THE ROLE OF ATYPICAL PATHOGENS: MYCOPLASMA PNEUMONIAE, CHLAMYDIA PNEUMONIAE, AND LEGIONELLA PNEUMOPHILA IN RESPIRATORY INFECTION

1998 ◽  
Vol 12 (3) ◽  
pp. 569-592 ◽  
Author(s):  
Thomas M. File ◽  
James S. Tan ◽  
Joseph F. Plouffe
2014 ◽  
Vol 4 (S1) ◽  
Author(s):  
Dorina Savoschin ◽  
Ala Cojocaru ◽  
Liubov Vasilos ◽  
Olga Cirstea ◽  
Alexandra Guscov ◽  
...  

2016 ◽  
Vol 10 (07) ◽  
pp. 741-746 ◽  
Author(s):  
Hakan Cinemre ◽  
Cengiz Karacer ◽  
Murat Yücel ◽  
Aziz Öğütlü ◽  
Fatma Behice Cinemre ◽  
...  

Introduction: Influenza-like illness (ILI) and acute respiratory infection (ARI) are common presentations during winter and indiscriminate antibiotic use contributes significantly to the emerging post-antibiotic era. Methodology: Otherwise healthy 152 patients, presenting to outpatient clinics with ILI/ARI, were included. Patients had history & physical, CRP, hemogram and nasopharyngeal swabs for rhinovirus A/B, influenza A/B, adenovirus A/B/C/D/E, coronavirus 229E/NL63 and OC43, parainfluenza virus 1/2/3, respiratory syncytial virusA/B, metapneumovirus and Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila and Bordetella pertussis by PCR and for ABHS culture. Results: Median (IR) age was 26.5 (16.5). Time to presentation was shorter in men (p = 0.027). Patients with rhinovirus had lower rates (20%) of myalgia (p = 0.043). Patients with influenza virus had higher rates (97%) of elevated CRP (p = 0.016). Logistic regression revealed that patients with ILI/ARI and CRP ≥ 5 mg/L were 60 times more likely to have influenza virus infection than other viral agents (OR = 60.0, 95% CI = 2.65 to 1,358.2, p = 0.010). Rhinovirus predominated in December (54%), March (36%), and April (33%). Influenza virus predominated in January (51%). Fever was most common with adenovirus (p = 0.198). All GABHS cultures were negative. Atypical organisms and Bordetella pertussis were negative in all but one patient. Conclusions: Influenza virus is the most likely pathogen in ILI/ARI when CRP ≥ 5 mg/L. This might be explained by tissue destruction. Myalgia is rare with rhinovirus probably due to absence of viremia. Negative bacteria by PCR and culture suggest unnecessary antibiotic use in ILI/ARI.


Author(s):  
Puneeta Singh ◽  
Shalabh Malik ◽  
Vandana Lal

Background: Atypical bacterial and viral pathogens play an important role in atypical pneumonia are responsible for one of the leading causes of morbidity and mortality, particularly in developing countries. Objective: The purpose of this study to determine the prevalence of bacterial and viral pathogens causing acute atypical pneumonia in different age groups and seasonality patterns of prevalence in India. Methods: This retrospective study was conducted on 680 samples tested during December 2018 to August 2019, performed at Microbiology department of Dr. Lal Path Labs. Serum samples were used for Pneumoslide IgM test diagnose 9 Atypical bacterial & viral pathogens: Legionella pneumophila (LP), Mycoplasma pneumoniae (MP), Coxiella burnetti (COX), Chlamydophila pneumonia (CP) Adenovirus (ADV), Respiratory syncytial virus (RSV) Influenza A (INFA), Influenza B (INFB), Parainfluenza serotypes 1,2 &3(PIVs). Results: Of a total 477(70.1%) samples were positive for atypical pneumonia pathogens. Atypical pneumonia was seen in extremes of age ie: <=5 years and >60 elderly adults without much of a gender bias. Co infections was seen in 62.1%. Legionella pneumophila (42.5%) was the dominant pathogen followed by Influenza B (41.7%) Mycoplasma pneumoniae (33.4%), Parainfluenza serotypes 1,2 &3 (29.4%) respectively. Atypical pneumonia has a spring predominance that is peaking in March. Conclusion: Among six predominant atypical pathogens, Legionella pneumophila and Influenza B was most predominant pathogens, as a causative agent of atypical pneumonia followed by Mycoplasma pneumoniae seen mostly in young (0-5 years) comparison to all age groups. Hence, Pneumoslide IgM as a multi panel test needed to ensure initiation of targeted therapy. Pneumoslide IgM, by IFA is a rapid, cost effective easy to identify & classify atypical pneumonia causing pathogens.


Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1489
Author(s):  
Susanne Paukner ◽  
David Mariano ◽  
Anita F. Das ◽  
Gregory J. Moran ◽  
Christian Sandrock ◽  
...  

Lefamulin was the first systemic pleuromutilin antibiotic approved for intravenous and oral use in adults with community-acquired bacterial pneumonia based on two phase 3 trials (Lefamulin Evaluation Against Pneumonia [LEAP]-1 and LEAP-2). This pooled analysis evaluated lefamulin efficacy and safety in adults with community-acquired bacterial pneumonia caused by atypical pathogens (Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydia pneumoniae). In LEAP-1, participants received intravenous lefamulin 150 mg every 12 h for 5–7 days or moxifloxacin 400 mg every 24 h for 7 days, with optional intravenous-to-oral switch. In LEAP-2, participants received oral lefamulin 600 mg every 12 h for 5 days or moxifloxacin 400 mg every 24 h for 7 days. Primary outcomes were early clinical response at 96 ± 24 h after first dose and investigator assessment of clinical response at test of cure (5–10 days after last dose). Atypical pathogens were identified in 25.0% (91/364) of lefamulin-treated patients and 25.2% (87/345) of moxifloxacin-treated patients; most were identified by ≥1 standard diagnostic modality (M. pneumoniae 71.2% [52/73]; L. pneumophila 96.9% [63/65]; C. pneumoniae 79.3% [46/58]); the most common standard diagnostic modality was serology. In terms of disease severity, more than 90% of patients had CURB-65 (confusion of new onset, blood urea nitrogen > 19 mg/dL, respiratory rate ≥ 30 breaths/min, blood pressure <90 mm Hg systolic or ≤60 mm Hg diastolic, and age ≥ 65 years) scores of 0–2; approximately 50% of patients had PORT (Pneumonia Outcomes Research Team) risk class of III, and the remaining patients were more likely to have PORT risk class of II or IV versus V. In patients with atypical pathogens, early clinical response (lefamulin 84.4–96.6%; moxifloxacin 90.3–96.8%) and investigator assessment of clinical response at test of cure (lefamulin 74.1–89.7%; moxifloxacin 74.2–97.1%) were high and similar between arms. Treatment-emergent adverse event rates were similar in the lefamulin (34.1% [31/91]) and moxifloxacin (32.2% [28/87]) groups. Limitations to this analysis include its post hoc nature, the small numbers of patients infected with atypical pathogens, the possibility of PCR-based diagnostic methods to identify non-etiologically relevant pathogens, and the possibility that these findings may not be generalizable to all patients. Lefamulin as short-course empiric monotherapy, including 5-day oral therapy, was well tolerated in adults with community-acquired bacterial pneumonia and demonstrated high clinical response rates against atypical pathogens.


2020 ◽  
Author(s):  
Alessandra Oliva ◽  
Guido Siccardi ◽  
Ambra Migliarini ◽  
Francesca Cancelli ◽  
Martina Carnevalini ◽  
...  

Abstract The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only 2 cases of Chlamydia pneumoniae have been reported in a large US study so far. In the present report, we describe a series of 7 patients where co-infection with C. pneumoniae (n=5) or M. pneumoniae (n=2) and SARS-CoV-2 was detected in a large teaching hospital in Rome. An extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed.


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