Cytokines in Mycoplasma pneumoniae infections

Mycoplasma pneumoniae (M. pneumoniae) is one of the smallest free-living bacteria known. Along with other unique characteristics of this genus, it lacks the typical peptidoglycan cell wall of most eubacteria. Best known for causing tracheobronchitis and atypical pneumonia in humans, this pathogen also causes a number of extrapulmonary syndromes such as meningitis/encephalitis and arthritis. Recent studies also suggest that infection may be associated with chronic conditions such as asthma. Although the mechanisms of M. pneumoniae pathogenesis remain to be elucidated, one important component of M. pneumoniae infections is the induction of proinflammatory and other cytokines in both acute and chronic conditions. In this review, we survey the induction of cytokines by M. pneumoniae in different model systems, and we discuss the possible role of induced cytokines in M. pneumoniae pathogenesis.     

肺炎支原体IgG类抗体亲和力检测的实验研究与临床应用

目的探讨肺炎支原体IgG类抗体亲和力检测在肺炎支原体感染诊断中的意义。方法用被动颗粒凝集试验(PPA)和间接免疫荧光法(IFA)检测儿童上呼吸道感染者血清IgM类抗体水平,同时用IFA法检测其IgG类抗体的亲和力,并对检测结果进行相关性分析和一致性检验。结果在IgM类抗体检测上PPA法检出阳性率(60/120)高于IFA法(49/120),两法检测结果缺乏一致性。而IFA法检测IgG类抗体阳性的97例中,有22例检出低亲和力IgG类抗体,其中20例同时检出IgM类抗体,两法检测结果具有显著的相关性(P<0.001)和较好的一致性(0.7>Kappa>0.4)。结论肺炎支原体低亲和力IgG类抗体检测有与IgM类抗体检测类似的早期诊断价值,可与IgM类抗体联合检测用于区分近期感染、感染后复发或再次感染。     

Epidemiology and pathogenesis of Bacillus cereus infections

Bacillus cereus is a causative agent in both gastrointestinal and in nongastrointestinal infections. Enterotoxins, emetic toxin (cereulide), hemolysins, and phoshpolipase C as well as many enzymes such as beta-lactamases, proteases and collagenases are known as potential virulence factors of B. cereus. A special surface structure of B. cereus cells, the S-layer, has a significant role in the adhesion to host cells, in phagocytosis and in increased radiation resistance. Interest in B. cereus has been growing lately because it seems that B. cereus-related diseases, in particular food poisonings, are growing in number.     

Single tube real time PCR for detection of Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila from clinical samples of CAP

We designed a multiplex real time PCR for rapid, sensitive and specific detection of Streptococcus pneumoniae, Legionella pneumophila, Chlamydophila pneumoniae and Mycoplasma pneumoniae. The study cases consisted of 129 patients with community acquired pneumonia (CAP). Bacteriological techniques were implemented for detection of the cultivable organisms. DNA were extracted from sputa, throat swabs, bronchoalveolar lavages and tracheal aspirates and used as templates in real time PCR. The primers and probes were designed for cbpA (S. pneumoniae), p1adhesin (M. pneumoniae), mip (L. pneumophila) and ompA (C. pneumoniae). After optimization of real time PCR for every organism, the experiments were continued in multiplex in a single tube. Of 129 CAP specimens, the positive cultures included 14 (10.85%) for S. pneumoniae, 9 (6.98%) for L. pneumophila and 3 (2.33%) for M. pneumoniae. Four specimens (3.10%) were positive for C. pneumoniae by real time PCR. The sensitivity of our real time PCR was 100% for all selected bacteria. The specificity of the test was 98.26%, 98.34%, 100% and 100% for S. pneumoniae, L. pneumophila, M. pneumoniae and C. pneumoniae, respectively. This is the first report on the use of multiplex real time PCR for detection of CAP patients in the Middle East. The method covers more than 90% of the bacterial pathogens causing CAP.     

New laboratory techniques for isolation of Mycoplasma pneumoniae

The SP-4 culture medium, developed originally for newly isolated plant and insect mycoplasmas (spiroplasmas), has markedly improved the recovery of Mycoplasma pneumoniae from human clinical materials. This medium, in combination with a direct fluorescent antibody test, can enhance the recovery and identification of the organism by 30-40 percent over conventional culture procedures. Although these modifications are a clear improvement in diagnostic techniques for M. pneumoniae, the time required for growth and identification of the agent is still a major disadvantage for rapid clinical diagnosis. Thus, there remains a critical need for techniques that can specifically identify the major antigens (or other components) of the organism within the first week of the infection.     

儿童肺炎支原体咽拭子快速液体培养结果分析

目的分析儿童肺炎支原体（MP）咽拭子快速液体培养的结果及与患儿年龄以及季节的关系,为临床诊断、治疗肺炎支原体感染提供依据。方法选取深圳市宝安区人民医院1217例急性呼吸道感染的患儿,采用咽拭子快速液体培养基进行筛查,观察其阳性率。结果在1217例患儿中,共检出阳性281例,阳性率为23．09％。〈1岁、1～3岁、3～6岁和6～14岁各年龄组的阳性率分别为15．13％、26．52％、28．31％和18．07％;不同季节MP感染率分别为春23．75％,夏20．11％,秋18．61％,冬29．72％。1～3岁,3—6岁小儿感染率明显高于6—14和〈1岁儿童（P〈0．01）;冬春季阳性率较夏秋季高。结论MP快速液体培养鉴定对MP诊断具有重要的临床诊断价值。肺炎支原体感染全年均可发病,好发于冬季,以3—6岁小儿多见。     

Serodiagnosis of clinical infections caused by Mycoplasma pneumoniae in Poland in 1970-2010

The aim of the study was evaluation of the reliability of serodiagnosis of mycoplasmosis in Poland after replaced of classical assays, as complement fixation test (CFT) and immunoelectroprecipitation test (IEPT), by the ELISA method. The data were obtained from National Public Health Institute in Warsaw (NPHI), which receives quarterly reports of serologically confirmed infection from Sanitary and Epidemiological Stations through the country. Previously, from the 1970 to 1999 the serodiagnosis in Poland was performed only by uniform CFT using the same M. pneumoniae FH antigen prepared at the Mycoplasma Laboratory of NPHI. The first data of M. pneumoniae serological investigation performed by commercial ELISA, mainly Virotech, which gradually replaced the CFT, were obtained in 2000. In the studied period 1970-2010 a total of over 300 thousand patients with respiratory tract infections (85% were children below 18 years old) were tested. During these studies five epidemics of mycoplasmosis were noted in Poland before 2000. However, after introduction of ELISA for serodiagnosis this characteristic distinct difference in epidemic and endemic occurrence of M pneumoniae infections have not been seen. In our opinion it may be caused by changes in the epidemiological pattern of M. pneumoniae infections in Poland as well as, paradoxical, by the decrease of sensitivity and specificity of serological investigation performed by ELISA since 2000. First of all, for the economical reasons 98% of the patients were tested by ELISA only once, secondly, the mycoplasmosis in many laboratories was confirmed only on the basis of the presence of IgG antibodies. The results of our analysis showed also usefulness in the serodiagnosis of mycoplasmosis, mainly during the first 2 weeks of the disease, of IEPT, which detect only specific IgM antibodies to M pneumoniae antigens.     

Development of a PCR-based method for diagnosing Mycoplasma pneumoniae infections

The polymerase chain reaction was used to detect clinical samples of Mycoplasma pneumoniae. A 245-bp region of the cytoadhesin P1 gene was shown to be specifically amplified in Myc. pneumoniae , but not in other species of Mollicutes. Picogram amounts of Myc. pneumoniae DNA could be detected per ml blood serum by use of a simple and reliable protocol for sample preparation and a PCR reaction involving two rounds of amplification. Application of the PCR-based method for the detection of Myc. pneumoniae in serum samples and throat swabs from patients with atypical pneumonia showed that it could be used in clinical diagnosis.     

新生隐球菌感染12例临床特点及实验室检测的回顾性分析

目的:了解新生隐球菌深部感染的临床特点及实验室检测,分析其耐药性.方法:对12例新生隐球菌感染患者的临床资料进行网顾性分析;应用美国BD9240全自动血液分析仪进行细菌培养和真菌培养,阳性酵母样真菌经API20C鉴定到种;FUNGS 3进行真菌药敏试验.结果:12例患者均经病原学确诊;其中中枢神经系统感染6例,血液感染5例,腹腔感染1例;新生隐球菌对临床常用5种抗真菌药物除2例氟康唑中介外,其余均敏感.结论:新生隐球菌不仅引起中枢神经系统感染,也可引起身体多部位感染,死亡率较高;早期病原学检测对疾病的诊断和治疗十分重要,联合用药预后较好.     

Mycoplasma pneumoniae infections in a rural setting in Canada.

Mycoplasma pneumoniae infection was monitored in patients with symptoms of acute respiratory tract infection in a village in southeastern Ontario from April 1983 to April 1984. M. pneumoniae was isolated from 51 (48%) of the 106 patients. The incidence began to increase in May 1983, reached a peak in July and declined to normal by mid-August. During the epidemic period M. pneumoniae was detected in 36 of the 43 symptomatic patients. The most prominent features of the outbreak were the considerable intrafamilial attack rate and the high frequency of pneumonia among infected patients. Treatment with tetracyclines and erythromycin reduced the duration of the illness and accelerated the resolution of symptoms.     

Polymerase chain reaction as a sensitive and rapid method for specific detection of Mycoplasma pneumoniae in clinical samples

The fast diagnosis of Mycoplasma primary atypical pneumonia is impaired by the lack of routinely available culture methods for isolation of Mycoplasma pneumoniae from clinical specimens. Likewise, serological methods commonly used for diagnosis are insensitive and non-specific. In this study, we have established and applied the polymerase chain reaction (PCR) technique to detect M. pneumoniae DNA in clinical samples originating from the respiratory tract. The PCR results were compared with those from culture and serology tests. To standardize the detection of M. pneumoniae by PCR, we first used DNA from culture grown organisms and clinical samples seeded with M. pneumoniae. PCR amplification was performed with M. pneumoniae-specific primers to amplify 144, 153 and 631 bp DNA fragments by using primer pairs MP5-1/MP5-2, P1-178/P1-331 and P1-178/P1-809, respectively. The amplification of the 631 bp DNA fragment was found to be most sensitive for the detection of M. pneumoniae. Using the most sensitive PCR, a total of 47 respiratory specimens from patients suspected of community acquired pneumonia were tested. While none of the specimens were positive for M. pneumoniae in culture, 6 specimens gave positive results by PCR. In 4 out of the 5 PCR positive samples tested serologically, the results were supported by elevated levels of anti-mycoplasma IgG/IgM/IgA. Thus, these results suggest that PCR is the most sensitive method to detect M. pneumoniae in clinical specimens.