Volume 19 Issue 4
Apr.  2021
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WU Chao-xiong, WANG Ai-min, CAI Zhen-dang. Correlation between 23S rRNA mutation of Mycoplasma pneumoniae and clinical characteristics and drug resistance in children[J]. Chinese Journal of General Practice, 2021, 19(4): 603-606. doi: 10.16766/j.cnki.issn.1674-4152.001872
Citation: WU Chao-xiong, WANG Ai-min, CAI Zhen-dang. Correlation between 23S rRNA mutation of Mycoplasma pneumoniae and clinical characteristics and drug resistance in children[J]. Chinese Journal of General Practice, 2021, 19(4): 603-606. doi: 10.16766/j.cnki.issn.1674-4152.001872
shu

Correlation between 23S rRNA mutation of Mycoplasma pneumoniae and clinical characteristics and drug resistance in children

doi: 10.16766/j.cnki.issn.1674-4152.001872

  • Department of Pediatrics, Wenzhou Integrated Traditional Chinese and Western Medicine Hospital, Wenzhou, Zhejiang 325000, China

Funds:

 2015ZA237

  • Received Date: 2020-06-10
    Available Online: 2022-02-16
    Abstract
  •   Objective  This study aimed to observe the mutation characteristics of 23S rRNA gene in children with Mycoplasma pneumoniae (MP) and explore the correlation amongst the mutation, clinical characteristics and drug resistance in children.  Methods  A total of 214 cases of infantile MP with 23S rRNA gene mutation treated with the combination of traditional Chinese and Western medicine in a hospital in Wenzhou from January 2016 to January 2019 were collected and divided into the non-mutated group (36 cases) and mutated group (178 cases). Patient's general information, clinical data and drug susceptibility test results were collected on the basis of medical records to analyse the correlation between 23S rRNA gene mutation with the clinical characteristic and drug resistance of the patients.  Results  A total of 178 cases (83.18%) of 23S rRNA gene mutations were detected. Compared with the non-mutated group, the proportion of severe pneumonia in the mutated group was higher (83.18%); the mean fever time was longer (7.22±2.13) d; the hospital stay was longer (8.30±3.25) d, and the time to normal body temperature was longer (6.45±2.33) d. The differences were statistically significant (all P < 0.05). The drug susceptibility test results showed that the drug resistance rates of azithromycin and roxithromycin in the mutated group (38.20% vs. 25.84%) were significantly higher than those in non-mutated group (13.89% vs. 8.33%), all P < 0.05. Multivariate logistic regression analysis showed that the severity of pneumonia, the time to return to normal body temperature and 23S rRNA gene mutation were independent related factors of MP resistance (OR=1.693, 1.285, 3.338, all P < 0.05).  Conclusion  The mutation of A2603G gene in 23S rRNA is the main type of MP mutation, which has evident resistance to macrolide antibiotics, which can increase the proportion of children with severe pneumonia and significantly prolong the clinical treatment time of children.

     

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