Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou

Xu, Yingchun; Zhu, Lan-Juan; Xu, Dan; Tao, Xiaofen; Li, Shuxian; Tang, Lanfang; Chen, Zhimin

doi:10.1007/s12519-011-0318-0

Cited by 33 publications

(29 citation statements)

References 20 publications

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“…During the entire period, the changes in the annual cycle of positive rates were irregular, with peaks in early summer (in 2012), mid-summer (in 2013), and early autumn (in 2014). This is in line with reports describing more M. pneumoniae infections with increased relative humidity and ambient temperature (19,20). In our neighborhood areas, recent epidemic outbreaks of M. pneumoniae infections were also noted in South Korea from 2010 to 2011, in Japan from 2011 to 2012, and in Beijing and Shanghai, China, in 2012 (4,21,22).…”

Section: Discussionsupporting

confidence: 93%

Emergence of Macrolide-Resistant Mycoplasma pneumoniae in Hong Kong Is Linked to Increasing Macrolide Resistance in Multilocus Variable-Number Tandem-Repeat Analysis Type 4-5-7-2

Law

Chan

et al. 2015

J Clin Microbiol

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Macrolide-resistant Mycoplasma pneumoniae (MRMP) is rapidly emerging in Asia, but information on the temporal relationship between the increase in macrolide resistance and changes in strain types is scarce. Between 2011 and 2014, M. pneumoniae infection was diagnosed by PCR as part of routine care in a health care region in Hong Kong. Testing was initiated by clinicians, mainly in patients with suspected M. pneumoniae pneumonia. Specimens positive for M. pneumoniae were retrospectively investigated by macrolide resistance genotyping and a four-locus (Mpn13 to -16) multilocus variable-number tandem-repeat analysis (MLVA) scheme. The overall percentage of M. pneumoniae-positive specimens was 17.9%, with annual rates ranging from 9.8% to 27.2%. The prevalence of MRMP had rapidly increased from 13.6% in 2011 to 30.7% in 2012, 36.6% in 2013, and 47.1% in 2014 (P ‫؍‬ 0.038). Two major MLVA types, 4-5-7-2 and 3-5-6-2, accounted for 75% to 85% of the infections each year. MLVA types 4-5-7-2 and 3-5-6-2 predominated among macrolide-resistant and macrolide-sensitive groups, respectively. The increase in MRMP was mainly caused by increasing macrolide resistance in the prevalent MLVA type 4-5-7-2, changing from 25.0% in 2011 to 59.1% in 2012, to 89.7% in 2013, and to 100% in 2014 (P < 0.001). In conclusion, increasing MRMP in Hong Kong was linked to a single MLVA type, which was both prevalent and increasingly resistant to macrolides. Mycoplasma pneumoniae is a common cause of communityacquired pneumonia and other respiratory tract infections (1). Community epidemics occur at intervals of 3 to 7 years. Infections develop in persons of all ages, but it is primarily a disease of children and teenagers (2). When treatment is indicated, a macrolide is usually the drug of choice (1, 2). However, macrolideresistant M. pneumoniae (MRMP) has become increasingly prevalent worldwide, and high rates of infection (Ͼ80%) have been found in certain parts of the world (3-6). MRMP infections have been associated with persistence of symptoms, slower reduction in bacterial load, longer hospital stays, requirement of alternative therapy, and higher frequency of complications (1,7,8). Strain typing is important for understanding changes in disease epidemiology and for investigations of outbreaks. In 2009, a multilocus variable-number tandem-repeat analysis (MLVA) scheme based upon five loci (Mpn1 and Mpn13 to -16) was developed for the molecular typing of M. pneumoniae (9). It was initially used for an investigation of isolates but was later modified for directly typing M. pneumoniae in respiratory specimens (10-12). An amended 4-locus MLVA scheme was later proposed after studies raised concerns on the instability of the Mpn1 locus (13,14). In clinical laboratories, culture and characterization of M. pneumoniae are seldom performed. Therefore, M. pneumoniae typing was usually carried out on isolates collected from sporadic cases and outbreaks (9,13,15), limiting the inferences that can be made about trends in M. pneumoniae infections. In addit...

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Section: Discussionsupporting

confidence: 93%

Emergence of Macrolide-Resistant Mycoplasma pneumoniae in Hong Kong Is Linked to Increasing Macrolide Resistance in Multilocus Variable-Number Tandem-Repeat Analysis Type 4-5-7-2

Law

Chan

et al. 2015

J Clin Microbiol

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“…The results of the present study show a similar, albeit less evident, cycle from 2000 to 2009, which could be associated with differences in the region, time and detection methods of the study. The annual incidence of MPP showed a gradually increasing trend from 16.9 to 31.9% in this study, which is similar to that reported in other studies (27,28). The age distribution of MPP in the present study was also comparable to the age-related increase reported in the literature (1,5,7).…”

Section: Discussionsupporting

confidence: 91%

Epidemiology and clinical features of segmental/lobar pattern Mycoplasma pneumoniae pneumonia: A ten-year retrospective clinical study

Jin

Yue

Li³

et al. 2015

Experimental and Therapeutic Medicine

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plays an important role in community-acquired pneumonia. However, epidemiological and clinical studies on the segmental/lobar pattern (S/L) radiographic-pathologic subtype of pediatric pneumonia (MPP) are rare. The current study retrospectively analyzed the epidemiological and clinical characteristics of pediatric MPP patients. A total of 1,933 children with MPP received treatment at a single hospital between 2000 and 2009, of which 684 (35.4%) were diagnosed with S/L-MPP. The annual incidence of S/L-MPP in children with MPP increased throughout the duration of this study (from 6.4 to 59.6%, P<0.001), which was particularly evident after 2003. S/L-MPP was predominantly found in pre-school-aged children (4-6 years old; 56.6%). Compared with non-S/L-MPP, S/L-MPP was more closely associated with severe manifestations, including higher rates of fever (90.2 vs. 83.3%), pleural effusion (3.9 vs. 1.3%), extrapulmonary manifestations (26.2 vs. 21.2%), abnormal white blood cell counts (65.5 vs. 55.2%), abnormal C-reactive protein levels (30.9 vs. 23.7%) and bacterial co-infection (32.0 vs. 24.9%), as well as longer durations of fever (4.13±4.28 vs. 3.02±2.22 days) and hospitalization (12.70±4.54 vs. 9.22±5.12 days). Older S/L-MPP patients showed higher rates and longer durations of fever and cough; however, they also displayed a lower rate of extrapulmonary manifestations when compared with younger patients. In conclusion, the annual incidence of S/L-MPP has increased in recent years. Pre-school-aged children (4-6 years) with MPP are more likely to display a segmental/lobar pattern, which is associated with more severe clinical manifestations than other MPP infection patterns.

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“…Mycoplasma pneumoniae (MP) is an extracellular pathogen that attaches to ciliated epithelial cells of the respiratory tract mucosa and causes damage [1, 2]. MP infection is the dominant cause of pneumonia in children [3–6], who present with more than 40% of community-acquired pneumonia [7–9].…”

Section: Introductionmentioning

confidence: 99%

Mycoplasma pneumoniaeInfection in Children Is a Risk Factor for Developing Allergic Diseases

Shao

et al. 2014

The Scientific World Journal

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Mycoplasma pneumoniae (MP) infection is the dominant cause of pneumonia in children. We sought to determine the relationship between MP infection and secondary allergic disease and to clarify the associated mechanisms of inflammatory response. A prospective study was performed among 1330 patients diagnosed with pneumonia to investigate the patient immune status by determining the correlation between MP infection, immunoglobulin E (IgE) levels, and a spectrum of associated serum cytokines. Serum IgE, IL-4, IL-6, and IL-10 levels for MPP patients in the acute phase were obviously higher than those in the recovery phase (P < 0.01). MPP patients with allergic conditions had increased serum IgE levels and increased IL-4/INF-γ ratio, and IgE and Eosinophil Cationic Protein were further elevated in patients who eventually developed secondary asthma changes. Patients with severe pneumonia and high clinical pulmonary infection scores presented higher levels of IL-4 and IL-5 in serum than those with low scores (P < 0.01). The proportion of CD4+ and CD8+ T cells that secreted IL-4 was significantly increased in MPP patients with elevated IgE. Our data demonstrate a significant correlation between MP infection and IgE levels, which is associated with a Th1/Th2 cytokine imbalance.

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Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou

Abstract: This study showed that the MPP rate was higher in older children than in younger ones. Girls had a higher positive rate of MPP than boys. In Hangzhou, MPP was more prevalent in summer and autumn. Air temperature was the only meteorological factor affecting the prevalence of MPP.

Cited by 33 publications

References 20 publications

Emergence of Macrolide-Resistant Mycoplasma pneumoniae in Hong Kong Is Linked to Increasing Macrolide Resistance in Multilocus Variable-Number Tandem-Repeat Analysis Type 4-5-7-2

Emergence of Macrolide-Resistant Mycoplasma pneumoniae in Hong Kong Is Linked to Increasing Macrolide Resistance in Multilocus Variable-Number Tandem-Repeat Analysis Type 4-5-7-2

Epidemiology and clinical features of segmental/lobar pattern Mycoplasma pneumoniae pneumonia: A ten-year retrospective clinical study

Mycoplasma pneumoniaeInfection in Children Is a Risk Factor for Developing Allergic Diseases

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