More Complications Occur in Macrolide-Resistant than in Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia
More Complications Occur in Macrolide-Resistant than in Macrolide-Sensitive Mycoplasma pneumoniae Pneumonia
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DOI：
10.1128/aac.01806-13
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发表时间：
2014-02-01
影响因子：
4.9
通讯作者：
Chen, Zhimin
中科院分区：
文献类型：
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作者：
Zhou, Yunlian;Zhang, Yuanyuan;Chen, Zhimin
目的了解肺炎支原体大环内酯类耐药基因型分布情况，分析大环内酯类耐药基因型与肺炎支原体肺炎（MPP）临床表现的关系。M. 23 S rRNA基因全长测序对235例MPP患儿的鼻咽抽吸物（NPA）进行了肺炎支原体（Pneumoniae）检测。我们还回顾性比较了大环内酯类耐药（MR）M的临床特征。肺炎支原体感染和大环内酯敏感型（MS）M.肺炎感染。共有206名患者在M.肺炎23 S rRNA基因，这些患者被称为MR患者。其余29名没有点突变的患者被称为MS患者。在206例MR患者中，199例（96.6%）有A2063 G突变，6例有A2063 T突变，其余患者有A2064 G突变。在临床表现中，我们发现中位发热持续时间为8天（范围：0至42天）和6天（0至14天）中位住院天数为8d，与对照组比较差异有显著性（P< 0.01）（2至45天）和6天（3至16天）大环内酯类药物治疗后中位发热时间为5d MR组和MS组分别为0 ~ 42天和3天（0 ~ 10天）（P< 0.01）。MR组肺外并发症发生率明显高于MS组（P< 0.05）。MR组的影像学改变较MS组严重（P< 0.05）。MR M的发病率不断增加。肺炎已成为儿科患者的重要临床问题，可导致更多的肺外并发症和严重的临床特征和放射学表现。
We sought to understand the situation of macrolide-resistant genotypes of Mycoplasma pneumoniae, and analyze the relationship between macrolide-resistant genotypes and clinical manifestations of Mycoplasma pneumoniae pneumonia (MPP). Full-length sequencing of the 23S rRNA gene of M. pneumoniae was performed in 235 nasopharyngeal aspirates (NPAs) from children with MPP. We also retrospectively compared the clinical characteristics of macrolide-resistant (MR) M. pneumoniae infections and macrolide-sensitive (MS) M. pneumoniae infections. A total of 206 patients had point mutations in the M. pneumoniae 23S rRNA gene, and these patients are referred to as MR patients. The remaining 29 patients without point mutations are referred to as MS patients. Among 206 MR patients, 199 (96.6%) had A2063G mutations, 6 had A2063T mutations, and the remaining patients had an A2064G mutation. Among the clinical manifestations, we found that the median fever durations were 8 days (range, 0 to 42 days) and 6 days (0 to 14 days) (P< 0.01), the median hospitalization durations were 8 days (2 to 45 days) and 6 days (3 to 16 days) (P< 0.01), and the median fever durations after macrolide therapy were 5 days (0 to 42 days) and 3 days (0 to 10 days) (P< 0.01), respectively, in the MR and MS groups. We also found that the incidence of extrapulmonary complications in the MR group was significantly higher than that in the MS group (P< 0.05). Moreover, the radiological findings were more serious in the MR group than in the MS group (P< 0.05). The increasing prevalence of MR M. pneumoniae has become a significant clinical issue in the pediatric patients, which may lead to more extrapulmonary complications and severe clinical features and radiological manifestations.