Abstract
Mycoplasma pneumoniae pneumonia (MPP) becomes one of the most important health problems in China recently. Date for MPP inChinais scarce. Although macrolides and/or cortical steroids had been reported to be effective treatment for MPP, the long-term outcome remained uncertain. A study on status of MPP in China was conducted via a systematic review of published studies which have the Chinese data and collected from published PubMed and core journals of China Knowledge Resource Integrated Database (CNKI). The analysis was based on epidemiology, clinical characteristics, treatment, drug resistance and prognosis. Twenty five articles concerned about MPP in Chinese children and adolescent were enrolled, including 11 studies on epidemiology/etiology, 11 studies on clinical characteristics, 7 studies on drug resistance, 5 studies on treatment from mainland China respectively. The overall incidence of MPP ranged from 7.1% to 54.4%. Fever and cough were most frequently identified in manifestations. Drug resistance to macrolides ranged from 18.9% to 90%. The outcome of treatment in patients who received combined treatment of macrolides, cephalosporin antibiotics and/or cortical steroid seems to be better than those who received macrolides only. Macrolide combined with cephalosporin or cortical steroid both may decrease the severity of MPP in the past decade. There was not enough evidence to suggest that cortical steroid can decrease the mortality of MPP in children. And a multi-center, randomized double blind research on the effect of cortical steroid was encouraged.
Highlights
Mycoplasma pneumoniae (MP) is among the smallest microorganisms which is capable of self-replication, with a whole genome [1]
Our study findings indicate that pathogens isolated in patients with community acquired pneumonia (CAP) in China seem to differ from those described from Western countries
Streptococcus pneumoniae remains the most important pathogen in adults of all ages admitted to hospital with CAP [33], and the fulminant Mycoplasma pneumoniae pneumonia (MPP) cases were rarely reported in Japan [34]
Summary
Mycoplasma pneumoniae (MP) is among the smallest microorganisms which is capable of self-replication, with a whole genome [1]. MP is a frequent cause of community acquired pneumonia (CAP) in children, which has been well described and is considered self-limited in most cases. When it adheres to human airway epithelial cells, MP can trigger a series of immunological responses, which result in both atypical respiratory tract symptoms (e.g. fever, cough, headache, sore throat, runny nose, general malaise) and various extra-pulmonary complications such as encephalitis, meningoencephalitis, Guillain-Barre syndrome, optic neuritis, nephritis, rash, arthritis, and pericarditis [2]. Drug resistance to the macrolides has been observed in Mycoplasma pneumoniae strains and appears to have been increasing in China and other area all over the world since year 2000. The present study may provide a whole view on MP infection in large Chinese pediatric population
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