社区获得性支原体肺炎的临床研究

Clinical study of community-acquired Mycoplasma pneumonia in adult patients

目的探讨肺炎支原体急性感染致社区获得性肺部感染成年患者的临床特征及其耐药性。方法选取医院2014年1月-2016年7月收治的502例社区获得性肺部感染(CAP)成年患者为研究对象,根据是否感染肺炎支原体(MP)分为MP感染组和非MP感染组,对两组患者的临床资料及影像学特点进行比较分析。结果 502例CAP患者中共检出MP感染患者170例(MP感染组),MP感染率为33.86%;MP感染组和非MP感染组患者在白细胞计数(WBC)、淋巴细胞比例(LY%)、中性粒细胞比例(NEUT%)、血红蛋白浓度(HB)等指标无明显差异;MP感染组感染部位位于左中下肺叶的患者明显多于非MP感染组患者,差异有统计学意义(P<0.05);MP感染组对抗菌药物的敏感性以四环素类最高,其次为喹诺酮类,大环内酯类最低,其中以强力霉素(92.35%)敏感性最佳。结论 MP感染所致CAP成年患者在临床上多具有纵隔淋巴结肿大的影像学特征,由于该类患者对于不同抗菌药物存在不同程度的耐药性,因此建议临床治疗考虑首选四环素类抗菌药物进行治疗。

OBJECTIVE To explore the clinical characteristics of adult patients with community-acquired pulmonary infection caused by Mycoplasma pneumoniae acute infection and observe the drug resistance.METHODS A total of 502 adult patients with community-acquired pneumonia （CAP） who were treated in the hospital from Jan 2014 to Jul 2016 were recruited as the study subjects and divided into the MP infection group and the non-MP infection group according to the status of M.pneumoniae （MP） infection.The clinical data and drug resistance were observed and compared between the two groups of patients.RESULTS Of the 502 patients with CAP, 170 had MP infection, with the incidence of MP infection 33.86%.There was no significant difference in the white blood cell （WBC） counts, percentage of lymphocytes （LY%）, percentage of neutrophils （NEUT%）, or hemoglobin （HB） concentration between the MP infection group and the non-MP infection group.The patients with left lower lung lobe infection were significntly more in the MP infection group than in the non-MP infection group （P〈0.05）.The result of drug susceptibility testing for the M.pneumoniae showed that tetracycline was the most sensitive antibiotic, followed by quinolones, the drug susceptibility rate to macrolides was lowest, and the drug susceptibility rate to doxycycline was the highest （92.35%）.CONCLUSION The adult patients with CAP induced by MP infection may have the imaging characteristic of mediastinal lymph node enlargement, and it is suggested that tetracycline should be used as preferred antibiotic for clinical treatment due to various degrees of drug resistance.