More complications occurred in macrolide-resistant Mycoplasma pneumoniae pneumonia.
Antimicrob Agents Chemother. 2013 Nov 25;
Authors: Zhou Y, Zhang Y, Sheng Y, Zhang L, Shen Z, Chen Z
Objectives:To understand the situation of macrolide-resistant genotypes of Mycoplasma pneumoniae (MP), and analyze the relationship between macrolide-resistant genotypes and clinical manifestations of Mycoplasma pneumoniae pneumonia (MPP).Methods:Full-length sequencing of the 23S rRNA gene of MP was performed in 235 nasopharyngeal aspirates (NPAs) from children with MPP. We also retrospectively compared the clinical characteristics of macrolide-resistant (MR) MP infections and macrolide-sensitive (MS) MP infections.Results:A total of 206 patients had point mutations in the 23S rRNA gene of MP, and they were defined as MR patients. The remaining 29 patients without point mutations were defined as MS patients. Among 206 MR patients, 199 (96.6%) had A2063G mutations, 6 with A2063T mutations, and the remaining one with an A2064G mutation. Concerning clinical manifestations, we found the median fever duration was 8 (range 0∼42) days and 6 (0∼14) days (P<0.01), the median hospitalization duration was 8 (2∼45) days and 6 (3∼16) days (P<0.01), and the median fever duration after macrolide therapy was 5 (0∼42) days and 3 (0∼10) days (P<0.01), respectively in the MR and MS group. We also found the incidence of extra-pulmonary complications in the MR group was significantly higher than that in the MS group (P<0.05). And radiological findings were more serious in the MR group than those in the MS group (P<0.05).Conclusions:The increasing prevalence of MR MP has become a significant clinical issue in the pediatric patients, which may lead to more extra-pulmonary complications, and severe clinical features and radiological manifestations.
PMID: 24277047 [PubMed - as supplied by publisher]