Clinical features and efficacy of methylprednisolone of pediatric community-acquired Mycoplasma pneumoniae pneumonia in Hainan region
10.3760/cma.j.cn311365-20240723-00214
- VernacularTitle:海南地区儿童社区获得性肺炎支原体肺炎的临床特征及甲泼尼龙疗效分析
- Author:
Shouye WU
1
;
Mei ZENG
;
Qionghua ZHOU
;
Daojiong LIN
;
Zhongqiu WEI
Author Information
1. 海南省妇女儿童医学中心感染科，海口 571103
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae;
Children;
Community-acquired pneumonia;
Methylprednisolone therapy
- From:
Chinese Journal of Infectious Diseases
2024;42(11):647-655
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical and epidemiological characteristics of community-acquired Mycoplasma pneumoniae (Mp) pneumonia in children in Hainan region, as well as the efficacy of low-dose methylprednisolone adjuvant therapy. Methods:Children with community-acquired pneumonia (CAP) in Hainan Women and Children′s Medical Center from October 2021 to September 2022 were enrolled. Sputum or nasopharyngeal swabs were collected and respiratory pathogens were detected by multiplex fluorescence quantitative polymerase chain reaction capillary electrophoresis fragment analysis. The clinical features, epidemiological characteristics, severity of disease and detection of combined pathogens of the children were analyzed. The clinical characteristics and outcomes of children with and without low-dose methylprednisolone (once a day, 1 to 2 mg/kg each time) adjuvant therapy were analyzed. Statistical analysis was performed using the nonparametric rank-sum test.Results:A total of 3 032 children who were hospitalized with CAP underwent testing for respiratory pathogens. The positive detection rate of Mp was 25.46%(772/3 032), and Mp was prevalent throughout the year, with a high detection rate of 47.06% to 64.84% from May to September. Among the children with Mp pneumonia, the age was 5.4(2.9, 7.6) years, 446 cases (57.77%) were detected with other respiratory pathogens, 84.84%(655/772) had fever with a duration of 6(2, 7) days, 75.57% of the children had high fever (the peak temperature was more than 39 ℃), and 98.96%(764/772) had cough. There were 100 cases (12.95%) developed severe Mp pneumonia, mostly in children under five years of age (67.00%(67/100)), 30.00%(30/100) with wheezing, 17.00%(17/100) with pulmonary atelectasis, and 4.00%(4/100) with pleural effusion. Comparison with children who did not use methylprednisolone, children treated with methylprednisolone achieved clinical resolution of fever faster (1.0(0, 1.0) d vs 6.0(4.0, 7.0) d), and the difference was statistically significant ( Z=-15.82, P<0.001). There were nine children with early methylprednisolone treatment and 411 children with delayed methylprednisolone treatment, and there was no significant difference in time to clinical resolution of fever between early and delayed methylprednisolone treatment (0.5(0, 1.0) d vs 1.0(0, 1.0) d; Z=-0.71, P=0.479). Conclusions:Mp is a common pathogen causing CAP in children older than five years in Hainan region, which is mostly accompanied by clinical symptoms of high fever. Severe cases are mostly seen in children younger than five years, with the presence of wheezing, pulmonary atelectasis, pleural effusion. Low-dose methylprednisolone combined with antimicrobial treatment can significantly shorten the clinical fever time in children with Mp. Mp pneumonia is often associated with the detection of various other pathogens, but infection should be distinguished from colonization.
