Effect of Macrolide Resistance and Mycoplasma pneumoniae DNA Load in Bronchoalveolar Lavage Fluid on Immune and Inflammatory Responses in Children with Mycoplasma pneumoniae Pneumonia.

IF 1.5 4区医学 Q2 PEDIATRICS

Indian pediatrics Pub Date : 2025-09-24 DOI:10.1007/s13312-025-00190-7

Haiqin Zhong, Zeyu Zeng, Haoxiang Gu, Xiaoyan Dong

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引用次数: 0

Abstract

Objective: To investigate the impact of macrolide resistance and Mycoplasma pneumoniae DNA (MP-DNA) load in bronchoalveolar lavage fluid (BALF) on immune and inflammatory responses in children with Mycoplasma pneumoniae pneumonia (MPP).

Methods: This retrospective study included 190 hospitalized children with MPP who underwent bronchoscopy. Patients were classified as macrolide-resistant or macrolide-sensitive based on 23S rRNA mutation analysis. MP-DNA load and cytokines in BALF and inflammatory markers in blood were measured. MRMP patients were further stratified by MP-DNA load for subgroup analysis.

Results: Of 1029 children screened, 474 had MPP, and 190 who underwent bronchoscopy were analyzed. Macrolide-resistant mycoplasma pneumonia (MRMP) accounted for 73.2% of cases and was associated with longer fever duration and hospital stay, lower lymphocyte counts, higher BALF total cell counts and neutrophil proportions, and increased inflammatory cytokines. Among MRMP patients, those with high MP-DNA loads had greater BALF cytokine levels than those with low loads. MP-DNA load positively correlated with IL‑1β and IL‑6 levels.

Conclusions: Macrolide resistance and high pathogen load are associated with enhanced airway inflammation and immune dysregulation in children with MPP. Early detection of resistance and quantification of pathogen load may guide timely antibiotic adjustment and improve clinical outcomes.

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支气管肺泡灌洗液大环内酯耐药及肺炎支原体DNA负荷对肺炎支原体肺炎患儿免疫和炎症反应的影响

目的：探讨大环内酯类药物耐药性及支气管肺泡灌洗液（BALF）中肺炎支原体DNA （MP-DNA）载量对肺炎支原体肺炎（MPP）患儿免疫和炎症反应的影响。方法：本回顾性研究纳入190例接受支气管镜检查的住院MPP患儿。根据23S rRNA突变分析将患者分为大环内酯耐药或敏感。检测MP-DNA载量、BALF细胞因子及血液炎症标志物。MRMP患者进一步按MP-DNA负荷分层进行亚组分析。结果：在1029名接受筛查的儿童中，474名患有MPP， 190名接受了支气管镜检查。耐大环内酯支原体肺炎（MRMP）占病例的73.2%，与较长的发热时间和住院时间、较低的淋巴细胞计数、较高的BALF总细胞计数和中性粒细胞比例以及炎症因子增加有关。在MRMP患者中，高MP-DNA负荷患者的BALF细胞因子水平高于低负荷患者。MP-DNA负荷与IL - 1β和IL - 6水平呈正相关。结论：大环内酯耐药和高病原体负荷与MPP患儿气道炎症和免疫失调增强有关。早期发现耐药性和病原体负荷的量化可以指导及时调整抗生素和改善临床结果。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.