The Analyses Of Macrolide-resistant And Clinical Features Of 78 Hospitalized Children With Mycoplasma Pneumoniae Pneumonia

Objective: To explore the drug resistance of children with Mycoplasma pneumoniae pneumonia in Guiyang city,and the clinical feature of children with positive drug resistance,to help and guide the clinical work.Methods: Collected 78 MMP children from January 2017 to December 2017 in the people's hospital of guizhou province.Useing Polymerase Chain Reaction coupling with Taqman fluorescent probe technique to detect the resistance gene mutation points A2063 G and A2064 G in children with diagnosed MPP infection,divided them into macrolide-suspectible group and macrolide-resistant group according to the test result of resistance genes,counted up and analyzed the macrolide-resistant rates and the clinical features of the two groups of children.Results: Macrolide-resistant rates: among 78 MMP children,48 MMP children's A2063 G or A2064 G genetic mutation sites were positive.The macrolide-resistant rates were 61.5%(48/78);2.Gender and age: There were no statistically significant differences in gender composition between macrolide-resistant group and macrolide-suspectible group.The macrolide-resistant group were(5.3±2.9)years old,but the macrolide-suspectible group were(3.7±2.7)years old.The ages of macrolide-resistant group are biger than the macrolide-suspectible group's ages,and the differences were statistically significant(P=0.015)3.Clinical characteristics analysis:(1)The fever time after azithromycins' treatment: the macrolide-resistant group was significantly longer than the macrolide-suspectible group,and the differences were statistically significant(P=0.008);(2)the degree of fever: the macrolide-resistant group was(8.5±5.1)days,and the macrolide-suspectible group was(4.6±5.3)days,and the differences were statistically significant(P=0.002);(3)The cost of hospitalization: the macrolide-resistant group is(15391.7±12123.9)yuan,the macrolide-suspectible group is(9776.4±6003.8)yuan,and the differences were statistically significant(P=0.008);(4)There were no statistically significant differences between macrolide-resistant group and macrolide-suspectible group in coughing time,pulmonary rale disappearing time and the hospitalization days(P>0.05);4.the lactate dehydrogenase in the macrolide-resistant group,c-reactive protein,and erythrocyte sedimentation were all higher than those in the macrolide-suspectible group,and the differences were statistically significant(P<0.05),no statistical difference was found in the remaining laboratory indexes(P>0.05).5.Occurrence of pulmonary complications: macrolide-resistant group included 3 cases of atelectasis,6 cases of bronchial stenosis,14 cases of pulmonary consolidations and 11 cases of pleural effusion,macrolide-suspectible group included pulmonary 0 case of pulmonary obstruction,2 cases of bronchial stenosis,9 cases of pulmonary edema and 3 cases of pleural effusionand,there were no statistical differences(P>0.05).6.Treatment analysis:(1)The average day of using Azithromycin in macrolide-resistant group was(10.6+4.3)days,which in macrolide-suspectible group was(9.0+2.9)days;(2)The using of glucocorticoid in macrolide-resistant group were 25 cases,which in macrolide-suspectible group were 6 cases.(3)the using of r-immunoglobulin in macrolide-resistant group were 10 cases,which in macrolide-suspectible group was 2cases.(4)the treatment of fiberoptic bronchoscope lavage in macrolide-resistant group was 22 cases,which in macrolide-suspectible group was 14 cases.There were no statistically significant differences were found in(1)(3)(4)(P>0.05)except(2)(P=0.005)7.Infection of Severe Mycoplasma Pneumoniae Pneumonia in macrolide-resistant group was 34 cases,which in macrolide-suspectible group was 7 cases;infection of Refractory Mycoplasma Pneumoniae Pneumonia in macrolide-resistant group was 27 cases,which in macrolide-suspectible group was 8 cases,there were statistical differences(P<0.05).Conclusion:(1)The macrolide-resistant rates of 78 hospitalized children with MMP are61.5%.(2)The increase of c-reactive protein,lactate dehydrogenase and erythrocyt e sedimentation have clinical guiding value for early identification of Macroliide resis tance Mycoplasma Pneumoniae(3)The total fever time of the MRMP children and the fever time after using azithromycin were significantly prolonged,and the hospitalization cost increased.(4)The macrolide-resistance of MPP has certain predictive value for the occurrence of SMPP and RMPP.