High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia
Abstract Background An increased number of refractory mycoplasma pneumoniae (MP) pneumonia (MPP) cases have been reported. However the duration of MP infection in lower airway and the course of anti-MP treatment remains unclear. Methods We retrospectively reviewed the medical records of 94 MPP child...
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BMC
2019-12-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-019-4667-y |
| _version_ | 1818435280657448960 |
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| author | Jinrong Liu Fei Zhao Jie Lu Hui Xu Hui Liu Xiaolei Tang Haiming Yang Jianzhong Zhang Shunying Zhao |
| author_facet | Jinrong Liu Fei Zhao Jie Lu Hui Xu Hui Liu Xiaolei Tang Haiming Yang Jianzhong Zhang Shunying Zhao |
| author_sort | Jinrong Liu |
| collection | DOAJ |
| description | Abstract Background An increased number of refractory mycoplasma pneumoniae (MP) pneumonia (MPP) cases have been reported. However the duration of MP infection in lower airway and the course of anti-MP treatment remains unclear. Methods We retrospectively reviewed the medical records of 94 MPP children. Patients were classified into two groups. The long-term group (Group LT) was defined as bronchoalveolar lavage fluid (BALF) remained MP-positive by PCR after 30 days of the disease course. The non-long-term group (Group NLT) was defined as BALF became MP-negative by PCR within 30 days of disease and patients who only needed one bronchoscopy lavage therapy. MP loads, clinical outcomes were analyzed along with other clinical measurements. Results The average levels of inflammatory markers such as C reactive protein and lactate dehydrogenase in Group LT were significantly higher than those in Group NLT. Airway and lung damage in Group LT were more severe than Group NLT. 28 patients developed necrotizing pneumonia and 8 patients developed pulmonary embolism in Group LT. Mean maximum MP loads in BALF were 107.46 ± 0.93 and 104.86 ± 0.93 in Groups LT and NLT, respectively. There was persistent MP DNA in Group LT, even lasted for 120 days. One severe MPP patient in Group LT had MP-associated bloodstream infection. After 3 months of follow-up, chest imaging revealed incomplete absorption of pulmonary consolidation in 33 patients of Group LT [including 13 airway obliterans (AO) patients] and in 7 patients of Group NLT (including 2 AO patients). Conclusion MP loads of BALF were associated with the subsequent duration of MP DNA in lower airway. High MP loads and persistent long-term MP DNA in lower airway were associated with severity of pediatric MPP. |
| first_indexed | 2024-12-14T16:50:23Z |
| format | Article |
| id | doaj.art-88ae380e09574ac6a06c9104a7df0e48 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-14T16:50:23Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-88ae380e09574ac6a06c9104a7df0e482022-12-21T22:54:04ZengBMCBMC Infectious Diseases1471-23342019-12-011911810.1186/s12879-019-4667-yHigh Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumoniaJinrong Liu0Fei Zhao1Jie Lu2Hui Xu3Hui Liu4Xiaolei Tang5Haiming Yang6Jianzhong Zhang7Shunying Zhao8Department of Respiratory Medicine II, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthNational Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory of Infectious Disease Prevention and ControlKey Laboratory of Major Diseases in Children, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Respiratory Medicine II, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Respiratory Medicine II, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Respiratory Medicine II, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Respiratory Medicine II, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthNational Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory of Infectious Disease Prevention and ControlDepartment of Respiratory Medicine II, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthAbstract Background An increased number of refractory mycoplasma pneumoniae (MP) pneumonia (MPP) cases have been reported. However the duration of MP infection in lower airway and the course of anti-MP treatment remains unclear. Methods We retrospectively reviewed the medical records of 94 MPP children. Patients were classified into two groups. The long-term group (Group LT) was defined as bronchoalveolar lavage fluid (BALF) remained MP-positive by PCR after 30 days of the disease course. The non-long-term group (Group NLT) was defined as BALF became MP-negative by PCR within 30 days of disease and patients who only needed one bronchoscopy lavage therapy. MP loads, clinical outcomes were analyzed along with other clinical measurements. Results The average levels of inflammatory markers such as C reactive protein and lactate dehydrogenase in Group LT were significantly higher than those in Group NLT. Airway and lung damage in Group LT were more severe than Group NLT. 28 patients developed necrotizing pneumonia and 8 patients developed pulmonary embolism in Group LT. Mean maximum MP loads in BALF were 107.46 ± 0.93 and 104.86 ± 0.93 in Groups LT and NLT, respectively. There was persistent MP DNA in Group LT, even lasted for 120 days. One severe MPP patient in Group LT had MP-associated bloodstream infection. After 3 months of follow-up, chest imaging revealed incomplete absorption of pulmonary consolidation in 33 patients of Group LT [including 13 airway obliterans (AO) patients] and in 7 patients of Group NLT (including 2 AO patients). Conclusion MP loads of BALF were associated with the subsequent duration of MP DNA in lower airway. High MP loads and persistent long-term MP DNA in lower airway were associated with severity of pediatric MPP.https://doi.org/10.1186/s12879-019-4667-yRefractoryMycoplasma pneumoniaeLower airwayLoadsDuration |
| spellingShingle | Jinrong Liu Fei Zhao Jie Lu Hui Xu Hui Liu Xiaolei Tang Haiming Yang Jianzhong Zhang Shunying Zhao High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia BMC Infectious Diseases Refractory Mycoplasma pneumoniae Lower airway Loads Duration |
| title | High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia |
| title_full | High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia |
| title_fullStr | High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia |
| title_full_unstemmed | High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia |
| title_short | High Mycoplasma pneumoniae loads and persistent long-term Mycoplasma pneumoniae DNA in lower airway associated with severity of pediatric Mycoplasma pneumoniae pneumonia |
| title_sort | high mycoplasma pneumoniae loads and persistent long term mycoplasma pneumoniae dna in lower airway associated with severity of pediatric mycoplasma pneumoniae pneumonia |
| topic | Refractory Mycoplasma pneumoniae Lower airway Loads Duration |
| url | https://doi.org/10.1186/s12879-019-4667-y |
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