Retrospective Analysis of Mycoplasma pneumoniae Infection in Pediatric Fatal Pneumonia in Guangzhou,South China

Abstract

The objective of this study is to investigate the infection and distribution of Mycoplasma pneumoniae in autopsied pulmonary tissue of pediatric severe pneumonia. Mycoplasma pneumoniae nested polymerase chain reaction and immunohistochemistry were done on autopsy pulmonary tissue from 173 patients who died of severe pneumonia. Mycoplasma pneumoniae was identified in 135/173 (78.03%) and 114/173 (65.89%) samples of autopsied pulmonary tissue of lethal severe pneumonia via nested polymerase chain reaction and immunohistochemistry, respectively. The coincidence of both assays was 92.4%. Mycoplasma pneumoniae associated fatal pneumonia has showed an increasing trend from 1988 to 2005 in South China, and the fatality rate of Mycoplasma pneumoniae associated fatal pneumonia in infants, 1 to 12 months, has risen to 66.9% (97/145). Mycoplasma pneumoniae is a significant cause of severe pneumonia, it is a universal event in infants, and children have died of severe pneumonia in South China. Mycoplasma pneumoniae might be an important pathogen responsible for fatal pneumonia in Guangzhou area, South China.

Keywords

Mycoplasma pneumoniae fatal pneumonia pulmonary tissue nested PCR immunohistochemistry

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References

Heiskanen-Kosma T. , Korppi M. , Laurila A. , Jokinen C. , Kleemola M. , Saikku P. Chlamydia pneumoniae is an important cause of community-acquired pneumonia in school-aged children: serological results of a prospective, population-based study. Scand J Infect Dis . 1999; 31:255-259.

Yang XQ , Yi ZW , eds. Pediatrics. 6th ed. Beijing, China: People's Medical Publishing House; 2004:312.

Kim CK , Kim SW , Kim JS , et al. Bronchiolitis obliterans in the 1990s in Korea and the United States. Chest. 2001;120:1101-1106.

Oermann C. , Sockrider MM , Langston C. Severe necrotizing pneumonitis in a child with Mycoplasma pneumoniae infection . Pediatr Pulmonol. 1997;24:61-65.

Leong MA , Nachajon R. , Ruchelli E. , Allen JL Bronchitis obliterans due to Mycoplasma pneumoniae. Pediatr Pulmonol. 1997;23:375-381.

Chiou CC , Liu YC , Lin HH , Hsieh KS Mycoplasma pneumoniae infection complicated by lung abscess, pleural effusion, thrombocytopenia and disseminated intravascular coagulation. Pediatr Infect Dis J. 1997;16: 327-329.

Shi Y. , Shong Y. Modern Pulmonary Infection. Beijing, China: People's Military Medical Press; 1996 :33-42.

McIntosh K. Community-acquired pneumonia in children. N Engl J Med. 2002;346:429-437.

Zhang ZL , Zhou XL , Chen JL Clinic analysis of 160 cases of pediatric multi-organs function failure. Chin J Crit Care Med. 1987;7:11-14.

10.

Liu G. , Talkington DF , Fields BS , Levine OS , Yang Y. , Tondella ML Chlamydia pneumoniae and Mycoplasma pneumoniae in young children from China with community-acquired pneumonia. Diagn Microbiol Infect Dis. 2005;52:7-14.

11.

Ruuskanen O. , Mertsola J. Childhood community-acquired pneumonia . Semin Respir Infect. 1999;14:163-172.

12.

Gilsdorf JR Community-acquired pneumonia in children. Semin Respir Infect. 1987;2:145-146.

13.

Bartlett JG , Breiman RF , Mandell LA , File TM Community-acquired pneumonia in adults: guidelines for management. The Infectious Diseases Society of America. Clin Infect Dis. 1998;26:811-838.

14.

He ZP , Zhang CX , He YP Clinic analysis of 40 cases of pediatric Mycoplasma pneumoniae. Shaanxi Med J. 2004;33:50-51.

15.

Wang HT , Dong ZQ Extrapulmonary manifestation of Mycoplasma pneumoniae. J Applied Clin Pediat. 2003; 18:996-998.

16.

Hammerschlag MR Mycoplasma pneumoniae infections. Curr Opin Infect Dis. 2001;14:181-186.

17.

Guan DH , Wu SH Pediatric Infection. Beijing, China: People's Medical Publishing House; 2002:723-729.

18.

Nelson CT Mycoplasma and chlamydia pneumonia in pediatrics. Semin Respir Infect. 2002;17:10-14.

19.

Principi N. , Esposito S. Emerging role of Mycoplasma pneumoniae and chlamydia pneumoniae in paediatric respiratory-tract infections. Lancet Infect Dis. 2001;1:334-344.

20.

Xue XD Pediatrics. Beijing, China: People's Medical Publishing House; 2002:228.

21.

Wu L. , Skinner SJM , Lambie N. , Vuletic JC , Blasi F. , Black PN Immunohistochemical staining for chlamydia pneumoniae is increased in lung tissue from subjects with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;162:1148-1151.

22.

Waites KB , Talkington DF , Bébéar CM Mycoplasmas. In: Manual of Commercial Methods in Clinical Microbiology . 7th ed. Washington, DC: American Society for Microbiology; 2002:201-224.

23.

Talkington DF , Waites KB , Schwartz SB , Besser RE Emerging from obscurity: understanding pulmonary and extrapulmonary syndromes, pathogenesis, and epidemiology of human Mycoplasma pneumoniae infections. In: Scheld WM , Craig WA , Hughes JM , eds. Emerging Infections. 5ed. Washington, DC: American Society for Microbiology; 2001:57-84.

24.

Principi N. , Esposito S. , Blasi F. , Allegra L. Role of Mycoplasma pneumoniae and chlamydia pneumoniae in children with community-acquired lower respiratory tract infections . Clin Infect Dis. 2001;32:1281-1289.

25.

Su B. , Chen HM Clinic analysis of 56 cases of pediatric Mycoplasma pneumoniae infection. J Postgraduat Med. 2004;27:38.

26.

Nadala D. , Bossart W. , Zucol F. , Steiner F. , Berger C. , Lips U. Community-acquired pneumonia in children due to Mycoplasma pneumoniae: diagnostic performance of a seminested 16S rDNA-PCR. Diagn Microbiol Infect Dis. 2001;39:15-19.