综合评价方法在儿童支气管哮喘合并肺炎支原体感染治疗效果评估中的应用

APPLICATION OF A COMPREHENSIVE APPROACH FOR EVALUATION OF TREATMENT EFFECTIVENESS OF MYCOPLASMA INFECTION IN CHILDREN WITH BRONCHIAL ASTHMA.

机构信息

1Gamaleya National Research Center of Epidemiology and Microbiology, Moscow; Russia.

2Sechenov First Moscow State Medical University (Sechenov University), Russia.

出版信息

Georgian Med News. 2021 Oct(319):41-45.

Abstract

Aim - improvement of efficiency assessment methods of therapy of mycoplasma infection in children with bronchial asthma. The effectiveness of treatment of mycoplasma infection in the period of exacerbation of bronchial asthma in 250 children, aged 1 to 7 years, was evaluated. The children were on basic therapy and received treatment with azithromycin: three courses at a dose of 10 mg/kg of weight for 3 days with an interval of 4 days 5-7 days. Microbiological (culturing), immunological (DIF, AHAA), and genetic (PCR) methods were used to identify mycoplasma markers. The main focus was on identifying two species - M. pneumoniae and M. hominis, most commonly found in mycoplasma respiratory infections, including bronchial asthma. In 250 children with bronchial asthma, antigens of Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum, Mycoplasma arthritidis and Mycoplasma fermentrans were detected in 62,8%, 42,8%, 46,8 %, 31,6%, 45,6% of cases, respectively. A detailed study of the presence of M. pneumoniae and M. hominis antigens in the blood of 83 children with bronchial asthma showed that before treatment, the detection rate of M. pneumoniae and M. hominis antigens was 67.5% and 50.6%, respectively, in the CIC - 65.1% and 61.5%, DNA in the blood serum - 4.8% and 16.9%, and in the CIC - 27.7% and 32.5%, respectively. From 7 CIC samples containing M. hominis DNA and 2 CIC samples containing M. pneumoniae DNA, atypical cultures of "mini-colonies" of M. hominis and M. pneumoniae were isolated, the specificity of which was confirmed not only by DIF and PCR, but also by the ability to grow on a solid medium for mycoplasmas. After treatment by azithromycin, the number of positive tests on antigens and DNA in free state and in structure of CIC significantly decreased. The identification of specific markers of mycoplasma cells in the comprehensive diagnostics of mycoplasma infection in children with exacerbation of asthma, increases the effectiveness of therapy control for mycoplasma infection and improves the prognosis of bronchial asthma in patients.

摘要

目的 - 改进儿童支气管哮喘合并支原体感染治疗效果评估方法。评价 250 例 1 至 7 岁儿童支气管哮喘加重期治疗支原体感染的疗效。儿童接受基础治疗，并接受阿奇霉素治疗：3 天剂量为 10mg/kg 体重，共 3 个疗程，间隔 4 天，5-7 天。采用微生物学（培养）、免疫学（DIF、AHAA）和遗传学（PCR）方法鉴定支原体标志物。主要重点是鉴定两种最常见的支原体呼吸道感染，包括支气管哮喘的支原体 - 肺炎支原体和人型支原体。在 250 例支气管哮喘儿童中，检测到肺炎支原体、人型支原体、解脲脲原体、肺炎支原体和发酵支原体的抗原分别为 62.8%、42.8%、46.8%、31.6%和 45.6%。对 83 例支气管哮喘患儿血液中 M. pneumoniae 和 M. hominis 抗原的详细研究表明，在治疗前，CIC 中 M. pneumoniae 和 M. hominis 抗原的检出率分别为 67.5%和 50.6%，CIC 中分别为 65.1%和 61.5%，血清 DNA 中分别为 4.8%和 16.9%，CIC 中分别为 27.7%和 32.5%。从 7 个含有 M. hominis DNA 的 CIC 样本和 2 个含有 M. pneumoniae DNA 的 CIC 样本中分离出 M. hominis 和 M. pneumoniae 的非典型“迷你菌落”培养物，其特异性不仅通过 DIF 和 PCR 得到证实，而且还通过在固体培养基上生长的能力得到证实。用阿奇霉素治疗后，游离状态和 CIC 结构中抗原和 DNA 的阳性检测次数显著减少。在儿童哮喘加重期支原体感染的综合诊断中鉴定支原体细胞的特定标志物，可提高支原体感染治疗效果的控制，并改善患者支气管哮喘的预后。