Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractor...Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases.Complications may occur,such as necrotizing pneumonia and respiratory failure.Extrapulmonary complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also arise.In this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with M.pneumoniae pneumonia and their predictive value for mycoplasma severity"published by Wang et al.They reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory M.pneumoniae pneumonia cases.展开更多
Background: Mycoplasma pneumoniae (MP) is the primary causative agent of community-acquired pneumonia, which has increasingly become resistant to macrolides, complicating treatment regimens, especially with the co-inf...Background: Mycoplasma pneumoniae (MP) is the primary causative agent of community-acquired pneumonia, which has increasingly become resistant to macrolides, complicating treatment regimens, especially with the co-infection factor. Its worldwide prevalence has fluctuated due to the influence of the COVID-19 pandemic. The study investigated co-infection patterns in children diagnosed with Mycoplasma pneumoniae pneumonia (MPP). Methods: From June 2022 to December 2023, we retrospectively analyzed the clinical data for hospitalized children with Mycoplasma pneumoniae pneumonia in Wuhan, China. We collected data on age, sex, clinical information, and pathogenic results. We also collected sputum or bronchoalveolar lavage fluid (BALF) samples to test respiratory pathogens and macrolide resistance using targeted microbial next-generation sequencing (tNGS). We analyzed the data using SPSS. Results: The study involved 417 patients diagnosed with MPP, of whom 86.33% had co-infections. Co-infections were notably linked to lobar pneumonia, prominent imaging shadows and higher macrolide resistance rate. Key bacterial pathogens were Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, rhinoviruses, and human adenoviruses (HADV). In MPP cases, Candida albicans was the fungal pathogen related to co-infections. The co-infection with HADV and human bocavirus 1 (HBoV1) correlated with prolonged fever, whereas Bordetella pertussis was linked to prolonged cough. In contrast, Candida albicans exhibited a weaker association with diffuse large-area infiltration on chest imaging, and its co-infection was less likely to result in severe disease. Conclusion: These results offer valuable insight into Mycoplasma pneumoniae pneumonia in children, highlighting the impact of co-infections on the disease’s clinical outcomes.展开更多
Multidrug-resistant Klebsiella pneumoniae(MDR-KP)is characterized by high mortality and risk of nosocomial transmission,and biofilm constitutes the primary challenge in the treatment of its implant-associated and refr...Multidrug-resistant Klebsiella pneumoniae(MDR-KP)is characterized by high mortality and risk of nosocomial transmission,and biofilm constitutes the primary challenge in the treatment of its implant-associated and refractory pulmonary infections.Notably,the hypoxic microenvironment and the physical barrier of biofilm leading to the increased tolerance of the bacteria to antibiotics.Herein,a hypoxia-responsive hybrid nanoparticle(CHLip@FLD/COL)loaded separately with anti-biofilm candidate fingolimod(FLD)and antibiotic colistin(COL)is achieved targeting antibacterial efficacy against MDR-KP in vitro and in vivo.CHLip@FLD/COL is composed of hybridizing hypoxia-responsive lipids(HLipid)and lipid A targeting materials DSPE-mPEG-COL.HLipid is synthesized by hexadecanedioic acid esterified with nitroimidazole,while DSPE-mPEG is coupling with vector COL via amide reaction.The relative level of extracellular polymeric substances and the NIR-IIb sO2 images of the infection site are used as indicators to establish mature biofilm models.CHLip@FLD/COL readily releases FLD and COL in hypoxic conditions,and its MIC against MDR-KP is only one-sixteenth of that when COL is used alone in vitro.The nanoparticle exhibits bacterial targeting ability and antibacterial effect in the pulmonary infection and biofilm infection mice models.Bacterial loads eliminated by 4 Log10 CFU and 2 Log10 CFU,respectively.The strategy provides a valuable reference for the treatment of refractory infections caused by MDR-KP.展开更多
Background:Bacterial pneumonia remains a leading cause of morbidity and mortality worldwide despite the widespread availability of antibiotics.Novel pneumonia therapies and biomarkers are urgently needed to improve ou...Background:Bacterial pneumonia remains a leading cause of morbidity and mortality worldwide despite the widespread availability of antibiotics.Novel pneumonia therapies and biomarkers are urgently needed to improve outcomes and advance personalized therapy.Using an established baboon model of S.pneumoniae pneumonia,we sought to characterize the temporal dynamics of pneumonia host responses to identify novel potential diagnostic and therapeutic molecular targets.Methods:We performed whole blood transcriptomics,unbiased proteomics,and peripheral cytokine measurements serially in baboons inoculated with S.pneumoniae(n=23)or saline(n=10)and modeled the peripheral blood host response using principal components analysis and complex sparse logistic regression.Differentially expressed genes were analyzed for pathway analysis.Results:Inoculated animals developed characteristic signs and symptoms of pneumonia.A 39-gene signature was derived that classified S.pneumoniae infection with high accuracy(auROC 0.9 and 0.99 at 24 and 48 h post-inoculation,respectively).Similar performance was observed for 48-h biomarker signatures derived from peripheral blood plasma proteomic and cytokine measurements(both auROC>0.9).The gene signature retained strong diagnostic performance(auROC=0.88)when transformed to human orthologs and applied to patients with acute respiratory illness(n=34)or healthy controls(n=20).Pathway analysis at 48 h identified downregulation of mitophagy and glucocorticoid signaling in peripheral blood.Conclusions:We report novel peripheral blood gene and protein expression signatures of S.pneumoniae pneumonia that could improve pneumonia diagnosis and found distinct pathways that may be amenable to modulation.Our findings illustrate how non-human primate models of bacterial pneumonia can successfully translate biomarker discoveries to patients.展开更多
Introduction: The misuse of antibiotics has driven the emergence of antimicrobial resistance, with certain bacterial species, including Klebsiella pneumoniae, initially susceptible to most antibiotics, now exhibiting ...Introduction: The misuse of antibiotics has driven the emergence of antimicrobial resistance, with certain bacterial species, including Klebsiella pneumoniae, initially susceptible to most antibiotics, now exhibiting resistance to multiple antimicrobial agents. The objective of this study was to investigate the distribution and antimicrobial resistance profiles of Klebsiella pneumoniae strains isolated at the Yaoundé Central Hospital. Methodology: The study was conducted over a period of 4 months (March 1st, 2023-July 1st, 2023) and involved 32 strains isolated from bacterial cultures performed on patients, regardless of sex. The different Klebsiella pneumoniae strains were isolated using conventional methods. Identification, antibiogram, and detection of resistance enzyme production were generated using the VITEK 2 system. The Carbapenem-resistant K.N.I.V.O. kit was used to detect carbapenemases. Data analysis was performed using EXCEL 2019 software. Results: Out of 196 samples collected from various biological products, 32 Klebsiella pneumoniae strains were isolated, representing 16.32% (196/32). Urine samples were most frequently affected, accounting for 53.125%. The emergency department was the most represented (40.63%) by these isolates. The mean age was 50 years, with a minimum of 20 years and a maximum of 80 years. The sex ratio was equal to 1. The identified strains were resistant to cefotaxime (78.13%), cefoxitin (62.50%), tobramycin (71.88%), gentamicin (56.25%), ofloxacin (81.25%), and cotrimoxazole (78.13%). 78.25% were ESBL producers. Three strains were resistant to carbapenems, accounting for 9.37%;one of which exhibited the NDM type. Conclusion: This study highlights the evolving bacterial resistance to antibiotics, which requires adequate measures through the strengthening of the Antimicrobial Resistance (AMR) program in Cameroon.展开更多
This article discusses the findings presented by Zhang et al.They analyzed the risk factors and clinical characteristics associated with Klebsiella pneumoniae infection in patients with liver cirrhosis treated at a ho...This article discusses the findings presented by Zhang et al.They analyzed the risk factors and clinical characteristics associated with Klebsiella pneumoniae infection in patients with liver cirrhosis treated at a hospital in Beijing.In this article,we focus on the connection between chronic kidney disease and the intestinal microbiota,and propose microbiota transplantation as a potential treatment for this patient group.We also examine an intriguing phenomenon related to hepatic encephalopathy,and provide insights into the future research.展开更多
Klebsiella pneumoniae infections(KPIs),particularly carbapenem-resistant Klebsiella pneumoniae(CRKP),pose significant challenges in liver transplantation(LT)recipients,with high morbidity and mortality.Guo et al’s st...Klebsiella pneumoniae infections(KPIs),particularly carbapenem-resistant Klebsiella pneumoniae(CRKP),pose significant challenges in liver transplantation(LT)recipients,with high morbidity and mortality.Guo et al’s study highlights risk factors,such as elevated day-one alanine aminotransferase levels and prolonged catheterization,and identifies polymyxin B and ceftazidime/avibactam as effective treatments.However,limitations like the absence of pre-transplant colonization data and host-pathogen interaction insights highlight the need for enhanced strategies.Future directions should include routine CRKP colonization surveillance,immune and genomic profiling,and the development of novel therapeutics.By integrating these approaches,we can improve the prevention,diagnosis,and treatment of KPIs in LT patients.展开更多
Background Ferroptosis is characterized by increased production of reactive oxygen species(ROS)and membrane lipid peroxidation that can exacerbate inflammatory damage.Extracellular vesicles(EVs)isolated from bovine mi...Background Ferroptosis is characterized by increased production of reactive oxygen species(ROS)and membrane lipid peroxidation that can exacerbate inflammatory damage.Extracellular vesicles(EVs)isolated from bovine milk have many biological functions,including antioxidant properties.However,the role of EVs on Klebsiella pneumoniaeinduced ferroptosis and oxidative stress in bovine mammary epithelial cells(bMECs)and murine mammary tissue is unclear.In this study,EVs were isolated from bovine colostrum,mature milk and clinical mastitis milk(defined as C-EVs,M-EVs and CM-EVs,respectively)and assessed by transmission electron microscopy,Western blot and transcriptome sequencing.Effects of EVs on K.pneumoniae-induced ferroptosis and oxidative stress in bMECs were evaluated with immunofluorescence and Western blot.Results In bMECs,infection with K.pneumoniae induced oxidative stress,decreasing protein expression of Nrf2,Keap1 and HO-1 plus SOD activity,and increasing ROS concentrations.However,protein expression of GPX4,ACSL4 and S100A4 in bMECs,all factors that regulate ferroptosis,was downregulated by K.pneumoniae.Furthermore,this bacterium compromised tight junctions in murine mammary tissue,with low expression of ZO-1 and Occludin,whereas protein expression of Nrf2 and GPX4 was also decreased in mammary tissue.Adding C-EVs,M-EVs or CMEVs reduced oxidative stress and ferroptosis in K.pneumoniae-infected bMECs in vitro and murine mammary tissues in vivo.Conclusion In conclusion,all 3 sources of milk-derived EVs alleviated oxidative stress and ferroptosis in K.pneumoniae-infected bMECs and mammary tissues.展开更多
The escalation in the incidence of multidrug-resistant Gram-negative bacteria is becoming a pressing global concern.Polymyxin B(PMB),a conventional antibiotic with notable therapeutic efficacy against Gram-negative ba...The escalation in the incidence of multidrug-resistant Gram-negative bacteria is becoming a pressing global concern.Polymyxin B(PMB),a conventional antibiotic with notable therapeutic efficacy against Gram-negative bacterial infections,serves as a crucial final recourse against carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Nevertheless,the clinical usage of PMB is impeded by its pronounced nephrotoxicity and poor infection site targeting.This investigation is geared to construct a nanoparticle formulation(named HA-PMB@H)comprising hyaluronic acid(HA)and PMB via a simple Schiff base reaction and further coating HA by electrostatic action.HA-PMB@H shows an average size of(153.8±24.3)nm,and a mean zeta potential of(−25.6±5.2)mV.Additionally,PMB can be released from HA-PMB@H more thoroughly and efficiently at pH 5.5 compared to pH 7.4,which demonstrates the Schiff base modification of PMB paves the way for its release at focus of infection.The uptake ratio of HA-PMB@H by alveolar epithelial cells(RLE-6TN)surpassed that of free PMB devoid of HA,which facilitates to the intracellular sterilization of PMB.Furthermore,the employment of HA-PMB@H ameliorated the toxicity of PMB towards human embryonic kidney cells(HEK 293)and pulmonary microvascular endothelial cells(HULEC-5a).What is more,HA-PMB@H effectively managed severe pneumonia induced by CRKP samples from clinical patients diagnosed with CRKP infection in vivo,substantially enhancing the survival rate of mice.Consequently,this nano-delivery system holds promising clinical significance in the combat against drug-resistant bacterial infections.展开更多
Dear Editor,Central retinal artery occlusion(CRAO)is a devastating ocular event caused by obstruction of the central retinal artery,leading to a sudden and significant loss of vision.A hallmark of CRAO on funduscopic ...Dear Editor,Central retinal artery occlusion(CRAO)is a devastating ocular event caused by obstruction of the central retinal artery,leading to a sudden and significant loss of vision.A hallmark of CRAO on funduscopic examination is a characteristic“cherry-red spot”at the fovea surrounded by a pale retina[1].The anterior segment typically appears unremarkable.展开更多
AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vi...AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.展开更多
BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has...BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has emerged as a crucial global health concern due to high mortality rate in children under 5 years,potentially life-threatening complications,and growing challenges in pediatric treatment associated with rising macrolide resistance.Additionally,MPP can be complicated by other bacterial and/or viral pathogens,which may exacerbate disease severity.After the lifting of strict non-pharmaceutical interventions(NPIs)worldwide,the dramatic rise of incidence of MPP in Asia and Europe was observed.AIM To perform the comprehensive study of community acquired MPP cases registered in 2023 in Baoding Hospital,China.METHODS A total of 1160 children from 1 month to 15 years old with confirmed MPP diagnosis were enrolled in the study.The blood and respiratory samples were collected within the 24 hours after admission.The hematological parameters,biochemical markers,cytokine profiles were assessed.The respiratory samples were tested for the presence of M.pneumoniae and other 23 bacterial/viral pathogens by multiplex polymerase chain reaction(PCR).The macrolide resistance mutations(A2063G,A2064G in the 23S rRNA gene of M.pneumoniae)were determined by PCR.RESULTS Number of MPP cases has dramatically increased starting August with peak in November.SMPP and general MPP(GMPP)were identified in 264 and 896 of 1160 hospitalized children.The binary logistic regression analysis identified six[C-reactive protein(CRP),lactate dehydrogenase,procalcitonin,erythrocyte sedimentation rate,fibrin and fibrinogen degradation products(FDPs),D-dimer]and four(neutrophils,CRP,FDPs,prothrombin time)predictors of SMPP in age groups 2-5 years and 6-15 years,respectively.Children with SMPP showed significantly higher levels of cytokine interleukin(IL)-17F(2-5 years),and cytokines interferon-gamma,tumor necrosis factoralpha,IL-10(6-13 years).Concomitant viral/bacterial pathogens were determined in 24.3%and 28.0%cases of SMPP and GMPP.Among them,Streptococcus pneumoniae(S.pneumoniae)and Haemophilus influenzae(H.influenzae)were predominant.93.2%cases of MPP were associated with macrolide resistant M.pneumoniae.CONCLUSION Specific MPP epidemiological pattern associated with lifting NPIs was revealed:Increase of hospitalized cases,prevalence of S.pneumoniae and H.influenzae among concomitant pathogens,93.2%of macrolide resistant M.pneumonia.展开更多
Tigecycline is one of the most critical drugs for treating Gram-negative bacterial infections;however,the emergence of the tigecycline resistance efflux pump TMexCD1-TOprJ1 poses a global health threat.The evolutionar...Tigecycline is one of the most critical drugs for treating Gram-negative bacterial infections;however,the emergence of the tigecycline resistance efflux pump TMexCD1-TOprJ1 poses a global health threat.The evolutionary relationships and epidemiological trends of tmexCD1-toprJ1-positive strains across various ecological niches remain largely unexplored.In this study,we employed whole-genome sequencing(WGS)of tmexCD1-toprJ1-positive bacteria from humans,food,animals,and the environment in China to assess the epidemiological and genomic features of these strains,analyzing both newly collected strains and data from the GenBank database.From 3434 samples collected during 2019-2022,145tmexCD1-toprJ1-carrying strains(4.5%)were isolated.The majority of the tmexCD1-toprJ1-positive Enterobacterales exhibited resistance to nearly all antimicrobials,including colistin(42.13%).tmexCD1-toprJ1 was predominantly identified in Klebsiella pneumoniae(K.pneumoniae)from chicken feces in China but was also detected in multiple ecological niches and other countries.Phylogenetic analysis revealed the clonal transmission of tmexCD1-toprJ1-positive ST37 K.pneumoniae across diverse ecological niches as well as the international spread of the ST15 K.pneumoniae clone-producing TMexCD1-TOprJ1.tmexCD1-toprJ1 is mainly carried by Klebsiella spp.specific narrow host range plasmids,which may limit the spread of tmexCD1-toprJ1 across different bacterial species.Notably,due to the fitness cost posed by tmexCD1-toprJ1,the occurrence of tmexCD1-toprJ1-positive Enterobacterales in both food animals and humans in China has declined significantly following the withdrawal of antibiotics as growth promoters in food animals in China since 2020.However,tmexCD1-toprJ1 has been captured by broad-host-range plasmids and hypervirulent carbapenem-resistant K.pneumoniae ST11-KL64 strains in healthcare settings.The frequent use of tetracyclines in chicken farming likely contributes to the high detection rate of tmexCD1-toprJ1;therefore,to reduce the threat of tmexCD1-toprJ1-positive K.pneumoniae,continuous monitoring of tmexCD1-toprJ1 across different ecological niches and strict enforcement of antimicrobial policies in animal husbandry,particularly in the poultry industry,are urgently required.展开更多
Objective:To study the risk prediction model for multiple bronchoalveolar lavage in children with mycoplasma pneumoniae pneumonia(MPP).Methods:151 pediatric patients with MPP admitted in our hospital from July to Dece...Objective:To study the risk prediction model for multiple bronchoalveolar lavage in children with mycoplasma pneumoniae pneumonia(MPP).Methods:151 pediatric patients with MPP admitted in our hospital from July to December 2023 were selected,the incidence rate of multiple bronchoalveolar lavage was recorded.A logistic multivariate regression model was employed to analyze relevant factors and construct a risk prediction model for multiple bronchoalveolar lavage in children with MPP.Results:Among 151 children with MPP,64 cases underwent multiple bronchoalveolar lavage,accounting for 42.38%.The Logistic multivariate model analysis revealed that the pleural effusion,sepsis,and abnormally elevated serum levels of LDH and D-D were independent influence factors for multiple bronchoalveolar lavage in children with MPP(p<0.05),based on this,a Nomogram prediction model can be established.The ROC analysis results showed that the AUC of the model to judge the multiple bronchoalveolar lavage in MPP patients was 0.828(SE=0.035,95%CI=0.760-0.896,p<0.001),the sensitivity was 0.813 and the specificity was 0.759.Conclusion:The multiple bronchoscopic bronchoalveolar lavage in MPP patients are associated with the levels of LDH and D-D,as well as the presence of pleural effusion and sepsis complications,the risk prediction model established,which based on this has high accuracy.展开更多
Objective:To analyse the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)in children under two years of age.Methods:A retrospective analysis was conducted on 112 paediatric cases of MPP admitted to our...Objective:To analyse the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)in children under two years of age.Methods:A retrospective analysis was conducted on 112 paediatric cases of MPP admitted to our hospital between January 2022 and December 2023.Clinical data including symptoms,signs,imaging findings,and prognosis were collected.Results:Analysis of clinical symptom distribution revealed coughing in 100.0%of cases,comprising both paroxysmal dry cough and productive cough.Fever was present in 61.61%of cases,with additional manifestations including wheezing,vomiting,diarrhoea,and respiratory distress.Pulmonary rales were the most prevalent finding at 75.89%,alongside other signs such as diminished breath sounds.Imaging analysis of all 112 pneumonia cases revealed bronchopneumonia accounted for 70.54%of cases,representing a relatively high proportion.Treatment involved macrolide antibiotics,including azithromycin,with bronchodilators and corticosteroids added for significant wheezing.The overall treatment efficacy rate was 90.18%.Conclusion:Analysis of Mycoplasma pneumoniae characteristics in children under 2 years indicates that MPP in infants and young children under 2 presents with mild symptoms,pronounced signs,and relatively mild overall inflammation,resulting in a comparatively high overall cure rate.展开更多
Objective:To investigate the correlation between Mycoplasma pneumoniae infection and childhood asthma,and to explore the impact of Mp infection on airway inflammation and airway hyperresponsiveness in children with as...Objective:To investigate the correlation between Mycoplasma pneumoniae infection and childhood asthma,and to explore the impact of Mp infection on airway inflammation and airway hyperresponsiveness in children with asthma.Methods:58 children with bronchopneumonia admitted to the First People’s Hospital of Jintan,Changzhou from April 2024 to October 2024 were selected as the study subjects.The levels of cytokines IL-4,IL-17,TGF-β1,and INF-γ in the serum were compared between the MP group and non-MP group,as well as between the MP wheezing group and MP nonwheezing group.Results:The levels of IL-17 and IL-4 in the MP group were significantly higher than those in the non-MP group(P<0.05),while there was no statistically significant difference in the other indicators(P>0.05).Statistically significant differences in IL-17 and IL-4 were observed between the wheezing and non-wheezing groups(P<0.05),while there was no statistically significant difference in the other indicators(P>0.05).There was a significant difference in IL-17 among the groups(P<0.05).The difference in IL-17 between the MP group and non-MP group was significant(P<0.05),and the difference between the wheezing and non-wheezing groups was marginally significant(P<0.05).Conclusion:M.pneumoniae infection may be one of the risk factors for the onset of childhood asthma,but its mechanism remains unclear.Further research is needed to determine whether Mp infection can serve as a biomarker for childhood asthma and to elucidate its underlying mechanism.展开更多
BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneu...BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.展开更多
BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatm...BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.展开更多
文摘Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases.Complications may occur,such as necrotizing pneumonia and respiratory failure.Extrapulmonary complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also arise.In this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with M.pneumoniae pneumonia and their predictive value for mycoplasma severity"published by Wang et al.They reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory M.pneumoniae pneumonia cases.
文摘Background: Mycoplasma pneumoniae (MP) is the primary causative agent of community-acquired pneumonia, which has increasingly become resistant to macrolides, complicating treatment regimens, especially with the co-infection factor. Its worldwide prevalence has fluctuated due to the influence of the COVID-19 pandemic. The study investigated co-infection patterns in children diagnosed with Mycoplasma pneumoniae pneumonia (MPP). Methods: From June 2022 to December 2023, we retrospectively analyzed the clinical data for hospitalized children with Mycoplasma pneumoniae pneumonia in Wuhan, China. We collected data on age, sex, clinical information, and pathogenic results. We also collected sputum or bronchoalveolar lavage fluid (BALF) samples to test respiratory pathogens and macrolide resistance using targeted microbial next-generation sequencing (tNGS). We analyzed the data using SPSS. Results: The study involved 417 patients diagnosed with MPP, of whom 86.33% had co-infections. Co-infections were notably linked to lobar pneumonia, prominent imaging shadows and higher macrolide resistance rate. Key bacterial pathogens were Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, rhinoviruses, and human adenoviruses (HADV). In MPP cases, Candida albicans was the fungal pathogen related to co-infections. The co-infection with HADV and human bocavirus 1 (HBoV1) correlated with prolonged fever, whereas Bordetella pertussis was linked to prolonged cough. In contrast, Candida albicans exhibited a weaker association with diffuse large-area infiltration on chest imaging, and its co-infection was less likely to result in severe disease. Conclusion: These results offer valuable insight into Mycoplasma pneumoniae pneumonia in children, highlighting the impact of co-infections on the disease’s clinical outcomes.
基金granted by National Key Research and Development Program of China(2021YFD1800900)Science and Technology Innovation Key R&D Program of Chongqing(CSTB2024TIAD-STX0038)+3 种基金National Natural Science Foundation of China(82574334,32501226)Chongqing Science and Technology Commission(CSTB2023NSCQ-JQX0002)Special Fund for Youth Team of Southwest University(SWU-XJLJ202306)Chongqing Natural Science Foundation(CSTB2024NSCQ-MSX0547).
文摘Multidrug-resistant Klebsiella pneumoniae(MDR-KP)is characterized by high mortality and risk of nosocomial transmission,and biofilm constitutes the primary challenge in the treatment of its implant-associated and refractory pulmonary infections.Notably,the hypoxic microenvironment and the physical barrier of biofilm leading to the increased tolerance of the bacteria to antibiotics.Herein,a hypoxia-responsive hybrid nanoparticle(CHLip@FLD/COL)loaded separately with anti-biofilm candidate fingolimod(FLD)and antibiotic colistin(COL)is achieved targeting antibacterial efficacy against MDR-KP in vitro and in vivo.CHLip@FLD/COL is composed of hybridizing hypoxia-responsive lipids(HLipid)and lipid A targeting materials DSPE-mPEG-COL.HLipid is synthesized by hexadecanedioic acid esterified with nitroimidazole,while DSPE-mPEG is coupling with vector COL via amide reaction.The relative level of extracellular polymeric substances and the NIR-IIb sO2 images of the infection site are used as indicators to establish mature biofilm models.CHLip@FLD/COL readily releases FLD and COL in hypoxic conditions,and its MIC against MDR-KP is only one-sixteenth of that when COL is used alone in vitro.The nanoparticle exhibits bacterial targeting ability and antibacterial effect in the pulmonary infection and biofilm infection mice models.Bacterial loads eliminated by 4 Log10 CFU and 2 Log10 CFU,respectively.The strategy provides a valuable reference for the treatment of refractory infections caused by MDR-KP.
基金Bill and Melinda Gates Foundation,Grant/Award Number:OPP1017554。
文摘Background:Bacterial pneumonia remains a leading cause of morbidity and mortality worldwide despite the widespread availability of antibiotics.Novel pneumonia therapies and biomarkers are urgently needed to improve outcomes and advance personalized therapy.Using an established baboon model of S.pneumoniae pneumonia,we sought to characterize the temporal dynamics of pneumonia host responses to identify novel potential diagnostic and therapeutic molecular targets.Methods:We performed whole blood transcriptomics,unbiased proteomics,and peripheral cytokine measurements serially in baboons inoculated with S.pneumoniae(n=23)or saline(n=10)and modeled the peripheral blood host response using principal components analysis and complex sparse logistic regression.Differentially expressed genes were analyzed for pathway analysis.Results:Inoculated animals developed characteristic signs and symptoms of pneumonia.A 39-gene signature was derived that classified S.pneumoniae infection with high accuracy(auROC 0.9 and 0.99 at 24 and 48 h post-inoculation,respectively).Similar performance was observed for 48-h biomarker signatures derived from peripheral blood plasma proteomic and cytokine measurements(both auROC>0.9).The gene signature retained strong diagnostic performance(auROC=0.88)when transformed to human orthologs and applied to patients with acute respiratory illness(n=34)or healthy controls(n=20).Pathway analysis at 48 h identified downregulation of mitophagy and glucocorticoid signaling in peripheral blood.Conclusions:We report novel peripheral blood gene and protein expression signatures of S.pneumoniae pneumonia that could improve pneumonia diagnosis and found distinct pathways that may be amenable to modulation.Our findings illustrate how non-human primate models of bacterial pneumonia can successfully translate biomarker discoveries to patients.
文摘Introduction: The misuse of antibiotics has driven the emergence of antimicrobial resistance, with certain bacterial species, including Klebsiella pneumoniae, initially susceptible to most antibiotics, now exhibiting resistance to multiple antimicrobial agents. The objective of this study was to investigate the distribution and antimicrobial resistance profiles of Klebsiella pneumoniae strains isolated at the Yaoundé Central Hospital. Methodology: The study was conducted over a period of 4 months (March 1st, 2023-July 1st, 2023) and involved 32 strains isolated from bacterial cultures performed on patients, regardless of sex. The different Klebsiella pneumoniae strains were isolated using conventional methods. Identification, antibiogram, and detection of resistance enzyme production were generated using the VITEK 2 system. The Carbapenem-resistant K.N.I.V.O. kit was used to detect carbapenemases. Data analysis was performed using EXCEL 2019 software. Results: Out of 196 samples collected from various biological products, 32 Klebsiella pneumoniae strains were isolated, representing 16.32% (196/32). Urine samples were most frequently affected, accounting for 53.125%. The emergency department was the most represented (40.63%) by these isolates. The mean age was 50 years, with a minimum of 20 years and a maximum of 80 years. The sex ratio was equal to 1. The identified strains were resistant to cefotaxime (78.13%), cefoxitin (62.50%), tobramycin (71.88%), gentamicin (56.25%), ofloxacin (81.25%), and cotrimoxazole (78.13%). 78.25% were ESBL producers. Three strains were resistant to carbapenems, accounting for 9.37%;one of which exhibited the NDM type. Conclusion: This study highlights the evolving bacterial resistance to antibiotics, which requires adequate measures through the strengthening of the Antimicrobial Resistance (AMR) program in Cameroon.
基金Supported by the Key Research and Development Project of the Science and Technology Department of Sichuan Province,China,No.2023YFS0280the High-level Research Initiation Fund Program of the First Affiliated Hospital of Chengdu Medical College,China,No.CYFY-GQ43.
文摘This article discusses the findings presented by Zhang et al.They analyzed the risk factors and clinical characteristics associated with Klebsiella pneumoniae infection in patients with liver cirrhosis treated at a hospital in Beijing.In this article,we focus on the connection between chronic kidney disease and the intestinal microbiota,and propose microbiota transplantation as a potential treatment for this patient group.We also examine an intriguing phenomenon related to hepatic encephalopathy,and provide insights into the future research.
基金Supported by the Second Batch of Social Development Science and Technology Program Projects of Taizhou Science and Technology Bureau in 2023,No.24ywb80.
文摘Klebsiella pneumoniae infections(KPIs),particularly carbapenem-resistant Klebsiella pneumoniae(CRKP),pose significant challenges in liver transplantation(LT)recipients,with high morbidity and mortality.Guo et al’s study highlights risk factors,such as elevated day-one alanine aminotransferase levels and prolonged catheterization,and identifies polymyxin B and ceftazidime/avibactam as effective treatments.However,limitations like the absence of pre-transplant colonization data and host-pathogen interaction insights highlight the need for enhanced strategies.Future directions should include routine CRKP colonization surveillance,immune and genomic profiling,and the development of novel therapeutics.By integrating these approaches,we can improve the prevention,diagnosis,and treatment of KPIs in LT patients.
基金supported by the National Natural Science Foundation of China(32273082 and U21A20262).
文摘Background Ferroptosis is characterized by increased production of reactive oxygen species(ROS)and membrane lipid peroxidation that can exacerbate inflammatory damage.Extracellular vesicles(EVs)isolated from bovine milk have many biological functions,including antioxidant properties.However,the role of EVs on Klebsiella pneumoniaeinduced ferroptosis and oxidative stress in bovine mammary epithelial cells(bMECs)and murine mammary tissue is unclear.In this study,EVs were isolated from bovine colostrum,mature milk and clinical mastitis milk(defined as C-EVs,M-EVs and CM-EVs,respectively)and assessed by transmission electron microscopy,Western blot and transcriptome sequencing.Effects of EVs on K.pneumoniae-induced ferroptosis and oxidative stress in bMECs were evaluated with immunofluorescence and Western blot.Results In bMECs,infection with K.pneumoniae induced oxidative stress,decreasing protein expression of Nrf2,Keap1 and HO-1 plus SOD activity,and increasing ROS concentrations.However,protein expression of GPX4,ACSL4 and S100A4 in bMECs,all factors that regulate ferroptosis,was downregulated by K.pneumoniae.Furthermore,this bacterium compromised tight junctions in murine mammary tissue,with low expression of ZO-1 and Occludin,whereas protein expression of Nrf2 and GPX4 was also decreased in mammary tissue.Adding C-EVs,M-EVs or CMEVs reduced oxidative stress and ferroptosis in K.pneumoniae-infected bMECs in vitro and murine mammary tissues in vivo.Conclusion In conclusion,all 3 sources of milk-derived EVs alleviated oxidative stress and ferroptosis in K.pneumoniae-infected bMECs and mammary tissues.
基金supported by the National Natural Science Foundation of China(Nos.81860543,32360237)Guizhou Provincial Science and Technology Projects(Nos.ZK[2024]235,ZK[2023]Key Project 041).
文摘The escalation in the incidence of multidrug-resistant Gram-negative bacteria is becoming a pressing global concern.Polymyxin B(PMB),a conventional antibiotic with notable therapeutic efficacy against Gram-negative bacterial infections,serves as a crucial final recourse against carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Nevertheless,the clinical usage of PMB is impeded by its pronounced nephrotoxicity and poor infection site targeting.This investigation is geared to construct a nanoparticle formulation(named HA-PMB@H)comprising hyaluronic acid(HA)and PMB via a simple Schiff base reaction and further coating HA by electrostatic action.HA-PMB@H shows an average size of(153.8±24.3)nm,and a mean zeta potential of(−25.6±5.2)mV.Additionally,PMB can be released from HA-PMB@H more thoroughly and efficiently at pH 5.5 compared to pH 7.4,which demonstrates the Schiff base modification of PMB paves the way for its release at focus of infection.The uptake ratio of HA-PMB@H by alveolar epithelial cells(RLE-6TN)surpassed that of free PMB devoid of HA,which facilitates to the intracellular sterilization of PMB.Furthermore,the employment of HA-PMB@H ameliorated the toxicity of PMB towards human embryonic kidney cells(HEK 293)and pulmonary microvascular endothelial cells(HULEC-5a).What is more,HA-PMB@H effectively managed severe pneumonia induced by CRKP samples from clinical patients diagnosed with CRKP infection in vivo,substantially enhancing the survival rate of mice.Consequently,this nano-delivery system holds promising clinical significance in the combat against drug-resistant bacterial infections.
文摘Dear Editor,Central retinal artery occlusion(CRAO)is a devastating ocular event caused by obstruction of the central retinal artery,leading to a sudden and significant loss of vision.A hallmark of CRAO on funduscopic examination is a characteristic“cherry-red spot”at the fovea surrounded by a pale retina[1].The anterior segment typically appears unremarkable.
文摘AIM:To report the demographic and systemic characteristics of patients,clinical progression of endophthalmitis,and the efficacy of various treatment strategies,with a focus on identifying key factors for preserving vision in eyes with endogenous endophthalmitis due to Klebsiella pneumoniae(K.pneumoniae)liver abscess.METHODS:In this single-center,retrospective case series of 18 patients with endogenous endophthalmitis due to K.pneumoniae liver abscess were analyzed.Ophthalmologic features of endophthalmitis at early,intermediate and advanced stages were obtained from eyes with endophthalmitis of different severities.Prompt vitrectomy was considered primarily for all eyes except for very early endophthalmitis.Intravitreal injections of antibiotics were performed in eyes with endophthalmitis in the very early stages and in eyes where vitrectomy was not available,and additional control of infection was needed after vitrectomy.Evisceration was performed in eyes with corneoscleral perforation,advanced endophthalmitis,perforation with preseptal or orbital cellulitis,uncontrolled infection,or severe pain with no vision.RESULTS:Mean(±standard deviation)age of the 18 patients with endophthalmitis was 64.5±12.2(range:32-84)y,and 14 patients(77.8%)were males.Endophthalmitis tended to involve the retinal parenchyma first and then progressed into the vitreous cavity and anterior segments.However,it presented a tendency to cause massive subretinal abscesses even after vitrectomy with silicone oil tamponade.Very high intraocular pressure with new vessels on the iris(41.7%)were also commonly observed.Although all but three patients had systemic disease such as diabetes or hypertension,visual prognosis after treatment did not appear to depend significantly on underlying comorbidities.A final best-corrected visual acuity better than 20/60 was achieved only when lesions were detected very early,with relatively good initial visual acuity,likely reflecting lower bacterial inoculation in the eye.CONCLUSION:Detection of early endophthalmitis lesions appears to be the only way to preserve good vision in patients with K.pneumoniae liver abscesses.Therefore,proper guidelines for ophthalmologic screening remain to be established for subjects at a high risk of endophthalmitis.
基金Supported by Baoding Science and Technology Plan Project,No.2272P011Hebei Province Scientific Research Project,No.20241734Hebei Natural Science Foundation Project,No.H2024104011.
文摘BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has emerged as a crucial global health concern due to high mortality rate in children under 5 years,potentially life-threatening complications,and growing challenges in pediatric treatment associated with rising macrolide resistance.Additionally,MPP can be complicated by other bacterial and/or viral pathogens,which may exacerbate disease severity.After the lifting of strict non-pharmaceutical interventions(NPIs)worldwide,the dramatic rise of incidence of MPP in Asia and Europe was observed.AIM To perform the comprehensive study of community acquired MPP cases registered in 2023 in Baoding Hospital,China.METHODS A total of 1160 children from 1 month to 15 years old with confirmed MPP diagnosis were enrolled in the study.The blood and respiratory samples were collected within the 24 hours after admission.The hematological parameters,biochemical markers,cytokine profiles were assessed.The respiratory samples were tested for the presence of M.pneumoniae and other 23 bacterial/viral pathogens by multiplex polymerase chain reaction(PCR).The macrolide resistance mutations(A2063G,A2064G in the 23S rRNA gene of M.pneumoniae)were determined by PCR.RESULTS Number of MPP cases has dramatically increased starting August with peak in November.SMPP and general MPP(GMPP)were identified in 264 and 896 of 1160 hospitalized children.The binary logistic regression analysis identified six[C-reactive protein(CRP),lactate dehydrogenase,procalcitonin,erythrocyte sedimentation rate,fibrin and fibrinogen degradation products(FDPs),D-dimer]and four(neutrophils,CRP,FDPs,prothrombin time)predictors of SMPP in age groups 2-5 years and 6-15 years,respectively.Children with SMPP showed significantly higher levels of cytokine interleukin(IL)-17F(2-5 years),and cytokines interferon-gamma,tumor necrosis factoralpha,IL-10(6-13 years).Concomitant viral/bacterial pathogens were determined in 24.3%and 28.0%cases of SMPP and GMPP.Among them,Streptococcus pneumoniae(S.pneumoniae)and Haemophilus influenzae(H.influenzae)were predominant.93.2%cases of MPP were associated with macrolide resistant M.pneumoniae.CONCLUSION Specific MPP epidemiological pattern associated with lifting NPIs was revealed:Increase of hospitalized cases,prevalence of S.pneumoniae and H.influenzae among concomitant pathogens,93.2%of macrolide resistant M.pneumonia.
基金funded by the Guangdong Major Project of Basic and Applied Basic Research(2020B0301030007)the National Natural Science Foundation of China(32141002)+1 种基金the National Key Research and Development Program of China(2022YFC2303900)the Science and Technology Program of Guangzhou,China(2023A04J0755 and 202201010300)。
文摘Tigecycline is one of the most critical drugs for treating Gram-negative bacterial infections;however,the emergence of the tigecycline resistance efflux pump TMexCD1-TOprJ1 poses a global health threat.The evolutionary relationships and epidemiological trends of tmexCD1-toprJ1-positive strains across various ecological niches remain largely unexplored.In this study,we employed whole-genome sequencing(WGS)of tmexCD1-toprJ1-positive bacteria from humans,food,animals,and the environment in China to assess the epidemiological and genomic features of these strains,analyzing both newly collected strains and data from the GenBank database.From 3434 samples collected during 2019-2022,145tmexCD1-toprJ1-carrying strains(4.5%)were isolated.The majority of the tmexCD1-toprJ1-positive Enterobacterales exhibited resistance to nearly all antimicrobials,including colistin(42.13%).tmexCD1-toprJ1 was predominantly identified in Klebsiella pneumoniae(K.pneumoniae)from chicken feces in China but was also detected in multiple ecological niches and other countries.Phylogenetic analysis revealed the clonal transmission of tmexCD1-toprJ1-positive ST37 K.pneumoniae across diverse ecological niches as well as the international spread of the ST15 K.pneumoniae clone-producing TMexCD1-TOprJ1.tmexCD1-toprJ1 is mainly carried by Klebsiella spp.specific narrow host range plasmids,which may limit the spread of tmexCD1-toprJ1 across different bacterial species.Notably,due to the fitness cost posed by tmexCD1-toprJ1,the occurrence of tmexCD1-toprJ1-positive Enterobacterales in both food animals and humans in China has declined significantly following the withdrawal of antibiotics as growth promoters in food animals in China since 2020.However,tmexCD1-toprJ1 has been captured by broad-host-range plasmids and hypervirulent carbapenem-resistant K.pneumoniae ST11-KL64 strains in healthcare settings.The frequent use of tetracyclines in chicken farming likely contributes to the high detection rate of tmexCD1-toprJ1;therefore,to reduce the threat of tmexCD1-toprJ1-positive K.pneumoniae,continuous monitoring of tmexCD1-toprJ1 across different ecological niches and strict enforcement of antimicrobial policies in animal husbandry,particularly in the poultry industry,are urgently required.
文摘Objective:To study the risk prediction model for multiple bronchoalveolar lavage in children with mycoplasma pneumoniae pneumonia(MPP).Methods:151 pediatric patients with MPP admitted in our hospital from July to December 2023 were selected,the incidence rate of multiple bronchoalveolar lavage was recorded.A logistic multivariate regression model was employed to analyze relevant factors and construct a risk prediction model for multiple bronchoalveolar lavage in children with MPP.Results:Among 151 children with MPP,64 cases underwent multiple bronchoalveolar lavage,accounting for 42.38%.The Logistic multivariate model analysis revealed that the pleural effusion,sepsis,and abnormally elevated serum levels of LDH and D-D were independent influence factors for multiple bronchoalveolar lavage in children with MPP(p<0.05),based on this,a Nomogram prediction model can be established.The ROC analysis results showed that the AUC of the model to judge the multiple bronchoalveolar lavage in MPP patients was 0.828(SE=0.035,95%CI=0.760-0.896,p<0.001),the sensitivity was 0.813 and the specificity was 0.759.Conclusion:The multiple bronchoscopic bronchoalveolar lavage in MPP patients are associated with the levels of LDH and D-D,as well as the presence of pleural effusion and sepsis complications,the risk prediction model established,which based on this has high accuracy.
文摘Objective:To analyse the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)in children under two years of age.Methods:A retrospective analysis was conducted on 112 paediatric cases of MPP admitted to our hospital between January 2022 and December 2023.Clinical data including symptoms,signs,imaging findings,and prognosis were collected.Results:Analysis of clinical symptom distribution revealed coughing in 100.0%of cases,comprising both paroxysmal dry cough and productive cough.Fever was present in 61.61%of cases,with additional manifestations including wheezing,vomiting,diarrhoea,and respiratory distress.Pulmonary rales were the most prevalent finding at 75.89%,alongside other signs such as diminished breath sounds.Imaging analysis of all 112 pneumonia cases revealed bronchopneumonia accounted for 70.54%of cases,representing a relatively high proportion.Treatment involved macrolide antibiotics,including azithromycin,with bronchodilators and corticosteroids added for significant wheezing.The overall treatment efficacy rate was 90.18%.Conclusion:Analysis of Mycoplasma pneumoniae characteristics in children under 2 years indicates that MPP in infants and young children under 2 presents with mild symptoms,pronounced signs,and relatively mild overall inflammation,resulting in a comparatively high overall cure rate.
基金Research Project of Jiangsu Maternal and Child Health Care Association(Project No.:FX202335)。
文摘Objective:To investigate the correlation between Mycoplasma pneumoniae infection and childhood asthma,and to explore the impact of Mp infection on airway inflammation and airway hyperresponsiveness in children with asthma.Methods:58 children with bronchopneumonia admitted to the First People’s Hospital of Jintan,Changzhou from April 2024 to October 2024 were selected as the study subjects.The levels of cytokines IL-4,IL-17,TGF-β1,and INF-γ in the serum were compared between the MP group and non-MP group,as well as between the MP wheezing group and MP nonwheezing group.Results:The levels of IL-17 and IL-4 in the MP group were significantly higher than those in the non-MP group(P<0.05),while there was no statistically significant difference in the other indicators(P>0.05).Statistically significant differences in IL-17 and IL-4 were observed between the wheezing and non-wheezing groups(P<0.05),while there was no statistically significant difference in the other indicators(P>0.05).There was a significant difference in IL-17 among the groups(P<0.05).The difference in IL-17 between the MP group and non-MP group was significant(P<0.05),and the difference between the wheezing and non-wheezing groups was marginally significant(P<0.05).Conclusion:M.pneumoniae infection may be one of the risk factors for the onset of childhood asthma,but its mechanism remains unclear.Further research is needed to determine whether Mp infection can serve as a biomarker for childhood asthma and to elucidate its underlying mechanism.
文摘BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.
文摘BACKGROUND Liver transplant(LT)recipients are susceptible to carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.Comprehensive research addressing the incidence,timing,infection sites,resistance patterns,treatment options,and associated risk factors among LT recipients with CRKP is now lacking.AIM To assess the incidence,resistance,therapy,and risk factors of CRKP infections post-LT,and to evaluate the impact of them on prognosis.METHODS A retrospective study was conducted,including 430 consecutive patients who underwent LT between January 2015 and June 2023.This study aimed to investigate the risk factors for CRKP infections and their influence on outcomes using logistic regression analysis.RESULTS Among the 430 patients who underwent LT,20(4.7%)experienced at least one documented CRKP infection within 3 months post-transplantation.The median time from LT to the onset of CRKP infections was 6.5 days.The lungs and bloodstream were the most common sites of CRKP infections.CRKP isolates were relatively susceptible to ceftazidime/avibactam(93.7%),polymyxin B(90.6%),and tigecycline(75.0%)treatment.However,all isolates were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin treatment.Recipients with CRKP infections had a mortality rate of 35%,the rate was 12.5%for those receiving ceftazidime/avibactam therapy.Multivariate analysis identified female sex[odds ratio(OR)=3.306;95%confidence interval(CI):1.239-8.822;P=0.017],intraoperative bleeding≥3000 mL(OR=3.269;95%CI:1.018-10.490;P=0.047),alanine aminotransferase on day 1 post-LT≥1500 U/L(OR=4.370;95%CI:1.686-11.326;P=0.002),and post-LT mechanical ventilation(OR=2.772;95%CI:1.077-7.135;P=0.035)as significant variables associated with CRKP.CRKP infections were related to an intensive care unit length(ICU)of stay≥7 days and 6-month all-cause mortality post-LT.CONCLUSION CRKP infections were frequent complications following LT,with poor associated outcomes.Risk factors for post-LT CRKP infections included female sex,significant intraoperative bleeding,elevated alanine aminotransferase levels,and the need for mechanical ventilation.CRKP infections negatively impacted survival and led to prolonged ICU stays.
