Atypical bacterial etiology of acute respiratory infections and clinical characterizations among Iranian children

M. Halaji; T. Hashempour; G. R. Pouladfar; F. Ghasabi; R. Khashei

doi:10.14715/cmb/2017.63.8.24

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Vol. 63 No. 8: Issue 8

Issue Published : September 4, 2017

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Atypical bacterial etiology of acute respiratory infections and clinical characterizations among Iranian children

https://doi.org/10.14715/cmb/2017.63.8.24

M. Halaji

Department of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

T. Hashempour

Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

G. R. Pouladfar

Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

F. Ghasabi

Department of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

R. Khashei

Department of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Corresponding Author(s) : R. Khashei

seddigh.hadi@gmail.com

Cellular and Molecular Biology, Vol. 63 No. 8: Issue 8
Article Published : August 30, 2017

Abstract

Acute respiratory infections (ARIs) in children younger than 5 years of age are one of the leading causes of morbidity and mortality, particularly in developing countries. Mycoplasma pneumoniae and Chlamydophila pneumoniae are prevalent causative agents of ARIs, worldwide. We sought M. pneumoniae and C. pneumoniae in respiratory samples from Iranian children with ARIs. From November 2014 to April 2015, respiratory samples of 150 children aged 1 month to 15 years old were screened for presence of M. pneumoniae and C. pneumoniae. Polymerase chain reaction (PCR) and culture methods were used to detect these bacteria in respiratory samples in the form of throat swabs and nasopharyngeal aspirates. A questionnaire containing demographic and clinical information has been filled up for all participants in this study. Our obtained data showed that out of 150 tested samples, 7 (4.7%) were PCR positive for M. pneumoniae and only one (0.7%) positive sample for C. pneumoniae was detected. However, none of the tested samples was detected M. pneumoniae using the bacterial culture method. All patients with ARIs due to M. pneumoniae showed up with sore throat and flu like symptoms. According to our data, PCR method is more sensitive than culture for detection of M. pneumoniae. With regards to our results, it appears that M. pneumoniae and especially C. pneumoniae were infrequent causative agents in our studied population.

Keywords

Mycoplasma pneumoniae Chlamydophila pneumoniae ARIs PCR.

Halaji, M., Hashempour, T., Pouladfar, G. R., Ghasabi, F., & Khashei, R. (2017). Atypical bacterial etiology of acute respiratory infections and clinical characterizations among Iranian children. Cellular and Molecular Biology, 63(8), 115–119. https://doi.org/10.14715/cmb/2017.63.8.24

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References

Rudan I, O'Brien KL, Nair H, Liu L, Theodoratou E, Qazi S, et al. Epidemiology and etiology of childhood pneumonia in 2010: estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries. J Glob Health. 2013; 3:010401.
Bellos A, Mulholland K, O'Brien KL, Qazi SA, Gayer M, Checchi F. The burden of acute respiratory infections in crisis-affected populations: a systematic review. Confl Health. 2010; 4:3.
Hara M, Takao S, Shimazu Y, Nishimura T. Three-year study of viral etiology and features of febrile respiratory tract infections in Japanese pediatric outpatients. Pediatr Infect Dis J. 2014; 33:687-92.
Liu J, Ai H, Xiong Y, Li F, Wen Z, Liu W, et al. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China. Plos One. 2015; 10:e0119170.
Chen Z, Ji W, Wang Y, Yan Y, Zhu H, Shao X, et al. Epidemiology and associations with climatic conditions of Mycoplasma pneumoniae and Chlamydophila pneumoniae infections among Chinese children hospitalized with acute respiratory infections. Ital J Pediatr. 2013; 39:34.
She RC, Thurber A, Hymas WC, Stevenson J, Langer J, Litwin CM, et al. Limited utility of culture for Mycoplasma pneumoniae and Chlamydophila pneumoniae for diagnosis of respiratory tract infections. J Clin Microbiol. 2010; 48:3380-82.
Layani-Milon M-P, Gras I, Valette M, Luciani J, Stagnara J, Aymard M, et al. Incidence of upper respiratory tract Mycoplasma pneumoniae infections among outpatients in Rhí´ne-Alpes, France, during five successive winter periods. J Clin Microbiol. 1999; 37:1721-26.
Pawate S, Sriram S. The role of infections in the pathogenesis and course of multiple sclerosis. Ann Indian Acad Neurol. 2010; 13:80-86.
Campbell LA, Perez Melgosa M, Hamilton DJ, Kuo CC, Grayston JT. Detection of Chlamydia pneumoniae by polymerase chain reaction. J Clin Microbiol. 1992; 30:434-39.
Cunningham AF, Ward ME. Characterization of human humoral responses to the major outer membrane protein and OMP2 of Chlamydophila pneumoniae. FEMS Microbiol Lett. 2003; 227:73-79.
Berebichez-Fridman R, Blachman-Braun R, Azrad-Daniel S, Vázquez-Campuzano R, Vázquez-López R. Atypical pneumonias caused by Legionella pneumophila, Chlamydophila pneumoniae and Mycoplasma pneumoniae. Rev Med Hosp Gen Mex. 2015; 78:188-95.
Waites KB, Xiao L, Paralanov V, Viscardi RM, Glass JI. Molecular methods for the detection of Mycoplasma and Ureaplasma infections in humans: a paper from the 2011 William Beaumont Hospital Symposium on molecular pathology. J Mol Diagn. 2012; 14: 437-50.
Cho MC, Kim H, An D, Lee M, Noh SA, Kim MN, et al. Comparison of sputum and nasopharyngeal swab specimens for molecular diagnosis of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Ann Lab Med. 2012; 32: 133-38.
Lehman DC and Mahon CR. Mycoplasma and Ureaplasma. In: Mahon CR, Lehman DC, Manuselis G, (eds.), Textbook of Diagnostic Microbiology, 5th ed. Saunders Elsevier, Inc; 2015, pp. 552-62.
Wu J, Li XJ, Zhu W, Liu XP. Detection and pathological value of papillomavirus DNA and p16INK4A and p53 protein expression in cervical intraepithelial neoplasia. Oncol Lett. 2014; 7:738-44.
Kleemola SR, Karjalainen JE, Räty RK. Rapid diagnosis of Mycoplasma pneumoniae infection: clinical evaluation of a commercial probe test. J Infect Dis. 1990; 162:70-75.
Demkin VV, Zimin AL. A new amplification target for PCR–RFLP detection and identification of Chlamydiaceae species. Arch Microbiol. 2005; 183:169-75.
Nomanpour B, Ghodousi A, Babaei T, Jafari S, Feizabadi M. Single tube real time PCR for detection of Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila from clinical samples of CAP. Acta Microbiol Immunol Hung. 2012; 59:171-84.
Oskooee MB, Karimi A, Shiva F, Fallah F, Tabatabaei SR, Shirvani F, et al. Detection of Mycoplasma pneumoniae and Chlamydia trachomatis in Iranian children with acute lower respiratory infections by polymerase chain reaction. Asian Pac J Trop Dis. 2014; 4:S302-06.
Ghotaslou R, Sharifi S, Akhi MT, Soroush MH. Epidemiology, clinical features, and laboratory detection of Mycoplasma pneumoniae infection in East Azerbaijan, Iran. Turk J Med Sci. 2013; 43:521-24.
Naghipour M, Cuevas LE, Bakhshinejad T, Mansour-Ghanaei F, Noursalehi S, Alavy A, et al. Contribution of viruses, Chlamydia spp. and Mycoplasma pneumoniae to acute respiratory infections in Iranian children. J Trop Pediatr. 2007; 53 (3):179-84.
Duenas Meza E, Jaramillo CA, Correa E, Torres-Duque CA, García C, González M, et al. Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation. J Asthma. 2016; 53:253-60.
Sauteura PMM, Bleischa B, Voit A, Maurer FP, Relly C, Berger C, et al. Survey of macrolide-resistant Mycoplasma pneumoniae in children with community-acquired pneumonia in Switzerland. Swiss Med Wkly. 2014; 144:w14041.
Sí¸rensen CM, Schí¸nning K, Rosenfeldt V. Clinical characteristics of children with Mycoplasma pneumoniae infection hospitalized during the Danish 2010-2012 epidemic. Dan Med J. 2013; 60:A4632.
Shafik CF, Mohareb EW, Yassin AS, Amin MA, El Kholy A, El-Karaksy H, et al. Viral etiologies of lower respiratory tract infections among Egyptian children under five years of age. BMC Infect Dis. 2012; 12:350.
Dumke R, Schnee C, Pletz MW, Rupp J, Jacobs E, Sachse K, et al. Mycoplasma pneumoniae and Chlamydia spp. infection in community-acquired pneumonia, Germany, 2011–2012. Emerg Infect Dis. 2015; 21 (3):426-34.
Fukutani KF, Nascimento-Carvalho CM, Van der Gucht W, Wollants E, Khouri R, Dierckx T, et al. Pathogen transcriptional profile in nasopharyngeal aspirates of children with acute respiratory tract infection. J Clin Virol. 2015; 69:190-96.
Chen K, Jia R, Li L, Yang C, Shi Y. The aetiology of community associated pneumonia in children in Nanjing, China and aetiological patterns associated with age and season. BMC Public Health. 2015; 15:113.
Hadi N, Kashef S, Moazzen M, Pour MS, Rezaei N. Survey of Mycoplasma pneumoniae in Iranian children with acute lower respiratory tract infections. Braz J Infect Dis. 2011; 15 (2):97-101.
Huang F, Lu L, Jiang W, Yan Y, Ji W, Yang B, et al. The epidemiology and clinical features of Mycoplasma pneumoniae infection in neonates. Braz J Infect Dis. 2016; 20:374-78.
Miyashita N, Kawai Y, Kato T, Tanaka T, Akaike H, Teranishi H, et al. Rapid diagnostic method for the identification of Mycoplasma pneumoniae respiratory tract infection. J Infect Chemother. 2016; 22:327-30.

References

Rudan I, O'Brien KL, Nair H, Liu L, Theodoratou E, Qazi S, et al. Epidemiology and etiology of childhood pneumonia in 2010: estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries. J Glob Health. 2013; 3:010401.

Bellos A, Mulholland K, O'Brien KL, Qazi SA, Gayer M, Checchi F. The burden of acute respiratory infections in crisis-affected populations: a systematic review. Confl Health. 2010; 4:3.

Hara M, Takao S, Shimazu Y, Nishimura T. Three-year study of viral etiology and features of febrile respiratory tract infections in Japanese pediatric outpatients. Pediatr Infect Dis J. 2014; 33:687-92.

Liu J, Ai H, Xiong Y, Li F, Wen Z, Liu W, et al. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China. Plos One. 2015; 10:e0119170.

Chen Z, Ji W, Wang Y, Yan Y, Zhu H, Shao X, et al. Epidemiology and associations with climatic conditions of Mycoplasma pneumoniae and Chlamydophila pneumoniae infections among Chinese children hospitalized with acute respiratory infections. Ital J Pediatr. 2013; 39:34.

She RC, Thurber A, Hymas WC, Stevenson J, Langer J, Litwin CM, et al. Limited utility of culture for Mycoplasma pneumoniae and Chlamydophila pneumoniae for diagnosis of respiratory tract infections. J Clin Microbiol. 2010; 48:3380-82.

Layani-Milon M-P, Gras I, Valette M, Luciani J, Stagnara J, Aymard M, et al. Incidence of upper respiratory tract Mycoplasma pneumoniae infections among outpatients in Rhí´ne-Alpes, France, during five successive winter periods. J Clin Microbiol. 1999; 37:1721-26.

Pawate S, Sriram S. The role of infections in the pathogenesis and course of multiple sclerosis. Ann Indian Acad Neurol. 2010; 13:80-86.

Campbell LA, Perez Melgosa M, Hamilton DJ, Kuo CC, Grayston JT. Detection of Chlamydia pneumoniae by polymerase chain reaction. J Clin Microbiol. 1992; 30:434-39.

Cunningham AF, Ward ME. Characterization of human humoral responses to the major outer membrane protein and OMP2 of Chlamydophila pneumoniae. FEMS Microbiol Lett. 2003; 227:73-79.

Berebichez-Fridman R, Blachman-Braun R, Azrad-Daniel S, Vázquez-Campuzano R, Vázquez-López R. Atypical pneumonias caused by Legionella pneumophila, Chlamydophila pneumoniae and Mycoplasma pneumoniae. Rev Med Hosp Gen Mex. 2015; 78:188-95.

Waites KB, Xiao L, Paralanov V, Viscardi RM, Glass JI. Molecular methods for the detection of Mycoplasma and Ureaplasma infections in humans: a paper from the 2011 William Beaumont Hospital Symposium on molecular pathology. J Mol Diagn. 2012; 14: 437-50.

Cho MC, Kim H, An D, Lee M, Noh SA, Kim MN, et al. Comparison of sputum and nasopharyngeal swab specimens for molecular diagnosis of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Ann Lab Med. 2012; 32: 133-38.

Lehman DC and Mahon CR. Mycoplasma and Ureaplasma. In: Mahon CR, Lehman DC, Manuselis G, (eds.), Textbook of Diagnostic Microbiology, 5th ed. Saunders Elsevier, Inc; 2015, pp. 552-62.

Wu J, Li XJ, Zhu W, Liu XP. Detection and pathological value of papillomavirus DNA and p16INK4A and p53 protein expression in cervical intraepithelial neoplasia. Oncol Lett. 2014; 7:738-44.

Kleemola SR, Karjalainen JE, Räty RK. Rapid diagnosis of Mycoplasma pneumoniae infection: clinical evaluation of a commercial probe test. J Infect Dis. 1990; 162:70-75.

Demkin VV, Zimin AL. A new amplification target for PCR–RFLP detection and identification of Chlamydiaceae species. Arch Microbiol. 2005; 183:169-75.

Nomanpour B, Ghodousi A, Babaei T, Jafari S, Feizabadi M. Single tube real time PCR for detection of Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila from clinical samples of CAP. Acta Microbiol Immunol Hung. 2012; 59:171-84.

Oskooee MB, Karimi A, Shiva F, Fallah F, Tabatabaei SR, Shirvani F, et al. Detection of Mycoplasma pneumoniae and Chlamydia trachomatis in Iranian children with acute lower respiratory infections by polymerase chain reaction. Asian Pac J Trop Dis. 2014; 4:S302-06.

Ghotaslou R, Sharifi S, Akhi MT, Soroush MH. Epidemiology, clinical features, and laboratory detection of Mycoplasma pneumoniae infection in East Azerbaijan, Iran. Turk J Med Sci. 2013; 43:521-24.

Naghipour M, Cuevas LE, Bakhshinejad T, Mansour-Ghanaei F, Noursalehi S, Alavy A, et al. Contribution of viruses, Chlamydia spp. and Mycoplasma pneumoniae to acute respiratory infections in Iranian children. J Trop Pediatr. 2007; 53 (3):179-84.

Duenas Meza E, Jaramillo CA, Correa E, Torres-Duque CA, García C, González M, et al. Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation. J Asthma. 2016; 53:253-60.

Sauteura PMM, Bleischa B, Voit A, Maurer FP, Relly C, Berger C, et al. Survey of macrolide-resistant Mycoplasma pneumoniae in children with community-acquired pneumonia in Switzerland. Swiss Med Wkly. 2014; 144:w14041.

Sí¸rensen CM, Schí¸nning K, Rosenfeldt V. Clinical characteristics of children with Mycoplasma pneumoniae infection hospitalized during the Danish 2010-2012 epidemic. Dan Med J. 2013; 60:A4632.

Shafik CF, Mohareb EW, Yassin AS, Amin MA, El Kholy A, El-Karaksy H, et al. Viral etiologies of lower respiratory tract infections among Egyptian children under five years of age. BMC Infect Dis. 2012; 12:350.

Dumke R, Schnee C, Pletz MW, Rupp J, Jacobs E, Sachse K, et al. Mycoplasma pneumoniae and Chlamydia spp. infection in community-acquired pneumonia, Germany, 2011–2012. Emerg Infect Dis. 2015; 21 (3):426-34.

Fukutani KF, Nascimento-Carvalho CM, Van der Gucht W, Wollants E, Khouri R, Dierckx T, et al. Pathogen transcriptional profile in nasopharyngeal aspirates of children with acute respiratory tract infection. J Clin Virol. 2015; 69:190-96.

Chen K, Jia R, Li L, Yang C, Shi Y. The aetiology of community associated pneumonia in children in Nanjing, China and aetiological patterns associated with age and season. BMC Public Health. 2015; 15:113.

Hadi N, Kashef S, Moazzen M, Pour MS, Rezaei N. Survey of Mycoplasma pneumoniae in Iranian children with acute lower respiratory tract infections. Braz J Infect Dis. 2011; 15 (2):97-101.

Huang F, Lu L, Jiang W, Yan Y, Ji W, Yang B, et al. The epidemiology and clinical features of Mycoplasma pneumoniae infection in neonates. Braz J Infect Dis. 2016; 20:374-78.

Miyashita N, Kawai Y, Kato T, Tanaka T, Akaike H, Teranishi H, et al. Rapid diagnostic method for the identification of Mycoplasma pneumoniae respiratory tract infection. J Infect Chemother. 2016; 22:327-30.

Author biographies is not available.