Relationship between 23S rRNA domain V locus mutations in mycoplasma pneumoniae and clinical characteristics plus macrolide resistance in pediatric M. pneumoniae pneumonia
10.3760/cma.j.cn431274-20241218-01887
- VernacularTitle:肺炎支原体23S rRNA结构域Ⅴ区位点基因突变与小儿肺炎支原体肺炎临床特征及耐药的关系
- Author:
Chilong DU
1
;
Wenjing ZHAO
;
Songyi GAO
;
Xiaoqian GAO
;
Lanxin ZHAO
;
Tian TIAN
Author Information
1. 西安市中心医院儿科，西安 710003
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae;
Mutation;
RNA, ribosomal, 23S;
Drug Resistance
- From:
Journal of Chinese Physician
2025;27(7):1004-1008
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between 23S rRNA domain V locus mutations in mycoplasma pneumoniae (MP) and the clinical characteristics plus macrolide resistance in pediatric MP pneumonia.Methods:A retrospective analysis was conducted on 220 children with MP pneumonia admitted to the Xi′an Central Hospital from January 2021 to June 2024. Patients were divided into a mutation group and a non-mutation group according to the presence or absence of point mutations at positions 2063, 2064, 2067 and 2617 within the 23S rRNA domain V. General data, clinical features [disease course, fever duration, length of hospital stay, time to resolution of chest X-ray infiltrates, pleural effusion, pulmonary parenchymal lesions, white blood cell count (WBC), lactate dehydrogenase (LDH), MP-DNA load] and macrolide resistance were compared between the two groups.Results:Among the 220 enrolled patients, 114 were assigned to the mutation group and 106 to the non-mutation group. Mutations detected in the 23S rRNA domain V were A2063 ( n=107), C2617 ( n=2), A2064 ( n=2) and A2067 ( n=0); three patients had combined A2063+ A2064 mutations. The proportion of severe pneumonia was higher in the mutation group ( P<0.05). Compared with the non-mutation group, the mutation group exhibited longer disease course, fever duration, hospital stay and time to resolution of chest X-ray infiltrates; higher rates of pleural effusion; and higher LDH levels and MP-DNA loads (all P<0.05). Both groups showed the highest resistance to first-generation macrolides (erythromycin, erythromycin ethylsuccinate, erythromycin stearate) and the highest sensitivity to third-generation macrolides (telithromycin, josamycin). Resistance rates to first-and second-generation macrolides were significantly higher in the mutation group (all P<0.05). Conclusions:Mutations in the 23S rRNA domain V of MP are closely associated with clinical severity in pediatric MP pneumonia, and patients harboring these mutations display higher rates of macrolide resistance.
