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Chinese Journal of Evidence -Based Pediatric ›› 2016, Vol. 11 ›› Issue (5): 357-360.

• Original Papers • Previous Articles     Next Articles

The clinical characteristics of macrolide-resistant Mycoplasma pneumoniae pneumonia in Children: a case-control study

FENG Xue-li1, LI Qing-jing2, SUN Lin2, JIAO Wei-wei2, XU Bao-ping1, YIN Ju1, GUO Yan1, SHEN Chen2, LI Jie-qiong2, XU Fang2, QI Hui2, XIAO Jing2, SHEN A-dong2   

  1. 1 Department of Respiratory, Beijing Children's Hospital, Capital Medical University; 2 MOE Key Laboratory of Major Diseases in Children， National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases，Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University，Beijing, 100045, China
  • Received:2016-09-19 Revised:2016-11-04 Online:2016-10-25 Published:2016-10-25
  • Contact: SHEN A-dong

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Abstract:

Objective To analyze the clinical characteristics of macrolide-resistant Mycoplasma pneumoniae (MP) pneumonia. Methods Children with Mycoplasma pneumoniae pneumonia in the Respiratory Department of Beijing Children's Hospital were included, from January 2014 to December 2015. All children were taken swabs for DNA and drug-resistant gene detection on admission, and were divided into macrolide-resistant group (MR) and macrolide-sensitive (MS) group according to the detection results, the clinical data and curative effect indexes were compared between these two groups. Results 225 patients who were detected for the drug-resistant gene were analyzed, including 195 MR cases and 30 MS cases. All patients in two groups were with high fever and cough, and there were no significant differences in gender, age, highest temperature, the proportion of severe pneumonia, acute peripheral blood leukocyte count, acute phase proportion of neutrophils, acute phase CRP value between these two groups; The chest X-ray films of all cases showed lobar consolidation, mainly with unilateral lesion of right lung, but the proportion of bilateral lesions in MR group was higher than that in MS group (P = 0.056). The total course and the fever time after using macrolide in MR group were significantly longer than those in MS group ［total course (18.3±6.1）vs (16.5±4.2) d, P=0.031；(7.0±4.3）vs (4.7±3.4) d ,P=0.003］. Analyzing curative effect, the total fever time and the total course in the group using macrolide at beginning were significantly longer than those in the group using other antibiotics at beginning ［total fever time (9.6±3.5) vs (12.1±5.6) d；total course (16.1±4.1) vs (19.3±6.6) d；P<0.001］. Conclusion The resistant rate of MP was 87.6% in Beijing Children's Hospital. The patients with MR-MPs had higher risk for bilateral lesions, longer fever time and total course than the patients with MS-MPs. There was no difference for other clinical characteristics between these two groups. In addition, early application of macrolide could shorten course and fever time of patient with MR-MP.