Center of Translational Immunology, UMC Utrecht, Utrecht, the Netherlands; Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, Utrecht, the Netherlands.
Laboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC University Medical Center Rotterdam - Sophia Children's Hospital, Rotterdam, the Netherlands.
EBioMedicine. 2023 Dec;98:104868. doi: 10.1016/j.ebiom.2023.104868. Epub 2023 Nov 10.
Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in school-aged children and can be preceded by asymptomatic carriage. However, its role in recurrent respiratory tract infections is unclear. We studied the prevalence of M.pneumoniae carriage in children with recurrent respiratory infections and identified associated factors.
We tested M.pneumoniae carriage by qPCR in children with recurrent infections and their healthy family members in a cross-sectional study. Serum and mucosal total and M.pneumoniae-specific antibody levels were measured by ELISA and nasopharyngeal microbiota composition was characterized by 16S-rRNA sequencing.
Prevalence of M.pneumoniae carriage was higher in children with recurrent infections (68%) than their family members without infections (47% in siblings and 27% in parents). M.pneumoniae carriage among family members appeared to be associated with transmission within the household, likely originating from the affected child. In logistic regression corrected for age and multiple comparisons, IgA (OR 0.16 [0.06-0.37]) and total IgG deficiency (OR 0.15 [0.02-0.74]) were less prevalent in M.pneumoniae carriers (n = 78) compared to non-carriers (n = 36). In multivariable analysis, the nasopharyngeal microbiota of M.pneumoniae carriers had lower alpha diversity (OR 0.27 [0.09-0.67]) and a higher abundance of Haemophilus influenzae (OR 45.01 [2.74-1608.11]) compared to non-carriers.
M.pneumoniae carriage is highly prevalent in children with recurrent infections and carriers have a less diverse microbiota with an overrepresentation of disease-associated microbiota members compared to non-carriers. Given the high prevalence of M.pneumoniae carriage and the strong association with H. influenzae, we recommend appropriate antibiotic coverage of M.pneumoniae and H. influenzae in case of suspected pneumonia in children with recurrent respiratory tract infections or their family members.
Wilhelmina Children's Hospital Research Fund, 'Christine Bader Stichting Irene KinderZiekenhuis', Sophia Scientific Research Foundation, ESPID Fellowship funded by Seqirus, Hypatia Fellowship funded by Radboudumc and The Netherlands Organisation for Health Research and Development (ZonMW VENI grant to LM Verhagen).
肺炎支原体是学龄儿童社区获得性肺炎的常见病因，可无症状携带。然而，其在反复呼吸道感染中的作用尚不清楚。我们研究了反复呼吸道感染患儿中肺炎支原体携带的流行情况，并确定了相关因素。
我们在一项横断面研究中，通过 qPCR 检测反复感染患儿及其健康家庭成员的肺炎支原体携带情况。通过 ELISA 检测血清和黏膜总抗体和肺炎支原体特异性抗体水平，并通过 16S-rRNA 测序描述鼻咽微生物群落组成。
反复感染患儿的肺炎支原体携带率（68%）高于无感染的家庭成员（兄弟姐妹中为 47%，父母中为 27%）。家庭成员中的肺炎支原体携带似乎与家庭内传播有关，可能源自受感染的儿童。在年龄校正和多重比较的逻辑回归中，与非携带者（n=36）相比，肺炎支原体携带者（n=78）中 IgA（比值比[OR]0.16[0.06-0.37]）和总 IgG 缺乏症（OR 0.15[0.02-0.74]）的患病率较低。在多变量分析中，与非携带者相比，肺炎支原体携带者的鼻咽微生物群落多样性较低（OR 0.27[0.09-0.67]），流感嗜血杆菌丰度较高（OR 45.01[2.74-1608.11]）。
反复感染患儿肺炎支原体携带率高，与非携带者相比，携带者的微生物群落多样性较低，与疾病相关的微生物成员较多。鉴于肺炎支原体携带率高，与流感嗜血杆菌的强关联，我们建议在反复呼吸道感染患儿或其家庭成员疑似肺炎时，对肺炎支原体和流感嗜血杆菌进行适当的抗生素覆盖。
威廉敏娜儿童医院研究基金、“Christine Bader Stichting Irene KinderZiekenhuis”、索菲亚科学研究基金会、ESPID 奖学金由 Seqirus 资助、Hypatia 奖学金由 Radboudumc 和荷兰健康研究与发展组织（ZonMW VENI 赠款授予 LMVerhagen）资助。
