Carriage of Mycoplasma pneumoniae in the Upper Respiratory Tract of Symptomatic and Asymptomatic Children: An Observational Study

Spuesens, Emiel B. M.; Fraaij, Pieter L. A.; Visser, Eline G.; Hoogenboezem, Theo; Hop, Wim C. J.; Adrichem, L.N.A. van; Weber, Frank; Moll, Henriëtte A.; Broekman, Berth; Berger, Marjolein Y.; Rijsoort-Vos, Tineke van; Belkum, Alex van; Schutten, Martin; Pas, Suzan D.; Osterhaus, Albert D. M. E.; Hartwig, Nico G.; Vink, Cornelis; Rossum, Annemarie M. C. van

doi:10.1371/journal.pmed.1001444

Cited by 250 publications

(250 citation statements)

References 26 publications

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“…However, the diagnostics of bacterial infections in children with respiratory infections are difficult because blood culture results are rarely positive, sputum or samples from bronchoalveolar lavage are difficult to obtain, 37 and the clinical significance of bacterial diagnostics from the nasopharynx in children with ARI is limited due to high rates of colonization of common bacterial pathogens. 38,39 Finally, the qPCR method used in our study was not appropriate to adequately assess viral load, which has been found to be associated with severity of disease. 40 …”

Section: Discussionmentioning

confidence: 87%

Clinical Utility of PCR for Common Viruses in Acute Respiratory Illness

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Quantitative real-time polymerase chain reaction allows sensitive detection of respiratory viruses. The clinical significance of detection of specific viruses is not fully understood, however, and several viruses have been detected in the respiratory tract of asymptomatic children. WHAT THIS STUDY ADDS:Our results indicate that quantitative real-time polymerase chain reaction is limited at distinguishing acute infection from detection in asymptomatic children for rhinovirus, bocavirus, adenovirus, enterovirus, and coronavirus. abstract BACKGROUND: Acute respiratory illness (ARI) accounts for a large proportion of all visits to pediatric health facilities. Quantitative real-time polymerase chain reaction (qPCR) analyses allow sensitive detection of viral nucleic acids, but it is not clear to what extent specific viruses contribute to disease because many viruses have been detected in asymptomatic children. Better understanding of how to interpret viral findings is important to reduce unnecessary use of antibiotics. OBJECTIVE:To compare viral qPCR findings from children with ARI versus asymptomatic control subjects.METHODS: Nasopharyngeal aspirates were collected from children aged #5 years with ARI and from individually matched, asymptomatic, population-based control subjects during a noninfluenza season. Samples were analyzed by using qPCR for 16 viruses. RESULTS:Respiratory viruses were detected in 72.3% of the case patients (n 5 151) and 35.4% of the control subjects (n 5 74) (P 5 .001). Rhinovirus was the most common finding in both case patients and control subjects (47.9% and 21.5%, respectively), with a population-attributable proportion of 0.39 (95% confidence interval: 0.01 to 0.62). Metapneumovirus, parainfluenza viruses, and respiratory syncytial virus were highly overrepresented in case patients. Bocavirus was associated with ARI even after adjustment for coinfections with other viruses and was associated with severe disease. Enterovirus and coronavirus were equally common in case patients and control subjects.CONCLUSIONS: qPCR detection of respiratory syncytial virus, metapneumovirus, or parainfluenza viruses in children with ARI is likely to be causative of disease; detection of several other respiratory viruses must be interpreted with caution due to high detection rates in asymptomatic children. Although acute respiratory illness (ARI) in childrenaccountsfora large part ofall visits to pediatric health facilities and is a great economic burden on society, 1,2 our tools to diagnose the etiologic agents have until recently been limited. 3 Treatment with antibiotics induces development of antibiotic resistance in bacteria 4 and has a negligible effect on most ARIs, which generally are of viral origin. 5,6 Nevertheless, antibiotics are frequently prescribed due to lack of clinically valid diagnostic tests verifying a viral etiology. 7 Sensitive methods, such as quantitative real-time polymerase chain reaction (qPCR) analyses on nasopharyngeal samples, for a number of viru...

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Section: Discussionmentioning

confidence: 87%

Clinical Utility of PCR for Common Viruses in Acute Respiratory Illness

et al. 2014

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“…Furthermore, cultural and molecular detection of M. pneumoniae in healthy individuals and long-term carriage of bacteria after the period of typical respiratory symptoms and adequate antibiotic therapy are known facts (18,19). Future studies have to prove whether a range of bacterial load is associated with this phenomenon and might be used to differentiate patients with acute illness due to M. pneumoniae from symptom-less carriers or M. pneumoniae-positive patients with symptoms of CAP caused by other microorganisms (20). In this context, knowledge of the sensitivity of the real-time PCR approach used is a precondition for the evaluation of the significance of the concentration of genome copies measured.…”

mentioning

confidence: 99%

Evaluation of Five Real-Time PCR Assays for Detection of Mycoplasma pneumoniae

Dumke

Jacobs

2014

J Clin Microbiol

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“…[3,9,12] Recent studies have also shown that asymptomatic carriage of Mp in the upper respiratory tract is common in children. [5,13] EEG is often abnormal with diffuse slowing, as in our patient; focal abnormalities are less common. [3,12] Brain MRI shows abnormalities in about half of the patients, mainly focal ischaemia or edema, or increased signal intensities.…”

Section: Discussionmentioning

confidence: 47%

Meningoencephalitis and otitis media in a child withMycoplasma pneumoniaeinfection

Pelkonen

Sarajuuri

Rautanen

et al. 2017

Acta Oto-Laryngologica Case Reports

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We report on a previously healthy 11-year-old male presenting with meningoencephalitis and otitis media. Computed tomography demonstrated opacification of the right middle ear and mastoid ear cells, but no destructive changes. Anti-Mycoplasma pneumoniae IgG and IgM were positive in serum and at high concentrations in cerebrospinal fluid (CSF), and its nucleic acid was detected in the middle ear fluid and in a throat swab, but not in CSF. EEG showed generalized slowing and right temporal sharp waves. Brain MRI imaging remained normal. After a 3-week treatment with doxycycline and a tympanostomy tube, the patient recovered, and no long-term neurological sequelae have appeared. Diagnostics and pathogenetic mechanisms in meningoencephalitis caused by M. pneumoniae are discussed. ARTICLE HISTORY

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Carriage of Mycoplasma pneumoniae in the Upper Respiratory Tract of Symptomatic and Asymptomatic Children: An Observational Study

Cited by 250 publications

References 26 publications

Clinical Utility of PCR for Common Viruses in Acute Respiratory Illness

Clinical Utility of PCR for Common Viruses in Acute Respiratory Illness

Evaluation of Five Real-Time PCR Assays for Detection of Mycoplasma pneumoniae

Meningoencephalitis and otitis media in a child withMycoplasma pneumoniaeinfection

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