Clinical And Bronchoscopy Characteristics Of Mycoplasma Pneumoniae Pneumonia In Children With 23S RRNA Resistance Gene Positive In Bronchoalveolar Lavage Fluid

Objective: To investigate clinical and bronchoscopy characteristics of mycoplasma pneumoniae pneumonia in children with 23 S rRNA resistance gene positive in bronchoalveolar lavage fluid.Methods: Selecting 61 hospitalized children diagnosed with mycoplasma pneumoniae pneumonia as subjects from October 2017 to June 2018 in the Department of Pediatric Respiratory Medicine of Shengjing Hospital affiliated to China Medical University.Bronchoscopy was performed on each subject and the bronchoalveolar lavage fluid was taken used to detect the 2063 site mutation of the 23 S rRNA V region gene in BALF,divided them into drug-resistant gene positive group and drug-resistant gene negative group.The clinical manifestations,relevant laboratory data,imaging data,and bronchoscopy findings in different load groups were compared.Results: In the drug-resistance gene positive group,CRP,PCT,D-D and serum IL-6 level were higher,fever clearance time and hospitalization days(d)were longer,RMPP and extrapulmonary complications were more likely to occur,bronchoscopy mainly showed mucosal erosion,necrosis,sputum plug / plastic sputum plug and bronchitis stenosis.Large-area pulmonary consolidation / atelectasis was more common in the drug-resistant gene-positive group.Bronchoscopy mainly showed longitudinal mucosal wrinkled walls,flocculent and mucous secretions in the resistance gene-negative group.There was no significant difference in IL-6 levels of BALF between the two groups.Conclusion: The point mutation of 23 S rRNA V region gene is closely related to the clinical characteristics of children with mycoplasma pneumoniae pneumonia.Children with A2063 G mutation are more prone to RMPP and extrapulmonary complications,and their imaging manifestation and bronchoscopy are more severe.The level of leukocytes and D-dimer in the blood have significance for the early identification of drug resistance.The systemic excessive immune inflammatory response caused by mycoplasma pneumoniae pneumoniae with drug-resistant gene positive needs to be attentioned.