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Gavaud A, Holub M, Asquier-Khati A, Faure K, Leautez-Nainville S, Le Moal G, Goehringer F, Luque Paz D, Arnould B, Gerber V, Martin-Blondel G, Declerck C, Gazaignes S, Blanchi S, Loubet P, Mrozek N, Perpoint T, Cresta M, Mailhe M, Bleibtreu A, Cazanave C, Bébéar C, Pourcher V, Tubach F, Palich R. Mycoplasma pneumoniae infection in adult inpatients during the 2023-24 outbreak in France (MYCADO): a national, retrospective, observational study. THE LANCET. INFECTIOUS DISEASES 2025:S1473-3099(24)00805-3. [PMID: 39986287 DOI: 10.1016/s1473-3099(24)00805-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 11/15/2024] [Accepted: 11/28/2024] [Indexed: 02/24/2025]
Abstract
BACKGROUND An epidemic of Mycoplasma pneumoniae infection has been observed in France since September, 2023. We aimed to describe the characteristics of adults hospitalised for M pneumoniae infection and identify factors associated with severe outcomes of infection. METHODS MYCADO is a retrospective observational study including adults hospitalised for 24 h or more in 76 hospitals in France for a M pneumoniae infection between Sept 1, 2023, and Feb 29, 2024. Clinical, laboratory, and imaging data were collected from medical records. We identified factors associated with severe outcomes of infection, defined as a composite of intensive care unit (ICU) admission or in-hospital death, using multivariable logistic regression. FINDINGS 1309 patients with M pneumoniae infection were included: 718 (54·9%) were men and 591 (45·1%) were women; median age was 43 years (IQR 31-63); 288 (22·0%) had chronic respiratory failure; 423 (32·3%) had cardiovascular comorbidities; and 105 (8·0%) had immunosuppression. The most common symptoms were cough (1098 [83·9%]), fever (1023 [78·2%]), dyspnoea (948 [72·4%]), fatigue (550 [42·0%]), expectorations (473 [36·1%]), headache (211 [16·1%]), arthromyalgia (253 [19·3%]), ear, nose, and throat symptoms (202 [15·4%]), diarrhoea (138 [10·5%]), and vomiting (132 [10·1%]). 156 (11·9%) of 1309 patients had extra-respiratory manifestations, including 36 (2·8%) with erythema multiforme, 19 (1·5%) with meningoencephalitis, 44 (3·4%) with autoimmune haemolytic anaemia, and 17 (1·3%) with myocarditis. The median hospital stay was 8 days (IQR 6-11). 424 (32·4%) patients had a severe outcome of infection, including 415 (31·7%) who were admitted to the ICU and 28 (2·1%) who died in hospital. Those more likely to present with severe outcomes of infection were patients with hypertension, obesity, chronic liver failure, extra-respiratory manifestations, pulmonary alveolar consolidation or bilateral involvement on CT scan, as well as elevated inflammatory markers, lymphopenia or neutrophilic polynucleosis, and those who did not versus did receive any antibiotic active against M pneumoniae before admission. INTERPRETATION This national, observational study highlighted unexpected, atypical radiological presentations, a high proportion of transfers to the ICU, and an association between severity and delayed administration of effective antibiotics. This should remind clinicians that no radiological presentation can rule out M pneumoniae infection, and encourage them to reassess patients early after prescribing a β-lactam, or even to discuss prescribing macrolides as first-line treatment in the context of an epidemic. FUNDING None. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Ariane Gavaud
- Sorbonne University, INSERM, Pierre Louis Epidemiology and Public Health Institute, AP-HP, Pitié-Salpêtrière Hospital, Infectious Diseases Department, Paris, France
| | - Matthieu Holub
- Sorbonne University, INSERM, Pierre Louis Epidemiology and Public Health Institute, AP-HP, Pitié-Salpêtrière Hospital, Infectious Diseases Department, Paris, France
| | | | | | | | - Gwenael Le Moal
- Infectious Diseases Department, Poitiers University Hospital, INSERM U1070, PHAR2, Poitiers University, Poitiers, France
| | | | | | | | | | - Guillaume Martin-Blondel
- Infectious Diseases Department, Toulouse University Hospital, Toulouse Institute for Infectious and Inflammatory Disease (Infinity), INSERM UMR1291, CNRS UMR051, Toulouse III University, Toulouse, France
| | | | | | | | - Paul Loubet
- Infectious and Tropical Diseases Department, Nîmes University Hospital, Bacterial Virulence and Chronic Infections, INSERM U1047, Montpellier University, Nîmes, France
| | - Natacha Mrozek
- Clermont Ferrand University Hospital, Clermont Ferrand, France
| | - Thomas Perpoint
- Infectious Diseases Department, Hospices Civils de Lyon, Lyon, France
| | | | | | - Alexandre Bleibtreu
- Sorbonne University, INSERM, Pierre Louis Epidemiology and Public Health Institute, AP-HP, Pitié-Salpêtrière Hospital, Infectious Diseases Department, Paris, France
| | - Charles Cazanave
- Infectious and Tropical Diseases Department, Bordeaux University Hospital, National Reference Centre for Bacterial STIs, UMR CNRS 5234 MFP, ARMYNE team, Bordeaux University, Bordeaux, France
| | - Cécile Bébéar
- Infectious and Tropical Diseases Department, Bordeaux University Hospital, National Reference Centre for Bacterial STIs, UMR CNRS 5234 MFP, ARMYNE team, Bordeaux University, Bordeaux, France
| | - Valérie Pourcher
- Sorbonne University, INSERM, Pierre Louis Epidemiology and Public Health Institute, AP-HP, Pitié-Salpêtrière Hospital, Infectious Diseases Department, Paris, France
| | - Florence Tubach
- Sorbonne University, INSERM, Pierre Louis Epidemiology and Public Health Institute, AP-HP, Pitié-Salpêtrière Hospital, Public Health Department, PSL-CFX Clinical Research Unit, CIC-1901, Paris, France
| | - Romain Palich
- Sorbonne University, INSERM, Pierre Louis Epidemiology and Public Health Institute, AP-HP, Pitié-Salpêtrière Hospital, Infectious Diseases Department, Paris, France.
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Yeoh K, Aikeremu D, Aw-Yeong B, Slavin MA, Williams E. An Unusual and Difficult to Detect Cause of Infection in Two Trauma Patients. Clin Infect Dis 2023; 77:154-157. [PMID: 36202767 PMCID: PMC10320131 DOI: 10.1093/cid/ciac748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kim Yeoh
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
| | - Dilare Aikeremu
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Benjamin Aw-Yeong
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Monica A Slavin
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
- Department of Infectious Diseases, and National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Eloise Williams
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
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Fu Y, Zhang TQ, Dong CJ, Xu YS, Dong HQ, Ning J. Clinical characteristics of 14 pediatric mycoplasma pneumoniae pneumonia associated thrombosis: a retrospective study. BMC Cardiovasc Disord 2023; 23:1. [PMID: 36600223 DOI: 10.1186/s12872-022-03030-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/26/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the clinical characteristics and long-term prognosis of mycoplasma pneumoniae pneumonia (MPP)-associated thrombosis and to gain a better understanding of the diagnosis and treatment of the disease. METHODS The medical records of 14 children with MPP-associated thrombosis between January 2016 and April 2020 were retrospectively reviewed at the Tianjin Children's Hospital. RESULTS The ages of the patients ranged from 3 to 12 years old. Among the 14 cases, there were five cases of pulmonary embolism, two cases of cerebral infarction, one case of splenic infarction, one case of cardiac embolism, two cases of cardiac embolism with comorbid pulmonary embolism, one case of internal carotid artery and pulmonary embolism, one case of combined internal carotid artery and the cerebral infarction, and one case combined cardiac embolism and lower limb artery embolism. All cases had elevated D-dimer levels. After thrombolysis and anticoagulation therapy, three cases with cerebral embolism still suffered from neurological sequelae. In contrast, the remaining cases did not develop complications. CONCLUSION MPP-associated thrombosis can occur in any vessel of the body. Thrombosis-associated symptoms may be complex and non-specific. Elevated D-dimer levels in a child with refractory mycoplasma pneumoniae pneumonia should raise suspicion of thrombosis. The long-term prognosis of thrombosis was favorable after the timely administration of anticoagulant therapy.
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Affiliation(s)
- Y Fu
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - T Q Zhang
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - C J Dong
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - Y S Xu
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - H Q Dong
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - J Ning
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.
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Biosensors, modern technology for the detection of cancer-associated bacteria. Biotechnol Lett 2022; 44:683-701. [PMID: 35543825 DOI: 10.1007/s10529-022-03257-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/30/2022] [Indexed: 11/02/2022]
Abstract
Cancer is undoubtedly one of the major human challenges worldwide. A number of pathogenic bacteria are deemed to be potentially associated with the disease. Accordingly, accurate and specific identification of cancer-associated bacteria can play an important role in cancer control and prevention. A variety of conventional methods such as culture, serology, and molecular-based methods as well as PCR and real-time PCR have been adopted to identify bacteria. However, supply costs, machinery fees, training expenses, consuming time, and the need for advanced equipment are the main problems with the old methods. As a result, advanced and modern techniques are being developed to overcome the disadvantages of conventional methods. Biosensor technology is one of the innovative methods that has been the focus of researchers due to its numerous advantages. The main purpose of this study is to provide an overview of the latest developed biosensors for recognizing the paramount cancer-associated bacteria.
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Diagnosis and treatment of mycoplasmal septic arthritis: a systematic review. INTERNATIONAL ORTHOPAEDICS 2019; 44:199-213. [PMID: 31792575 DOI: 10.1007/s00264-019-04451-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/11/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Septic arthritis caused by Mycoplasma is rare. The diagnosis and effective treatment of mycoplasmal septic arthritis remains a serious problem for clinicians. The aim of this systematic review was to document the available evidence on the diagnosis and treatment methods for mycoplasmal septic arthritis and to provide guidance for clinicians. METHODS The PubMed, EMBASE, and Cochrane Library databases were searched in December 2018.The searches were limited to the English language. Article screening and data extraction and compilation were conducted by two independent reviewers. All the included studies were assessed using the Methodological Index for Non-randomized Studies (MINORS) tool. RESULTS There was a total of 33 articles including 34 cases of mycoplasmal septic arthritis and eight of them were periprosthetic joint infection (PJI). Twenty-four patients (70.6%) were immunocompromised, and the synovial fluid white blood cell (WBC) count was significantly lower in the immunocompromised group than in the immunocompetent group (48,527 × 106/L vs. 100,640 × 106/L; P = 0.009). The traditional culture method took longer, and the positivity rate was lower than that of nucleic acid testing (50% vs. 100%; P = 0.016). Only 19.2% (5/26) of patients treated with empiric antibiotics were relieved of symptoms, while 82.4% (28/34) of patients achieved satisfactory results after being treated with antibiotics against Mycoplasma. CONCLUSION The possibility of mycoplasmal septic arthritis should be considered if patients with joint infections have a history of immunocompromised, repeated negative cultures, and poor empiric antibiotic treatment results. The rational use of nucleic acid testing technologies can help in the clinical diagnosis and treatment of mycoplasmal septic arthritis.
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Pneumocystis jirovecii Pneumonia in an Immunocompetent Japanese Man: A Case Report and Literature Review. Case Rep Pulmonol 2019; 2019:3981681. [PMID: 30984437 PMCID: PMC6431524 DOI: 10.1155/2019/3981681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/20/2019] [Indexed: 11/18/2022] Open
Abstract
We herein report the case of a 37-year-old immunocompetent man who died from Pneumocystis jirovecii pneumonia (PCP). He was initially treated for an acute exacerbation of interstitial pneumonia; however, the elevation of the patient's serum (1-3) β-D glucan (BG) level suggested the possibility of PCP and sulfamethoxazole trimethoprim was added. A postmortem pathological examination and retrospective Grocott's methenamine silver (GMS) staining of the bronchoalveolar lavage fluid (BALF), which was obtained on the day of admission, revealed PCP. The present case suggests that it is essential to perform a BG assay and GMS staining of BALF specimens when patients show diffuse ground-glass opacity on chest computed tomography, regardless of their immune status.
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Interleukin-17A Exacerbates Disease Severity in BALB/c Mice Susceptible to Lung Infection with Mycoplasma pulmonis. Infect Immun 2018; 86:IAI.00292-18. [PMID: 29986888 DOI: 10.1128/iai.00292-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/29/2018] [Indexed: 12/18/2022] Open
Abstract
Mycoplasmas are atypical bacteria that disrupt the immune response to promote respiratory tract infections and secondary complications. However, not every immunologic response that protects or damages the host during mycoplasma infection is known. Interleukin-17A (IL-17A) is elevated in individuals infected with mycoplasmas, but how IL-17A and its cellular sources dictate disease outcome remains unclear. Here, IL-17A is hypothesized to worsen disease in individuals susceptible to mycoplasma infection. Thus, monoclonal anti-IL-17A antibodies were given to disease-susceptible BALB/c mice and disease-resistant C57BL/6 mice infected with Mycoplasma pulmonis Neutralizing the function of IL-17A using anti-IL-17A antibodies reduced disease severity during M. pulmonis infection in BALB/c, but not C57BL/6, mice. Neutralizing IL-17A also reduced the incidence of neutrophilic lung lesions during infection in BALB/c mice. Reduced pathology occurred without impacting the bacterial burden, demonstrating that IL-17A is not required for mycoplasma clearance. The main source of IL-17A throughout infection in BALB/c mice was CD4+ T cells, and neutralizing IL-17A after infiltration of the lungs by T cells reduced disease severity, identifying the Th17 response as a herald of late mycoplasma pathology in susceptible mice. Neutralizing IL-17A did not further reduce disease during M. pulmonis infection in BALB/c mice depleted of neutrophils, suggesting that IL-17A requires the presence of pulmonary neutrophils to worsen respiratory pathology. IL-17A is a pathological element of murine respiratory mycoplasma infection. Using monoclonal antibodies to neutralize IL-17A could reduce disease severity during mycoplasma infection in humans and domesticated animals.
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Swanepoel T, Sabbar M, Baartman TL, Laburn HP, Mitchell D, Dukhan T, Harden LM. Simulated acute central Mycoplasma infections in rats induce fever, anorexia, body mass stunting and lethargy but spare memory. Physiol Behav 2016; 163:294-304. [PMID: 27180133 DOI: 10.1016/j.physbeh.2016.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 10/21/2022]
Abstract
Despite the documented post-infectious neurological complications of a central nervous system (CNS) Mycoplasma infection in humans, very few studies have investigated the acute inflammatory responses and sickness behaviours induced by CNS Mycoplasma infections. We therefore determined the effect of acute central administration of fibroblast-stimulating lipopeptide-1 (FSL-1), derived from Mycoplasma salivarium, and FAM-20 from a more pathogenic species, namely Mycoplasma pneumoniae, on behavioural and inflammatory responses in rats. Male Sprague-Dawley rats had radiotransmitters implanted, intra-abdominally, to measure body temperature and cage activity continuously. After recovery from surgery, rats were conditioned in a fear conditioning task and then immediately received an intra-cisterna magna (i.c.m.) injection of either: (1) FSL-1 (10 or 100μg/5μl) or its vehicle (phosphate-buffered saline, 5μl), or (2) FAM-20 (10 or 100μg/5μl) or its vehicle (dimethyl sulfoxide, 5μl). Body mass and food intake were measured daily. Memory was assessed seven days after injection using fear conditioning tests. A single, i.c.m. injection of either FSL-1 or FAM-20 induced profound, dose-dependent fever, anorexia, lethargy and body mass stunting in rats. Moreover, rats that received an i.c.m. injection of 100μg/5μl FAM-20 had a significant increase in the concentration of IL-1β in both the hypothalamus and the hippocampus for ~27h after injection. Seven days after FSL-1 or FAM-20 injection, when body mass of rats still was stunted, they maintained their memory for fear of the context and for fear of the tone, despite the increase in hippocampal IL-1β concentration after FAM-20 administration. Thus, acute simulated CNS Mycoplasma infections caused pronounced sickness responses and brain inflammation in rats, but spared fear memory.
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Affiliation(s)
- Tanya Swanepoel
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Mariam Sabbar
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Tamzyn L Baartman
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Helen P Laburn
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Tanusha Dukhan
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
| | - Lois M Harden
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
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Brown RJ, Nguipdop-Djomo P, Zhao H, Stanford E, Spiller OB, Chalker VJ. Mycoplasma pneumoniae Epidemiology in England and Wales: A National Perspective. Front Microbiol 2016; 7:157. [PMID: 26909073 PMCID: PMC4754400 DOI: 10.3389/fmicb.2016.00157] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/29/2016] [Indexed: 11/13/2022] Open
Abstract
Investigations of patients with suspected Mycoplasma pneumoniae infection have been undertaken in England since the early 1970s. M. pneumoniae is a respiratory pathogen that is a common cause of pneumonia and may cause serious sequelae such as encephalitis and has been documented in children with persistent cough. The pathogen is found in all age groups, with higher prevalence in children aged 5–14 years. In England, recurrent epidemic periods have occurred at ~4-yearly intervals. In addition, low-level sporadic infection occurs with seasonal peaks from December to February. Voluntarily reports from regional laboratories and hospitals in England from 1975 to 2015 were collated by Public Health England for epidemiological analysis. Further data pertaining cases of note and specimens submitted to Public Health England from 2005 to 2015 for confirmation, molecular typing is included.
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Affiliation(s)
- Rebecca J Brown
- Public Health EnglandLondon, UK; Department of Child Health, University Hospital Wales, Cardiff University School of MedicineCardiff, UK
| | - Patrick Nguipdop-Djomo
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine London, UK
| | | | | | - O Brad Spiller
- Department of Child Health, University Hospital Wales, Cardiff University School of Medicine Cardiff, UK
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Abstract
ABSTRACT:Five patients with evidence of focal encephalopathy are reported. In each case, evidence of mycoplasma pneumoniae infection was detected. No patient improved with conventional antibiotic therapy, but in three subjects, rapid and complete recovery did occur contemporaneously with the administration of high dose steroid therapy. It is suggested that focal as well as diffuse cerebral or cerebellar lesions may occur as manifestations of auto-immune disease complicating mycoplasmal infections in young people and that this illness may be designated as acute mycoplasma-associated encephalopathy.
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[Neurological symptoms due to Mycoplasma pneumoniae infection in nine children]. Arch Pediatr 2015; 22:699-707. [PMID: 26047743 DOI: 10.1016/j.arcped.2015.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 02/06/2015] [Accepted: 04/23/2015] [Indexed: 11/24/2022]
Abstract
Mycoplasma pneumoniae infection is common in children. Extrapulmonary symptoms usually reveal as neurological symptoms, mainly as encephalitis with significant morbidity and mortality. Various other neurological presentations have also been reported. We describe a cohort of nine children with neurological manifestations due to M. pneumoniae infection, including five cases of encephalitis, one of polyradiculoneuritis, one of ophthalmoplegia, one of optic neuritis, and one of myositis. Progression was variable from ad integrum recovery to severe brain damage. Diagnosis is usually confirmed by PCR and/or serological follow-up, but the latter is still insufficiently used in practice to systematically affirm the diagnosis. Therapeutic management is not clearly defined and long-term progression can be uncertain despite early antibiotic and/or anti-inflammatory treatments.
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Saraya T, Kurai D, Nakagaki K, Sasaki Y, Niwa S, Tsukagoshi H, Nunokawa H, Ohkuma K, Tsujimoto N, Hirao S, Wada H, Ishii H, Nakata K, Kimura H, Kozawa K, Takizawa H, Goto H. Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications. Front Microbiol 2014; 5:410. [PMID: 25157244 PMCID: PMC4127663 DOI: 10.3389/fmicb.2014.00410] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 07/20/2014] [Indexed: 01/30/2023] Open
Abstract
Mycoplasma pneumoniae (Mp) is a leading cause of community acquired pneumonia. Knowledge regarding Mp pneumonia obtained from animal models or human subjects has been discussed in many different reports. Accumulated expertise concerning this critical issue has been hard to apply clinically, and potential problems may remain undiscovered. Therefore, our multidisciplinary team extensively reviewed the literature regarding Mp pneumonia, and compared findings from animal models with those from human subjects. In human beings, the characteristic pathological features of Mp pneumonia have been reported as alveolar infiltration with neutrophils and lymphocytes and lymphocyte/plasma cell infiltrates in the peri-bronchovascular area. Herein, we demonstrated the novel aspects of Mp pneumonia that the severity of the Mp pneumonia seemed to depend on the host innate immunity to the Mp, which might be accelerated by antecedent Mp exposure (re-exposure or latent respiratory infection) through up-regulation of Toll-like receptor 2 expression on bronchial epithelial cells and alveolar macrophages. The macrolides therapy might be beneficial for the patients with macrolide-resistant Mp pneumonia via not bacteriological but immunomodulative effects. This exhaustive review focuses on pathogenesis and extends to some therapeutic implications such as clarithromycin, and discusses the various diverse aspects of Mp pneumonia. It is our hope that this might lead to new insights into this common respiratory disease.
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Affiliation(s)
- Takeshi Saraya
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Daisuke Kurai
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Kazuhide Nakagaki
- Department of Virology and Immunology, College of Veterinary Medicine, Nippon Veterinary and Animal Science University Mitaka, Japan
| | - Yoshiko Sasaki
- Gunma Prefectural Institute of Public Health and Environmental Sciences Maebashi, Japan
| | - Shoichi Niwa
- Gunma Prefectural Institute of Public Health and Environmental Sciences Maebashi, Japan
| | - Hiroyuki Tsukagoshi
- Gunma Prefectural Institute of Public Health and Environmental Sciences Maebashi, Japan
| | - Hiroki Nunokawa
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Kosuke Ohkuma
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Naoki Tsujimoto
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Susumu Hirao
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Hiroo Wada
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Haruyuki Ishii
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Koh Nakata
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital Niigata, Japan
| | - Hirokazu Kimura
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases Tokyo, Japan
| | - Kunihisa Kozawa
- Gunma Prefectural Institute of Public Health and Environmental Sciences Maebashi, Japan
| | - Hajime Takizawa
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
| | - Hajime Goto
- Department of Respiratory Medicine, Kyorin University School of Medicine Mitaka, Japan
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Rosales-Pérez M, Giono-Cerezo S, Girón J, Yáñez A, Cedillo L. Adherence of a Clinical Strain of <i>Mycoplasma fermentans</i> to Human Cultured Epithelial Cells. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/aim.2014.411079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gil C, González AAS, León IL, Rivera A, Olea RS, Cedillo L. Detection of Mycoplasmas in Patients with Amyotrophic Lateral Sclerosis. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/aim.2014.411077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Li CM, Gu L, Yin SJ, Yang R, Xie Y, Guo XZ, Fu YX, Cheng D. Age-specific Mycoplasma pneumoniae pneumonia-associated myocardial damage in children. J Int Med Res 2013; 41:1716-23. [PMID: 24026772 DOI: 10.1177/0300060513497559] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To measure Mycoplasma pneumoniae pneumonia (MPP)-associated myocardial damage in different age groups of children with pneumonia. METHODS Children aged 0-14 years with pneumonia and myocardial damage (serum creatine kinase isoenzyme-MB [CK-MB] concentration >25 U/l) were enrolled in the study. The children were classified as Mycoplasma pneumoniae immunoglobulin M positive (M. pneumoniae IgM+) or negative (M. pneumoniae IgM-) based on a serological test. Children were stratified into four age groups in order to analyse age-specific MPP-associated myocardial damage. RESULTS The incidence of fever was significantly higher in children who were M. pneumoniae IgM+ compared with M. pneumoniae IgM- children. The median serum CK-MB concentration was significantly higher in children who were M. pneumoniae IgM+ compared with those who were M. pneumoniae IgM-. Children who were M. pneumoniae IgM+ in the 13-36 months and 72 months-14 years age groups had significantly higher median serum CK-MB concentrations than those who were M. pneumoniae IgM- in the same age group. CONCLUSIONS M. pneumoniae infection was associated with greater myocardial damage in children aged 13-36 months and 72 months-14 years. This suggests age-specific immune responses to M. pneumoniae.
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Affiliation(s)
- Cheng-Mei Li
- Department of Paediatrics, Tenth People's Hospital, Tongji University, Shanghai, China
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17
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Protein P37 of mycoplasma hyorhinis induces secretion of TNF-α from human peripheral blood mononuclear cells. Sci Bull (Beijing) 2013. [DOI: 10.1007/bf03325650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Transverse myelitis (TM) includes a pathobiologically heterogeneous syndrome characterized by acute or subacute spinal cord dysfunction resulting in paresis, a sensory level, and autonomic (bladder, bowel, and sexual) impairment below the level of the lesion. Etiologies for TM can be broadly classified as parainfectious, paraneoplastic, drug/toxin-induced, systemic autoimmune disorders, and acquired demyelinating diseases. We discuss the clinical evaluation, workup, and acute and long-term management of patients with TM. Additionally, we briefly discuss various disease entities that may cause TM and their salient distinguishing features, as well as disorders that may mimic TM.
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Affiliation(s)
- Shin C. Beh
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd, Dallas, TX 75390, USA
| | - Benjamin M. Greenberg
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd, Dallas, TX 75390, USA
| | - Teresa Frohman
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd, Dallas, TX 75390, USA
| | - Elliot M. Frohman
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd, Dallas, TX 75390, USA
- Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323, Harry Hines Blvd, Dallas, TX 75390, USA
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19
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Lee SY, Lee YH, Chun BY, Lee SY, Cha SI, Kim CH, Park JY, Lee J. An adult case of Fisher syndrome subsequent to Mycoplasma pneumoniae infection. J Korean Med Sci 2013; 28:152-5. [PMID: 23341726 PMCID: PMC3546094 DOI: 10.3346/jkms.2013.28.1.152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 10/24/2012] [Indexed: 11/20/2022] Open
Abstract
Reported herein is an adult case of Fisher syndrome (FS) that occurred as a complication during the course of community-acquired pneumonia caused by Mycoplasma pneumoniae. A 38-yr-old man who had been treated with antibiotics for serologically proven M. pneumoniae pneumonia presented with a sudden onset of diplopia, ataxic gait, and areflexia. A thorough evaluation including brain imaging, cerebrospinal fluid examination, a nerve conduction study, and detection of serum anti-ganglioside GQ1b antibody titers led to the diagnosis of FS. Antibiotic treatment of the underlying M. pneumoniae pneumonia was maintained without additional immunomodulatory agents. A complete and spontaneous resolution of neurologic abnormalities was observed within 1 month, accompanied by resolution of lung lesions.
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Affiliation(s)
- So Yeon Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yong Hoon Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Bo Young Chun
- Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Shin Yup Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung Ick Cha
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Chang Ho Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Yong Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jaehee Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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20
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Zhu C, Wang S, Hu S, Yu M, Zeng Y, You X, Xiao J, Wu Y. Protective efficacy of a Mycoplasma pneumoniae P1C DNA vaccine fused with the B subunit of Escherichia coli heat-labile enterotoxin. Can J Microbiol 2012; 58:802-10. [DOI: 10.1139/w2012-051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In the present study, we investigated the immunomodulatory responses of a DNA vaccine constructed by fusing Mycoplasma pneumoniae P1 protein carboxy terminal region (P1C) with the Escherichia coli heat-labile toxin B subunit (LTB). BALB/c mice were immunized by intranasal inoculation with control DNAs, the P1C DNA vaccine or the LTB–P1C fusion DNA vaccine. Levels of the anti-M. pneumoniae antibodies and levels of interferon-γ and IL-4 in mice were increased significantly upon inoculation of the LTB–P1C fusion DNA vaccine when compared with the inoculation with P1C DNA vaccine. The LTB–P1C fusion DNA vaccine efficiently enhanced the M. pneumoniae-specific IgA and IgG levels. The IgG2a/IgG1 ratio was significantly higher in bronchoalveolar lavages fluid and sera from mice fusion with LTB and P1C than mice receiving P1C alone. When the mice were challenged intranasally with 107 CFU M. pneumoniae strain (M129), the LTB–P1C fusion DNA vaccine conferred significantly better protection than P1C DNA vaccine (P < 0.05), as suggested by the results, such as less inflammation, lower histopathological score values, lower detectable number of M. pneumoniae strain, and lower mortality of challenging from 5 × 108 CFU M. pneumoniae. These results indicated that the LTB–P1C fusion DNA vaccine efficiently improved protective efficacy against M. pneumoniae infection and effectively attenuated development of M. pneumoniae in mice.
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Affiliation(s)
- Cuiming Zhu
- Department of Microbiology and Immunology, Pathogenic Biology Institute, University of South China, Hengyang 421001, China
- Xiangya School of Medicine, Central South University, Changsha 410078, China
| | - Shiping Wang
- Xiangya School of Medicine, Central South University, Changsha 410078, China
| | - Shihai Hu
- Department of Microbiology and Immunology, Pathogenic Biology Institute, University of South China, Hengyang 421001, China
| | - Minjun Yu
- Department of Microbiology and Immunology, Pathogenic Biology Institute, University of South China, Hengyang 421001, China
| | - Yanhua Zeng
- Department of Microbiology and Immunology, Pathogenic Biology Institute, University of South China, Hengyang 421001, China
| | - Xiaoxing You
- Department of Microbiology and Immunology, Pathogenic Biology Institute, University of South China, Hengyang 421001, China
| | - Jinhong Xiao
- Department of Microbiology and Immunology, Pathogenic Biology Institute, University of South China, Hengyang 421001, China
| | - Yimou Wu
- Department of Microbiology and Immunology, Pathogenic Biology Institute, University of South China, Hengyang 421001, China
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21
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Yang C, Chalasani G, Ng YH, Robbins PD. Exosomes released from Mycoplasma infected tumor cells activate inhibitory B cells. PLoS One 2012; 7:e36138. [PMID: 22558358 PMCID: PMC3338602 DOI: 10.1371/journal.pone.0036138] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 03/31/2012] [Indexed: 01/28/2023] Open
Abstract
Mycoplasmas cause numerous human diseases and are common opportunistic pathogens in cancer patients and immunocompromised individuals. Mycoplasma infection elicits various host immune responses. Here we demonstrate that mycoplasma-infected tumor cells release exosomes (myco+ exosomes) that specifically activate splenic B cells and induce splenocytes cytokine production. Induction of cytokines, including the proinflammatory IFN-γ and the anti-inflammatory IL-10, was largely dependent on the presence of B cells. B cells were the major IL-10 producers. In splenocytes from B cell deficient μMT mice, induction of IFN-γ+ T cells by myco+ exosomes was greatly increased compared with wild type splenocytes. In addition, anti-CD3-stimulated T cell proliferation was greatly inhibited in the presence of myco+ exosome-treated B cells. Also, anti-CD3-stimulated T cell signaling was impaired by myco+ exosome treatment. Proteomic analysis identified mycoplasma proteins in exosomes that potentially contribute to the effects. Our results demonstrate that mycoplasma-infected tumor cells release exosomes carrying mycoplasma components that preferentially activate B cells, which in turn, are able to inhibit T cell activity. These results suggest that mycoplasmas infecting tumor cells can exploit the exosome pathway to disseminate their own components and modulate the activity of immune cells, in particular, activate B cells with inhibitory activity.
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Affiliation(s)
- Chenjie Yang
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Geetha Chalasani
- Renal-Electrolyte Division, Departments of Medicine and Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Yue-Harn Ng
- Renal-Electrolyte Division, Departments of Medicine and Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Paul D. Robbins
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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22
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Pemira SM, Tolan RW. Mycoplasma pneumoniae infection presenting as bullous papular purpuric gloves and socks syndrome: novel association and review of the literature. Clin Pediatr (Phila) 2011; 50:1140-3. [PMID: 21878609 DOI: 10.1177/0009922811414290] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Papular purpuric gloves and socks syndrome (PPGSS) is a self-limited, often febrile illness with symmetric edema and erythema of the hands and feet; papular, petechial, and purpuric acral dermatosis; and mucosal lesions in children and young adults. Most of the cases of PPGSS have been reported to be caused by parvovirus B19 and other viruses. This study describes a case resulting from Mycoplasma pneumoniae infection in an adolescent male and reviews the literature.
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23
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Genital mycoplasmas in placental infections. Infect Dis Obstet Gynecol 2010; 1:275-81. [PMID: 18475351 PMCID: PMC2364351 DOI: 10.1155/s1064744994000244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/1994] [Accepted: 05/12/1994] [Indexed: 11/20/2022] Open
Abstract
Objective: The involvement of the genital mycoplasmas Ureaplasma urealyticum
and Mycoplasma hominis in complications of pregnancy has remained
controversial especially because these microorganisms are frequent colonizers of the
lower genital tract. Recovery of bacteria from the placenta appears to be the sole technique
to represent a true infection and not vaginal contamination. Therefore, we investigated the
presence of genital mycoplasmas, aerobic and anaerobic bacteria, and fungi in human
placentas and evaluated their association with morbidity and mortality of pregnancy. Methods: We cultured placentas from 82 women with complicated
pregnancies. One hundred placentas from women with uncomplicated pregnancies were
evaluated as controls. When possible, placentas were examined histologically for presence
of chorioamnionitis. Results: Microorganisms were recovered from 52% of the placentas
of complicated pregnancies and U. urealyticum was the microorganism isolated most
frequently from the placenta. A significant association between positive mycoplasma
culture of the placenta and complication of pregnancy was found, and chorioamnionitis
was positively related to isolation of mycoplasmas. Conclusions: These data suggest that genital mycoplasmas are
able to infect the human placenta where they can cause chorioamnionitis.
This infection of the placenta by genital mycoplasmas is related to preterm birth and
fatal outcome of pregnancy.
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24
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Pathogenesis of extrapulmonary manifestations of Mycoplasma pneumoniae infection with special reference to pneumonia. J Infect Chemother 2010; 16:162-9. [DOI: 10.1007/s10156-010-0044-x] [Citation(s) in RCA: 156] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Indexed: 12/30/2022]
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25
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Rae DO, Chenoweth PJ, Brown MB, Genho PC, Moore SA, Jacobsen KE. Reproductive performance of beef heifers: effects of vulvo-vaginitis, Ureaplasma diversum and prebreeding antibiotic administration. Theriogenology 2009; 40:497-508. [PMID: 16727333 DOI: 10.1016/0093-691x(93)90403-r] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/1993] [Accepted: 05/19/1993] [Indexed: 11/22/2022]
Abstract
A group of 450 heifers, 13 to 15 mo of age, were individually identified, vaccinated (IBR, PI(3), Leptospira, Campylobacter fetus), examined (body condition score, reproductive tract evaluation, assessment of vaginal lesions), and cultured for U. diversum . Heifers were randomly allocated to either a treated group given chlortetracycline (approximately 350 mg/hd/d for 30 d in a grain crumble) or a nontreated control group. Prebreeding, most heifers showed signs of vulvovaginitis, 44% cultured positive for U. diversum . Significant associations were found between the severity of vaginal lesions and ovarian activity (P < 0.05), and between BCS and ovarian activity (P < 0.02). The U. diversum vaginal culture (positive or negative) showed no significant association with BCS, severity of vaginal lesions, or ovarian activity (all were P > 0.5). At pregnancy examination (35 d following conclusion of a 61-d breeding season), treated compared with nontreated heifers showed 1) a slight but not significant (P > 0.25) decrease in vaginal colonization by U. diversum (46 to 34% and 41 to 37%, respectively); 2) an association between increased severity of vaginal lesions and increasing pregnancy rate, especially in treated heifers; and 3) an increased pregnancy rate (72 and 57%, respectively; P < 0.01). Prebreeding treatment with chlortetracycline appeared to improve pregnancy rates in beef heifers with endemic U. diversum infections, although the role of U. diversum in heifer fertility is still not clear.
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Affiliation(s)
- D O Rae
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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26
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Miller RB, Ruhnke HL, Doig PA, Poitras BJ, Palmer NC. The effects of Ureplasma diversum inoculated into the amniotic cavity in cows. Theriogenology 2009; 20:367-74. [PMID: 16725853 DOI: 10.1016/0093-691x(83)90071-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/1983] [Accepted: 07/14/1983] [Indexed: 10/26/2022]
Abstract
Ureaplasma diversum was inoculated into the amniotic cavity in four cows. Two calves were aborted and two were born alive. One of the latter died shortly after birth and the other was killed. The cows remained clinically normal except that three retained their placenta. On microscopic examination there was a severe placentitis and an alveolitis was present in the lungs of all calves. Ureaplasma was recovered from four placentas and three lungs. Cows remained infected for a maximum of 132 days following inoculation and the organism was recovered in urine and vulvar swabs for a maximum of 17 and 60 days respectively following expulsion of the calf. Ureaplasma diversum has been isolated from natural cases of abortion with similar lesions. This experiment strongly supports a causal relationship between abortion, birth of calves with pneumonia and U. diversum infection.
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Affiliation(s)
- R B Miller
- Department of Pathology, Ontario Veterinary College, Guelph, Ontario, Canada N1G 2W1
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27
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Bodhankar S, Woolard MD, Sun X, Simecka JW. NK cells interfere with the generation of resistance against mycoplasma respiratory infection following nasal-pulmonary immunization. THE JOURNAL OF IMMUNOLOGY 2009; 183:2622-31. [PMID: 19625649 DOI: 10.4049/jimmunol.0802180] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of the present study was to determine the impact of NK cells on the development of protective adaptive immunity in response to nasal-pulmonary immunization against mycoplasma. Depletion of NK cells before nasal-pulmonary immunization enhanced resistance to mycoplasma respiratory infection. The effect of NK cells on the generation of protective immunity in lungs was dependent on lymphoid cells, as immunization of either SCID mice or immunocompetent mice depleted of CD4(+) T cells did not demonstrate any increased resistance in the presence or absence of NK cells. The presence of NK cells at the time of nasal-pulmonary immunization modulated mycoplasma-specific cytokine responses in lungs and lower respiratory nodes. In particular, NK cells skewed the mycoplasma-specific T cell cytokine responses in the draining lymph nodes to higher IL-4, IL-13, and IL-17 while lowering IFN-gamma responses. Adoptive transfer of total lung lymphocytes isolated from immunized mice into naive mice led to a significant reduction in the mycoplasma numbers in lungs, and the resistance was greater if cells were obtained from immunized mice that were depleted of NK cells. Similar results were obtained if purified B cells, T cells, or CD4(+) T cells were used. Interestingly, this is the first time that a favorable role of functional CD4(+) T cells in mediating protection in mycoplasma respiratory disease was demonstrated. Thus, NK cells can influence the responses of multiple lymphocyte populations capable of mediating resistance to mycoplasma infection.
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Affiliation(s)
- Sheetal Bodhankar
- Department of Molecular Biology and Immunology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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28
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MEHL M, PETZOLDT R, ENGEL S, BOLLMANN R, KÖHLER W. Die Veränderung der Natrium- und Kaliumkonzentration in einer Humanspermasuspension nach artifizieller Infektion mit Ureaplasma urealyticum. Andrologia 2009. [DOI: 10.1111/j.1439-0272.1986.tb01767.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mycoplasma pneumoniae--associated transverse myelitis and rhabdomyolysis. Pediatr Neurol 2009; 40:128-30. [PMID: 19135630 DOI: 10.1016/j.pediatrneurol.2008.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Revised: 10/06/2008] [Accepted: 10/13/2008] [Indexed: 11/24/2022]
Abstract
Mycoplasma pneumoniae is a common cause of respiratory tract infection. Extrapulmonary manifestations of M. pneumoniae infection are also common. The present case is that of a previously healthy 4-year-old boy who displayed a novel simultaneous onset of both acute rhabdomyolysis and transverse myelitis associated with an infection of M. pneumoniae. He had no preceding symptoms or signs of respiratory tract infection. Intravenous immunoglobulin (1 g/kg per day) for 2 days was prescribed initially for the deterioration of neurologic condition. His rhabdomyolysis resolved without complication, but neurologic sequelae remained during 2 years of follow-up. Evaluation for M. pneumoniae infection is recommended in patients with idiopathic rhabdomyolysis and transverse myelitis, even if in the absence of antecedent respiratory symptoms.
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Tigecycline therapy significantly reduces the concentrations of inflammatory pulmonary cytokines and chemokines in a murine model of Mycoplasma pneumoniae pneumonia. Antimicrob Agents Chemother 2009; 53:1546-51. [PMID: 19139287 DOI: 10.1128/aac.00979-08] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Mycoplasma pneumoniae is one of the causative agents of atypical community-acquired pneumonia. Tigecycline belongs to a new class of glycylcycline antimicrobials that have activity against a wide range of microorganisms, including in vitro activity against M. pneumoniae. We investigated the effect of tigecycline on microbiologic, histologic, and immunologic indices in a murine model of M. pneumoniae pneumonia. BALB/c mice were inoculated intranasally with M. pneumoniae and treated subcutaneously with tigecycline or placebo for 6 days. Outcome variables included quantitative bronchoalveolar lavage (BAL) M. pneumoniae culture, lung histopathologic score (HPS), BAL cytokine and chemokine concentrations (tumor necrosis factor alpha [TNF-alpha], gamma interferon [IFN-gamma], interleukin 1beta [IL-1beta], IL-2, IL-4, IL-5, IL-6, IL-10, IL-12 [p40/p70], granulocyte-macrophage colony-stimulating factor, MIP-1alpha, MIG, KC, MCP-1, and IP-10). BAL M. pneumoniae concentrations in mice treated with tigecycline (MpTige) tended to be reduced compared with mice treated with placebo (MpPl); however this did not reach statistical significance. The lung HPS was significantly lower, as well as the parenchymal-pneumonia subscore, in the MpTige mice than in the MpPl mice. MpTige mice had significantly lower BAL cytokine concentrations of IL-1beta, IL-12 (p40/p70), IFN-gamma, and TNF-alpha; of the chemokines, MIG, MIP-1alpha, and IP-10 were statistically lower in MpTige mice. While tigecycline treatment demonstrated a modest microbiologic effect, it significantly improved lung histologic inflammation and reduced pulmonary cytokines and chemokines.
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31
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Cherry JD. MYCOPLASMA AND UREAPLASMA INFECTIONS. FEIGIN AND CHERRY'S TEXTBOOK OF PEDIATRIC INFECTIOUS DISEASES 2009:2685-2714. [DOI: 10.1016/b978-1-4160-4044-6.50213-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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32
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Kamer B, Woźniakowska-Gęsicka T, Pasowska R, Pyziak K, Kiciński P, Bujnowski T, Czkwianianc E, Czupryniak A, Grabowski W, Gzik-Musiał M, Haze E, Małecka-Panas E, Mazurkiewicz D, Pałczyńska-Moździerz J, Pankowska A, Podgórska B, Rzepkowska E, Sobantka D, Sołek B, Wojtuń J, Ziółkowska-Grześkowiak R, Życka-Podkowska J. Częstość mykoplazmatycznych zapaleń płuc u dzieci w Łodzi i makroregionie na podstawie obserwacji własnych. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s0031-3939(08)70209-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mycoplasma pneumoniae infection and environmental tobacco smoke inhibit lung glutathione adaptive responses and increase oxidative stress. Infect Immun 2008; 76:4455-62. [PMID: 18644874 DOI: 10.1128/iai.00136-08] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chronic cigarette smoking evokes a lung glutathione (GSH) adaptive response that results in elevated GSH levels in the lung epithelial lining fluid (ELF). Currently, little is known about how the lung regulates or maintains steady-state levels of ELF GSH. Pathogens such as Mycoplasma pneumoniae can exacerbate airway inflammation and oxidative stress. The present study examined whether M. pneumoniae infections synergize with environmental tobacco smoke (ETS) to disrupt lung GSH adaptive responses. Mice were exposed separately and in combination to ETS and M. pneumoniae for 16 weeks. ETS exposure resulted in a doubling of ELF GSH levels, which was blocked in the M. pneumoniae-exposed mice. In addition, the ETS-plus-M. pneumoniae-exposed mice had elevated levels of oxidized glutathione (GSSG), resulting in a dramatic change in the ELF redox state that corresponded with an increase in lung tissue DNA oxidation. Similar findings were observed in human lung epithelial cells in vitro. Cells exposed separately or in combination to cigarette smoke extract and M. pneumoniae for 48 h had elevated apical levels of GSH compared to control cells, and these increases were blocked by M. pneumoniae and were also associated with increased cellular DNA oxidation. Further studies showed that M. pneumoniae exposure blocked ETS-induced increases in GSH reductase, an enzyme that recycles GSSG back to GSH, both in vitro and in vivo. These studies suggest that M. pneumoniae infection synergizes with ETS and suppresses the lung's ability to respond appropriately to environmental challenges leading to enhanced oxidative stress.
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Harada K, Tanaka H, Komori S, Tsuji Y, Nagata K, Tsutsui H, Koyama K. Vaginal infection withUreaplasma urealyticumaccounts for preterm delivery via induction of inflammatory responses. Microbiol Immunol 2008; 52:297-304. [DOI: 10.1111/j.1348-0421.2008.00039.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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35
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Kim SM, Heo JS, Shim EJ, Lee DH, Cho DJ, Kim DH, Min KS, Yoo KY. Two cases of central nervous system complications caused by Mycoplasma pneumoniae infection. KOREAN JOURNAL OF PEDIATRICS 2008. [DOI: 10.3345/kjp.2008.51.5.533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Shin Mi Kim
- Department of Pediatrics, College of Medicine, Hallym University, Korea
| | - Ji Seung Heo
- Department of Pediatrics, College of Medicine, Hallym University, Korea
| | - Eun Jung Shim
- Department of Pediatrics, College of Medicine, Hallym University, Korea
| | - Dae Hyoung Lee
- Department of Pediatrics, College of Medicine, Hallym University, Korea
| | - Do Jun Cho
- Department of Pediatrics, College of Medicine, Hallym University, Korea
| | - Dug Ha Kim
- Department of Pediatrics, College of Medicine, Hallym University, Korea
| | - Ki Sik Min
- Department of Pediatrics, College of Medicine, Hallym University, Korea
| | - Ki Yang Yoo
- Department of Pediatrics, College of Medicine, Hallym University, Korea
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Intranasal interleukin-12 therapy inhibits Mycoplasma pneumoniae clearance and sustains airway obstruction in murine pneumonia. Infect Immun 2007; 76:732-8. [PMID: 18039833 DOI: 10.1128/iai.00878-07] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mycoplasma pneumoniae is a leading cause of pneumonia and is associated with asthma. Evidence links M. pneumoniae respiratory disease severity with interleukin-12 (IL-12) concentrations in respiratory secretions. We evaluated the effects of IL-12 therapy on microbiologic, inflammatory, and pulmonary function indices of M. pneumoniae pneumonia in mice. BALB/c mice were inoculated with M. pneumoniae or SP4 broth. Mice were treated with intranasal IL-12 or placebo daily for 8 days, starting on day 1 after inoculation. Mice were evaluated at baseline and on days 1, 3, 6, and 8 after therapy. Outcome variables included quantitative bronchoalveolar lavage (BAL) M. pneumoniae culture, lung histopathologic score (HPS), BAL cytokine concentrations determined by enzyme-linked immunosorbent assay (tumor necrosis factor alpha [TNF-alpha], gamma interferon [IFN-gamma], IL-1b, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, and granulocyte-macrophage colony-stimulating factor), and plethysmography, both before and after methacholine treatment. M. pneumoniae-infected mice treated with IL-12 (MpIL12 mice) were found to have significantly higher BAL M. pneumoniae concentrations than those of M. pneumoniae-infected mice treated with placebo (MpP mice) (P < 0.001). MpIL12 mice had higher BAL concentrations of IL-12, IFN-gamma, TNF-alpha, and IL-6, with differences in IL-12 and IFN-gamma concentrations reaching statistical significance (P < 0.001). Airway obstruction was statistically elevated in MpIL12 mice compared to that in MpP mice (P = 0.048), while airway hyperreactivity was also elevated in MpIL12 mice but did not reach statistical significance (P = 0.081). Lung parenchymal pneumonia subscores were significantly higher in MpIL12 mice (P < 0.001), but no difference was found for overall HPS, even though a strong trend was noticed (P = 0.051). Treatment of experimental M. pneumoniae pneumonia with intranasal IL-12 was associated with more severe pulmonary disease and less rapid microbiologic and histological resolution.
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Hsing J, Welgampola M, Kiernan MC. Reversible myeloradiculopathy due to Mycoplasma pneumoniae. J Clin Neurosci 2007; 14:61-4. [PMID: 17092721 DOI: 10.1016/j.jocn.2005.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Accepted: 08/14/2005] [Indexed: 10/23/2022]
Abstract
A 22-year-old man presented with flaccid paraparesis and a thoracic sensory level in the context of a recent respiratory illness. Investigations established cerebrospinal pleocytosis with elevated protein, and subsequent serological testing confirmed raised antibody titres to Mycoplasma pneumoniae. Nerve conduction studies established that H-reflexes were prolonged and somatosensory evoked responses were delayed from the lower limbs bilaterally. Although imaging of the spinal cord revealed no abnormality, clinical and neurophysiological findings were consistent with a myeloradiculopathy. The patient was treated with pulse intravenous methylprednisone and underwent complete recovery over a 4-week period.
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Affiliation(s)
- Joanna Hsing
- Institute of Neurological Sciences, Prince of Wales Hospital, Sydney, Australia
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Salvatore CM, Fonseca-Aten M, Katz-Gaynor K, Gomez AM, Mejias A, Somers C, Chavez-Bueno S, McCracken GH, Hardy RD. Respiratory tract infection with Mycoplasma pneumoniae in interleukin-12 knockout mice results in improved bacterial clearance and reduced pulmonary inflammation. Infect Immun 2006; 75:236-42. [PMID: 17074851 PMCID: PMC1828434 DOI: 10.1128/iai.01249-06] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mycoplasma pneumoniae is a leading cause of pneumonia and is associated with asthma. Evidence links M. pneumoniae respiratory disease severity with interleukin-12 (IL-12) concentration in respiratory secretions. We evaluated the microbiologic, inflammatory, and pulmonary function indices of M. pneumoniae pneumonia in IL-12 (p35) knockout (KO) mice and wild-type (WT) mice to determine the role of IL-12 in M. pneumoniae respiratory disease. Eight-week-old wild-type BALB/c mice and 8-week-old IL-12 (p35) KO BALB/c mice were inoculated once intranasally with 10(7) CFU of M. pneumoniae. Mice were evaluated at days 2, 4, and 7 after inoculation. Outcome variables included quantitative bronchoalveolar lavage (BAL) M. pneumoniae culture, lung histopathologic scores (HPS), BAL cytokine concentrations determined by enzyme-linked immunosorbent assay (tumor necrosis factor alpha [TNF-alpha], gamma interferon [IFN-gamma], IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-10, and granulocyte-macrophage colony-stimulating factor) and plethysmography, before and after methacholine, to assess airway obstruction (AO) and airway hyperreactivity (AHR). IL-12 (p35) KO mice infected with M. pneumoniae were found to have significantly lower BAL M. pneumoniae concentrations compared with M. pneumoniae-infected WT mice. Lung HPS and the parenchymal pneumonia subscores (neutrophilic alveolar infiltrate), as well as AO, were significantly lower in infected KO mice. No difference was found for AHR. Infected KO mice had significantly lower BAL concentrations of IFN-gamma than WT mice; a trend toward lower BAL concentrations was observed for IL-10 (P = 0.065) and TNF-alpha (P = 0.078). No differences were found for IL-1beta, IL-2, IL-4, IL-5, or IL-6. The lack of IL-12 in experimental M. pneumoniae pneumonia was associated with less severe pulmonary disease and more rapid microbiologic and histologic resolution.
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Affiliation(s)
- C M Salvatore
- Department of Pediatric Infectious Diseases, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9063, USA
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Shankar EM, Kumarasamy N, Balakrishnan P, Vengatesan A, Kownhar H, Solomon S, Rao UA. Seroprevalence of Mycoplasma pneumoniae in HIV-infected patients using a microparticle agglutination test. J Med Microbiol 2006; 55:759-763. [PMID: 16687596 DOI: 10.1099/jmm.0.46402-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Mycoplasma pneumoniae is increasingly recognized as a common and important pathogen in community settings, and is responsible for various pulmonary and extrapulmonary conditions in the normal population. However, the seroepidemiology of acute M. pneumoniae infection in HIV-infected individuals is still unclear worldwide. This study examined the seroprevalence of antibodies to M. pneumoniae in HIV-infected patients admitted with respiratory complaints at a tertiary AIDS care centre in Chennai, India. A commercial gelatin microparticle agglutination test (Serodia-Myco II, Fujirebio) was used for the determination of antibodies against M. pneumoniae in acute serum specimens. Of the 200 HIV-infected patients with underlying pulmonary conditions tested, 34 (17 % positivity; 95 % CI 12-23 %) had antibodies specific to M. pneumoniae, while among the 40 patients with no underlying pulmonary symptoms, five (12.5 % positivity; 95 % CI 4-27 %) had evidence of anti-M. pneumoniae antibody. This shows that the incidence of M. pneumoniae seropositivity is greater in patients with underlying pulmonary complaints. Most positive titres were found in the age group 28-37 years in the symptomatic and symptom-free groups (64.7 and 60 %, respectively). The positive titres ranged from 40 to >20 480. High titres (> or =320) were found in 10 out of the 39 patients (25.6 %). This seroprevalence study reports a 16.2 % prevalence of M. pneumoniae infections in HIV-infected patients by a particle agglutination test.
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Affiliation(s)
| | | | | | - A Vengatesan
- Clinical Epidemiology Unit, Government Stanley Medical College and Hospital, Chennai 600 113, India
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Grandics P. The cancer stem cell: evidence for its origin as an injured autoreactive T cell. Mol Cancer 2006; 5:6. [PMID: 16478542 PMCID: PMC1386699 DOI: 10.1186/1476-4598-5-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2006] [Accepted: 02/14/2006] [Indexed: 02/06/2023] Open
Abstract
This review explores similarities between lymphocytes and cancer cells, and proposes a new model for the genesis of human cancer. We suggest that the development of cancer requires infection(s) during which antigenic determinants from pathogens mimicking self-antigens are co-presented to the immune system, leading to breaking T cell tolerance. Some level of autoimmunity is normal and necessary for effective pathogen eradication. However, autoreactive T cells must be eliminated by apoptosis when the immune response is terminated. Apoptosis can be deficient in the event of a weakened immune system, the causes of which are multifactorial. Some autoreactive T cells suffer genomic damage in this process, but manage to survive. The resulting cancer stem cell still retains some functions of an inflammatory T cell, so it seeks out sites of inflammation inside the body. Due to its defective constitutive production of inflammatory cytokines and other growth factors, a stroma is built at the site of inflammation similar to the temporary stroma built during wound healing. The cancer cells grow inside this stroma, forming a tumor that provides their vascular supply and protects them from cellular immune response. As cancer stem cells have plasticity comparable to normal stem cells, interactions with surrounding normal tissues cause them to give rise to all the various types of cancers, resembling differentiated tissue types. Metastases form at an advanced stage of the disease, with the proliferation of sites of inflammation inside the body following a similar mechanism. Immunosuppressive cancer therapies inadvertently re-invigorate pathogenic microorganisms and parasitic infections common to cancer, leading to a vicious circle of infection, autoimmunity and malignancy that ultimately dooms cancer patients. Based on this new understanding, we recommend a systemic approach to the development of cancer therapies that supports rather than antagonizes the immune system.
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Shankar EM, Kumarasamy N, Balakrishnan P, Solomon S, Lejith R, Vengatesan A, Anand Rao U. Serosurveillance of acute Mycoplasma pneumoniae infection among HIV infected patients with pulmonary complaints in Chennai, Southern India. J Infect 2006; 53:325-30. [PMID: 16442630 DOI: 10.1016/j.jinf.2005.11.184] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2005] [Accepted: 11/18/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND The true seroepidemiology of acute Mycoplasma pneumoniae infection in HIV infected individuals is ambiguous. METHODS This study examined the serosurveillance of IgM antibodies to M. pneumoniae in HIV infected patients presenting with pulmonary symptoms at a tertiary AIDS care center in Chennai, Southern India, using cold-haemagglutination test and commercial enzyme linked immunosorbent assay in acute serum specimens. RESULTS One hundred HIV infected patients had enrolled in the study; 21 (21%) were positive for M. pneumoniae IgM antibodies by ELISA and 34 (34%) showed evidence of cold hemagglutinins. CONCLUSION This serosurveillance study reports a 21% prevalence of M. pneumoniae IgM antibody among HIV infected patients with pulmonary symptoms by ELISA and non-specific diagnosis was confirmed in 34% of the cases screened. Determination of cold agglutination titer could be used as a substitute to other expensive procedures in limited resource settings and third-world nations to diagnose M. pneumoniae infections for prompt initiation of therapy, as CAT has been found to be 100% sensitive and 84% specific in the diagnosis of M. pneumoniae infection.
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Affiliation(s)
- Esaki Muthu Shankar
- Mycoplasma Laboratory of the Department of Microbiology, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, Tamil Nadu, India
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Yeom JS, Bae WT, Park ES, Seo JH, Lim JY, Park CH, Woo HO, Youn HS. A clinical study on the etiology of parapneumonic effusion in children. KOREAN JOURNAL OF PEDIATRICS 2006. [DOI: 10.3345/kjp.2006.49.1.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jung-Sook Yeom
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Won-Tae Bae
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Eun-Sil Park
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Ji-Hyun Seo
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jae-Young Lim
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Chan-Hoo Park
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Hyang-Ok Woo
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Hee-Shang Youn
- Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
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Lee I, Kim TS, Yoon HK. Mycoplasma pneumoniae pneumonia: CT features in 16 patients. Eur Radiol 2005; 16:719-25. [PMID: 16215734 DOI: 10.1007/s00330-005-0026-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2005] [Revised: 06/21/2005] [Accepted: 09/02/2005] [Indexed: 11/29/2022]
Abstract
The objective of this study was to assess the computed tomography (CT) features of Mycoplasma pneumoniae pneumonia. We retrospectively reviewed CT findings of 16 patients (M:F = 9:7, age range 1-74 years, median 9 years) with serologically proven Mycoplasma pneumoniae pneumonia and with chest CT scan available. Two distinctive patterns of CT features of M. pneumoniae pneumonia were noted between the paediatric (age < 18 years) and the adult (age > or = 18 years) groups. The pediatric group (n=11) showed lobar or segmental consolidation (100%) with frequent pleural effusion (82%) and regional lymphadenopathy (82%) and mild volume decrease of the involved lobe (73%), while four of the five adult patients showed diffuse and/or multifocal, centrilobular or peribronchovascular areas of ground-glass attenuation (80%) with a lobular distribution, and frequent thickening of interlobular septa (60%) and the bronchial walls (40%) were also detected at high-resolution CT. The CT finding of a lobar or segmental consolidation with a parapneumonic effusion seen in our children with M. pneumoniae pneumonia was similar to that of bacterial lobar pneumonia. In contrast, the CT findings noted in our adult patients consisted of a mixture of a bacterial bronchopneumonia pattern and a viral interstitial pneumonia pattern.
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Affiliation(s)
- Inho Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, South Korea
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Guleria R, Nisar N, Chawla TC, Biswas NR. Mycoplasma pneumoniae and central nervous system complications: a review. ACTA ACUST UNITED AC 2005; 146:55-63. [PMID: 16099235 DOI: 10.1016/j.lab.2005.04.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2004] [Revised: 03/28/2005] [Accepted: 04/03/2005] [Indexed: 11/18/2022]
Abstract
Mycoplasma pneumoniae is a common cause of community-acquired pneumonia. Little is known about the extrapulmonary manifestations of this organism. Numerous central nervous system (CNS) manifestations have been described with M. pneumoniae. CNS involvement is probably the most common site of involvement in addition to the respiratory system. Up to 7% of patients hospitalized with M. pneumoniae may have CNS symptoms. Common CNS presentations include encephalitis, aseptic meningitis, polyradiculitis, cerebellar ataxia, and myelitis. The mechanism behind these CNS manifestations remains unclear. Direct invasion, neurotoxin production, or an immune-mediated mechanism has been proposed. Newer diagnostic techniques for the direct detection of the antigen and the microorganism are proving useful for the detection of extrapulmonary disease. This review comprehensively reviews the CNS complications that have been reported with M. pneumoniae.
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Affiliation(s)
- Randeep Guleria
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
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Abstract
Acute respiratory infections (ARIs) are the most common infections in humans, accounting for half of all acute conditions each year in the United States. Acute bronchitis episodes represent a significant portion of these illnesses. This article focuses on acute bronchitis in otherwise healthy individuals.
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Affiliation(s)
| | - Ralph Gonzales
- Department of Medicine, University of California, San Francisco, 3333 California Street, Box 1211, San Francisco, CA 94118, USA
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Sparing R, Spitzer C, Häfner H, Zolldann D, Reinges MHT, Krings T, Noth J, Kosinski CM. Fulminante Mycoplasma-pneumoniae-assoziierte Meningoenzephalitis des Erwachsenen. DER NERVENARZT 2004; 75:1016-21. [PMID: 15103415 DOI: 10.1007/s00115-004-1718-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Mycoplasma pneumoniae (M. pn.) commonly causes respiratory tract infections in humans. In a certain percentage of cases it may also be associated with various peripheral and central nervous system manifestations. We report a case of a 38-year-old previously healthy man who presented with hemiplegia and somnolence after he had suffered from a febrile respiratory infection 10 days earlier. Clinical features and laboratory investigations supported the diagnosis of an acute M. pneumoniae-associated meningoencephalitis. He was treated by an aggressive antibiotic and immunomodulatory regimen over the course of several weeks in the neurocritical care unit. Decompressive hemicraniectomy was performed due to life-threatening raised intracranial pressure. However, the patient recovered almost completely and presented with a mild neurological deficit after 3 months. Based on this case we give a review of the literature and discuss potential pathomechanisms and diagnostic approaches.
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Affiliation(s)
- Roland Sparing
- Neurologische Klinik, Universitätsklinikum der RWTH Aachen, Aachen.
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Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev 2004; 17:697-728, table of contents. [PMID: 15489344 PMCID: PMC523564 DOI: 10.1128/cmr.17.4.697-728.2004] [Citation(s) in RCA: 903] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Mycoplasma pneumoniae is a unique bacterium that does not always receive the attention it merits considering the number of illnesses it causes and the degree of morbidity associated with it in both children and adults. Serious infections requiring hospitalization, while rare, occur in both adults and children and may involve multiple organ systems. The severity of disease appears to be related to the degree to which the host immune response reacts to the infection. Extrapulmonary complications involving all of the major organ systems can occur in association with M. pneumoniae infection as a result of direct invasion and/or autoimmune response. The extrapulmonary manifestations are sometimes of greater severity and clinical importance than the primary respiratory infection. Evidence for this organism's contributory role in chronic lung conditions such as asthma is accumulating. Effective management of M. pneumoniae infections can usually be achieved with macrolides, tetracyclines, or fluoroquinolones. As more is learned about the pathogenesis and immune response elicited by M. pneumoniae, improvement in methods for diagnosis and prevention of disease due to this organism may occur.
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Affiliation(s)
- Ken B Waites
- Department of Pathology, WP 230, University of Alabama at Birmingham, 619 19th St. South, Birmingham, AL 35249, USA.
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Drasbek M, Nielsen PK, Persson K, Birkelund S, Christiansen G. Immune response to Mycoplasma pneumoniae P1 and P116 in patients with atypical pneumonia analyzed by ELISA. BMC Microbiol 2004; 4:7. [PMID: 15018643 PMCID: PMC362870 DOI: 10.1186/1471-2180-4-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2003] [Accepted: 02/05/2004] [Indexed: 12/04/2022] Open
Abstract
Background Serology is often used for the diagnosis of Mycoplasma pneumoniae. It is important to identify specific antigens that can distinguish between the presence or absence of antibodies against M. pneumoniae. The two proteins, P116 and P1, are found to be immunogenic. By using these in ELISA it is possible to identify an immune response against M. pneumoniae in serum samples. Results A recombinant protein derived from the P116 protein and one from the P1 protein were used in two ELISA tests, rP116-ELISA and rP1-ELISA. Human serum samples from patients with atypical pneumonia were tested and compared to the results of the complement fixation test. There was a good agreement between the two tests but the rP1-ELISA showed the best discrimination between positive and negative samples. Conclusion Two ELISA tests based on recombinant proteins have been analysed and compared to the complement fixation test results. The two ELISA tests were found suitable for use in serodiagnostics of M. pneumoniae infections. The use of specific antigens eliminates the risk of cross reaction to an immune response against other bacteria.
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Affiliation(s)
- Mette Drasbek
- Loke Diagnostics ApS, Forskerparken Aarhus, Gustav Wieds Vej 10 C, DK-8000 Aarhus C, Denmark
| | - Pernille K Nielsen
- Department of Medical Microbiology and Immunology, The Bartholin Building, University of Aarhus, DK-8000 Aarhus C, Denmark
| | - Kenneth Persson
- Department of Clinical Microbiology, Malmo University Hospital, Sweden
| | - Svend Birkelund
- Loke Diagnostics ApS, Forskerparken Aarhus, Gustav Wieds Vej 10 C, DK-8000 Aarhus C, Denmark
- Department of Medical Microbiology and Immunology, The Bartholin Building, University of Aarhus, DK-8000 Aarhus C, Denmark
| | - Gunna Christiansen
- Department of Medical Microbiology and Immunology, The Bartholin Building, University of Aarhus, DK-8000 Aarhus C, Denmark
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Lo SC, Wang RYH, Grandinetti T, Zou N, Haley CLD, Hayes MM, Wear DJ, Shih JWK. Mycoplasma hominis lipid-associated membrane protein antigens for effective detection of M. hominis-specific antibodies in humans. Clin Infect Dis 2003; 36:1246-53. [PMID: 12746769 DOI: 10.1086/374851] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2003] [Accepted: 01/30/2003] [Indexed: 11/03/2022] Open
Abstract
Lipid-associated membrane proteins (LAMPs) from 14 Mycoplasma hominis isolates or strains share similar protein and antigenicity profiles. Of 31 human immunodeficiency virus-infected patients from whose samples M. hominis was cultured, 28 tested strongly positive for serum antibodies to M. hominis LAMPs. The remaining 3 serum samples showed low antibody titer to LAMPs from all of the 14 M. hominis isolates or strains, which was likely the result of the compromised immune systems of the patients. Thus, M. hominis LAMPs as a whole are homogenous in antigenicity within the species, despite having many different serotypes. Serological study involving 564 healthy blood donors and 211 patients attending sexually transmitted disease clinics by LAMPs showed that general populations were widely exposed to M. hominis. Women were infected with M. hominis at a younger age than were men. The prevalence of infection increased markedly among sexually active persons.
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Affiliation(s)
- Shyh-Ching Lo
- Armed Forces Institute of Pathology, Department of Infectious and Parasitic Diseases Pathology, Washington, DC 20306, USA.
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Loussaief C, Battikh R, Louzir B, M'saddek F, Abdelhafidh NB, Bahri M, Mâalaoui H, Ajmi F, Othmani S. [Myeloradiculoneuritis of Mycoplasma pneumoniae: a case report]. Rev Med Interne 2003; 24:273-5. [PMID: 12706790 DOI: 10.1016/s0248-8663(02)00818-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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