南宁市某妇幼医院重症肺炎支原体肺炎感染患儿临床特征及耐药性分析

Analysis of clinical characteristics and drug resistance of children with severe Mycoplasma pneumoniae pneumonia infection in a Nanning Maternal and Child Health Hospital

目的分析南宁市妇幼保健院重症肺炎支原体肺炎(SMPP)感染患儿的临床特征及耐药性。方法收集并分析2023年8月至11月南宁市妇幼保健院收治的122例SMPP感染患儿的临床资料,按照耐药基因检测结果分为耐药组(n=60)和非耐药组(n=62)。采用被动凝集法、荧光PCR法检测患儿支气管肺泡灌洗液中肺炎支原体对大环内酯类抗生素的耐药基因,并分析其临床特征和耐药情况。结果SMPP患儿的临床特点主要是高热或超高热、伴有阵发性咳嗽、发热时间<7 d、多数存在肺部湿啰音。两组住院天数、丙氨酸转氨酶、发热持续总天数比较,差异有统计学意义(P<0.05);两组使用激素和多西环素比较,差异有统计学意义(P<0.05);两组肺气肿、肺不张、肺脓肿、胸腔积液及塑型性支气管炎发生率比较,差异无统计学意义(P>0.05);两组免疫球蛋白(Ig)A、IgM、总IgE水平比较,差异有统计学意义(P<0.05)。结论SMPP感染患儿对激素和多西环素类药物的耐药性较敏感,耐药患儿的支气管镜下表现及临床特征较明显,且耐药患儿的相关Ig水平更高,临床诊疗中应密切关注患儿耐药性的发生和发展。

Objective To analyze the clinical characteristics and drug resistance of children with severe Mycoplasma pneumoniae pneumonia(SMPP)infection in Nanning Maternity and Child Health Hospital.Methods The clinical data of 122 children with SMPP infection admitted to Nanning Maternity and Child Health Hospi tal from August to November 2023 were collected and analyzed.According to the results of drug resistance gene detection,they were divided into drug resistance group(n=60)and non-drug resistance group(n=62).The resistance genes of Mycoplasma pneumoniae to macrolide antibiotics in bronchoalveolar l avage fluid were detected by passive agglutination and fluorescent PCR,and their clinical characteristics and drug resistance were analyzed.Results The clinical characteristics of SMPP children were mainly high fever or ultra-high fever,accompanied by paroxysmal cough,fever time<7 days,and most of the pulmonary moist rales.There were statistically significant differences in hospitalization days,alanine aminotransferase,and total days of fever duration between the two groups(P<0.05).There was statistically significant difference in the use of hormones and Doxycycline between the two groups(P<0.05).There was no significant difference in the incidence of emphysema,atelectasis,pulmonary abscess,pleural effusion,and plastic bronchitis between the two groups(P>0.05).There were significant differences in the levels of immunoglobulin(Ig)A,IgM,and total IgE between the two groups(P<0.05).Conclusion Children infected with SMPP are more sensitive to hormone and Doxycycline drug resistance,and the bronchoscopic manifestations and clinical characteristics of drug-resistant children are more obvious,and the level of related Ig in drug-resistant children is higher.In clinical diagnosis and treatment,close attention should be paid to the occurrence and development of d rug resistance in children.