Clinical analysis of mycoplasma pneumoniae pneumonia with 23SrRNA A2063G gene mutation in 24 cases / 中国小儿急救医学

Objective To analyse the clinical manifestations of mycoplasma pneumoniae pneumonia(MPP) with 23SrRNA A2063G gene mutation,and improve the ability of diagnosis and treatment of patient infected with MPP.Methods MP-DNA was detected by fluorescent quantitative real-time PCR in sputum specimens from 36 children with MPP,then we detected the drug resistance gene mutation sites by nest-PCR and DNA sequencing,on this basis we classified into two groups of macrolide-resistant MP and macrolide-sensitive MP,and compared the clinical manifestations,laboratory findings,chest imagings and treatment between two groups.Results Of these 36 cases of MPP,24 cases had macrolide-resistant gene mutation with an A2063G transition in domain V of the 23SrRNA,12 cases had no macrolide-resistant gene mutation.Compared to macrolide-sensitive MP group,macrolide-resistant MP group had longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and had higher white blood cells counts and CRP.In the macrolide-resistant MP group,the temperature subsided within 5 days after macrolide treatment alone of 12 cases,3 cases needed switch to fluoroquinolones therapy,10 cases combined with glucocorticoids and 6 cases combined with intravenous immunoglobulin,all 24 patients had good outcomes.While in macrolide-sensitive MP group,the temperature susided between 12 hours to 3 days after macrolide treatment of 8 cases.Conclusions Compared to patients infected by macrolide-sensitive MP,those mycoplasma pneumoniae pneumonia patients with 23SrRNA A2063G gene mutation have longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and have higher white blood cells counts and CRP.Some macrolide-resistant MPP patients have good response to macrolide antibiotics treatment,while the severe cases need combined with glucocorticoids and immunoglobulin,or should change antibiotics.

Carriage and the detection of PCR with Mycoplasma pneumoniae in children / 国际儿科学杂志

Mycoplasma pneumonia(MP)is a common cause of respiratory tract infections in children. The symptoms of MP infection range from mild to severe,which is often self-limiting.A few cases can develop to severe extrapulmonary complications.Because the symptoms and imagings of MP infection are not specific,so it may by means of diagnostic tests such as serology or PCR to guide the accurate therapy and to reduce the oc-currence of drug-resistance.In addition,recent studies indicate that MP can be carriage in the upper respiratory tract among healthy children,but clinically it is discriminate between MP infection and carriage.The asympto-matic carriage of MP could be the results of recent infection or the pathogenic persistence after infections.