Relationships between the varied ciliated respiratory epithelium abnormalities and severity of Mycoplasma pneumoniae pneumonia.

Abstract

The pathogenesis of Mycoplasma pneumoniae infection involves cytoadherence of M. pneumoniae to the ciliated respiratory epithelium (CRE), followed by CRE injury caused by the M. pneumoniae. However, whether CRE abnormalities are related to the severity of M. pneumoniae pneumonia (MP) remains to be determined. Thirty-eight patients with MP and 8 controls who underwent fiber-optic bronchoscopy with bronchial biopsy were included in this study. Patients with MP were divided into 2 groups: a mild disease group (12 patients) and a severe disease group (26 patients). The clinical features, laboratory findings, chest radiographic findings, and CRE abnormalities were characterized. Patients with severe pneumonia had a higher epithelial integrity score than those with mild pneumonia (5.1 ± 0.76 vs 3.8 ± 0.75; p < 0.01). Patients with severe CRE abnormalities had a longer duration of fever (p < 0.01), higher C-reactive protein (p < 0.01), and lower proportion of blood lymphocytes (p < 0.05) compared to those with mild abnormalities. Patients with a positive bacteria culture had a higher epithelial integrity score compared to those with a negative culture (6.0 ± 0.44 vs 4.8 ± 0.71; p < 0.01). CRE abnormalities are closely related to the severity of MP. These findings extend our current knowledge of MP.