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中国成年社区获得性肺炎住院患者的肺炎支原体感染情况

Mycoplasma pneumoniae infection in hospitalized adult patients with community-acquired pneumonia in China.

作者信息

Shangguan Zongxiao, Sun Qingfeng, Zhang Minghua, Ding Jiguang, Yi Lingao, Gao Yuantong, Zhan Aixia, Zhao Renguo, Ci Xiao

机构信息

The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

J Infect Dev Ctries. 2014 Oct 15;8(10):1259-66. doi: 10.3855/jidc.4721.

Abstract

INTRODUCTION

This study aimed to investigate the prevalence, clinical and radiographic features, and antibiotic responses of Mycoplasma pneumoniae (M. pneumoniae) infections in hospitalized adults with community-acquired pneumonia (CAP) in China.

METHODOLOGY

Serum specimens collected from 189 CAP patients in both acute phase and convalescence were tested for IgG, IgA, and IgM mixed antibodies specific to M. pneumoniae. The clinical and radiographic characteristics and efficacy of three antibiotic regimens were compared between patients with M. pneumoniae infection and those without.

RESULTS

Among 189 CAP patients, 88 (46.6%) were positive for M. pneumoniae infection. Compared to the negative patients, patients with M. pneumoniae infection were significantly younger, had higher rates of dry cough, and had white blood cell counts of <1010/L, but had less purulent sputum. Radiography further showed more centrilobular nodules, ground-glass opacities, tree-in-bud patterns and thickened bronchovascular bundles, but less pleural effusion and larger tracts of real opacities in patients with M. pneumoniae infections. Among the three regimens used, patients with moxifloxacin required significantly shorter fever abatement, treatment, and hospitalization times than those with azithromycin plus ceftriaxone and ceftriaxone only.

CONCLUSIONS

M. pneumoniae infection was present in almost half of the CAP population in east China, with some distinct clinical and radiographic features. Moxifloxacin was an effective antibiotic for this infection.

摘要

引言

本研究旨在调查中国社区获得性肺炎(CAP)住院成人中肺炎支原体(M. pneumoniae)感染的患病率、临床和影像学特征以及抗生素反应。

方法

收集189例CAP患者急性期和恢复期的血清标本,检测肺炎支原体特异性IgG、IgA和IgM混合抗体。比较肺炎支原体感染患者和未感染患者的临床和影像学特征以及三种抗生素治疗方案的疗效。

结果

189例CAP患者中,88例(46.6%)肺炎支原体感染呈阳性。与阴性患者相比,肺炎支原体感染患者明显更年轻,干咳发生率更高,白细胞计数<10×10⁹/L,但脓性痰较少。影像学进一步显示,肺炎支原体感染患者的小叶中心结节、磨玻璃影、树芽征和支气管血管束增粗更多,但胸腔积液较少,实变影范围较大。在使用的三种治疗方案中,莫西沙星治疗的患者退热、治疗和住院时间明显短于阿奇霉素联合头孢曲松组和单用头孢曲松组。

结论

在中国东部,近一半的CAP患者存在肺炎支原体感染,具有一些独特的临床和影像学特征。莫西沙星是治疗这种感染的有效抗生素。

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