Mycoplasma infections and different human carcinomas

AIM To explore relationships between human carcinomas and mycoplasma infection.METHODS Monoclonal antibody PD4, which specifically recognizes a distinct protein from mycoplasma hyorhinis, was used to detect mycoplasma infection in different paraffinembedded carcinoma tissues with immunohistochemistry. PCR was applied to amplify the mycoplasma DNA from the positive samples for confirming immunohistochemistry.RESULTS Fifty of 90 cases (56%) of gastric carcinoma were positive for mycoplasma hyorhinis. In other gastric diseases, the mycoplasma infection ratio was 28% (18/49) in chronic superficial gastritis, 30% (14/ 46) in gastric ulcer and 37% (18/ 49) in intestinal metaplasia. The difference is significant with gastric cancer (X2=12.06, P＜0.05). In colon carcinoma, the mycoplasma infection ratio was 55.1% (32/58), but it was 20.9% (10/49) in adenomarous polyp (X2=13.46, P＜0.005).Gastric and colon cancers with high differentiation had a higher mycoplasma infection ratio than those with low differentiation (P＜ 0.05). Mycoplasma infection in esophageal cancer, lung cancer, breast cancer and glioma was 50.9% (27/53), 52.6% (31/ 59), 39.7%(25/63) and 41% (38/91), respectively. The mycoplasma DNA was successfully amplified with the DNA extracted from the cancer tissues that were positive for mycoplasma infection (detected with antibody PD4).CONCLUSION There was high correlation between mycoplasma infection and different cancers, which suggests the possibility of an association between the two. The mechanism involved in oncogenesis by mycoplasma remains unknown.

Can the detection of IgA anti-Mycoplasma pneumoniae added to IgM increase diagnostic accuracy in patients with infections of the lower respiratory airways?

AIM To evaluate the increase in diagnostic yield, by using IgA in addition to IgM, instead of IgM alone, in relation to the age of the patients.METHODS The study considered 1067 blood samples from patients with clinical signs of lower respiratory tract infections, tested for anti-Mycoplasma IgG, IgM and IgA antibody.RESULTS The increase in diagnostic yield with IgA, compared to IgM detection alone was of 3.5% with statistically significant differences between age groups(0.8% for those equal/under 50 years of age and 4.3% for those over 50).CONCLUSION Our findings demonstrate that IgA detection lead to a twofold increase in the number of diagnoses among the older age groups, but it did not result in relevant increase among the younger age groups.

Establishment of a Predictive Diagnostic Model for Acute Mycoplasma Pneumoniae Infection in Elderly Patients with Community-acquired Pneumonia

We established a diagnostic model to predict acute Mycoplasma pneumoniae （M. pneumonia） infection in elderly Community-acquired pneumonia （CAP） patients. We divided 456 patients into acute and non-acute M. pneumoniae infection groups. Binary logistic regression and receiver operating characteristic （ROC） curves were used to establish a predictive model. The following independent factors were identified： age 〉 70 years; serum cTNT level 〉 0.0S ng/mL; lobar consolidation; mediastinal lymphadenopathy; and antibody titer in the acute phase 〉 1：40. The area under the ROC curve of the model was 0.923 and a score of 2 7 score predicted acute M. pneumoniae infection in elderly patients with CAP. The predictive model developed in this study has high diagnostic accuracy for the identification of elderly acute M. pneumoniae infection.

Efficacy of different antibiotics in treatment of children with respiratory mycoplasma infection

BACKGROUND Respiratory infections in children are common pediatric diseases caused by pathogens that invade the respiratory system.Children are considerably susceptible to Mycoplasma pneumoniae infection.There has been widespread clinical attention on treatment strategies for this disease.AIM To analyze the clinical efficacy of different antibiotics in treating pediatric respiratory mycoplasma infections.METHODS We included 106 children with a confirmed diagnosis of respiratory mycoplasma infection who were admitted to our hospital from April 2017 to July 2019 and grouped them using a random number table.Among them,53 children each received clarithromycin or erythromycin.The clinical efficacy of both drugs was evaluated and compared.We performed the multiplex polymerase chain reaction(MP-PCR)test and determined the MP-PCR negative rate in children after the end of the treatment course.We compared the incidence of toxic and side effects,including nausea,diarrhea,and abdominal pain;further,we recorded the length of hospitalization,antipyretic time,and drug costs.Additionally,we evaluated and compared the compliance of the children during treatment.RESULTS The erythromycin group showed a significantly higher total effective rate of clinical treatment than the clarithromycin group.MP-PCR test results showed that the clarithromycin group had a significantly higher MP-PCR negative rate than the erythromycin group.Moreover,children in the clarithromycin group had shorter fever time,shorter hospital stays,and lower drug costs than those in the erythromycin group.The clarithromycin group had a significantly higher overall drug adherence rate than the erythromycin group.The incidence of toxic and side effects was significantly lower in the clarithromycin group than in the erythromycin group(P<0.05).CONCLUSION Our findings indicate that clarithromycin has various advantages over erythromycin,including higher application safety,stronger mycoplasma clearance,and higher medication compliance in children;therefore,it can be actively promoted.

Pathogenic Mycoplasma Infections in Chronic Illnesses: General Considerations in Selecting Conventional and Integrative Treatments

The presence of pathogenic mycoplasmas in various chronic illnesses and their successful suppression using conventional and integrative medicine approaches are reviewed. Evidence gathered over the last three decades has demonstrated the presence of pathogenic mycoplasma species in the blood, body fluids and tissues from patients with a variety of chronic clinical conditions: atypical pneumonia, asthma and other respiratory conditions;oral cavity infections;urogenital conditions;neurodegenerative and neurobehavioral diseases;autoimmune diseases;immunosuppressive diseases;inflammatory diseases;and illnesses and syndromes of unknown origin, such as fatiguing illnesses. Only recently have these small intracellular bacteria received attention as possible causative agents, cofactors or opportunistic infections or co-infections in these and other conditions. Their clinical management is often inadequate, primarily because of missed diagnosis, under- and inadequate treatment and the presence of persister or dormant microorganisms due to biofilm, resistence and other mechanisms. Pathogenic Mycoplasma species infections have been suppressed slowly by anti-microbial and integrative treatments, resulting in gradual reductions in morbidity, but not in every patient. Even if mycoplasmas are not a cause or an initial trigger for many chronic illnesses, they appear to play important roles in the inception, progression, morbidity and relapse of chronic illnesses in rather large patient subsets. Ignoring such infections can result in failure to achieve eventual patient recovery, even with application of potentially curative treatments.

A prokaryotic mycoplasma-like organism infection in the scallop Argopecten irradians

Intracytoplasmic infection with a prokaryotic mycoplasma-like organism （MLO） were characterized in the scallop Argopecten irradians, and the first report of such infection in this scallop was represented. Ultrastructurally these microorganisms are usually pleomorphic and variable in morphology and size, and appear in several cell types such as small spherical body, rod-shaped bodies and longer filament-shaped body. They lack a cell wall. These observations revealed that these types of the prokaryote showed some characteristics of a mycoplasma-like organism （MLO）. MLO reproduced in two ways： binary fission and budding. The results of isolation and purification showed that a large number of MLOs existed in the tissues of diseased scallops. The results of experimental infection revealed that the MLO is pathogenic to the scallop Argopecten irradians.

Susceptibility of Mixed Infection of Ureaplasma Urealyticum and Mycoplasma Hominis to Seven Antimicrobial Agents and Comparison with that of Ureaplasma Urealyticum Infection

In order to investigate the susceptibility of mixed infection of Ureaplasma Urealyticum (UU) and Mycoplasma Hominis (MH) to 7 kinds of antimicrobial agents and comparison with that of UU infection in NGU patients, the in vitro susceptibility was determined by using microdilution method. The positive results were analyzed. The results showed that the sequence of susceptibility to 7 kinds of antimicrobial agents for both UU infection group and UU-MH mixed infection group was almost the same from the highest susceptibility to the lowest accordingly: Josamycin, Doxycycline, Minocycline, Sparfloxacin, Roxithromycin, Ofloxacin and Azithromycin. The total drug resistance rate for UU-MH mixed infection group (97. 67 %) was significantly higher than that for UU infection group (44. 67 %, P<.0. 01). The highest drug resistance rate in UU group and UU-MH mixed infection group was 31. 33 % (Ofloxacin) and 90. 48 % (Azithromycin) respectively. UU-MH mixed infection showed an increased drug resistance and changes of drug resistance spectrum.

COVID-19 Coronavirus: Is Infection along with <i>Mycoplasma</i>or Other Bacteria Linked to Progression to a Lethal Outcome?

Most patients with COVID-19 disease caused by the SARS-CoV-2 virus recover from this infection, but a significant fraction progress to a fatal outcome. As with some other RNA viruses, co-infection or activation of latent bacterial infections along with pre-existing health conditions in COVID-19 disease may be important in determining a fatal disease course. Mycoplasma spp. (M. pneumonaie, M. fermentans, etc.) have been routinely found as co-infections in a wide number of clinical conditions, and in some cases this has progressed to a fatal disease. Although preliminary, Mycoplasma pneumoniae has been identified in COVID-19 disease, and the severity of some signs and symptoms in progressive COVID-19 patients could be due, in part, to Mycoplasma or other bacterial infections. Moreover, the presence of pathogenic Mycoplasma species or other pathogenic bacteria in COVID-19 disease may confer a perfect storm of cytokine and hemodynamic dysfunction, autoimmune activation, mitochondrial dysfunction and other complications that together cannot be easily corrected in patients with pre-existing health conditions. The positive responses of only some COVID-19 patients to antibiotic and anti-malaria therapy could have been the result of suppression of Mycoplasma species and other bacterial co-infections in subsets of patients. Thus it may be useful to use molecular tests to determine the presence of pathogenic Mycoplasma species and other pathogenic bacteria that are commonly found in atypical pneumonia in all hospitalized COVID-19 patients, and when positive results are obtained, these patients should treated accordingly in order to improve clinical responses and patient outcomes.

Update and actual trends on bacterial infections following liver transplantation

Recent advances in effective antimicrobial prophylactic strategies have led to a decline in the incidence of opportunistic infections in liver transplant recipients. However, morbidity and mortality due to infectious diseases remain as major problems. Bacterial infections occurring early after transplant are mainly related to the technical aspects of the procedure. By contrast, after the first postoperative days and beyond, the nature and variety of infectious complications change. Opportunistic bacterial infections are uncommon after 6 mo in patients receiving stable and reduced maintenance doses of immunosuppression with good graft function and little is documented about these cases in the literature. Transplant recipients may be more susceptible to some pathogens, such as the Nocardia species, Legionella species, Listeria monocytogenes , Mycoplasma species, Salmonella species or Rhodococcus equi. Respiratory infections due to capsulated bacteria, such as Streptococcus pneumoniae and Haemophilus inf uenza, can be life- threatening if not promptly treated in this population. These late bacterial infections may be very diffi cult to recognize and treat in this population. In this article, we review what has been described in the literature with regards to late bacterial infections following liver transplantation.

Descriptive Epidemiology for <i>Mycoplasma pneumoniae</i>Infection Using (Nursery) School Absenteeism Surveillance System, and Proposal for Countermeasures

Objective: We present descriptive epidemiology of Mycoplasma infection using the (Nursery) School Absenteeism Surveillance System ((N)SASSy) in addition to national official sentinel surveillance for infectious diseases (NOSSID). It is expected to be helpful for early detection and response to outbreak of Mycoplasma infection and also to be useful for antimicrobial resistance measures. Method: The study period was 2010-2014 seasons. The study area was the whole of Ibaraki prefecture, Japan. NOSSID reports the number of patients with Mycoplasma pneumonia from 13 sentinel hospitals. We compare the number of patients and the incidence rate of NOSSID with the same information in (N)SASSy. Result: In NOSSID, the largest number of patients by age was 27 patients of one year old in 2012. (N)SASSy showed that the incidence rate in the elementary schools is high in 2011 and 2012. Especially, the second grade students were the highest. Discussion: Even though Mycoplasma infection is well known as a pediatric disease, we showed that second grade was the highest in incidence at first. Because (N)SASSy is timely and real-time information collection, evaluation and sharing countermeasures with (nursery) schools, public health centers, and physicians are useful for students and nursery school children, and communities. Conclusion: Because mycoplasma infection is common pediatric infectious diseases and because some patients rarely develop severe infections, we must prevent larger outbreaks. (N)SASSy can provide timely intervention at the initial phase of outbreak by monitoring situations in (nursery) schools and comparing data to baseline information.

New Research Progress in Mycoplasma pneumoniae Infection

As an important pathogen of respiratory tract infection, Mycoplasma pneumoniae (MP) may not only lead to primary atypical pneumonia but also cause systemic organ conditions.MP causes respiratory tract infection among school-age children and is also an important infectious agent for adult respiratory tract infection. Intensive studies on roles of MP infection on the innate immune system significantly aid development of targeted therapy drugs. Epidemic studies on associated symptoms also help in clinical prevention and diagnosis and show importance to personalized treatment utilizing different drugs for different patients. This study summarizes the abovementioned three points based on MP studies in recent years.

Effect of adjuvant therapy of transfer factor oral solution on the infection process of children with Mycoplasma pneumonia

Objective:To explore the effect of adjuvant transfer factor oral solution therapy on the infection process of children with mycoplasma pneumonia.Methods:A total of 164 children with mycoplasma pneumonia who were treated in our hospital between January 2017 and January 2018 were selected as the research subjects and divided into control group (n=82) and transfer factor oral solution group (n=82) by random number table method. Control group received clinical routine therapy for children with mycoplasma pneumonia, transfer factor oral solution group received both routine therapy and transfer factor oral solution therapy, and both groups were treated for consecutive 1 week. The differences in infection-related index levels were compared between the two groups before and after treatment.Results:Before treatment, the differences in serum levels of inflammatory factors, coagulation indexes and immunoglobulins were not statistically significant between the two groups. After 1 week of treatment, serum inflammatory factors IL-2, IL-13 and IL-18 contents of transfer factor oral solution group were lower than those of control group;serum coagulation index FIB level was lower than that of control group whereas PT and APTT levels were higher than those of control group;serum immunoglobulins IgG, IgA and IgM contents were lower than those of control group.Conclusion: Adjuvant transfer factor oral solution therapy can effectively relieve the systemic inflammatory response and reduce the coagulation system and humoral immune system function damage in children with mycoplasma pneumonia.

A Study on Infertility of Males Infected with <i>Mycoplasma hominis</i>with Reference to Sperm Morphology

Objectives: The main objective of this study was to investigate the effect of Mycoplasma hominis infection on the morphology of sperms and its association with the infertility of men. The patients were referred to the Urology Departments of Mosul General Hospital and Soran Hospital in Mosul and Erbil respectively. Methods: The present study was carried out from April 2019 to March 2020 and the number of the patients group was 108. The patients aged 20 to 60 years. Semen was collected from infertile men of a couple that female failed to become pregnant after one year of regular and unprotected intercourse of marriage and submitted for seminal fluid analysis as well as for bacteriological investigations Results: M. hominis was detected in 14 semen specimens (12.9%) from the infertile men. The teratozoospermia, normozoospermia, asthenoteratozoospermia, oligoasthenoteratozoospermia, asthenozoospermia, oligozoospermia, oligoasthenozoospermia and leukospermia were seen among patients examined. Statistically, there were no significant differences between these forms of infected infertile men and non-infected infertile men (P > 0.05). Conclusions: The results of present study demonstrated that the genital Mycoplasma hominis seems to be widespread among male partners of infertile couples in Iraq. The present data did not show any significant differences between forms of the sperm concentration and sperm morphology related to the infection by M. hominis.

滑液囊支原体与鸡传染性支气管炎病毒共感染对SPF鸡的致病性研究

为比较滑液囊支原体(MS)和鸡传染性支气管炎病毒(IBV)共感染对SPF鸡的致病性,本研究将144只28日龄SPF鸡随机均分为阴性对照组、MS感染组、IBV-M41感染组、IBV-M41+MS共感染组、IBV-QX感染组、IBV-QX+MS共感染组共6组,采用50μL/只剂量按相应分组点眼感染MS (106CCU50)、IBV(105EID50),阴性对照组以50μL/只点眼KM2培养基(左眼)和PBS (右眼)。感染后每天观察临床症状,在感染后7 d、14 d、21 d和28 d每组随机剖检6只鸡,观察气囊炎和气囊损伤评分,并采集气管进行病原再分离,其中MS经支原体液体培养基培养后进行PCR鉴定,IBV接种SPF鸡胚后进行RT-PCR鉴定。此外,各组鸡气管均经10%甲醛固定后进行粘膜厚度检测以及病理损伤评分。结果显示:除阴性对照组和MS感染组,其他组鸡在感染后4 d均出现一过性呼吸道症状。剖检结果显示MS感染组鸡在感染后21 d出现气囊炎,28 d仍可见气囊炎;而IBV-M41感染组和IBV-QX感染组鸡在感染后7 d或14 d出现气囊炎,且气囊炎的发生率均未超过50%。感染后14 d IBV-QX+MS共感染组鸡气囊炎发生率达100%(6/6),直至21 d并且大部分鸡气囊炎可持续至感染后28 d (5/6),而IBV-M41+MS共感染组鸡气囊炎仅可持续至感染后21 d,且气囊炎的发生率最高在感染后14 d (5/6)。IBV-QX+MS共感染组鸡平均气囊损伤评分在感染后14 d、21d和28 d均极显著高于单一感染组(P<0.001),而IBV-M41+MS共感染组鸡仅在感染后14 d极显著高于单一感染组(P<0.001)。病原再分离结果显示,各感染组鸡均在气管中再分离到MS(感染后28 d内)或IBV(感染后7 d内)。病理损伤检测结果显示,共感染组鸡较各单一感染组鸡气管粘膜增厚持续时间更长以及病理损伤更为严重。IBV-M41+MS共感染组鸡在感染后14 d平均气管粘膜厚度显著低于IBV-QX+MS共感染组(P<0.05),而在感染后21 d极显著低于IBV-QX+MS共感染组(P<0.001),其余各组鸡在感染后14 d和21 d均极显著低于IBV-QX+MS共感染组鸡(P<0.001)。IBV M41+MS共感染组鸡最早14 d出现气管病变,而IBV QX+MS共感染组鸡在共感染后7 d就可见气管病理损伤,且共感染组鸡的平均气管损伤评分均极显著高于单一MS或IBV感染组(P<0.01或P<0.001)。上述结果证实MS和IBV共感染较单一感染对28日龄SPF鸡的致病性更强,IBV M41或QX株与MS共感染对SPF鸡的致病性存在差异,本研究为临床IB和MS的防控提供科学参考依据。

MALDI-TOF-MS鉴定成人颅内感染人型支原体1例

人型支原体是一类没有细胞壁、具有多形性、可通过滤菌器的已知最小原核型微生物。在人体中,其主要引起泌尿生殖系统感染,而在成人颅内感染中极为少见,且引起的颅内感染在诊断、治疗、预后管理等方面尚缺乏统一的共识。本文报告1例成人因车祸伤行神经外科手术后出现人型支原体颅内感染的病例,旨在为临床此类疾病诊治提供参考。

绵羊肺炎支原体小鼠感染模型的建立

旨在探索小鼠作为绵羊肺炎支原体(Mycoplasma ovipneumoniae,Mo)实验室感染模型的可行性,筛选建立Mo感染小鼠模型的最佳方法。将60只BALB/c小鼠随机分为对照组、Mo感染组1、感染组2、感染组3和感染组4(n=12)。Mo感染组1小鼠分别滴鼻30μL和腹腔注射25μL 10^(8 )CCU·mL^(-1) Mo NJ01株菌液各1次,Mo感染组2和3小鼠分别滴鼻2和3次30μL 10^(8 )CCU·mL^(-1) Mo NJ01株菌液,Mo感染组4小鼠喉头喷雾50μL 10^(8 )CCU·mL^(-1) Mo NJ01株菌液2次,对照组用正常培养基处理。分别于感染后第0、7和14天称量小鼠体重。感染后第14天处死所有小鼠,采集血液和肺组织。通过HE染色法进行肺组织病理学检查、剖检进行肺组织病理评分、qPCR方法检测肺组织中Mo的载荷量和ELISA检测血清Mo IgG水平,确定小鼠感染模型是否建立成功及最佳建立方法。Mo感染组2和组4中小鼠体重第14天时分别比对照组显著降低17.2%(P<0.05)和21.6%(P<0.05);感染第13天,感染组2和组4小鼠出现死亡;感染后第14天剖检,Mo感染组2和组4小鼠肺部有炎症,肺病变平均评分分别为3.5和3.3,均显著高于Mo感染组1(P<0.05)和组3(P<0.05),而对照组小鼠无病变;组织病理学检查发现,Mo感染组小鼠肺可见不同程度的间质性肺炎,肺泡腔内有炎细胞浸润;对照组小鼠肺组织结构正常、完整,肺泡内未见明显细胞浸润。小鼠肺组织中Mo DNA拷贝数在Mo感染组1和组3中分别为10^(2.56)和10^(3.21)拷贝·g^(-1);感染组2和组4分别为10^(3.84)和10^(3.77)拷贝·g^(-1),且显著高于Mo感染组1(P<0.05)和组3(P<0.05),对照组为阴性。小鼠血清Mo抗体OD_(450 nm)值在Mo感染组1、组2、组3和组4分别为0.63、1.05、0.81和0.99,均显著高于对照组(P<0.05),且组2和组4均显著高于1组(P<0.05)。本研究通过1×10^(8 )CCU·mL^(-1)的Mo NJ01株菌液滴鼻2次或喉头喷雾2次均可成功建立Mo感染小鼠模型。为绵羊肺炎支原体的致病机制及防治策略研究奠定基础。

膳食模式与学龄期肺炎支原体肺炎患儿疾病复发的关系

目的:探讨学龄期肺炎支原体肺炎患儿膳食模式与疾病复发的关系。方法:选取2018年7月—2024年3月在本院确诊的学龄期肺炎支原体肺炎患儿160例,并定期在营养科进行营养咨询,均进行问卷调查、体格检查和实验室检测,采用因子分析提取膳食模式,采用多因素Logistic回归模型分析膳食模式与反复呼吸道感染的关系。结果:复发与未复发患儿在年龄、BMI、MP抗体阳性比例、用免疫增强剂比例、CD4+/CD8+、IgA方面比较,P<0.05,在性别、用抗过敏药比例、用锌剂比例、CD3+、IgG、IgM方面比较,P>0.05;高水平的肉食模式、高水平的素食模式与反复呼吸道感染复发相关,在调整混杂因素以后,高水平肉食模式是反复呼吸道感染复发的危险因素(OR=2.52,95%CI:1.17~5.21),同时高水平的素食模式是反复呼吸道感染复发的保护因素(OR=0.37,95%CI:0.19~0.86)。结论:学龄期肺炎支原体肺炎患儿的膳食模式与疾病复发之间存在着关联性,在学龄期肺炎支原体肺炎患儿的治疗和预防中,应当重视膳食的合理搭配和调节,尤其需要控制肉类的摄入量,适当增加蔬果、谷物、豆类等植物性食物的比例,以提高免疫力,降低呼吸道感染的风险。

2例人型支原体导致骨折术后手术部位感染的病例报告

人型支原体可定植于人体泌尿生殖系统,为机会性致病菌,其引起的骨折术后手术部位感染较为罕见。由于人型支原体缺乏细胞壁,革兰染色阴性,常规细菌培养易漏检,感染后诊断和治疗较为困难。该文分析2例骨折术后人型支原体伤口感染患者的临床资料、治疗经过、检验确诊及微生物药敏结果,以提高临床医生与检验人员对生殖道以外部位人型支原体感染的认识,减少误诊和漏诊。

慢加急性乙型肝炎肝衰竭患者细菌感染病原菌分布及血清PCT、IFN-γ和IL-6水平变化分析

目的调查慢加急性乙型肝炎肝衰竭(HBV-ACLF)患者细菌感染病原菌分布特征,分析血清降钙素原(PCT)、干扰素-γ(IFN-γ)和白细胞介素-6(IL-6)水平预测细菌感染的效能。方法2019年12月~2023年1月我院收治的HBV-ACLF患者86例,常规分离和鉴定菌种,采用电化学发光免疫法检测血清PCT水平,采用ELISA法检测血清IFN-γ和IL-6水平,应用受试者工作特征(ROC)曲线评估血清指标联合预测HBV-ACLF患者发生细菌感染的效能。结果本组发生细菌感染者37例,未发生明确感染者49例;在37例HBV-ACLF并发细菌感染患者中,共检出68株感染病原菌,其中革兰氏阴性菌41株(60.3%),革兰氏阳性菌27株(39.7%);感染组血清PCT、IFN-γ和IL-6水平分别为(10.9±3.1)μg/L、(46.5±1.9)pg/mL和(16.9±1.6)pg/mL,均显著高于未感染组【分别为(0.9±0.1)μg/L、(20.1±2.4)pg/mL和(4.8±0.9)pg/mL,P<0.05】,28 d和90 d病死率分别为67.6%和75.7%,均显著高于未感染组(分别为8.2%和12.2%,P<0.05);经ROC分析显示,分别以PCT>3.3μg/L、IFN-γ>45.5 pg/mL和IL-6>15.4pg/mL为截断点,其联合预测HBV-ACLF患者并发细菌感染的曲线下面积(AUC)为0.874,诊断的灵敏度为93.6%,特异度为84.1%。结论HBV-ACLF患者细菌感染的病原菌分布具有一定的特征性,以革兰氏阴性菌感染为主,除检测血清PCT水平外,监测血清IFN-γ和IL-6水平可能有助于早期发现细菌感染而给予预防性处理,或能提供生存率。

槐杞黄颗粒联合甲泼尼龙琥珀酸钠对肺炎支原体感染致大叶性肺炎患儿临床症状、炎症因子及免疫功能的影响

目的:观察槐杞黄颗粒联合甲泼尼龙琥珀酸钠对肺炎支原体感染致大叶性肺炎患儿临床症状、炎症反应及免疫功能的影响。方法:选取2020年1月~2022年12月某院收治的150例肺炎支原体感染致大叶性肺炎患儿为研究对象,采用随机数字表法分为对照组和观察组,每组75例。对照组在常规治疗基础上加用甲泼尼龙琥珀酸钠,观察组在对照组治疗基础上加用槐杞黄颗粒。比较两组患儿中医证候积分、炎症因子[高迁移率族蛋白B1(HMGB1)、降钙素原(PCT)、白细胞介素-17(IL-17)、IL-35]、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、临床症状(发热、咳喘、肺部阴影)改善时间以及临床疗效。结果:治疗前,两组中医证候积分比较无统计学差异(P>0.05);治疗后,两组中医证候主症积分、次症积分和总积分均降低,且观察组各项积分均低于对照组(P<0.05)。治疗前,两组HMGB1、PCT、IL-17、IL-35等炎症因子水平比较均无统计学差异(P>0.05);治疗后,两组HMGB1、PCT、IL-17均降低,IL-35均升高(P<0.05),且观察组HMGB1、PCT、IL-17低于对照组,IL-35高于对照组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较无统计学差异(P>0.05);治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均升高,且观察组各指标高于对照组(P<0.05)。观察组退热、咳喘消失、肺部阴影消失时间均短于对照组(P<0.05),且临床治疗总有效率高于对照组(P<0.05)。结论:槐杞黄颗粒联合甲泼尼龙琥珀酸钠可有效减轻肺炎支原体感染致大叶性肺炎患儿的炎症反应,提高免疫功能,加快临床症状的改善和消失。