Leng Maodong, Xu Lu, Dong Zhen, Yang Junmei
Department of Clinical Laboratory, Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, Henan, People's Republic of China.
Pediatric Internal Medicine Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, Henan, People's Republic of China.
J Inflamm Res. 2024 Oct 15;17:7339-7346. doi: 10.2147/JIR.S491981. eCollection 2024.
() pneumonia presses a serious threat on children's health. This study was aimed to investigate the clinical significance of pathogen loads and macrolide resistance levels for macrolide-resistant (MRMP)-induced pneumonia in children.
Serum levels of inflammatory markers including lactic dehydrogenase (LDH), D-dimer, C-reactive protein (CRP) were tested. RT‒PCR was used for the detection of and the macrolide resistance levels. The patients were classified into high pathogen load and low pathogen load groups based on the Ct values of the gene, and high macrolide resistance level and low macrolide resistance level groups based on the relative levels of macrolide resistance associated mutations to that of the gene. The rates of alternative antibiotic use and hospitalization days were recorded, and the leukocyte counts were tested.
The rates of elevated inflammatory markers from high to low were LDH, CRP and D-dimer. The Ct values of the gene ranged from 19 to 35, and patients with higher pathogen loads had greater rates of alternative antibiotic use; higher levels of LDH, D-dimer, CRP and neutrophil counts (NEUT); and longer hospitalization durations. The range of the macrolide resistance levels was 0.31-2.11, and the rates of alternative antibiotic use, NEUT, CRP and D-dimer levels were higher in patients with higher macrolide resistance levels.
LDH was a more frequently elevated serum inflammatory marker than D-dimer and CRP, and the pathogen load and macrolide resistance levels possessed important clinical significance for MRMP-induced pneumonia in children.
（）肺炎严重威胁儿童健康。本研究旨在探讨病原体载量和大环内酯类耐药水平对儿童大环内酯类耐药（MRMP）所致肺炎的临床意义。
检测血清中乳酸脱氢酶（LDH）、D-二聚体、C反应蛋白（CRP）等炎症标志物水平。采用RT-PCR检测（原文此处信息不完整）及大环内酯类耐药水平。根据（原文此处基因名称不完整）基因的Ct值将患者分为高病原体载量组和低病原体载量组，根据大环内酯类耐药相关突变与（原文此处基因名称不完整）基因的相对水平分为高大环内酯类耐药水平组和低大环内酯类耐药水平组。记录替代抗生素使用比例和住院天数，并检测白细胞计数。
炎症标志物升高比例从高到低依次为LDH、CRP和D-二聚体。（原文此处基因名称不完整）基因的Ct值范围为19至35，病原体载量较高的患者替代抗生素使用率更高；LDH、D-二聚体、CRP和中性粒细胞计数（NEUT）水平更高；住院时间更长。大环内酯类耐药水平范围为0.31 - 2.11，大环内酯类耐药水平较高的患者替代抗生素使用率、NEUT、CRP和D-二聚体水平更高。
LDH是比D-二聚体和CRP更常升高的血清炎症标志物，病原体载量和大环内酯类耐药水平对儿童MRMP所致肺炎具有重要临床意义。
