High co-expression of TNF-α and CARDS toxin is a good predictor for refractory Mycoplasma pneumoniae pneumonia

Abstract Objective: To evaluate the discriminative ability of laboratory abnormalities between general mycoplasma pneumoniae pneumonia (GMPP) and refractory MPP (RMPP) in children. Methods: An electronic search in PubMed, Web of Science, Embase, and Cochrane Library was performed to identify studies reporting on laboratory abnormalities in children with GMPP and RMPP. Data were independently extracted by two reviewers. Meta-analyses within the random-effects model were used to synthesize data. Effect sizes were calculated as standardized mean differences (SMD) or weighted mean difference (WMD). The Newcastle-Ottawa Scale (NOS) was used to assess the methodologic quality of included studies. Results: Twenty-one articles (3,877 patients) comparing laboratory findings between patients with GMPP and RMPP were eligible for this meta-analysis. Patients with RMPP had significantly increased neutrophils, CD8+ lymphocytes, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), D-dimer, total IgA, total IgM, as well as decreased lymphocytes, hemoglobin, and albumin. Multiple inflammatory biomarkers (C-reactive protein [CRP], procalcitonin [PCT], erythrocyte sedimentation rate [ESR], ferritin, interleukin [IL]-6, IL-10, IL-17, IL-18, interferon-γ [IFN-γ], and tumor necrosis factor-α [TNF-α]) were also markedly elevated in RMPP patients. Conclusions: Elevated levels of CD8+ lymphocytes, LDH, AST, D-dimer, total IgA, total IgM, inflammatory biomarkers (CRP, PCT, ESR, ferritin, IL-6, IL-10, IL-17, IL-18, IFN-γ, and TNF-α), and lower lymphocytes, hemoglobin, and albumin are associated with RMPP and thus may be used as early identification or even prediction of RMPP in children. Keywords: Child; Refractory Mycoplasma pneumoniae pneumonia; clinical chemistry; meta-analysis

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Mycoplasma pneumoniae pneumonia. Massive pulmonary involvement and pleural effusion

JAMA ◽

10.1001/jama.194.9.1010 ◽

1965 ◽

Vol 194 (9) ◽

pp. 1010-1011 ◽

Cited By ~ 1

Author(s):

H. G. Decancq

Keyword(s):

Pleural Effusion ◽

Mycoplasma Pneumoniae ◽

Pulmonary Involvement ◽

Mycoplasma Pneumoniae Pneumonia

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A Diagnostic Dilemma: PCR or Serology to Detect Mycoplasma Pneumoniae Pneumonia in Children

10.1542/peds.140.1_meetingabstract.39 ◽

2017 ◽

Author(s):

Cristina E. Figallo ◽

Liz Bayes ◽

Mariana Lanata ◽

Veronica Etinger

Keyword(s):

Mycoplasma Pneumoniae ◽

Diagnostic Dilemma ◽

Mycoplasma Pneumoniae Pneumonia

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Clinical, radiographic and hematological characteristics of Mycoplasma pneumoniae pneumonia

Jornal de Pediatria ◽

10.2223/jped.2044 ◽

2010 ◽

Vol 0 (0) ◽

Cited By ~ 1

Author(s):

Letícia Alves Vervloet ◽

Paulo Augusto Moreira Camargos ◽

Damião Ranulfo Fernandes Soares ◽

Gabriel Antônio de Oliveira ◽

Janúncio Nunes de Oliveira

Keyword(s):

Mycoplasma Pneumoniae ◽

Mycoplasma Pneumoniae Pneumonia

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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.

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Clinical characteristics of refractory mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy

BMC Infectious Diseases ◽

10.1186/s12879-021-05830-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhenli Zhu ◽

Tongqiang Zhang ◽

Wei Guo ◽

Yaoyao Ling ◽

Jiao Tian ◽

...

Keyword(s):

Clinical Features ◽

Mycoplasma Pneumoniae ◽

Pulse Therapy ◽

Roc Curve Analysis ◽

Related Factors ◽

Laboratory Findings ◽

Usage Rate ◽

Group I ◽

Group Ii ◽

Mycoplasma Pneumoniae Pneumonia

Abstract Background To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia (RMPP) under different doses, to summarize the clinical features of children treated with glucocorticoid pulse therapy. Methods The clinical data of 125 children with RMPP hospitalized in Tianjin Children’s Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Compare the clinical features, laboratory findings, and imaging between the two groups, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy. Results (1) The median age of the group II was older than that of the group I(P < 0.05). (2) We found more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings in group II, which needed oxygen more often, higher the hormone, higher usage rate of gamma globulin, higher usage rate of bronchoscopy, and higher incidence of plastic bronchitis(P < 0.05). (3) WBC, CRP, LDH, FER, D-D dimer, APTT, TT, PCT, IL-6 and the percentage of neutrophils in peripheral blood in Group II were higher than those in Group I(P < 0.05). (4) In ROC curve analysis, CRP, LDH, FER, and neutrophils of leukocyte classification were independent related factors that could be used as valuable predictors of methylprednisolone pulse therapy for RMPP in children. The cut-off values were CRP44.45 mg/L, LDH590IU/L, FER411ng/L, and neutrophils in leukocyte classification were 73.75%, respectively. Conclusion CRP ≥ 44.45 mg/L, LDH ≥ 590 IU/L, FER ≥ 411 ng/L, neutrophil≥73.75%, lung consolidation, and pleural effusion may be predictors that guide the treatment of RMPP with pulse dose of GC.

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Microbiologic and Immunologic Evaluation of a Single High Dose of Azithromycin for Treatment of Experimental Mycoplasma pneumoniae Pneumonia

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.49.9.3970-3973.2005 ◽

2005 ◽

Vol 49 (9) ◽

pp. 3970-3973 ◽

Cited By ~ 15

Author(s):

Ana María Ríos ◽

Mónica Fonseca-Aten ◽

Asunción Mejías ◽

Susana Chávez-Bueno ◽

Kathy Katz ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

High Dose ◽

Single High Dose ◽

Cytokines And Chemokines ◽

Lung Histopathology ◽

Mycoplasma Pneumoniae Pneumonia

ABSTRACT We evaluated the efficacy of azithromycin therapy given as a single high dose or divided over 5 days for the treatment of mild experimental Mycoplasma pneumoniae pneumonia. Although both azithromycin regimens significantly reduced quantitative cultures, lung histopathology, and pulmonary cytokines and chemokines, there were no significant differences between the two regimens.

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