Microbiology and Infection Research Group, Department of Biomedical Sciences, Cardiff Metropolitan University, Western Avenue, Cardiff. CF5 2YB, UK.
Division of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
J Med Microbiol. 2024 Oct;73(10). doi: 10.1099/jmm.0.001910.
is a leading cause of community-acquired pneumonia among school-aged children and young adults. Infections occur throughout the year but tend to surge during winter months across Europe. A characteristic epidemic cycle, where a substantial surge in the number of infections occurs, is seen approximately every 1-4 years and hypothesized to be driven by changes in immunity and a shift in circulating variants. Once thought to be an organism of low virulence, it has now been found to possess several virulence factors, including toxin production, biofilm formation and evasion of antibody-mediated immunity. The lack of a cell wall and reduced metabolic pathways limit the options for antibiotic treatment. Acquired macrolide resistance is a growing concern, with >80% of cases in China being macrolide-resistant. Although efforts have been made to develop a vaccine, there are still substantial hurdles to overcome in relation to vaccine-enhanced disease, which results from an inappropriate immune response among vaccinated individuals.
是导致学龄儿童和青年社区获得性肺炎的主要原因之一。感染全年都有发生，但在欧洲的冬季月份往往会激增。大约每 1-4 年就会出现一个特征性的流行周期，大量感染病例会突然增加，这被认为是由免疫变化和循环变异引起的。过去被认为是一种低毒力的病原体，现在已经发现它具有多种毒力因子，包括毒素产生、生物膜形成和逃避抗体介导的免疫。缺乏细胞壁和减少的代谢途径限制了抗生素治疗的选择。获得性大环内酯类耐药性是一个日益令人关注的问题，在中国，超过 80%的病例对大环内酯类耐药。尽管已经做出努力来开发疫苗，但在与疫苗增强疾病相关的方面仍然存在很大的障碍，疫苗增强疾病是由于接种人群中产生了不适当的免疫反应。
