Analysis of multidrug resistance gene locus mutations and clinical significance in children with Mycoplasma pneumoniae pneumonia
10.7499/j.issn.1008-8830.2407129
- VernacularTitle:儿童肺炎支原体肺炎多重耐药基因位点突变分析及临床意义
- Author:
Wei ZHANG
1
;
Yang WANG
;
Li-Jun CAI
Author Information
1. 湖北省妇幼保健院,湖北武汉 430016
- Keywords:
Mycoplasma pneumoniae pneumonia;
Targeted high-throughput sequencing;
Multidrug resistance gene locus;
Child
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(11):1176-1181
- CountryChina
- Language:Chinese
-
Abstract:
Objective To detect multidrug resistance gene locus mutations in children with Mycoplasma pneumoniae pneumonia through targeted high-throughput sequencing and to explore its clinical significance. Methods A retrospective analysis was conducted on the clinical data of 2899 children with Mycoplasma pneumoniae pneumonia,who underwent respiratory pathogen-targeted high-throughput sequencing,treated at Hubei Maternal and Child Health Care Hospital between January and December 2023. The patients were divided into a mutation group (n=885) and a non-mutation group (n=2014) based on whether there was a mutation in the 23SrRNA macrolide-resistant gene of Mycoplasma pneumoniae. Multivariate logistic regression analysis was used to investigate the risk factors for multidrug resistance gene locus mutations in children with Mycoplasma pneumoniae pneumonia. Results Among the 2899 children,885 cases (30.53％) had mutations in the 23SrRNA resistance gene,including 884 cases with the A2063G mutation and 1 case with the A2064G mutation. In children with 23SrRNA resistance gene mutations,treatment with doxycycline or ofloxacin was more effective than with azithromycin or clarithromycin,and doxycycline was more effective than ofloxacin (P<0.05). The mutation rate of resistance genes in children with Mycoplasma pneumoniae pneumonia increased with age (P<0.001). Multivariate logistic regression analysis showed that increased age,extrapulmonary infection,lung consolidation,prolonged fever,prolonged hospitalization,and elevated CRP levels were risk factors for 23SrRNA gene locus mutations (P<0.05). Conclusions Age,extrapulmonary infections,lung consolidation,duration of fever,length of hospitalization,and CRP levels are closely related to 23SrRNA resistance gene locus mutations. Detecting multidrug resistance gene locus mutations in children with Mycoplasma pneumoniae pneumonia can aid in early diagnosis and prediction of treatment efficacy,promoting rational clinical treatment.
