BACKGROUND:The COVID-19 pandemic has affected the epidemiology of Mycoplasma pneumoniae pneumonia (MPP). This study aimed to provide a comprehensive overview of research trends, challenges, and advancements in pediatric MPP, particularly in the post-COVID-19 era. METHODS:A bibliometric analysis of pediatric MPP literature (1992-2025) from the Web of Science was conducted using VOSviewer and CiteSpace. RESULTS:A total of 2357 relevant articles were published by 11,318 authors from 2714 institutions across 94 countries. Publications increased significantly during and after the COVID-19 pandemic. China and the United States were the most influential countries, while Soochow University and Capital Medical University were the most active institutions. The top 10 co-cited references included four research articles and six review articles. Over the past 34 years, the research focus has shifted from community-acquired pneumonia (CAP) and pediatric pulmonary diseases to MPP. Current research hotspots include epidemiology, diagnostics, macrolide resistance, refractory MPP, and co-infections, with recent citation bursts related to COVID-19. CONCLUSION:This bibliometric analysis provides a systematic overview of pediatric MPP research from the 1990s to the post-COVID-19 era. It highlights the need for stronger global collaboration and further epidemiological studies to address MPP-related challenges, especially amid evolving infectious threats like COVID-19. IMPACT:This study offers a comprehensive overview of pediatric Mycoplasma pneumoniae pneumonia (MPP) research from 1992 to 2025, revealing critical changes and advances in the field. Detailed analyses of core contributors, thematic evolution, research hotspots and frontiers advance the overall understanding of pediatric MPP. The findings reveal persistent challenges in epidemiology, diagnostics, macrolide resistance, refractory MPP, and co-infections. This study highlights the necessity of strengthening global collaboration and conducting continuous epidemiological surveillance on MPP amid emerging infectious threats such as COVID-19. These results provide valuable insights for addressing clinical challenges and developing novel therapeutic strategies.

To assess the prevalence and genetic basis of pretomanid (Pa) resistance, further to generate additional MIC data to support ECOFF/breakpoint setting in the microdilution system. Mycobacterium tuberculosis (MTB) isolates were collected from national drug resistance surveillance regions, with no prior pretomanid exposure. All strains were sub-cultured on Löwenstein-Jensen medium and tested against 12 anti-tuberculosis drugs with the Sensititre® MYCOTB plate. Pretomanid was serially diluted in 7H9 broth supplemented with 10

To characterize the mutation profile of the ahpC gene in isoniazid resistance (INHr) Mycobacterium tuberculosis (MTB) isolates and to evaluate the correlation between specific mutations and resistance levels, a total of 1,337 INHr MTB isolates were collected through the Chinese Drug Resistance Surveillance Program (2013-2020). The minimum inhibitory concentrations (MICs) for INH, rifampicin (RIF), and ethionamide were determined by broth microdilution, followed by whole-genome sequencing analysis. Among 1,337 INHr-MTB isolates, 45.5% (608/1,337) were multidrug-resistant (MDR), and 54.5% (729/1,337) were RIF-sensitive cases, with lineage 2 predominating (1,013/1,337, 75.8%). Resistance mutations were identified in 79.1% (1,058/1,337) of strains, primarily katG Ser315Thr (65.5%, 695/1,058) and inhA C-777T (19.7%, 208/1,058). Notably, 5.3% (56/1,058) isolates harbored standalone ahpC mutations, with 83.3% (5/6) C-81T, 60.0% (9/15) G-48A, 57.1% (4/7) C-54T, 50.0% (3/6) C-57T, and 42.1% (8/19) C-52T mutations showing high-level INH resistance. Accordingly, 91.7% (11/12) dual katG315+inhA mutations conferred high-level INH resistance, while ahpC C-57T mutants universally exhibited MDR. The ahpC mutations are associated with high-level INH resistance in variants without concurrent katG or inhA mutations. This finding significantly advances our understanding of tuberculosis resistance profiling, enabling more comprehensive detection of INHr-MTB and optimizing therapeutic strategies.IMPORTANCEAmong INH-resistant MTB clinical isolates, mutations in the ahpC promoter region have been considered to occur in combination with other mutations, such as katG and inhA, in a compensatory role. While the ahpC mutations have been incorporated into the World Health Organization (WHO)-recommended rapid diagnostic test, Xpert MTB/extensively drug-resistant tuberculosis (XDR), it has been still ambiguous about the standalone effects on INH resistance spectrum. Our findings demonstrate that the ahpC mutations are associated with high-level INH resistance in variants without concurrent katG or inhA mutations. This finding significantly advances our understanding of TB resistance profiling, enabling a more comprehensive detection of INHr-MTB and optimizing therapeutic strategies.

Child-friendly triage tests that do not rely on sputum for diagnosing active tuberculosis (ATB) in children are urgently required. This study aimed to assess a chemiluminescence-based urinary lipoarabinomannan test (AIMLAM) for diagnosing tuberculosis (TB) in children in China. Among the 579 children enrolled, 331 had TB, 169 had infectious diseases, and 79 were healthy controls. The area under the ROC curve of the AIMLAM test for distinguishing TB from non-TB (children with infectious diseases and healthy controls) was 0.74 (95% confidence interval [CI], 0.70-0.78), with a sensitivity of 52.2% (95% CI, 46.6%-57.6%) and a specificity of 91.9% (95% CI, 87.6%-94.9%). In 288 children with clinically diagnosed TB, the sensitivity of the test was 50.0% (95% CI, 44.1%-55.9%). LAM concentrations in extrapulmonary TB were significantly higher than those in pulmonary TB (P = 0.003), which resulted in a higher sensitivity of 63.6% (95% CI, 54.7%-72.1%). The diagnostic sensitivity of AIMLAM was significantly superior to that of Xpert (P = 0.004) and Ultra (P = 0.002). The sensitivity of AIMLAM is moderate but highest in extrapulmonary TB patients. The test appears to be promising for the rapid diagnosis of TB in children, especially in those with negative bacteriological results. IMPORTANCE:This study of a large-sample cohort of children in China assessed the diagnostic accuracy of the AIMLAM test kit as an auxiliary tool for childhood TB, and to determine an age-specific reference interval for LAM concentrations in children. Our findings showed that the overall sensitivity of AIMLAM was moderate, whereas a higher sensitivity was observed in patients with bacteriologically confirmed and severe TB. Age-specific cutoff values may be needed to optimize the diagnostic model in children. These results provide preliminary evidence for a method of diagnosing ATB in pediatric patients with samples that are difficult to obtain.

Tuberculosis screening in pediatric lupus nephritis (LN) patients presents unique diagnostic challenges. This study aimed to analyze the frequency of indeterminate QuantiFERON-TB Gold Plus (QFT-Plus) results among children with LN and the potential influence factors. A retrospective cohort study was conducted among patients under 18 years old with a confirmed diagnosis of LN screened for tuberculosis infection from January 2023 and August 2024. Demographic and clinical data were extracted from their electronic medical record, with categorical variables presented as frequencies and continuous variables as medians. Using SPSS 18.0 (Chicago, IL), we first performed univariate logistic regression to identify factors associated with indeterminate IFN-γ results (P < 0.05), then entered significant variables into multivariate models to determine independent predictors, reporting results as ORs, with statistical significance set at P < 0.05. Of 111 patients with LN, 49 (44.14

An observational, single-center study was conducted among hospitalized children with community-acquired pneumonia in the Baoding area. The objective was to compare the respiratory pathogen profiles and epidemiological patterns during and after the lifting of non-pharmaceutical interventions (NPIs, including mask-wearing, social distancing, lockdowns, etc.). A total of 9,362 hospitalized children diagnosed with CAP in Baoding from January 2022 to December 2023 were included. Both viral and bacterial pathogens were detected by multiplex PCR. The NPIs were lifted in Baoding from 2 December 2022. A comparative analysis was conducted on demographic data, epidemiological data, pathogen detection rates, and co-infection patterns that were compared between the full year 2022 and 2023. The detection rate of at least one pathogen significantly increased from 74.2% (2,925/3,940) in 2022 to 86.5% (4,690/5,422) in 2023 (P < 0.001). Mycoplasma pneumoniae, Streptococcus pneumoniae, human rhinovirus, respiratory syncytial virus (RSV), and Haemophilus influenzae were the predominant pathogens. Notably, co-infection rates rose from 25.1% (988/3,940) in 2022 to 45.1% (2,445/5,422) in 2023 (P < 0.001), particularly viral-bacterial co-infections. The positive detection rates for many pathogens among severe pneumonia cases increased. Additionally, an age shift in infection patterns was observed, with older children showing a higher prevalence of RSV. Following the lifting of NPIs, an increase in the detection rates of pathogens was observed, as were fluctuations in the dynamics of viral and bacterial pathogens, underscoring the urgent need to adapt clinical management and public health policies to address emerging infection trends. IMPORTANCE Community-acquired pneumonia (CAP) remains the leading infectious cause of death in children worldwide. Understanding the pathogens responsible for CAP is essential for effective diagnosis and treatment. This study examines the changes in respiratory pathogens and epidemiological patterns in children with CAP in Baoding, China, before and after the lifting of non-pharmaceutical interventions (NPIs). Data from 9,362 children diagnosed with CAP from January 2022 to December 2023 were analyzed. The detection rate of at least one pathogen increased significantly from 74.2% in 2022 to 86.5% in 2023. Notably, co-infection rates rose from 25.1% to 45.1%, with viral-bacterial co-infections being more common. This research underscores the urgent need to adapt clinical management and public health policies to address the changing infection trends, highlighting their importance and innovation in understanding the impact of NPIs on pediatric respiratory infections.

We retrospectively analyzed the epidemiological characteristics, mixed infections, and complications of chlamydial infection in pediatric inpatients based on a national database. The discharge data of pediatric inpatients with chlamydial infection was obtained from the Futang Research Center of Pediatric Development database from January 2016 to December 2022. A total of 10,211 patients with chlamydial infection were obtained, with patients < 1 year old predominantly (44.17

BACKGROUND:The respiratory microbiota plays a crucial role in the development of tuberculosis (TB). While existing research has underscored imbalances in the respiratory microbiota of adult patients with TB, information regarding the lower respiratory tract (LRT) microbiota in pediatric patients with TB remains scarce. METHODS:We employed 16S rRNA gene sequencing technology to investigate the LRT microbial communities of 85 children of different ages with active TB of different severities, 33 children with infectious diseases other than TB, and 48 sex- and age-matched healthy children. RESULTS:A marked imbalance in the respiratory microbiota was observed in children with TB, highlighted by reduced alpha diversity and a distinct microbial community structure. Comparative analysis indicated that patients with severe TB exhibited lower Neisseria levels than those with non-severe TB (1.01% vs. 3.93%, respectively; p = .02). Streptococcus and Gemella levels were lower in bacteriologically confirmed TB cases compared with clinically diagnosed cases, and higher in healthy children younger than 10 years old than in the older group. Spearman correlation analysis demonstrated significant associations between the microbiota of the LRT and cytokine concentrations in the sputum of children with TB (e.g., an inverse correlation between Veillonella and interleukin-17A). CONCLUSIONS:TB induced significant dysbiosis in the LRT microbiota of children that was associated with disease severity and the immunological response in the respiratory tract. Our findings may offer a deeper understanding of the role of the respiratory microbiome in TB pathogenesis and progression.

Objective To evaluate the accuracy of QuantiFERON-TB Gold Plus (QFT-Plus) assay, and analyze the quantitative interferon gamma (IFN-γ) responses to tuberculosis (TB) antigens and mitogen in children and adolescents with active TB and latent tuberculosis infection (LTBI) in China. Methods A retrospective study was conducted among patients <25 years old with suspected active TB or screened for LTBI. All patients underwent QFT-Plus tests at Beijing Children’s Hospital and Shenyang Chest Hospital from August 2022 to March 2024. Demographic and clinical data were extracted from their electronic medical record. Results A total of 18482 patients were recruited, including 179 (1.0%) patients with active TB disease, 334 (1.8%) LTBI and 17969 (97.2%) non-TB disease. The 5.8% (176/18482) patients had indeterminate results. The overall sensitivity for active TB was 83.4%, and specificity was 98.0%. The percent agreement between TB1 and TB2 was 90.3%. The IFN-γ production in response to mitogen and TB antigens observed among children <1 year of age was lower than that among other age groups. There was significant positive correlation between age and IFN-γ responses to mitogen, but negative correlation between age and IFN-γ responses to TB1 and TB2 antigen. Besides, there was no significant difference in response to QFT-Plus TB antigens in active TB and LTBI cases. Conclusion QFT-Plus assay is accurate in children and adolescents with active TB. IFN-γ responses to mitogen and MTB antigens are significantly affected by age. The new antigen tube TB2 increases the assay sensitivity.

OBJECTIVE:Various population pharmacokinetic (PPK) models have been established to help determine the appropriate dosage of docetaxel, however, no clear consensus on optimal dosing has been achieved. The purpose of this study is to perform an external evaluation of published models in order to test their predictive performance, and to find an appropriate PPK model for Chinese breast cancer patients. METHODS:A systematic literature search of docetaxel PPK models was performed using PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang databases. The predictive performance of eleven identified models was evaluated using prediction-based and simulation-based diagnostics on an independent dataset (112 docetaxel concentrations from 56 breast cancer patients). The -2×log (likelihood) and Akaike information criterion were also calculated to evaluate model fit. RESULTS:The median prediction error of eight of the eleven models was less than 10%. The model fitting results showed that the three-compartment model of Bruno et al. had the best prediction performance and that the three compartment model of Wang et al. had the best simulation effect. Furthermore, although the covariates that significantly affect PK parameters were different between them, seven models demonstrated that docetaxel PK parameters were influenced by liver function. CONCLUSIONS:Three compartment PPK models may be predictive of optimal docetaxel dosage for Chinese breast cancer patients. However, for patients with impaired liver function, the choice of which model to use to predict the blood concentration of docetaxel still requires great care.

Colistin is a last-resort antibiotic used for treating infections caused by carbapenem-resistant Gram-negative bacteria, particularly in critically patients, nevertheless its therapeutic window is narrow, and requires monitoring. A determination method suitable for clinical detection is conducive to ensure its efficacy and safety of patients with severe infection. We developed and validated a concise and accurate high-performance liquid chromatography-tandem mass spectrometry method for the determination of colistin A and B in human plasma. We used a Kinetex C18 column (50 mm x 2.1 mm, 2.6 mu m) with acetonitrile (containing 0.1% formic acid) as the protein precipitant and water (containing 0.2% formic acid and 5 mmol/L ammonium formate) - acetonitrile (containing 0.2% formic acid) as the gradient elution. The calibration curves were linear over concentration ranges of 0.06-4.00 mu g/mL (colistin A) and 0.1-7.0 mu g/mL (colistin B). The precision, accuracy, matrix effect, extraction recovery, and stability were all validated. This method was applied to the therapeutic drug monitoring for 50 critically ill patients. The trough, peak, and average steady-state concentrations of these patients were 0.8 +/- 0.4, 1.4 +/- 0.5, and 1.0 +/- 0.4 mu g/mL, respectively. And the concentrations of colistin in human plasma were closely related to the patient's renal function.

Data on epidemiology trends of paediatric tuberculosis (TB) are limited in China. So, we investigated the clinical and epidemiological profiles in diagnosed TB disease and TB infection patients at Beijing Children's Hospital. Of 3 193 patients, 51.05% had pulmonary TB (PTB) and 15.16% had extrapulmonary TB (EPTB). The most frequent forms of EPTB were TB meningitis (39.05%), pleural TB (29.75%), and disseminated TB (10.33%). PTB patients were significantly younger and associated with higher hospitalization frequency. Children aged 1-4 years exhibited higher risk of PTB and TB meningitis, and children aged 5-12 years had higher risk of EPTB. The proportion of PTB patients increased slightly from 40.9% in 2012 to 65% in 2019, and then decreased to 17.8% in 2021. The percentage of EPTB cases decreased from 18.3% in 2012 to 15.2% in 2019, but increased to 16.4% in 2021. Among EPTB cases, the largest increase was seen in TB meningitis. In conclusion, female and young children had higher risk of PTB in children. TB meningitis was the most frequent forms of EPTB among children, and young children were at high risk of TB meningitis. The distribution of different types of EPTB differed by age.

Objectives: To evaluate the diagnostic value of targeted next generation sequencing (tNGS) in childhood tuberculosis (TB) and compare the accuracy with Xpert MTB/RIF method. Methods: Children aged ≤18 years with symptoms suggestive of TB during July 2021 to December 2022 at Beijing Children's Hospital were included, and the performances of tNGS and Xpert were evaluated. Results: A total of 103 children with suspected TB were recruited, including 72 discharge diagnosis of TB and 31 non-TB cases. The mean age was 7.37 ± 4.77 years, and 62.1 % were male. The most common type of specimens was gastric aspirate (GA) (59, 57.3 %). Among all the 72 TB patients, tNGS showed higher sensitivity than Xpert, but the difference was not significant (34.7 %, 25/72 vs 20.8 %, 15/72; P = 0.063). The specificities of tNGS and Xpert were 87.1 % (27/31) and 96.8 % (30/31), respectively (P = 0.162). Among different types of specimen, the highest sensitivity of tNGS on sputum and pus was observed (80.0 %, 4/5), followed by pleural effusion (50.0 %, 2/4). One rifampin resistance and one protionamide resistance were detected in bacteriologically confirmed TB by tNGS. Conclusion: tNGS had a higher sensitivity but lower specificity compared to Xpert in diagnosis of children TB. tNGS yielded higher sensitivity than Xpert on gastric aspirate and sputum and pus.

ObjectiveWe aimed to compare QuantiFERON-TB Gold In-Tube (QFT-GIT) and X.DOT-TB for screening latent tuberculosis infection (LTBI) in kawasaki patients, and to identify the risk factors associated with indeterminate IGRA results.MethodsWe conducted a retrospective study on children with KD, who were screened for mycobacterium tuberculosis (Mtb) infection by either ELISA-based QFT-GIT or ELISPOT-based X.DOT-TB tests, admitted in Department of Cardiology, Beijing Children's Hospital from July 2019 to April 2022.ResultsA total of 1327 cases were included. Among them, 932 cases were tested by QFT-GIT and 395 cases by X.DOT-TB. The positive rate of children was 0.1% and 0.2%, and the indeterminate rate was 68.2% and 6.1% for QFT-GIT and X.DOT-TB, respectively. Patients with hypoproteinemia had a higher risk of indeterminate X.DOT-TB result. Female, critical ill, shock or hypoproteinemia presented statistically significant associations with an increased risk of indeterminate QFT-GIT result. High-dose of IVIG inhibited the release of IFN-γ by more than 90%, which might account for the high indeterminate incidence.ConclusionIt is recommended to perform X.DOT-TB rather than QFT-GIT to screen LTBI in patients with high level of the mitogen that can inhibit IFN-γ release. For KD children with positive IGRA results, it has a higher risk of activation TB infection when treated with immunosuppressive therapy in the future. Children with KD aged <5 years old had higher frequency of indeterminate IGRA results.

Microbial Drug ResistanceVol. 29, No. 3 DiseaseLetter to the Editor: In Vitro Activity of Oxazolidinone Against Nontuberculous Mycobacteria in ChinaHuiwen Zheng, Yiting Wang, Wencong He, Feina Li, Hui Xia, Jing Xiao, Xichao Ou, Shengfen Wang, Chen Shen, and Yanlin ZhaoHuiwen ZhengLaboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China.*These are co-first authors who contributed equally to this study.Search for more papers by this author, Yiting WangNational Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China.Institute for Immunization and Prevention, Beijing Center for Disease Control and Prevention, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control, Beijing, China.*These are co-first authors who contributed equally to this study.Search for more papers by this author, Wencong HeNational Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China.Search for more papers by this author, Feina LiLaboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China.Search for more papers by this author, Hui XiaNational Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China.Search for more papers by this author, Jing XiaoLaboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China.Search for more papers by this author, Xichao OuNational Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China.Search for more papers by this author, Shengfen WangNational Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China.Search for more papers by this author, Chen ShenAddress correspondence to: Chen Shen, PhD, Laboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing 100045, China E-mail Address: [email protected]Laboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, China.Search for more papers by this author, and Yanlin ZhaoAddress correspondence to: Yanlin Zhao, PhD, National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing 102200, China E-mail Address: [email protected]National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China.Search for more papers by this authorPublished Online:16 Mar 2023https://doi.org/10.1089/mdr.2022.0216AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetails Volume 29Issue 3Mar 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Huiwen Zheng, Yiting Wang, Wencong He, Feina Li, Hui Xia, Jing Xiao, Xichao Ou, Shengfen Wang, Chen Shen, and Yanlin Zhao.Letter to the Editor: In Vitro Activity of Oxazolidinone Against Nontuberculous Mycobacteria in China.Microbial Drug Resistance.Mar 2023.112-114.http://doi.org/10.1089/mdr.2022.0216Published in Volume: 29 Issue 3: March 16, 2023Online Ahead of Print:January 10, 2023PDF download

Since the onset of the COVID-19 pandemic in 2020, global efforts towards tuberculosis (TB) control have encountered unprecedented challenges. There is an urgent demand for efficient and cost-effective diagnostic technologies for TB. Recent advancements in CRISPR–Cas technologies have improved our capacity to detect pathogens. The present study established a CRISPR–Cas12a-based multiplex detection (designated as MCMD) that simultaneously targets two conserved insertion sequences (IS6110 and IS1081) to detect Mycobacterium tuberculosis complex (MTBC). The MCMD integrated a graphene oxide-assisted multiplex recombinase polymerase amplification (RPA) assay with a Cas12a-based trans-cleavage assay identified with fluorescent or lateral flow biosensor (LFB). The process can be performed at a constant temperature of around 37°C and completed within 1 h. The limit of detection (LoD) was 4 copies μL−1, and no cross-reaction was observed with non-MTBC bacteria strains. This MCMD showed 74.8% sensitivity and 100% specificity in clinical samples from 107 patients with pulmonary TB and 40 non-TB patients compared to Xpert MTB/RIF assay (63.6%, 100%). In this study, we have developed a straightforward, rapid, highly sensitive, specific, and cost-effective assay for the multiplex detection of MTBC. Our assay showed superior diagnostic performance when compared to the widely used Xpert assay. The novel approach employed in this study makes a substantial contribution to the detection of strains with low or no copies of IS6110 and facilitates point-of-care (POC) testing for MTBC in resource-limited countries.

Abstract Mycoplasma pneumoniae (MP) is a leading cause of pediatric community-acquired pneumonia (CAP) and advanced techniques for Mycoplasma pneumoniae pneumonia (MPP) diagnosis are urgently needed. Here, a novel diagnostic test combined multiple cross displacement amplification (MCDA) with CRISPR-Cas12a system targeting the CARDS gene of MP, termed MP-MCC, were developed for MPP detection. The MCDA assay was employed for nucleic acid amplification, and the CRISPR-Cas12a/CrRNA complex was used to decode the amplification products. Then, the detection result was observed via real-time fluorescence. The optimal conditions for our assay include a MCDA reaction at 61°C for 40 min and a CRISPR detection at 37°C for ~ 5 min. The results showed that reaction products were detectable from as little as 10fg of pure MP templates and from approximately 10 copies of plasmids containing CARDS genes. The specificity in detecting MP strains was 100%, and there was no cross-reaction to non-MP strains. Furthermore, our assay was further validated using clinical samples, which offered high sensitivity and specificity for MPP diagnostic. Taken together, the detection technique developed here has advantages on rapidity, sensitivity and specificity for MP detection, which could be used as a potential tool for clinical MPP diagnosis.

Background Interferon-gamma release assay (IGRA) is the main tool for the diagnosis of latent tuberculosis (TB) infection (LTBI). However, the indeterminate results were more frequent in children, and the underlying reasons were largely speculative. We aimed to compare QuantiFERON-TB Gold In-Tube (QFT-GIT) with X.DOT-TB (XDOT) for diagnosing LTBI, and to identify the risk factors associated with indeterminate results in children. Methods A retrospective study for children<18 years old, at risk for LTBI or progression to TB disease, received either QFT-GIT or X.DOT-TB tests was performed at Beijing Children’s Hospital from August 2019 to August 2022. Results A total of 33,662 children were recruited, including 15,129 (44.9%) tested with X.DOT-TB and 18,533 (55.1%) with QFT-GIT. Proportion of positive and indeterminate results in children with respiratory disease was significantly higher than did that with other diseases, respectively ( P < 0.001). The indeterminate rate of X.DOT-TB and QFT-GIT results decreased with increasing age ( P < 0.001). Proportion of QFT-GIT indeterminate results was higher than that of X.DOT-TB across age groups. Male, age and disease classification all presented a statistically significant association with indeterminate IGRA results. Conclusions The positive rates of X.DOT-TB and QFT-GIT in children were 3.1% and 1.8%, respectively. The X.DOT-TB assay performed better than QFT-GIT in children, and male, age and underlying diseases were associated with an increased risk of indeterminate IGRA results.

目的 研究北京地区儿童肺炎支原体(MP)感染情况和流行病学特征,为新冠肺炎疫情下本地区MP感染的防治提供理论依据.方法 选择2018年1月至2021年12月在首都医科大学附属北京儿童医院就诊的5951例社区获得性肺炎患儿为研究对象.所有患儿采集咽拭子标本,采用实时荧光核酸恒温扩增技术(SAT)检测MP靶标RNA.结果 5951例患儿的MP总检出率为36.62％(2179/5951).4年中MP出现一次暴发流行(2018年至2019年),流行年检出率可高达42.81％.新冠肺炎疫情爆发后,MP感染率明显降低;不同季节MP检出率差异具有统计学意义(P<0.0001),总检出率最高季节为秋季(47.48％)和夏季(41.78％);新冠肺炎疫情爆发后,MP的季节流行特点发生改变;各年龄组间MP检出率差异具有统计学意义(P<0.0001),学龄组患儿MP总检出率最高(60.24％),其次为青春组(49.47％),婴儿组MP总检出率最低(5.97％),且新冠肺炎疫情前后,MP感染高发人群未发生改变;女性患儿MP总检出率(38.75％,1037/2676)高于男性患儿(34.87％,1142/3275),差异具有统计学意义(χ2=9.56,P=0.002);新冠肺炎疫情爆发后,不同性别患儿间MP检出率差异无统计学意义(P>0.05).结果 MP是北京地区儿童社区获得性肺炎的主要病原体,其分布特点具有季节、年龄和性别差异.新冠肺炎疫情下,MP感染率明显降低,但无显著性别差异,且高发季节发生改变.