Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children
Objectives: The purpose of this study was to explore the clinical and laboratory characteristics of children with refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods: Seventy-six children with RMPP and 26 children with non-refractory M. pneumoniae pneumonia (NRMPP), confirmed by both serology...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2014-12-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971214016051 |
| _version_ | 1828471100954116096 |
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| author | Meijuan Wang Yuqing Wang Yongdong Yan Canhong Zhu Li Huang Xuejun Shao Jun Xu Hong Zhu Xiangle Sun Wei Ji Zhengrong Chen |
| author_facet | Meijuan Wang Yuqing Wang Yongdong Yan Canhong Zhu Li Huang Xuejun Shao Jun Xu Hong Zhu Xiangle Sun Wei Ji Zhengrong Chen |
| author_sort | Meijuan Wang |
| collection | DOAJ |
| description | Objectives: The purpose of this study was to explore the clinical and laboratory characteristics of children with refractory Mycoplasma pneumoniae pneumonia (RMPP).
Methods: Seventy-six children with RMPP and 26 children with non-refractory M. pneumoniae pneumonia (NRMPP), confirmed by both serology and fluorescent quantitation PCR in bronchoalveolar lavage fluid (BALF), were evaluated retrospectively.
Results: Compared to those with NRMPP, children with RMPP were older (66.6 ± 39.0 vs. 48.4 ± 35.4 months, p = 0.038) and had a longer duration of fever (12.7 ± 2.6 vs. 7.5 ± 1.8 days) and hospital stay (12.1 ± 3.2 vs. 7.4 ± 2.9 days). Children with RMPP presented neutrophil infiltration both in serum and BALF, as well as severe pulmonary lesions with pleural effusion. Children with RMPP had a significantly higher M. pneumoniae DNA load in BALF compared to NRMPP patients, and the M. pneumoniae load in BALF was significantly correlated with neutrophils and inversely correlated with macrophages for both the NRMPP and RMPP groups. The serum concentrations of tumor necrosis factor alpha (median 114.5 pg/ml, range 49.1–897.9 pg/ml) and interferon gamma (median 376.9 pg/ml, range 221.4–1997.6 pg/ml) were significantly higher in children with RMPP compared to children with NRMPP.
Conclusions: This study indicates that a direct microbe effect and the subsequent induced excessive host immune response contribute in part to the progression of RMPP. |
| first_indexed | 2024-12-11T05:05:15Z |
| format | Article |
| id | doaj.art-e0cca3d46e2748feb06868ad7df61ff8 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 1878-3511 |
| language | English |
| last_indexed | 2024-12-11T05:05:15Z |
| publishDate | 2014-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-e0cca3d46e2748feb06868ad7df61ff82022-12-22T01:20:03ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112014-12-0129C182310.1016/j.ijid.2014.07.020Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in childrenMeijuan Wang0Yuqing Wang1Yongdong Yan2Canhong Zhu3Li Huang4Xuejun Shao5Jun Xu6Hong Zhu7Xiangle Sun8Wei Ji9Zhengrong Chen10Department of Respiratory Disease, Soochow University Affiliated Children's Hospital, Jingde Road No. 303, Suzhou, Jiangsu Province, 215003, P.R. ChinaDepartment of Respiratory Disease, Soochow University Affiliated Children's Hospital, Jingde Road No. 303, Suzhou, Jiangsu Province, 215003, P.R. ChinaDepartment of Respiratory Disease, Soochow University Affiliated Children's Hospital, Jingde Road No. 303, Suzhou, Jiangsu Province, 215003, P.R. ChinaDepartment of Respiratory Disease, Soochow University Affiliated Children's Hospital, Jingde Road No. 303, Suzhou, Jiangsu Province, 215003, P.R. ChinaDepartment of Respiratory Disease, Soochow University Affiliated Children's Hospital, Jingde Road No. 303, Suzhou, Jiangsu Province, 215003, P.R. ChinaDepartment of Molecular Clinical Laboratory, Soochow University Affiliated Children's Hospital, Suzhou, P.R. ChinaDepartment of Molecular Clinical Laboratory, Soochow University Affiliated Children's Hospital, Suzhou, P.R. ChinaDepartment of Molecular Clinical Laboratory, Soochow University Affiliated Children's Hospital, Suzhou, P.R. ChinaDepartment of Cell Biology and Immunology, UNT Health Science Center at Fort Worth, Texas, USADepartment of Respiratory Disease, Soochow University Affiliated Children's Hospital, Jingde Road No. 303, Suzhou, Jiangsu Province, 215003, P.R. ChinaDepartment of Respiratory Disease, Soochow University Affiliated Children's Hospital, Jingde Road No. 303, Suzhou, Jiangsu Province, 215003, P.R. ChinaObjectives: The purpose of this study was to explore the clinical and laboratory characteristics of children with refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods: Seventy-six children with RMPP and 26 children with non-refractory M. pneumoniae pneumonia (NRMPP), confirmed by both serology and fluorescent quantitation PCR in bronchoalveolar lavage fluid (BALF), were evaluated retrospectively. Results: Compared to those with NRMPP, children with RMPP were older (66.6 ± 39.0 vs. 48.4 ± 35.4 months, p = 0.038) and had a longer duration of fever (12.7 ± 2.6 vs. 7.5 ± 1.8 days) and hospital stay (12.1 ± 3.2 vs. 7.4 ± 2.9 days). Children with RMPP presented neutrophil infiltration both in serum and BALF, as well as severe pulmonary lesions with pleural effusion. Children with RMPP had a significantly higher M. pneumoniae DNA load in BALF compared to NRMPP patients, and the M. pneumoniae load in BALF was significantly correlated with neutrophils and inversely correlated with macrophages for both the NRMPP and RMPP groups. The serum concentrations of tumor necrosis factor alpha (median 114.5 pg/ml, range 49.1–897.9 pg/ml) and interferon gamma (median 376.9 pg/ml, range 221.4–1997.6 pg/ml) were significantly higher in children with RMPP compared to children with NRMPP. Conclusions: This study indicates that a direct microbe effect and the subsequent induced excessive host immune response contribute in part to the progression of RMPP.http://www.sciencedirect.com/science/article/pii/S1201971214016051Refractory Mycoplasma pneumoniae pneumoniaChildrenClinical characteristics |
| spellingShingle | Meijuan Wang Yuqing Wang Yongdong Yan Canhong Zhu Li Huang Xuejun Shao Jun Xu Hong Zhu Xiangle Sun Wei Ji Zhengrong Chen Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children International Journal of Infectious Diseases Refractory Mycoplasma pneumoniae pneumonia Children Clinical characteristics |
| title | Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children |
| title_full | Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children |
| title_fullStr | Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children |
| title_full_unstemmed | Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children |
| title_short | Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children |
| title_sort | clinical and laboratory profiles of refractory mycoplasma pneumoniae pneumonia in children |
| topic | Refractory Mycoplasma pneumoniae pneumonia Children Clinical characteristics |
| url | http://www.sciencedirect.com/science/article/pii/S1201971214016051 |
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