Mycoplasma pneumoniae Respiratory Tract Infections in Nablus District

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Thaher, Aseel Fazi Hamad
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An-Najah National University
M. pneumoniae is known to be a common cause of respiratory tract infections in different age groups. Worldwide, the lack of rapid and standardized tests for the diagnosis of M. pneumoniae infection is a common problem that encounters researchers in this field. This prospective study was conducted to determine the prevalence of M. pneumoniae using classical ELISA and nested PCR techniques among patients with respiratory tract infections in Nablus Districts. The study included 129 inpatients and out patients visited or admitted to the involved clinics during September 2015 to April 2016. At the time of first visit to clinical settings, a throat swab was collected from all participants. Serum specimens were collected from 103 patients. A second serum specimen was available for 16 patients 7 to 15 days later. Throat swab specimens were tested by nested PCR for the detection of M. pneumoniae. Serum samples were tested for the presence of IgG and IgM antibodies by ELISA. Out of 129 examined throat swabs specimens, DNA of M. pneumoniae was detected by PCR in 15(11.6%) samples. M. pneumoniae specific IgM was detected in 4(3.9%) out of the 103 first serum sample. A total of 47(39%) patients possessed IgG at different titers in the first and/or second serum specimens. According to the applied diagnostic criteria (positive IgM with PCR or/and IgG serology [high titer, seroconversion or twofold increase in titer] or/and PCR confirmed by IgG serology), 10(7.8%) patients were diagnosed with current M. pneumoniae infection. Among these diagnosed cases, PCR detected 10 cases, while IgM in first serum specimen detected 4 cases. Most of M. pneumoniae infections were diagnosed during winter (10.4%). No difference in the prevalence of M. pneumoniae infection was found with respect to gender. The highest percentage of M. pneumoniae respiratory infection (11.3%) was found in patients with age range 25-64 years, followed by patients age range 0-9 (9.1%) and 10-24 (7%). No significant differences in the frequency of signs and symptoms in patients with M. pneumoniae infection compared to those with other infectious agents. Laboratory parameters showed significantly higher frequency of increase in lymphocytes count (P=0.001) in patients with M. pneumoniae infection compared to other infectious agents. On the contrary, the frequency of increase in WBCs and granulocytes counts were significantly lower in patients with M. pneumoniae infection (P= 0.006 and 0.000, respectively). In conclusion, M. pneumoniae seems to be an important etiological agent of respiratory tract infections in the area, thus more attention is required in adopting health policy for diagnosis and used medication policies.