Correlation of Mycoplasma pneumoniae resistance gene detection and refractory Mycoplasma pneumoniae pneumonia

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Objective To understand the correlation of gene detection of Mycoplasma pneumoniae and clinical refractory Mycoplasma pneumoniae pneumonia. Methods (1)For children with Mycoplasma pneumoniae pneumonia in our hospital with serum Mycoplasma pneumoniae antibody positive, we collected the pharyngeal swab specimens over the same period, applied nested PCR to amplify 23SrRNA gene and undergoing electrophoresis and find out 97 cases of both positive, conducted DNA sequencing analysis of macrolide resistant gene to isolate the mutants, compared clinical manifestations of drug-resistance gene group with no drug-resistance gene mutation group.(2)Ninety-seven cases of mycoplasma pneumonia(MPP)patients were devided into the general MPP group(68 cases)and refractory MPP group(29 cases), retrospectively analyzed clinical manifestation, laboratory examination and differences of imaging performance.Multivariate logistic regression analysis for the performance of refractory Mycoplasma pneumoniae pneumonia was carried out to examine whether there is relevance between the mutant of drug-resisting gene and refractory Mycoplasma pneumonia. Results (1)Seventeen of 97 cases(17.5%)were found out without mutations, the other 80 cases(82.5%)exist drug-resistance gene mutations.(2)Mutation of drug-resistance gene group showed high CRP values, heating time, hospitalization time, macrolide drug application time, application of macrolides fever time and longer cough, by statistical analysis with statistical significance, higher incidence of lobar pneumonia.(3)Compared to general MPP group, refractory MPP group showed high peripheral blood neutrophil percentage percentage, CRP, calcitonin)and lactate dehydrogenase(LDH)values, heating time, hospitalization time, macrolide drug application time, application of macrolides fever time and longer cough.There was significant difference(P<0.05); macrocyclic lactones drug application time and resistance gene mutation and refractory Mycoplasma pneumonia were correlated. Conclusion MPP drug-resistant genes are widespread.Drug resistance gene mutations group shows long clinical symptoms duration, slow recovery rate, higher CRP value, higher rates of lobar pneumonia.Compared with ordinary MPP group, there are higher drug resistance mutation rate, inflammatory indexes and lactate dehydrogenase value, large ring lactone class drugs after a longer time of cough and fever in RMPP group.Drug application time and resistant gene mutations are associated with RMPP. Key words: Refractory Mycoplasma pneumoniae pneumonia; Drug resistance; 23SrRNA gene; Mutation