMPP and RMPP infection in children showed distinct manifestation in chemokine profiles.

Purpose: To determine the efficacy of roxithromycin plus gamma globulin in the treatment of children with mycoplasma pneumonia (MPP) and its effect on immune function. Methods: From January 2019 to January 2021, 100 children with MPP assessed for eligibility in Qingdao Women and Children's Hospital, Shandong Province, China, were recruited and randomized (1:1) to receive either gamma globulin (control group) or roxithromycin plus gamma globulin (study group). Levels of tumor necrosis factor (TNF)-a, immunoglobulin (Ig)A, IgM, and IgG were evaluated. Clinical indices, including fever reduction, cough disappearance, duration of hospital stay, etc were also assessed. Results: The study group had a significantly higher clinical efficacy (88 %) than the control group (68 %) (p < 0.05). After treatment, patients in the study group showed lower levels of tumor necrosis factor (TNF)-a than those in the control group (p < 0.05). The eligible patients given roxithromycin plus gamma globulin showed significantly higher levels of immunoglobulin (Ig)A, IgM, and IgG versus those given gamma globulin alone (p < 0.05). Patients in the study group had a shorter time lapse before fever reduction, cough disappearance, lung sign disappearance, and duration of hospital stay than those in the control group (p < 0.05). Conclusion: Roxithromycin plus gamma globulin demonstrate significant benefits in the treatment of children with MPP by mitigating inflammatory response, enhancing immune function, and also significantly alleviating clinical symptoms. Thus, the combination treatment shows good potentials for use in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Mycoplasma pneumoniae (MP) infection is associated with extrapulmonary complications such as Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).Objective: We evaluated the differences in epidemiology, clinical characteristics, and disease outcomes between drug-induced and Mycoplasma-related SJS/TEN.Methods: All patients with SJS/TEN admitted to our center between 2003 and 2016 inclusive were treated under a standardized protocol. Comparative analysis was made between patients who tested positive for MP versus a control group with negative MP serology in the presence of high-notoriety drugs defined by an algorithm for assessment of drug causality in epidermal necrolysis >5.Results: Of 180 cases of SJS/TEN patients treated in our institution, 6 had positive MP serologies and were compared to a control group of 71 cases of drug-induced SJS/TEN with an algorithm for assessment of drug causality in epidermal necrolysis score of >5. There were no significant differences in baseline characteristics, disease classification, body surface area involved, and extent of mucosal involvement. We found significant differences in mortality rates between the Mycoplasma and control groups on discharge (0% vs 22.5%, P < .001) and at 1-year follow up (0% vs 32.4%, P = .002), respectively.Limitations: Retrospective design, small sample size.Conclusion: Although recent studies have shown that MP-induced SJS/TEN is morphologically different and deserves a separate classification system, this would need to be borne out in larger prospective studies. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the clinical efficacy of budesonide suspension through bronchofiberscopic lavage in the treatment of refractory mycoplasma pneumoniae pneumonia (RMPP). Methods: A total of 108 children with refractory mycoplasma pneumoniae pneumonia from June 2018 to October 2020 were randomly divided into two groups: the study group and the control group, with 54 cases in each group. Children in the control group were treated with anti-infective, antitussive, antipyretic routine symptomatic treatment and nebulization of budesonide suspension, while children in the study group were treated with bronchofiberscopic lavage with Budesonide suspension along with standard treatment as in control group. The clinical efficacy, changes in blood gas analysis indexes, levels of inflammatory mediators, time for improvement of clinical symptoms and the incidence of adverse reactions were compared between the two groups. Results: The efficacy of treatment in the study group was 85.19%, which was higher than 66.67% in the control group (P<0.05). The antipyretic time, antitussive time, lung rales disappearance time and length of hospital stay in the study group were shorter than those in the control group (P<0.05). Moreover, the levels of arterial oxygen partial pressure (PaO2) in the study group were higher than those in the control group, while the levels of partial pressure of carbon dioxide (PaCO2) and arterial oxygen saturation (SaO2) in the study group were lower than those in the control group (P<0.05). The levels of inflammatory mediators interleukin-6 (IL-6), interleukin-4 (IL-4), and interferon-γ (IFN-γ) in the study group were lower than those in the control group (P<0.05), and no significant difference was found in the comparison of the incidence of adverse reactions between the two groups (P>0.05). Conclusions: Budesonide suspension combined with bronchofiberscopic lavage with Budesonide suspension is a safe treatment regimen that can significantly improve the clinical outcome in children with RMPP. With such a combined treatment regimen, the clinical symptoms of children can be ameliorated, the ventilation function can be enhanced, and the level of inflammatory mediators will be reduced. [ABSTRACT FROM AUTHOR]

Objectives: Henoch–Schonlein purpura (HSP) is the most common childhood vasculitis, infection is the most essential inducement. We hypothesized that infection could impact the blood routine characteristics and/or outcome of vasculitis. Thus, we aim to find the most common infectious agent in HSP patients and identify convenient indicators to predict renal involvement in HSP patients with infection. Method: We conducted a retrospective study of 208 HSP children and 98 healthy children. Clinical parameters were compared in those cases. Results: A total of 68.75% of patients were infected with various pathogens. The mean platelet volume (MPV) (P < 0.02) was lower in HSP patients with infection than patients without infection. Mycoplasma pneumoniae (MP) infection accounted for the largest proportion (45.77%). MPV in HSP nephritis (HSPN) group was lower than in HSP patients (excluded renal involvement) in patients with MP infection. Logistic regression analysis found that age and MPV were risk factors for the occurrence of MP-infected HSPN. The receiver operating characteristic curve (ROC) analysis showed that the combination of MPV with the onset age at the optimal cut-off point had 81% sensitivity in predicting whether HSP patients with MP infection would develop into HSPN. Conclusions: Our research revealed that MP was the most commonly infected pathogen of children's HSP. MPV was an essential predictor of nephritis in HSP patients with MP infection. This discovery can prompt clinical treatments as well as reduce costs. Key Points • Mycoplasma pneumoniae (MP) accounts for the largest proportion in HSP children with infection. • MPV can be used as a predictor for the development of MP-triggered HSP to HSPN. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mycoplasma bovis is 1 of several bacterial pathogens associated with pneumonia in cattle. Its role in pneumonia of free-ranging ungulates has not been established. Over a 3-month period in early 2019, »60 free-ranging pronghorn with signs of respiratory disease died in northeast Wyoming, USA. A consistent finding in submitted carcasses was severe fibrinosuppurative pleuropneumonia and detection of M. bovis by PCR and immunohistochemical analysis. Multilocus sequence typing of isolates from 4 animals revealed that all have a deletion in 1 of the target genes, adh-1. A retrospective survey by PCR and immunohistochemical analysis of paraffin-embedded lung from 20 pronghorn that died with and without pneumonia during 2007–2018 yielded negative results. These findings indicate that a distinct strain of M. bovis was associated with fatal pneumonia in this group of pronghorn.

Mycoplasma pneumoniae, which causes atypical pneumonia, is a well-established pathogen of the respiratory tract. This bacterium is intrinsically susceptible to fluoroquinolones. But recently, drug-resistant forms of this bacterium have been reported. This study aims to determine the prevalence of this bacterium by ELISA and PCR and MIC to ciprofloxacin. The clinical samples (blood and nasopharyngeal swab) were collected from 100 patients, who were referred to selective hospitals in Tehran with respiratory complaints, were enrolled in 2017. Nasopharyngeal swab sample collections were cultured on PPLO broth and PPLO agar. After culturing and DNA extraction, PCR was performed by specific P1 genes primers. Ciprofloxacin's MIC of Mycoplasma pneumonia isolated was determined by the Micro-broth dilution method. The serum of IgG antibody titers was also measured by ELISA Mycoplasma pneumonia. In this study, out of 100 samples, 12 bacteria were isolated on PPLO agar. Using specific primers, 7 samples of Mycoplasma speciesism-specific were positive for the presence of M.pneumoniae and 2 Ciprofloxacin resistant isolates were evaluated. ELISA results show that IgG titer antibody is existent in 19 samples and 5 samples are intermediate as well. IgG antibody titer average in the whole sample is 27/66 U/ml, but it is in Positive samples by P1 PCR is 45/75 U/ml. This study showed that PCR is a sensitive and reliable method for rapid detection of M. pneumoniae bacteria in respiratory infectious samples, but the results of this method are different from the ELISA method. Additionally, it seems that the resistance to ciprofloxacin is relatively common among M. pneumoniae.

Objective: The purpose of this study was to compare imaging features between COVID-19 and mycoplasma pneumonia (MP). Materials and methods: The data of patients with mild COVID-19 and MP who underwent chest computed tomography (CT) examination from February 1, 2020 to April 17, 2020 were retrospectively analyzed. The Pneumonia-CT-LKM-PP model based on a deep learning algorithm was used to automatically quantify the number, volume, and involved lobes of pulmonary lesions, and longitudinal changes in quantitative parameters were assessed in three CT follow-ups. Results: A total of 10 patients with mild COVID-19 and 13 patients with MP were included in this study. There was no difference in lymphocyte counts at baseline between the two groups (1.43 ± 0.45 vs. 1.44 ± 0.50, p = 0.279). C-reactive protein levels were significantly higher in MP group than in COVID-19 group (p < 0.05). The number, volume, and involved lobes of pulmonary lesions reached a peak in 7–14 days in the COVID-19 group, but there was no peak or declining trend over time in the MP group (p < 0.05). Conclusion: Based on the longitudinal changes of quantitative CT, pulmonary lesions peaked at 7–14 days in patients with COVID-19, and this may be useful to distinguish COVID-19 from MP and evaluate curative effects and prognosis. [ABSTRACT FROM AUTHOR]

Abstract Background Children are especially vulnerable to pneumonia and the effects of air pollution. However, little is known about the impacts of air pollutants on pediatric admissions for Mycoplasma pneumonia. This study was conducted to investigate the impacts of air pollutants on pediatric hospital admissions for Mycoplasma pneumonia in Shanghai, China. Methods A cross-sectional design was applied to explore the association between pediatric hospital admissions and levels of air pollutants (fine particulate matter, particulate matter, ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide). Data on hospital admissions for pneumonia and levels of ambient air pollutants were obtained for the period of 2015 to 2018. Associations between pediatric admissions for Mycoplasma pneumonia and ambient air pollutants were calculated using logistic regression and described by the odds ratio and relevant 95% confidence interval. The hysteresis effects of air pollutants from the day of hospital admission to the previous 7 days were evaluated in single-pollutant models and multi-pollutant models with adjustments for weather variables and seasonality. Lag 0 was defined as the day of hospital admission, lag 1 was defined as the day before hospital admission, and so forth. Results In the single-pollutant models (without adjustment for other pollutants), pediatric hospital admissions for pneumonia were positively associated with elevated concentrations of nitrogen dioxide and fine particulate matter. A 0.5% increase in daily admissions per 10-μg/m3 increase in the nitrogen dioxide level occurred at lag 1 and lag 2, and a 0.3% increase in daily admissions per 10-μg/m3 increase in fine particulate matter occurred at lag 1. In the multi-pollutant models, nitrogen dioxide and fine particulate matter remained significant after inclusion of particulate matter, ozone, sulfur dioxide, and carbon monoxide. Conclusions This study illustrated that higher levels of nitrogen dioxide and fine particulate matter increase the risk of pediatric hospitalization for Mycoplasma pneumonia in Shanghai, China. These findings imply that the high incidence of Mycoplasma pneumonia in children in Asia might be attributed to the high concentration of specific air pollutants in Asia.