Bronchoscopes Characteristic Of Mycoplasma Pneumoniae Pneumonia In Children And P1 Genotyping

Objective:Bronchio-alreolarLavage Fluid(BALF) collected from Mycoplasma Pneumoniae Pneumonia(MPP) and Refractory Mycoplasma Pneumoniae Pneumonia(RMPP) in Tianjin Children Hospital from December 2010 to May 2011. To search for MPP and RMPP apply Real-time PCR detection information of Mycoplasma pneumoniae(MP) infection. Extract the purpose fragment of DNA.By PCR-RFLP, determine P1 genotyping of MP. To search for the main clinical characteristic of Mycoplasma Pneumoniae Pneumonia(MPP) in infants and children, endoscope characteristic by flexible bronchofiberscope.Method:Bronchio-alreolar Lavage Fluid(BALF) collected from 46 cases of MPP in Tianjin Children Hospital from December 2010 to May 2011. BALF were detected with TIA Namp Bacteria DNA Kit, and were detected for MP infection by Real-Time PCR. The type of MP clinical samples was determined by restriction fragment length polymorphism (RFLP) typing of the P1 gene. Then some of the positive samples were sequenced and compared with the M129 sequences deposited in Genbank. To analysis the main clinical characteristic of Mycoplasma Pneumoniae Pneumonia(MPP) in infants and children, endoscope characteristic flexible bronchofiberscope.2 patients were to accept biopsy and pathology by bronchofiberscope because of tube debouchemen obvious stenosis.Results:1. To 46 Bronchio-alreolar Lavage Fluid(BALF) samples of Mycoplasma pneumoniae Pneumonia, have 20 positive samples by Real-time PCR, are positive rate 43.4%.2. To 46 examples, have 20 positive samples by Nested-PCR, Between MPPG group and RMPP, (x2=2.936, p=0.087), P>0.05no obvious or significant statistical difference.3. To 20 positive samples was determined by restriction fragment length polymorphism (RFLP) typing of the P1 gene, consistent with P1 typeⅠ. By the nucleotide sequence homology was evaluated with BLAST, homology 99% with M129.4. To 46 examples of Mycoplasma pneumoniae Pneumonia, age 11 months-13 years, mean (6.61±2.76)years,6～9 years group is 20 examples, and 43.4%, chest X-ray :consolidation of lung (69.6%). hilus pulmonis phlegmasia (21.7%), hilus pulmonis and bronchus homogen or unhomogen shadow (17.4%), lung field iffuse overshadowing (13%), pleural effusion (17.4%),pulmonary atelectasis (6.5%).CT:schistic or sheet shadow (60.9%), hilus pulmonis or hilus pulmonis lymphadenectasis (21.7%).5. By fiexible bronchofiberscope, it is obvious that swelling and glutinosity secretions were shown in all patients. Meanwhile in some patients bronchoscopy showed:segmental bronchi ventilation lack(60.9%), tube debouchement inflammatory stenosis(26.1%), some formed gray mucous plug blocking bronchi(13%),some patients had sagittal saw fold(21.7%), blood vessel roughened(13%), mucosa nodule(8.7%), purulent secretion(10.9%). Some Polypoid neoplasm blocked bronchi(10.9%).2 patients were to accept biopsy and pathology by bronchofiberscope because of tube debouchemen obvious stenosis. Conlusion:1.46 examples of Mycoplasma pneumoniae Pneumonia have 20 positive samples by Real-time PCR. Nested-PCR rapidly diagnose MP infection,have reliable positive rate and superspecificity. Nested-PCR is gold method of rapidly MP diagnosis.2.20 positive sample by (HaeⅢ, HapⅡ)PCR-RFLP, are Pl-I.PCR-RFLP determine P1 genotyping of MP.3. This group MPP is 17.9% of CAP.>6 years are high occurrence group4. By flexible bronchofiberscope skill,help us therapy and diagnosis of MPP and evaluate MPP. BAL method improve clinical symptoms of MPP, is effective remedy.