Clinic analysis of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

Objective The aim of this paper is to analyze the clinic characteristics of MRMP in children by checking nucleic acid and mutational sites of mycoplasma pneumoniae(MP) from phlegm samples and help the clinic therapy of Mycoplasma pneumonia in children. Methods Total 182 children in our hospital from October, 2015 to August, 2016 were enrolled into this study. Mycoplasma pneumoniae nucleic acid and gene locus for macrolide resistance from sputum samples was detected by PCR and Taqman fluorescent probe. χ² test was conducted to compare the difference in the clinic characteristics between MRMP pneumonia and macrolide-sensitive Mycoplasma(MSMP) pneumonia. Results Among 182 MP pneumonia, there were 113 cases of MRMP accounting for 62.1%, 69 cases of MSMP accounting for 37.9%. A2063G mutation occurred in 99 cases, A2063T in 4 cases, A2063G was the main mutation. In 113 cases of MRMP pneumonia, 85 cases were with fever(temperature > 38℃) duration more than 7 days, for 75.2%; 78 cases with hospitalization time more than 7 days, for 69.0%; 69 cases with extra-pulmonary complications, for 61.1%; 58 cases with lungs lesions more than two lobes, for 51.3%, 55 cases with the use of glucocorticoid, for 48.7%, 47 cases with the level of CRP more than 40 mg/L, for 41.6%; 68 cases with Bronchoalveolar lavage, for 60.2%; 45 cases with intravenous immunoglobulin use, for 39.8%; 46 cases with the level of LDH >400 U/L, for 40.7%; MRMP had longer febrile periods, required longer hospitalization time, had higher rate of extra-pulmonary complications, lesions more than two lobes of lungs and CRP level more than 40 mg/L. More glucocorticoid, bronchoalveolar lavage and IVIG were used in MRMP. But there was no significant difference in LDH level. Conclusion The incidence of MRMP pneumonia is higher than MSMP. If children suffer from longer febrile periods, combine with extra-pulmonary complications, wide lesion range, moderately increased CRP level; we should consider the possibility of MRMP. The use of low-dose glucocorticoid, bronchoalveolar lavage and IVIG should be selected to deal with MRMP.