Open Medicine最新文献

{"title":"The dynamic interplay of M1/M2-like macrophages and adenosine deaminase activity modulates COVID-19 severity.","authors":"Tugce Bozkurt, Abdurrahman Simsek, Muhammed Ali Kizmaz, Eren Cagan, Hulya Kose, Ali Eren Iskin, Ayse Melda Payaslioğlu, Mehmet Karadag, Emin Halis Akalin, Sara Sebnem Kilic, Ferah Budak","doi":"10.1515/med-2026-1429","DOIUrl":"https://doi.org/10.1515/med-2026-1429","url":null,"abstract":"<p><strong>Objectives: </strong>The COVID-19 pandemic has highlighted the importance of understanding immune regulation underlying disease severity. Adenosine deaminase (ADA), an enzyme with ADA1 and ADA2 isoforms, modulates immune responses and is mainly expressed in lymphoid tissues. This study examined ADA activity and its relationship with macrophage polarization in COVID-19.</p><p><strong>Methods: </strong>A total of 120 COVID-19 patients stratified by disease severity and 40 healthy controls were included. Total ADA (tADA), ADA1, and ADA2 activities were measured using the Giusti-Galanti colorimetric method in both patient sera and culture supernatants. Cytokine and chemokine profiles associated with M1- and M2-like macrophages were quantified by ELISA. To mechanistically evaluate macrophage polarization, naïve monocytes were co-cultured with SARS-CoV-2-responsive lymphocytes under a COVID-19 microenvironment (pCOV) generated using viral peptide pools in the presence of COVID-19 patient sera. Macrophage subsets were characterized by flow cytometry using canonical surface markers. The relationship between ADA2 activity and macrophage polarization was functionally assessed using pentostatin, whereas EHNA was used exclusively for the differential measurement of ADA isoenzyme activities.</p><p><strong>Results: </strong>Elevated total ADA activity was observed in critical patients, correlating with disease severity. Cytokine profiling revealed a hybrid M1/M2-like phenotype in severe cases, characterized by simultaneous pro- and anti-inflammatory mediator release. ADA2 activity showed a strong positive correlation with M2-associated factors, and flow cytometry confirmed the presence of CD206⁺CD86⁺ hybrid macrophages.</p><p><strong>Conclusions: </strong>Overall, our findings suggest that ADA2 regulates macrophage plasticity in COVID-19, promoting M1/M2 hybrid polarization and contributing to immune dysregulation. ADA2 may serve as a biomarker for disease progression and a therapeutic target to modulate macrophage-driven inflammation in severe COVID-19.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261429"},"PeriodicalIF":1.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for pneumonia in children with <i>Bordetella pertussis</i> infection and co-infection status in Ningbo, China.","authors":"Chunyan Liu, Qian Xu, Zhuoling Li, Xiaoli Yang, Lili Guo, Xin Liu, Wenyuan Liu","doi":"10.1515/med-2026-1425","DOIUrl":"https://doi.org/10.1515/med-2026-1425","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Pertussis, also known as whooping cough,is a significant contributor to pneumonia cases in children. The existing literature regarding pertussis in China is sparse, highlighting the need for further research in this area. This research aimed to find out the factors related to pneumonia in B. Pertussis co-infected children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From January to April 2024,children identified with B. Pertussis infection were enrolled in the study. Subsequently, they were divided into two groups:one consisting of those without pneumonia and another comprising those with pneumonia. This study was a retrospective observational study. In this study, variables assessed included demographics, clinical symptoms and laboratory findings. The study examined the various risk factors associated with pneumonia resulting from infection with B. Pertussis in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-five patients participated in the study, Among the participants, individuals (77.30 %) had completed the full course of the pertussis vaccine, while 17 individuals (22.70 %) had not,with 29 belonging to the pneumonia group and 46 to the non-pneumonia group. There was borderline significance between the completion of vaccination and the occurrence of pneumonia (p=0.05). Those in the pneumonia group exhibited the highest recorded body temperature due to fever and increased expectoration (p&lt;0.05). Analysis using a univariate approach indicated significant correlations between the highest body temperature during fever,the cycle threshold at the initial detection,and expectoration with pneumonia (p&lt;0.05). Univariate logistic regression showed that the initial cycle threshold was significantly associated with pertussis-associated pneumonia (OR=1.483, p&lt;0.001); multivariate logistic regression further confirmed it as an independent risk factor (OR=0.675, 95 % CI: 0.542-0.839, p&lt;0.001). The group affected by pneumonia administered higher usage of erythromycin/cephalosporins (p&lt;0.05). Both univariate and multivariate logistic regression analyses revealed a substantial relationship between the initial detection cycle threshold and pneumonia (p&lt;0.05). 54.6 % patients had co-infections. In our pediatric population, the most commonly identified pathogens were human rhinovirus, mycoplasma pneumoniae and respiratory syncytial virus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The cycle threshold values were a risk factor for pneumonia in children with B. Pertussis infection,a lower initial Ct value (indicating higher bacterial load) is a significant risk factor for developing pneumonia in children with pertussis. There was higher usage of erythromycin/cephalosporins in the pneumonia group. While B. Pertussis has a high coinfection rate in childhood infections, mainly with HRV,MP and RSV, which also highlighed the importance of comprehensive pathogen detection. Clinical doctors should fully consider the above situation in children with B. P","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261425"},"PeriodicalIF":1.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From burden to action: Saudi Arabia's strategy on antimicrobial resistance.","authors":"Shuaibu Abdullahi Hudu, Abdulgafar Olayiwola Jimoh","doi":"10.1515/med-2026-1380","DOIUrl":"https://doi.org/10.1515/med-2026-1380","url":null,"abstract":"<p><p>Antimicrobial Resistance (AMR) is a significant public health challenge in Saudi Arabia and globally. This review consolidates evidence on the burden, drivers, policy responses, and progress in controlling AMR from 2010 to 2025 across human health, animal health, and the environment. The burden is substantial, especially from multidrug-resistant strains such as ESBL-producing Enterobacteriaceae, carbapenem-resistant <i>Klebsiella pneumoniae</i>, and methicillin-resistant <i>Staphylococcus aureus</i>. Factors contributing to this include antibiotic misuse, over-the-counter availability, mass gatherings, insufficient infection control, and agricultural use. Saudi Arabia has made progress through a One Health-oriented National Action Plan (2017, renewed 2022-2025), antimicrobial stewardship programs, surveillance efforts, and stricter regulations. However, challenges remain in community surveillance, laboratory capacity, and behavioral change. As indicated by key stakeholders, further efforts to expand stewardship, improve diagnostics, regulate antibiotic sales, and implement AI-driven surveillance are essential next steps. Increased investment in research, innovation, and partnerships can position Saudi Arabia as a leader in regional AMR containment initiatives.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261380"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelets and platelet-derived factors in curcumin treatment: a narrative review of mechanisms and translational potential.","authors":"Dandan Li, Yuxin Huo, Mutalifu Xiaheidan, Xiaotong Liu, Difeng Wu, Zihua Liu","doi":"10.1515/med-2026-1430","DOIUrl":"https://doi.org/10.1515/med-2026-1430","url":null,"abstract":"<p><p>Based on the characteristics of curcumin, such as low bioavailability, low toxicity, wide availability, and multiple biological activities, and in conjunction with its established pharmacological effects on anti-platelet activation, aggregation inhibition, and platelet count enhancement, the following hypothesis is proposed: Curcumin may exert therapeutic effects in multiple systems, including cardiovascular, neurological, digestive, musculoskeletal, and genitourinary systems, by modulating platelet function and its derived factors, thereby interfering with various disease-related pathways. In light of this, the present study aims to address the following questions: Through which specific molecular pathways and mechanisms does curcumin regulate platelets and their derived factors, thereby exerting therapeutic effects on diseases in different systems? Additionally, this research seeks to provide a theoretical foundation for further exploration of novel therapeutic directions for curcumin in disease treatment.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261430"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival benefits of immunotherapy combined with chemoradiotherapy in metastatic colorectal cancer: an analysis based on data from the SEER database.","authors":"Jie Zhang, Weijuan Jiang","doi":"10.1515/med-2026-1416","DOIUrl":"https://doi.org/10.1515/med-2026-1416","url":null,"abstract":"<p><strong>Objectives: </strong>Chemoradiotherapy (CRT) alone shows limited efficacy in improving outcomes for metastatic colorectal cancer (mCRC) patients. This study aimed to comprehensively evaluate the survival benefits of combining CRT with immunotherapy (CRT + IMT) in this population.</p><p><strong>Methods: </strong>Data from the SEER database were extracted for mCRC patients diagnosed between 2010-2015 and 2018-2020. Survival outcomes were assessed using Kaplan-Meier analysis, log-rank test, Cox regression, and propensity score matching (PSM) to minimize baseline differences between treatment groups, and multivariable Cox models were constructed based on variables selected by LASSO regression.</p><p><strong>Results: </strong>A total of 2,451 patients were identified, with 1,888 receiving CRT alone and 563 CRT + IMT. After 1:2 PSM, 1,594 remained. Kaplan-Meier curves showed CRT + IMT significantly improved overall survival (OS, p<0.0001) and cancer-specific survival (CSS, p<0.0001). Multivariable Cox confirmed CRT + IMT as an independent predictor (OS HR=0.54, 95 % CI: 0.44-0.65; CSS HR=0.54, 95 % CI: 0.44-0.66). Favorable factors included distal colon/rectal tumors, surgery, and combined therapy, while older age (>60), advanced stage, N2, and metastasis predicted worse survival. The subgroup analyses revealed a more pronounced benefit in specific cohorts, and significant interactions were observed for factors such as histologic grade and nodal stage.</p><p><strong>Conclusions: </strong>The combination of CRT and immunotherapy confers a significant survival advantage over CRT alone in patients with mCRC, supporting its potential role in optimized treatment strategies.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261416"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial polyps recurrence: risk factors, prevention, and management.","authors":"Aiyue Luo, Wei Shen, Xing Lv, Shuhong Yang","doi":"10.1515/med-2026-1417","DOIUrl":"https://doi.org/10.1515/med-2026-1417","url":null,"abstract":"<p><strong>Introduction: </strong>Endometrial polyps (EPs) are common intrauterine lesions often associated with abnormal uterine bleeding, infertility, and recurrence after treatment. Despite advances in diagnostic and surgical techniques, recurrence remains a clinical challenge. This review provides an overview of pathophysiology, risk factors, diagnostic strategies, and management options for recurrent EPs, emphasizing prevention. A literature search was conducted through PubMed, Scopus, Web of Science, Cochrane Library, and EMBASE, covering studies published up to November 30th, 2025.</p><p><strong>Content: </strong>Recurrent EPs are influenced by hormonal imbalances, genetic abnormalities, chronic inflammation, oxidative stress, and microbial dysbiosis. Risk factors include age, obesity, metabolic syndrome, incomplete resection, and altered microbiota. Diagnostic techniques include transvaginal ultrasound, hysteroscopy, and biomarker assays. Management options involve medical therapy (e.g., progesterone, LNG-IUS) and hysteroscopic removal. Preventive measures, such as post-polypectomy hormonal treatments, show promise in reducing recurrence.</p><p><strong>Summary and outlook: </strong>A multidisciplinary approach combining precise surgery with targeted hormonal and microbiota therapies is essential for minimizing recurrence. Future research should focus on personalized management based on molecular and microbiological profiles.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261417"},"PeriodicalIF":1.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The causal relationship in hypertensive encephalopathy: mechanistic analysis of five specific circulating cytokines.","authors":"Pengfei Zhang, Yijia Huang, Haoying Li, Can Zhang, Zhiren Chen","doi":"10.1515/med-2026-1412","DOIUrl":"https://doi.org/10.1515/med-2026-1412","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the causal relationship between genetically predicted levels of five circulating cytokines - CXCL11, IL-2, IL-4, leukemia inhibitory factor (LIF), and neurotrophin-3 (NT-3) - and the risk of hypertensive encephalopathy using a two-sample Mendelian randomization (MR) approach.</p><p><strong>Methods: </strong>Single nucleotide polymorphisms (SNPs) strongly associated with each cytokine (p<i><</i>5 × 10^-8) were selected from publicly available GWAS data. Summary statistics for HE were obtained from the FinnGen biobank (endpoint: I9_HYPERTENC). MR analyses were conducted using inverse-variance weighted (IVW), MR-Egger, weighted median, and weighted mode methods. Sensitivity analyses included heterogeneity testing, MR-Egger intercept assessment, and leave-one-out analysis.</p><p><strong>Results: </strong>Genetically higher levels of IL-2 (OR=0.35, 95 % CI: 0.13-0.99, p<i>=</i>0.043), IL-4 (OR=0.50, 95 % CI: 0.30-0.85, p<i>=</i>0.010), and NT-3 (OR=0.46, 95 % CI: 0.28-0.75, p<i>=</i>0.0038) were significantly associated with lower risk of HE. CXCL11 showed a significant positive association with HE risk (OR=2.79, 95 % CI: 1.26-6.20, p<i>=</i>0.028). LIF displayed a non-significant trend toward protection (OR=0.43, p<i>=</i>0.060). Results were consistent across sensitivity analyses with no evidence of pleiotropy or heterogeneity.</p><p><strong>Conclusions: </strong>This Mendelian randomization study provides evidence that genetically determined levels of IL-2, IL-4, and NT-3 are protective against hypertensive encephalopathy, while CXCL11 is a risk factor. These cytokines may serve as potential biomarkers or therapeutic targets for HE.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261412"},"PeriodicalIF":1.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MALDI-TOF MS, following separation gel coagulation tubes and short-term solid phase culture effectively detects pathogenic microbes from positive blood cultures.","authors":"Shujuan Chen, Kangying Wang, Haijian Tu","doi":"10.1515/med-2025-1302","DOIUrl":"https://doi.org/10.1515/med-2025-1302","url":null,"abstract":"<p><strong>Objectives: </strong>This study explored the viability of combining separation gel coagulation tubes with a short-term solid-phase culture method and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) for the detection of pathogens in positive blood culture bottles.</p><p><strong>Methods: </strong>Positive blood culture bottles (186) were collected from the Affiliated Hospital of Putian University. The blood culture bottles were processed using separation gel coagulation tubes to isolate plasma components. After centrifugation, the solid phase containing microbial cells was subjected to a 4-6 h short-term solid-phase culture. Bacterial identification was subsequently done using MALDI-TOF MS.</p><p><strong>Results: </strong>The genus and species identification coincidence rates for 107 Gram-negative bacteria were 90.7 % (97/107) and 86.0 % (92/107), respectively, and 73.7 % (56/76) and 72.4 % (55/76), respectively, for 76 Gram-positive bacteria. For the 37 isolates that were either identified only to the genus level or not identified, the coincidence rates of MALDI-TOF MS after 4 and 6 h of short-term solid-phase culture were 32.4 % (12/37) and 86.5 % (32/37), respectively.</p><p><strong>Conclusions: </strong>The combination of separation gel coagulation tubes, short-term solid-phase culture, and MALDI-TOF MS is fast and effective for identifying positive blood culture bottles in routine testing in clinical microbiology laboratories. Gram-negative bacteria are accurately and quickly identified compared to Gram-positive bacteria.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20251302"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Umbilical port-site endometriosis: a case presentation and narrative review of the literature.","authors":"Pawel Sadlecki, Katarzyna Dejewska, Malgorzata Walentowicz-Sadlecka","doi":"10.1515/med-2026-1411","DOIUrl":"https://doi.org/10.1515/med-2026-1411","url":null,"abstract":"<p><strong>Introduction: </strong>Umbilical port-site endometriosis is a rare form of abdominal wall endometriosis (AWE), especially following non-gynecologic surgeries. Diagnosing AWE is challenging because it mimics other abdominal wall masses.</p><p><strong>Content: </strong>We describe a 46-year-old woman with cyclic umbilical pain and a mass at a previous trocar site, 17 years after laparoscopic cholecystectomy. Her history included two earlier cesarean sections, both recognized risk factors for iatrogenic AWE. Imaging demonstrated a vascularized lesion. Surgical excision confirmed endometriosis. A narrative review of the literature (2000-2025) was conducted using PubMed, Scopus, and Google Scholar. Broad inclusion criteria were applied; SANRA principles guided quality appraisal. A basic quantitative summary of reported cases was included.</p><p><strong>Summary: </strong>Twenty-seven relevant publications were included. Port-site AWE remains rare, and standardized diagnostic pathways and follow-up protocols are lacking. Most cases were managed with wide local excision with negative margins. Recurrence data are sparse due to short or absent follow-up in many reports.</p><p><strong>Outlook: </strong>Clinicians - particularly general surgeons - should consider AWE in patients with painful masses at trocar or scar sites. Although the temporal association with cholecystectomy raises suspicion, prior cesarean sections provide a more plausible etiological source in this case. Long-term follow-up and international registries are needed to better characterize outcomes of port-site endometriosis.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261411"},"PeriodicalIF":1.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological trends, antimicrobial resistance, and genetic mutations of <i>Mycoplasma pneumoniae</i> in Wuhan, China: a post-COVID-19 perspective.","authors":"Shan Chen, Liang Luo, Lu Liu, Meng Wang, Qian Yin, Li Ma, Liu Yang, Jianglan Wang, Zhen Hu","doi":"10.1515/med-2026-1400","DOIUrl":"https://doi.org/10.1515/med-2026-1400","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the epidemiological trends, antimicrobial resistance patterns, and genetic mutations associated with <i>Mycoplasma pneumoniae</i> infections in Caidian District, Wuhan, Hubei Province.</p><p><strong>Methods: </strong>Totally 7,234 nasopharyngeal swabs were collected from patients with respiratory symptoms. RT-qPCR was used to detect <i>M. pneumoniae</i> DNA, and antimicrobial susceptibility testing was performed on cultured isolates. The 23S rRNA gene was sequenced to identify resistance-associated mutations at positions A2063G, A2064G, A2067G, and C2617G by Pyrosequencing.</p><p><strong>Results: </strong>The overall positivity rate for <i>M. pneumoniae</i> was 19.37 % (1,401/7,234), with significantly higher infection rates in children (32.75 %) compared to adults (9.84 %). Moreover, 20.51 % of <i>M. pneumoniae</i> isolates were susceptible to all tested antibiotics, while 24.36 % exhibited resistance to a single antibiotic class, with macrolide resistance being predominant (15.38 %). Multidrug resistance was observed in 55.13 % of isolates, primarily driven by macrolide-lincosamide co-resistance (34.62 %). The mutation rate in the 23S rRNA V domain was 94.87 %, with A2063G being predominant (65.38 %).</p><p><strong>Conclusions: </strong>This study reveals a high prevalence of macrolide resistance and multidrug resistance, primarily involving macrolide and lincosamide, in clinical isolates of <i>M. pneumoniae</i>. The high mutation rate in the 23S rRNA V domain underscores the need for continuous surveillance of resistance patterns and genetic mutations.</p>","PeriodicalId":19715,"journal":{"name":"Open Medicine","volume":"21 1","pages":"20261400"},"PeriodicalIF":1.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}