Baoding Key Laboratory for Precision Diagnosis and Treatment of Infectious Diseases in Children, Baoding Hospital of Beijing Children's Hospital, Capital Medical University, Baoding, Hebei, China.
Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Disease, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Front Cell Infect Microbiol. 2023 May 12;13:1181402. doi: 10.3389/fcimb.2023.1181402. eCollection 2023.
(MP) is a commonly occurring pathogen causing community-acquired pneumonia (CAP) in children. The global prevalence of macrolide-resistant MP (MRMP) infection, especially in Asian regions, is increasing rapidly. However, the prevalence of MRMP and its clinical significance during the COVID-19 pandemic is not clear.
This study enrolled children with molecularly confirmed macrolide-susceptible MP (MSMP) and MRMP CAP from Beijing Children's Hospital Baoding Hospital, Capital Medical University between August 2021 and July 2022. The clinical characteristics, laboratory findings, chest imaging presentations, and strain genotypes were compared between patients with MSMP and MRMP CAP.
A total of 520 hospitalized children with MP-CAP were enrolled in the study, with a macrolide resistance rate of 92.7%. Patients with MRMP infection exhibited more severe clinical manifestations (such as dyspnea and pleural effusion) and had a longer hospital stay than the MSMP group. Furthermore, abnormal blood test results (including increased LDH and D-dimer) were more common in the MRMP group (P<0.05). Multilocus variable-number tandem-repeat analysis (MLVA) was performed on 304 samples based on four loci (Mpn13-16), and M3562 and M4572 were the major types, accounting for 74.0% and 16.8% of the strains, respectively. The macrolide resistance rate of M3562 strains was up to 95.1%.
The prevalence of MRMP strains in hospitalized CAP patients was extremely high in the Baoding area, and patients infected with MRMP strains exhibited more severe clinical features and increased LDH and D-dimer. M3562 was the predominant resistant clone.
（MP）是一种常见的病原体，可导致儿童社区获得性肺炎（CAP）。大环内酯类耐药 MP（MRMP）感染的全球流行率，特别是在亚洲地区，正在迅速上升。然而，在 COVID-19 大流行期间，MRMP 的流行率及其临床意义尚不清楚。
本研究纳入了 2021 年 8 月至 2022 年 7 月期间首都医科大学附属北京儿童医院保定医院分子确诊的耐大环内酯类药物敏感 MP（MSMP）和 MRMP CAP 的患儿。比较了 MSMP 和 MRMP CAP 患儿的临床特征、实验室检查结果、胸部影像学表现和菌株基因型。
共纳入 520 例住院的 MP-CAP 患儿，大环内酯类药物耐药率为 92.7%。MRMP 感染患儿的临床表现更为严重（如呼吸困难和胸腔积液），住院时间也比 MSMP 组更长。此外，MRMP 组异常的血液检查结果（包括升高的 LDH 和 D-二聚体）更为常见（P<0.05）。对 304 例样本基于四个基因座（Mpn13-16）进行多位点可变数串联重复分析（MLVA），M3562 和 M4572 是主要类型，分别占菌株的 74.0%和 16.8%。M3562 株的大环内酯类药物耐药率高达 95.1%。
在保定地区，住院 CAP 患儿中 MRMP 株的流行率极高，感染 MRMP 株的患儿临床表现更为严重，LDH 和 D-二聚体升高。M3562 是主要的耐药克隆。
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