Comparison of the characteristics of macrolide-sensitive and macrolide-resistant Mycoplasma pneumoniae pneumonia requiring hospitalization in children
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: This study was performed to investigate differences in clinical, laboratory, and radiologic features of clinical course between macrolide-resistant Mycoplasma pneumoniae (MRMP) and macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in children. Methods: A total of 146 children hospitalized with Mycoplasma pneumoniae (MP) pneumonia in a tertiary hospital were enrolled in this study. Information on the characteristics was retrospectively obtained using electronic medical records. Results: The duration of fever and hospitalization was significantly longer and respiratory virus coinfection was more common in the MRMP group than in the MSMP group (47.0% vs. 24.1%, P=0.026). No significant intergroup difference in the laboratory findings, except monocytes (%), was observed. The proportion of patients with pneumonic lesions involving more than half of the whole lung was higher (28.2% vs. 10.3%), with a poorer response to the stepwise treatment for MP pneumonia, in the MRMP group than in the MSMP pneumonia group. MRMP pneumonia in children may be associated with a higher disease burden than MSMP pneumonia. Conclusion: MRMP pneumonia in children might be associated with a more increased disease burden than MSMP pneumonia. This study suggested the need of distinguished therapeutic approaches to reduce the disease burden due to MRMP pneumonia in children.
Abstract
Purpose: This study was performed to investigate differences in clinical, laboratory, and radiologic features of clinical course between macrolide-resistant Mycoplasma pneumoniae (MRMP) and macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in children. Methods: A total of 146 children hospitalized with Mycoplasma pneumoniae (MP) pneumonia in a tertiary hospital were enrolled in this study. Information on the characteristics was retrospectively obtained using electronic medical records. Results: The duration of fever and hospitalization was significantly longer and respiratory virus coinfection was more common in the MRMP group than in the MSMP group (47.0% vs. 24.1%, P=0.026). No significant intergroup difference in the laboratory findings, except monocytes (%), was observed. The proportion of patients with pneumonic lesions involving more than half of the whole lung was higher (28.2% vs. 10.3%), with a poorer response to the stepwise treatment for MP pneumonia, in the MRMP group than in the MSMP pneumonia group. MRMP pneumonia in children may be associated with a higher disease burden than MSMP pneumonia. Conclusion: MRMP pneumonia in children might be associated with a more increased disease burden than MSMP pneumonia. This study suggested the need of distinguished therapeutic approaches to reduce the disease burden due to MRMP pneumonia in children.
참고문헌 (23)
- Lee E, "Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea", BMC Infect Dis, 20, pp.132~ (2020)
- Zhai YY, "An analysis of 20 clinical cases of refractory mycoplasma pneumonia in children", Ann Palliat Med, 9, pp.2592~2599 (2020)
- Kim K, "Global trends in the proportion of macrolide-resistant Mycoplasma pneumoniae infections : a systematic review and meta-analysis", JAMA Netw Open, 5, pp.e2220949~ (2022)
- Zhou Y, "More complications occur in macrolide-resistant than in macrolide-sensitive Mycoplasma pneumoniae pneumonia", Antimicrob Agents Chemother, 58, pp.1034~1038 (2014)
- Cao B, "High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China", Clin Infect Dis, 51, pp.189~194 (2010)
- Chang CH, "Epidemiology and clinical manifestations of children with macrolide-resistant Mycoplasma pneumoniae pneumonia in Southern Taiwan", Pediatr Neonatol, 62, pp.536~542 (2021)
- Cardinale F, "Clinical relevance of Mycoplasma pneumoniae macrolide resistance in children", J Clin Microbiol, 51, pp.723~724 (2013)
- Choi JH, "Prevalence and clinical features of community-acquired pneumonia caused by macrolide-resistant Mycoplasma pneumoniae Isolated from adults in Jeju Island", Microb Drug Resist, 25, pp.577~581 (2019)
- Chen YC, "Macrolide-resistant Mycoplasma pneumoniae Infections in pediatric community-acquired pneumonia", Emerg Infect Dis, 26, pp.1382~1391 (2020)
- Pereyre S, "Mycoplasma pneumoniae : current knowledge on macrolide resistance and treatment", Front Microbiol, 7, pp.974~ (2016)
- 이은, "Prevalence and clinical manifestations of macrolide resistant Mycoplasma pneumoniae pneumonia in Korean children", Clinical and Experimental Pediatrics, 60(5), pp.151~157 (2017), 대한소아청소년과학회
- Tsai TA, "Rational stepwise approach for Mycoplasma pneumoniae pneumonia in children", J Microbiol Immunol Infect, 54, pp.557~565 (2021)
- Sun LL, "Meta-analysis of the clinical efficacy and safety of high-and low-dose methylprednisolone in the treatment of children with severe Mycoplasma pneumoniae pneumonia", Pediatr Infect Dis J, 39, pp.177~183 (2020)
- Kim HS, "Efficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children : meta-analysis of randomized controlled trials", BMC Pulm Med, 19, pp.251~ (2019)
- Yang EA, "Early corticosteroid therapy for Mycoplasma pneumoniae pneumonia irrespective of used antibiotics in children", J Clin Med, 8, pp.726~ (2019)
- Ishiguro N, "Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients", PLoS One, 12, pp.e0173635~ (2017)
- Bajantri B, "Mycoplasma pneumoniae : a potentially severe infection", J Clin Med Res, 10, pp.535~544 (2018)
- Chiu CY, "Impact of bacterial and viral coinfection on mycoplasmal pneumonia in childhood community-acquired pneumonia", J Microbiol Immunol Infect, 48, pp.51~56 (2015)
- Choo S, "Clinical significance of respiratory virus coinfection in children with Mycoplasma pneumoniae pneumonia", BMC Pulm Med, 22, pp.212~ (2022)
- Diseases GBD, "Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019", Lancet, 396, pp.1204~1222 (2020)
- Kim SH, "Clinical significance of pleural effusion in Mycoplasma pneumoniae pneumonia in children", Pathogens, 10, pp.1075~ (2021)
- Peuchant O, "Increased macrolide resistance of Mycoplasma pneumoniae in France directly detected in clinical specimens by real-time PCR and melting curve analysis", J Antimicrob Chemother, 64, pp.52~58 (2009)
- Narita M, "Classification of extrapulmonary manifestations due to Mycoplasma pneumoniae infection on the basis of possible pathogenesis", Front Microbiol, 7, pp.23~ (2016)