The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children

Maodong Leng,1 Lu Xu,1 Zhen Dong,2 Junmei Yang1 1Department 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; 2Pediatric Internal Medi...

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Main Authors: Leng M, Xu L, Dong Z, Yang J
Format: Article
Language:English
Published: Dove Medical Press 2024-10-01
Series:Journal of Inflammation Research
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Online Access:https://www.dovepress.com/the-clinical-significance-of-pathogen-loads-and-macrolide-resistance-l-peer-reviewed-fulltext-article-JIR
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author Leng M
Xu L
Dong Z
Yang J
author_facet Leng M
Xu L
Dong Z
Yang J
author_sort Leng M
collection DOAJ
description Maodong Leng,1 Lu Xu,1 Zhen Dong,2 Junmei Yang1 1Department 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; 2Pediatric Internal Medicine Department, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou, Henan, People’s Republic of ChinaCorrespondence: Junmei Yang, Department of Clinical Laboratory, Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, No. 33 of Longhu Outer Street, Zhengzhou East District, Zhengzhou, Henan Province, People’s Republic of China, Email yangjunmei7683@163.comObjective: Mycoplasma pneumoniae (M. pneumoniae) 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 M. pneumoniae (MRMP)-induced pneumonia in children.Methods: 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 M. pneumoniae infection 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 p1 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 p1 gene. The rates of alternative antibiotic use and hospitalization days were recorded, and the leukocyte counts were tested.Results: The rates of elevated inflammatory markers from high to low were LDH, CRP and D-dimer. The Ct values of the p1 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.Conclusion: 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.Keywords: Mycoplasma pneumoniae pneumonia, children, inflammation, macrolide resistance levels, pathogen load
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spelling doaj-art-a218437c4bd74faca2ed78df8e3c4fd92025-08-20T01:47:34ZengDove Medical PressJournal of Inflammation Research1178-70312024-10-01Volume 177339734696404The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in ChildrenLeng MXu LDong ZYang JMaodong Leng,1 Lu Xu,1 Zhen Dong,2 Junmei Yang1 1Department 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; 2Pediatric Internal Medicine Department, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou, Henan, People’s Republic of ChinaCorrespondence: Junmei Yang, Department of Clinical Laboratory, Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, No. 33 of Longhu Outer Street, Zhengzhou East District, Zhengzhou, Henan Province, People’s Republic of China, Email yangjunmei7683@163.comObjective: Mycoplasma pneumoniae (M. pneumoniae) 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 M. pneumoniae (MRMP)-induced pneumonia in children.Methods: 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 M. pneumoniae infection 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 p1 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 p1 gene. The rates of alternative antibiotic use and hospitalization days were recorded, and the leukocyte counts were tested.Results: The rates of elevated inflammatory markers from high to low were LDH, CRP and D-dimer. The Ct values of the p1 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.Conclusion: 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.Keywords: Mycoplasma pneumoniae pneumonia, children, inflammation, macrolide resistance levels, pathogen loadhttps://www.dovepress.com/the-clinical-significance-of-pathogen-loads-and-macrolide-resistance-l-peer-reviewed-fulltext-article-JIRmycoplasma pneumoniae pneumoniachildreninflammationmacrolide resistance levelspathogen load
spellingShingle Leng M
Xu L
Dong Z
Yang J
The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children
Journal of Inflammation Research
mycoplasma pneumoniae pneumonia
children
inflammation
macrolide resistance levels
pathogen load
title The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children
title_full The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children
title_fullStr The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children
title_full_unstemmed The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children
title_short The Clinical Significance of Pathogen Loads and Macrolide Resistance Levels for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children
title_sort clinical significance of pathogen loads and macrolide resistance levels for macrolide resistant mycoplasma pneumoniae pneumonia in children
topic mycoplasma pneumoniae pneumonia
children
inflammation
macrolide resistance levels
pathogen load
url https://www.dovepress.com/the-clinical-significance-of-pathogen-loads-and-macrolide-resistance-l-peer-reviewed-fulltext-article-JIR
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