肺炎支原体(Mycoplasma pneumoniae, MP)是儿童社区获得性肺炎的常见病原体,通过飞沫传播,周期性地引起地区性暴发流行。新冠疫情期间采取的非药物干预措施(non-pharmaceutical interventions, NPIs)在控制新型冠状病毒传播的同时,也显...肺炎支原体(Mycoplasma pneumoniae, MP)是儿童社区获得性肺炎的常见病原体,通过飞沫传播,周期性地引起地区性暴发流行。新冠疫情期间采取的非药物干预措施(non-pharmaceutical interventions, NPIs)在控制新型冠状病毒传播的同时,也显著影响了MP的流行病学特征、耐药性及临床表现。随着防控措施的放松,MP疫情出现了延迟但显著的反弹,这一现象可能与MP独特的生物学特征、免疫债务、病原体的交互影响以及抗生素经验性使用等多重因素有关。本文就新冠疫情期间及疫情后期MP流行病学、大环内酯类耐药性及临床表现进行了综述,了解新冠疫情对肺炎支原体感染的影响,并探讨了肺炎支原体肺炎的治疗进展。Mycoplasma pneumoniae is a common pathogen in community-acquired pneumonia in children, spreading through droplet transmission and periodically causing regional outbreaks. The non-pharmaceutical interventions implemented during the COVID-19 pandemic have significantly impacted the epidemiological characteristics, drug resistance, and clinical manifestations of M. pneumoniae while controlling the spread of the novel coronavirus. With the relaxation of containment measures, there has been a delayed but significant rebound in M. pneumoniae outbreaks. This phenomenon may be related to the unique biological characteristics of M. pneumoniae, immune debt, interactions with other pathogens, and the empirical use of antibiotics among multiple factors. This article reviews the epidemiology of M. pneumoniae, macrolide resistance, and clinical manifestations during and after the COVID-19 pandemic, aiming to understand the impact of the pandemic on M. pneumoniae infections, and explores the therapeutic advancements for M. pneumoniae pneumonia.展开更多
囊性纤维化(CF)是一种常染色体隐性遗传疾病,由于囊性纤维化跨膜传导调节因子(CFTR)基因变异引起上皮细胞运输障碍而发生,因涉及多个器官系统,其临床表现多种多样。近年来发现假性Bartter综合征(PBS)常作为CF患儿早期临床表现。PBS是CF...囊性纤维化(CF)是一种常染色体隐性遗传疾病,由于囊性纤维化跨膜传导调节因子(CFTR)基因变异引起上皮细胞运输障碍而发生,因涉及多个器官系统,其临床表现多种多样。近年来发现假性Bartter综合征(PBS)常作为CF患儿早期临床表现。PBS是CF的常见并发症,指在没有肾小管病变的情况下表现为低钠低钾低氯性碱中毒。Bartter综合征(BS)是一种由Henle环粗大升支的盐重吸收缺陷引起的遗传性肾小管疾病。由于早期CF-PBS的临床表现与BS相似,易出现误诊。本综述重点就CF-PBS与BS的发病机制、临床表现、诊断治疗进行鉴别,旨在提高临床医师对两种疾病的诊治水平,减少误诊及漏诊。Cystic fibrosis (CF) is an autosomal recessive disorder that occurs as a result of impaired epithelial cell transport caused by a variant in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Because of the involvement of multiple organ systems, its clinical manifestations are diverse. In recent years, pseudo-Bartter syndrome (PBS) has been identified as an early clinical manifestation in children with CF. PBS is a common complication of CF and refers to the presentation of low-sodium, low-potassium, and low-chlorine alkalosis in the absence of renal tubular pathology. Bartter syndrome (BS) is an inherited renal tubular disease caused by a defect in salt reabsorption in the thick ascending branch of the loop of Henle. As the clinical manifestations of early CF-PBS are similar to those of BS, it is easy to be misdiagnosed. This review focuses on the differentiation of CF-PBS from BS in terms of pathogenesis, clinical manifestations, diagnosis and treatment, with the aim of improving clinicians’ diagnosis and treatment of the two diseases and reducing misdiagnosis and underdiagnosis.展开更多
文摘肺炎支原体(Mycoplasma pneumoniae, MP)是儿童社区获得性肺炎的常见病原体,通过飞沫传播,周期性地引起地区性暴发流行。新冠疫情期间采取的非药物干预措施(non-pharmaceutical interventions, NPIs)在控制新型冠状病毒传播的同时,也显著影响了MP的流行病学特征、耐药性及临床表现。随着防控措施的放松,MP疫情出现了延迟但显著的反弹,这一现象可能与MP独特的生物学特征、免疫债务、病原体的交互影响以及抗生素经验性使用等多重因素有关。本文就新冠疫情期间及疫情后期MP流行病学、大环内酯类耐药性及临床表现进行了综述,了解新冠疫情对肺炎支原体感染的影响,并探讨了肺炎支原体肺炎的治疗进展。Mycoplasma pneumoniae is a common pathogen in community-acquired pneumonia in children, spreading through droplet transmission and periodically causing regional outbreaks. The non-pharmaceutical interventions implemented during the COVID-19 pandemic have significantly impacted the epidemiological characteristics, drug resistance, and clinical manifestations of M. pneumoniae while controlling the spread of the novel coronavirus. With the relaxation of containment measures, there has been a delayed but significant rebound in M. pneumoniae outbreaks. This phenomenon may be related to the unique biological characteristics of M. pneumoniae, immune debt, interactions with other pathogens, and the empirical use of antibiotics among multiple factors. This article reviews the epidemiology of M. pneumoniae, macrolide resistance, and clinical manifestations during and after the COVID-19 pandemic, aiming to understand the impact of the pandemic on M. pneumoniae infections, and explores the therapeutic advancements for M. pneumoniae pneumonia.
文摘囊性纤维化(CF)是一种常染色体隐性遗传疾病,由于囊性纤维化跨膜传导调节因子(CFTR)基因变异引起上皮细胞运输障碍而发生,因涉及多个器官系统,其临床表现多种多样。近年来发现假性Bartter综合征(PBS)常作为CF患儿早期临床表现。PBS是CF的常见并发症,指在没有肾小管病变的情况下表现为低钠低钾低氯性碱中毒。Bartter综合征(BS)是一种由Henle环粗大升支的盐重吸收缺陷引起的遗传性肾小管疾病。由于早期CF-PBS的临床表现与BS相似,易出现误诊。本综述重点就CF-PBS与BS的发病机制、临床表现、诊断治疗进行鉴别,旨在提高临床医师对两种疾病的诊治水平,减少误诊及漏诊。Cystic fibrosis (CF) is an autosomal recessive disorder that occurs as a result of impaired epithelial cell transport caused by a variant in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Because of the involvement of multiple organ systems, its clinical manifestations are diverse. In recent years, pseudo-Bartter syndrome (PBS) has been identified as an early clinical manifestation in children with CF. PBS is a common complication of CF and refers to the presentation of low-sodium, low-potassium, and low-chlorine alkalosis in the absence of renal tubular pathology. Bartter syndrome (BS) is an inherited renal tubular disease caused by a defect in salt reabsorption in the thick ascending branch of the loop of Henle. As the clinical manifestations of early CF-PBS are similar to those of BS, it is easy to be misdiagnosed. This review focuses on the differentiation of CF-PBS from BS in terms of pathogenesis, clinical manifestations, diagnosis and treatment, with the aim of improving clinicians’ diagnosis and treatment of the two diseases and reducing misdiagnosis and underdiagnosis.
