Mycoplasma pneumoniae 23S rRNA A2063G mutation does not influence chest radiography features in children with pneumonia

Objective To measure the rate of the A2063G mutation in the Mycoplasma pneumoniae ( M. pneumoniae) 23S rRNA domain V in children with pneumonia and to determine the correlation between radiographic findings and the presence of the A2063G mutation. Methods Patients who were hospitalized with a confirmed diagnosis of M. pneumoniae pneumonia were enrolled in this study. M. pneumoniae strains were collected for genotype analysis. Chest radiography was performed on all children prior to and following macrolide treatment. Clinical and imaging data were obtained. Results Of 211 patients, 195 (92.42%) harboured M. pneumoniae with the A2063G mutation. No significant differences were identified in inflammation score, chest radiography inflammation absorption grade before and after macrolide treatment, or pulmonary complications (atelectasis, hydrothorax, or pleuritis) prior to macrolide treatment when children were stratified based on the presence or absence of the A2063G mutation. Conclusions A high proportion of children with pneumonia harboured strains of M. pneumoniae with the A2063G mutation in the 23S rRNA domain V. However, no obvious chest radiographic features of M. pneumoniae pneumonia were associated with the A2063G variant.

Download Full-text

Mutations in domain V of Mycoplasma pneumoniae 23S rRNA are not associated with clinical characteristics of M. pneumoniae pneumonia in children: a case control study

10.21203/rs.2.23539/v1 ◽

2020 ◽

Author(s):

Huan Deng ◽

Yifan Zhu ◽

Jiamin Zhang ◽

Qiangquan Rong ◽

Yao Quan ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Lymphocyte Count ◽

Clinical Characteristics ◽

Clinical Symptoms ◽

Laboratory Data ◽

Point Mutations ◽

Community Acquired Pneumonia ◽

Pulmonary Complications ◽

23S Rrna ◽

Domain V

Abstract Background Mycoplasma pneumoniae (MP) is a common agent of community-acquired pneumonia in children and young adults that can lead to refractory or persistent Mycoplasma pneumoniae pneumonia (MPP). Macrolide-resistant MP harbors point mutations in domain V of 23S ribosomal Ribonucleic Acid (rRNA) with substitutions detected at positions 2063, 2064, 2067 and 2617. This study’s purpose is to investigate the prevalence and clinical characteristics of mutations in domain V of MP 23S rRNA. Methods We sequenced the 23S rRNA domain V of MP strains collected from children with MPP. Clinical and laboratory data were also obtained, including gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-Deoxyribonucleic Acid (DNA) load at enrollment, leukocyte count, neutrophil count, and lymphocyte count, immunomodulators treatment and pulmonary complications.Results Of 276 strains, 255 (92.39 %) harbored A to G transition at the position 2063 (A2063G), and 21 (7.61 %) were not mutated. There were no significant differences in gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-DNA load at enrollment, hospitalization days, lymphocyte count and pulmonary complications when patients were stratified based on the presence or absence of domain V mutations. We also found that children with refractory MPP experienced higher MP-DNA load than the non-refractory MPP, but the prevalence of domain V mutations was comparable.Conclusions We found that clinical MP strains harbored very high mutation rate in 23S rRNA domain V, especially A2063G mutation. However, these mutations were not associated with clinical symptoms, laboratory results, pulmonary complications and development of refractory pneumonia. Instead, MP-DNA load was significantly different between refractory and non-refractory MPP.

Download Full-text

Mutations in domain V of Mycoplasma pneumoniae 23S rRNA and clinical characteristics of pediatric M. pneumoniae pneumonia in Nanjing, China

Journal of International Medical Research ◽

10.1177/03000605211016376 ◽

2021 ◽

Vol 49 (6) ◽

pp. 030006052110163

Author(s):

Changdi Xu ◽

Huan Deng ◽

Jiamin Zhang ◽

Yifan Zhu ◽

Qiangquan Rong ◽

...

Keyword(s):

Hospital Stay ◽

Mycoplasma Pneumoniae ◽

Ribosomal Rna ◽

Clinical Characteristics ◽

Laboratory Data ◽

Pulmonary Complications ◽

23S Rrna ◽

High Prevalence ◽

Domain V ◽

23S Ribosomal Rna

Objective To investigate the prevalence of mutations in domain V of Mycoplasma pneumoniae (MP) 23S ribosomal RNA (rRNA) and the clinical characteristics of pediatric MP pneumonia (MPP) in Nanjing, China. Methods Domain V of 23S rRNA was sequenced in MP strains collected from children diagnosed with MPP in Nanjing. Clinical and laboratory data were obtained. Results Among the 276 MP strains, 255 (92.39%) harbored mutations, primarily A2063G in domain V of MP 23S rRNA. When children were stratified according to the presence or absence of mutations, no significant differences were found in sex, age, the MP DNA load at enrollment, lymphocyte counts, pulmonary complications, immunomodulator levels, fever duration, the duration of fever after macrolide therapy, and hospital stay. The prevalence of refractory MPP in the two groups was similar. Children with refractory MPP exhibited higher MP DNA loads than those with non-refractory MPP. Conclusions Despite the high prevalence of the A2063G mutation in domain V of MP 23S rRNA, mutations were not associated with the clinical characteristics of MPP. The MP DNA load significantly differed between refractory and non-refractory MPP.

Download Full-text

Mutations in domain V of Mycoplasma pneumoniae 23S rRNA are not associated with clinical characteristics of M. pneumoniae pneumonia in children: a case control study

10.21203/rs.2.23539/v2 ◽

2020 ◽

Author(s):

Huan Deng ◽

Yifan Zhu ◽

Jiamin Zhang ◽

Qiangquan Rong ◽

Yao Quan ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Lymphocyte Count ◽

Clinical Characteristics ◽

Clinical Symptoms ◽

Laboratory Data ◽

Point Mutations ◽

Community Acquired Pneumonia ◽

Pulmonary Complications ◽

23S Rrna ◽

Domain V

Abstract Background Mycoplasma pneumoniae (MP) is a common agent of community-acquired pneumonia in children and young adults that can lead to refractory or persistent Mycoplasma pneumoniae pneumonia (MPP). Macrolide-resistant MP harbors point mutations in domain V of 23S ribosomal Ribonucleic Acid (rRNA) with substitutions detected at positions 2063, 2064, 2067 and 2617. This study aims to investigate the prevalence and clinical characteristics of mutations in domain V of MP 23S rRNA. Methods We sequenced the 23S rRNA domain V of MP strains collected from children with MPP. Clinical and laboratory data were also obtained, including gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-Deoxyribonucleic Acid (DNA) load at enrollment, leukocyte count, neutrophil, and lymphocyte count, immunomodulators treatment and pulmonary complications. Results Of 276 strains, 255 (92.39 %) harbored A to G transition at the position 2063 (A2063G), and 21 (7.61 %) were not mutated. There were no significant differences in gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-DNA load at enrollment, hospitalization days, lymphocyte count and pulmonary complications when patients were stratified based on the presence or absence of domain V mutations. We also found that children with refractory MPP experienced higher MP-DNA load than the non-refractory MPP, but the prevalence of domain V mutations was no statistical difference. Conclusions We found that clinical MP strains harbored very high mutation rate in 23S rRNA domain V, especially A2063G mutation. However, these mutations were not associated with clinical symptoms, laboratory results, pulmonary complications and development of refractory MPP. Instead, MP-DNA load was significantly different between refractory and non-refractory MPP.

Download Full-text

Macrolide-Resistant and Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia in Children Treated Using Early Corticosteroids

Journal of Clinical Medicine ◽

10.3390/jcm10061309 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1309

Author(s):

Hye Young Han ◽

Ki Cheol Park ◽

Eun-Ae Yang ◽

Kyung-Yil Lee

Keyword(s):

Mycoplasma Pneumoniae ◽

Serological Test ◽

Corticosteroid Treatment ◽

23S Rrna ◽

Laboratory Parameters ◽

The Mean ◽

Domain V ◽

Positive Results ◽

Mycoplasma Pneumoniae Pneumonia

We have found that early corticosteroid therapy was effective for reducing morbidity during five Korea-wide epidemics. We evaluated the clinical and laboratory parameters of 56 children who received early corticosteroid treatment for pneumonia that was caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae) or macrolide-sensitive M. pneumoniae between July 2019 and February 2020. All subjects had dual positive results from a PCR assay and serological test, and received corticosteroids within 24–36 h after admission. Point mutation of residues 2063, 2064, and 2067 was identified in domain V of 23S rRNA. The mean age was 6.8 years and the male:female ratio was 1.2:1 (31:25 patients). Most of the subjects had macrolide-resistant M. pneumoniae (73%), and all mutated strains had the A2063G transition. No significant differences in clinical and laboratory parameters were observed between macrolide-resistant and macrolide-sensitive M. pneumoniae groups that were treated with early dose-adjusted corticosteroids. Higher-dose steroid treatment may be needed for patients who have fever that persists for >48 h or increased biomarkers such as lactate dehydrogenase concentration at follow-up despite a usual dose of steroid therapy.

Download Full-text

Radiographic Features of Lobar Agenesis of the Liver

Acta Radiologica ◽

10.1177/02841851960371p157 ◽

1996 ◽

Vol 37 (1P1) ◽

pp. 255-258 ◽

Cited By ~ 6

Author(s):

D. Makanjuola ◽

S. Al-Smayer ◽

I. Al-Orainy ◽

M. Al-Saleh

Keyword(s):

Chest Radiography ◽

Splenic Flexure ◽

Multidisciplinary Approach ◽

Hepatic Flexure ◽

Colonic Interposition ◽

Radiographic Findings ◽

Radiographic Features ◽

Chilaiditi’S Syndrome ◽

The Right ◽

Chilaiditi's Syndrome

Purpose: Our aim was to describe the radiographic features of lobar agenesis of the liver. Material and Methods: Six patients with lobar agenesis of the liver, 5 right- and one left-sided, are presented. CT was used to confirm diagnosis. Chest radiography, barium meals, and urograms were also analyzed. Results: In right-sided agenesis, the following were observed: a) hammock or U-shaped deformity of the stomach; b) colonic interposition of the diaphragm (Chilaiditi's syndrome); and c) reversal of the cranial orientation of the colonic hepatic flexure compared to the splenic flexure. The right kidney was higher in position than the left in both right- and left-sided lobar agenesis. Conclusion: Our radiographic findings can provide a multidisciplinary approach in the identification of this anatomic anomaly.

Download Full-text

Macrolide-Resistant Mycoplasma pneumoniae in the United States as Determined from a National Surveillance Program

Journal of Clinical Microbiology ◽

10.1128/jcm.00968-19 ◽

2019 ◽

Vol 57 (11) ◽

Cited By ~ 9

Author(s):

K. B. Waites ◽

A. Ratliff ◽

D. M. Crabb ◽

L. Xiao ◽

X. Qin ◽

...

Keyword(s):

United States ◽

Clinical Significance ◽

Mycoplasma Pneumoniae ◽

The United States ◽

Antimicrobial Treatment ◽

23S Rrna ◽

Surveillance Program ◽

National Surveillance ◽

Radiographic Findings ◽

Content Type

ABSTRACT There are sparse data to indicate the extent that macrolide-resistant Mycoplasma pneumoniae (MRMp) occurs in the United States or its clinical significance. Between 2015 and 2018, hospitals in 8 states collected and stored respiratory specimens that tested positive for M. pneumoniae and sent them to the University of Alabama at Birmingham, where real-time PCR was performed for detection of 23S rRNA mutations known to confer macrolide resistance. MRMp was detected in 27 of 360 specimens (7.5%). MRMp prevalence was significantly higher in the South and East (18.3%) than in the West (2.1%). A2063G was the predominant 23S rRNA mutation detected. MICs for macrolide-susceptible M. pneumoniae (MSMp) were ≤0.008 μg/ml, whereas MICs for MRMp were 16 to 32 μg/ml. Patients with MRMp infection were more likely to have a history of immunodeficiency or malignancy. Otherwise, there were no other significant differences in the clinical features between patients infected with MRMp and those infected with MSMp, nor were there any differences in radiographic findings, hospitalization rates, viral coinfections, the mean duration of antimicrobial treatment, or clinical outcomes. There was no significant change in MRMp incidence over time or according to age, sex, race/ethnicity, or status as an inpatient or an outpatient. Patients with MRMp were more likely to have received a macrolide prior to presentation, and their treatment was more likely to have been changed to a fluoroquinolone after presentation. This is the first national surveillance program for M. pneumoniae in the United States. Additional surveillance is needed to assess the clinical significance of MRMp and to monitor changes in MRMp prevalence.

Download Full-text

Emergence of Macrolide-Resistant Mycoplasma pneumoniae with a 23S rRNA Gene Mutation

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.49.6.2302-2306.2005 ◽

2005 ◽

Vol 49 (6) ◽

pp. 2302-2306 ◽

Cited By ~ 90

Author(s):

Miyuki Morozumi ◽

Keiko Hasegawa ◽

Reiko Kobayashi ◽

Nagako Inoue ◽

Satoshi Iwata ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Acute Bronchitis ◽

23S Rrna ◽

Rrna Gene ◽

Microdilution Method ◽

23S Rrna Gene ◽

Pediatric Outpatients ◽

Tract Infections ◽

Domain V ◽

Epidemiol Infect

ABSTRACT A total of 195 Mycoplasma pneumoniae strains were isolated from 2,462 clinical specimens collected between April 2002 and March 2004 from pediatric outpatients with respiratory tract infections. Susceptibilities to six macrolide antibiotics (ML), telithromycin, minocycline, levofloxacin, and sitafloxacin were determined by the microdilution method using PPLO broth. A total of 183 M. pneumoniae isolates were susceptible to all agents and had excellent MIC90s in the following order: 0.00195 μg/ml for azithromycin and telithromycin, 0.0078 μg/ml for clarithromycin, 0.0156 μg/ml for erythromycin, 0.0625 μg/ml for sitafloxacin, 0.5 μg/ml for minocycline, and 1 μg/ml for levofloxacin. Notably, 12 ML-resistant M. pneumoniae strains were isolated from patients with pneumonia (10 strains) or acute bronchitis (2 strains). These strains showed resistance to ML with MICs of ≥1 μg/ml, except to rokitamycin. Transition mutations of A2063G or A2064G, which correspond to A2058 and A2059 in Escherichia coli, in domain V on the 23S rRNA gene in 11 ML-resistant strains were identified. By pulsed-field gel electrophoresis typing, these strains were classified into groups I and Vb, as described previously (A. Cousin-Allery, A. Charron, B. D. Barbeyrac, G. Fremy, J. S. Jensen, H. Renaudin, and C. Bebear, Epidemiol. Infect. 124:103-111, 2000). These findings suggest that excessive usage of MLs acts as a trigger to select mutations on the corresponding 23S rRNA gene with the resultant occurrence of ML-resistant M. pneumoniae. Monitoring ML susceptibilities for M. pneumoniae is necessary in the future.

Download Full-text

Therapeutic Efficacy of Macrolides, Minocycline, and Tosufloxacin against Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Pediatric Patients

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00048-13 ◽

2013 ◽

Vol 57 (5) ◽

pp. 2252-2258 ◽

Cited By ~ 50

Author(s):

Yasuhiro Kawai ◽

Naoyuki Miyashita ◽

Mika Kubo ◽

Hiroto Akaike ◽

Atsushi Kato ◽

...

Keyword(s):

Antibiotic Therapy ◽

Mycoplasma Pneumoniae ◽

Pediatric Patients ◽

Definitive Treatment ◽

23S Rrna ◽

Content Type ◽

The Past ◽

First Choice ◽

Domain V ◽

Mycoplasma Pneumoniae Pneumonia

ABSTRACTThe importance of macrolide-resistant (MR)Mycoplasma pneumoniaehas become much more apparent in the past decade. We investigated differences in the therapeutic efficacies of macrolides, minocycline, and tosufloxacin against MRM. pneumoniae. A total of 188 children withM. pneumoniaepneumonia confirmed by culture and PCR were analyzed. Of these, 150 patients had a strain with an MR gene and 134 had one with an A-to-G mutation at position 2063 ofM. pneumoniae23S rRNA domain V. Azithromycin (n= 27), clarithromycin (n= 23), tosufloxacin (n= 62), or minocycline (n= 38) was used for definitive treatment of patients with MRM. pneumoniae. Defervescence within 48 h after the initiation of antibiotic therapy was observed in 41% of the patients in the azithromycin group, 48% of those in the clarithromycin group, 69% of those in the tosufloxacin group, and 87% of those in the minocycline group. The average number of days of fever after the administration of antibiotic treatment was lower in the minocycline and tosufloxacin groups than in the macrolide groups. The decrease in theM. pneumoniaeburden, as estimated by the number of DNA copies, after 48 to 96 h of treatment was more rapid in patients receiving minocycline (P= 0.016) than in those receiving tosufloxacin (P= 0.049), azithromycin (P= 0.273), or clarithromycin (P= 0.107). We found that the clinical and bacteriological efficacies of macrolides against MRM. pneumoniaepneumonia was low. Our results indicated that minocycline rather than tosufloxacin can be considered the first-choice drug for the treatment ofM. pneumoniaepneumonia in children aged ≥8 years.

Download Full-text

Point-of-care molecular diagnosis of Mycoplasma pneumoniae including macrolide sensitivity using quenching probe polymerase chain reaction

PLoS ONE ◽

10.1371/journal.pone.0258694 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258694

Author(s):

Nobuhisa Ishiguro ◽

Rikako Sato ◽

Toshihiko Mori ◽

Hiroshi Tanaka ◽

Mitsuo Narita ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Point Mutation ◽

Mycoplasma Pneumoniae ◽

Point Of Care ◽

23S Rrna ◽

Rrna Gene ◽

Chain Reaction ◽

23S Rrna Gene ◽

Polymerase Chain ◽

Domain V

Objectives Macrolides are generally considered to be the drugs of choice for treatment of patients with Mycoplasma pneumoniae infection. However, macrolide-resistant M. pneumoniae has been emerging since about 2000. The Smart Gene® system (MIZUHO MEDY Co., Ltd., Tosu, Japan) is a novel fully automated system for detection of pathogens using the method of quantitative polymerase chain reaction (qPCR) with QProbe (QProbe PCR). The entire procedure is completed within 50 min and the size of the instrument is small (15 x 34 x 30 cm). The purpose of this study was to evaluate the usefulness of the Smart Gene® system for detection of M. pneumoniae and detection of a point mutation at domain V of the 23S rRNA gene of M. pneumoniae. Materials Pharyngeal swab samples were collected from 154 patients who were suspected of having respiratory tract infections associated with M. pneumoniae. Results Compared with the results of qPCR, the sensitivity and specificity of the Smart Gene® system were 98.7% (78/79) and 100.0% (75/75), respectively. A point mutation at domain V of the 23S rRNA gene was detected from 7 (9.0%) of 78 M. pneumoniae-positive samples by the Smart Gene® system and these results were confirmed by direct sequencing. The minimum inhibitory concentrations of clarithromycin among the 5 isolates of M. pneumoniae with a point mutation at domain V of the 23S rRNA gene were >64 μg/ml and those among the 33 isolates without a mutation in the 23S rRNA gene were <0.0625 μg/ml. Conclusion The Smart Gene® system is a rapid and accurate assay for detection of the existence of M. pneumoniae and a point mutation at domain V of the 23S rRNA gene of M. pneumoniae at the same time. The Smart Gene® system is suitable for point-of-care testing in both hospital and outpatient settings.

Download Full-text

Pneumonia Characteristics of Hospitalized Children Infected with Macrolide-Resistant Mycoplasma Pneumoniae

10.21203/rs.3.rs-675299/v1 ◽

2021 ◽

Author(s):

feifei cui ◽

Xiu-jun Tian ◽

De-li Xin ◽

Xiao-hua Han ◽

Liang-yu Wang ◽

...

Keyword(s):

Drug Resistance ◽

Mycoplasma Pneumoniae ◽

Acute Phase ◽

Leukocyte Count ◽

Pulmonary Complications ◽

23S Rrna ◽

Hospitalized Children ◽

Drug Resistant ◽

Extra Pulmonary ◽

D Dimer

Abstract Background: To investigate the drug resistance and clinical characteristics of hospitalized children with drug-resistant Mycoplasma pneumoniae pneumonia (MRMP).Methods: Sixty patients with MPP admitted to the Second Pediatric Respiratory Ward of Shengjing Hospital, Affiliated to China Medical University from November 2016 to February 2017 were enrolled in the study.Results: Of these 53/60 (88.3%) patients had Mycoplasma pneumoniae nucleic acid identified by throat swab. 23S rRNA V region gene sequencing was performed, 47/49 (95.9%) had mutation sites, including 46 cases of A2063G, one case of A2064G, two cases of no mutation, and a final drug resistance rate of 95.9%. The summary characteristics of the 47 cases of drug-resistant MPP were based on 22 male and 25 female patients. The onset age was 6.9 ± 2.5 years and the total fever duration was 9.8 ± 3.7 days. The leukocyte count during the acute phase was (8,300 ± 4,200) cells/mm3, C-reactive Protein (CRP) was 18.2 (8.2–32.5) mg/L, neutrophil/lymphocyte ratio (NLR) was 2.1 (1.5–3.3), There was no significant difference between the acute phase and the convalescent phase for leukocyte count, P = 0.336. The NLR and CRP levels were significantly higher during the acute phase compared to the recovery period (P < 0.05). The level of lactate dehydrogenase (LDH) increased in 65.7% of patients, with a median of 248.5 (200.0–299.7) U/L. D-dimer levels were elevated in 59.4% of patients, with a median of 301.0 (188.5–545.0) mg/L. A total of 23/47 (48.9%) patients were diagnosed with severe MPP. The incidence of extra-pulmonary complications was 38.2%. Conclusions: In summary, MRMP patients had a fever of long duration, higher inflammatory index, higher LDH and D-dimer levels, and an increased incidence of extra-pulmonary complications.

Download Full-text