Impact of Epstein-Barr virus coinfection in Mycoplasma pneumoniae pneumonia

Xu, Yingchun; Li, Shuxian; Liu, Jinling; Zhou, Junfen; Jin, Fang; Chen, Xiaoyang; Wang, Yingshuo; Jiang, Yuan; Chen, Zhimin

doi:10.1097/md.0000000000019792

Cited by 6 publications

(1 citation statement)

References 26 publications

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“…Respiratory syncytial virus is the most common virus detected in children with pneumonia (Pneumonia Etiology Research for Child Health (PERCH) Study Group, (2019); Jain et al, 2015;Tsitsiklis et al, 2022), which was contrary to our result. The highest detection of virus was EBV during the epidemics of M. pneumoniae in our study, while a retrospective study found that co-infection of EBV and M. pneumoniae posed a higher risk for prolonged symptoms (Xu et al, 2020). Given the complexity of infections in children, unbiased mNGS should be extensively used for accurate and timely diagnoses to improve the prognoses of children.…”

Section: Discussionmentioning

confidence: 62%

High specificity of metagenomic next-generation sequencing using protected bronchial brushing sample in diagnosing pneumonia in children

Liu

Wang

Zhou

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundLower respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. Timely and accurate pathogen detection is crucial for proper clinical diagnosis and therapeutic strategies. The low detection efficiency of conventional methods and low specificity using respiratory samples seriously hindered the accurate detection of pathogens.MethodsIn this study, we retrospectively enrolled 1,032 children to evaluate the performance of metagenomics next-generation sequencing (mNGS) using bronchoalveolar lavage fluid (BALF) sample and protected bronchial brushing (BB) sample in diagnosing pneumonia in children. In addition, conventional tests (CTs) were also performed.ResultsThe specificity of BB mNGS [67.3% (95% CI 58.6%–75.9%)] was significantly higher than that of BALF mNGS [38.5% (95% CI 12.0%–64.9%)]. The total coincidence rate of BB mNGS [77.6% (95% CI 74.8%–80.5%)] was slightly higher than that of BALF mNGS [76.5% (95% CI 68.8%–84.1%)] and CTs [38.5% (95% CI 35.2%–41.9%)]. During the epidemics of Mycoplasma pneumoniae, the detection rate of M. pneumoniae in the >6-year group (81.8%) was higher than that in the 3–6-year (78.9%) and <3-year groups (21.5%). The highest detection rates of bacteria, fungi, and viruses were found in the <3-year, >6-year, and 3–6-year groups, respectively. mNGS detection should be performed at the duration of 5–7 days after the start of continuous anti-microbial therapy or at the duration of 6–9 days from onset to mNGS test.ConclusionsThis is the first report to evaluate the performance of BB mNGS in diagnosing pulmonary infections in children on a large scale. Based on our findings, extensive application of BB mNGS could be expected.

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Section: Discussionmentioning

confidence: 62%

High specificity of metagenomic next-generation sequencing using protected bronchial brushing sample in diagnosing pneumonia in children

Liu

Wang

Zhou

et al. 2023

Front. Cell. Infect. Microbiol.

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Evaluating the role of interleukin-2 and interleukin-12 in pediatric patients with concurrent Mycoplasma pneumoniae and Epstein-Barr virus infections

Hao

2024

World J Clin Cases

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BACKGROUND Mycoplasma pneumoniae (MP) frequently causes respiratory infections in children, whereas Epstein-Barr virus (EBV) typically presents subclinical manifestations in immunocompetent pediatric populations. The incidence of MP and EBV co-infections is often overlooked clinically, with the contributory role of EBV in pulmonary infections alongside MP remaining unclear. AIM To evaluate the serum concentrations of interleukin-2 (IL-2) and interleukin-12 (IL-12) in pediatric patients with MP pneumonia co-infected with EBV and assess their prognostic implications. METHODS We retrospectively analyzed clinical data from patients diagnosed with MP and EBV co-infection, isolated MP infection, and a control group of healthy children, spanning from January 1, 2018 to December 31, 2021. Serum IL-2 and IL-12 levels were quantified using enzyme-linked immunosorbent assay. Logistic regression was employed to identify factors influencing poor prognosis, while receiver operating characteristic (ROC) curves evaluated the prognostic utility of serum IL-2 and IL-12 levels in co-infected patients. RESULTS The co-infection group exhibited elevated serum IL-2 and C-reactive protein (CRP) levels compared to both the MP-only and control groups, with a reverse trend observed for IL-12 (P < 0.05). In the poor prognosis cohort, elevated CRP and IL-2 levels, alongside prolonged fever duration, contrasted with reduced IL-12 levels (P < 0.05). Logistic regression identified elevated IL-2 as an independent risk factor and high IL-12 as a protective factor for adverse outcomes (P < 0.05). ROC analysis indicated that the area under the curves for IL-2, IL-12, and their combination in predicting poor prognosis were 0.815, 0.895, and 0.915, respectively. CONCLUSION Elevated serum IL-2 and diminished IL-12 levels in pediatric patients with MP and EBV co-infection correlate with poorer prognosis, with combined IL-2 and IL-12 levels offering enhanced predictive accuracy.

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Immune and microbial signatures in immunocompetent and immunocompromised patients with pneumonia

Zhan,

Zhou,

et al. 2024

Preprint

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Background Pneumonia is a common acute respiratory infection that contributes to significant mortality and morbidity worldwide. The disruption of the airway microbiome in respiratory infection has been extensively reported. However, whether the changes in respiratory tract microbial communities during pneumonia were related to disease severity remains elusive. Herein, we aimed to investigate the correlation between the changes in airway microbiome and immune response in pneumonia patients. Methods We performed metagenomic and metatranscriptomic sequencing on immunocompetent (ICO) and immunocompromised host (ICH) with pneumonia using bronchoalveolar lavage fluid (BALF), blood, sputum, and swab samples. Results Compared to ICO patients with pneumonia, ICH patients had higher Pneumonia Severity Index (PSI) score. BALF metagenomic and metatranscriptomic sequencing showed higher microbial diversity in ICH patients, while ICH patients exhibited lower microbial diversity in sputum samples. Additionally, pneumonia patients with different PSI scores exhibited different microbial communities. Relative abundance of Human Gammaherpesvirus 4 (EBV) was positively correlated with PSI score. For ICH patients, BALF metatranscriptomic sequencing found 183 up-regulated genes and 85 down-regulated genes in EBV-detected group compared with EBV not-detected group, while there was no significant difference in ICO patients, indicating that EBV might be reactivated in ICH patients, while EBV might be latent in ICO patients. In ICH patients, we observed significant down-regulation of immune related genes and interferon stimulated genes in EBV-detected group compared to the not-detected group, including CSF1R, CXCR6, IL10, IL16, and TNFRSF25. Co-occurrence network analysis found positive correlations between EBV and Citrobacter freundii or Campylobacter concisus, indicating that synergistic effects on exacerbating the severity of pneumonia might exist between EBV and these two microbes. Conclusion EBV might be considered as a microbial signature for disease severity, which could regulate immune-related signaling pathways. Notably, we unravel that EBV presence might inhibit the immune response of hosts, reduce anti-inflammatory responses, and increase the possibilities of infections caused by other pathogens, exacerbating the pneumonia severity.

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Impact of Epstein-Barr virus coinfection in Mycoplasma pneumoniae pneumonia

Cited by 6 publications

References 26 publications

High specificity of metagenomic next-generation sequencing using protected bronchial brushing sample in diagnosing pneumonia in children

High specificity of metagenomic next-generation sequencing using protected bronchial brushing sample in diagnosing pneumonia in children

Evaluating the role of interleukin-2 and interleukin-12 in pediatric patients with concurrent Mycoplasma pneumoniae and Epstein-Barr virus infections

Immune and microbial signatures in immunocompetent and immunocompromised patients with pneumonia

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