TY - JOUR
T1 - Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children
AU - Wang, Meijuan
AU - Wang, Yuqing
AU - Yan, Yongdong
AU - Zhu, Canhong
AU - Huang, Li
AU - Shao, Xuejun
AU - Xu, Jun
AU - Zhu, Hong
AU - Sun, Xiangle
AU - Ji, Wei
AU - Chen, Zhengrong
N1 - Funding Information:
This work was supported by National Natural Science Foundation of China (Zhengrong Chen, grant number 81401296 ), the Social Development, Science and Technology Projects of Jiangsu Province (Wei Ji, grant number BE2012652 ) and the Science and Technology Projects for the youth of Suzhou (Zhengrong Chen, grant number SYS201350 ).
Publisher Copyright:
© 2014 The Authors.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - 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.
AB - 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.
KW - Children
KW - Clinical characteristics
KW - Refractory Mycoplasma pneumoniae pneumonia
UR - http://www.scopus.com/inward/record.url?scp=84922774935&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2014.07.020
DO - 10.1016/j.ijid.2014.07.020
M3 - Article
C2 - 25449230
AN - SCOPUS:84922774935
SN - 1201-9712
VL - 29
SP - 18
EP - 23
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -