Principi N, Esposito S, Blasi F, Allegra L
Pediatric Department I, University of Milan, Milan, Italy.
Clin Infect Dis. 2001 May 1;32(9):1281-9. doi: 10.1086/319981. Epub 2001 Apr 10.
In order to evaluate the role of Mycoplasma pneumoniae and Chlamydia pneumoniae, we studied 613 children aged 2-14 years who were hospitalized for community-acquired lower respiratory tract infections (LRTIs). The patients were enrolled in the study by 21 centers in different regions of Italy from May 1998 through April 1999. Paired serum samples were obtained on admission and after 4-6 weeks to assay the titers of M. pneumoniae and C. pneumoniae antibodies. Nasopharyngeal aspirates for the detection of M. pneumoniae and C. pneumoniae were obtained on admission. Acute M. pneumoniae infections in 210 patients (34.3%) and acute C. pneumoniae infections in 87 (14.1%) were diagnosed. Fifteen of the 18 children with M. pneumoniae and/or C. pneumoniae infections whose treatments were considered clinical failures 4-6 weeks after enrollment had not been treated with macrolides. Our study confirms that M. pneumoniae and/or C. pneumoniae plays a significant role in community-acquired LRTIs in children of all ages and that such infections have a more complicated course when not treated with adequate antimicrobial agents.
为了评估肺炎支原体和肺炎衣原体的作用，我们研究了613名2至14岁因社区获得性下呼吸道感染（LRTIs）而住院的儿童。这些患者于1998年5月至1999年4月期间由意大利不同地区的21个中心纳入研究。在入院时和4至6周后采集配对血清样本，以检测肺炎支原体和肺炎衣原体抗体的滴度。入院时采集鼻咽抽吸物用于检测肺炎支原体和肺炎衣原体。诊断出210例患者（34.3%）为急性肺炎支原体感染，87例患者（14.1%）为急性肺炎衣原体感染。在纳入研究4至6周后，其治疗被视为临床失败的18例肺炎支原体和/或肺炎衣原体感染儿童中，有15例未接受大环内酯类药物治疗。我们的研究证实，肺炎支原体和/或肺炎衣原体在各年龄段儿童的社区获得性下呼吸道感染中起重要作用，并且当未用适当的抗菌药物治疗时，此类感染病程更复杂。
