中文摘要：本研究意在通过2个临床案例探明儿童早期感染肺炎支原体后发生轻症肺炎和严重肺炎的指示性标志。文章回顾了儿科2个抗大环内酯类肺炎支原体感染，最终发展为不同肺炎症状的案例。首先，研究比较了2例病人的临床过程，分离病原并验证病原对大环内酯类的反应；然后对分离到的2个病原进行全基因组测序。尽管这两种病原表现出不同的临床感染症状，但对大环内酯类抗生素均表现出高度的耐药性。临床数据分析表明：感染早期，病者血样红细胞沉降率差异较大。全基因组分析结果表明，SNP多态位点主要集中在粘附素P1，该粘附素参与了肺炎支原体的治病过程。结论：支原体感染早期红细胞沉降率和粘附素P1蛋白的突变可以区分耐大环内酯类抗生素肺炎支原体感染后肺炎症状的轻重。
外文摘要：Cases of macrolide-resistant Mycoplasma pneumoniae have increased rapidly since 2000, especially in Asia. Patients infected with macrolide-resistant M pneumoniae usually present with severe M pneumoniae pneumonia. The aim of this study was to identify indicators for whether children at an early stage of M pneumoniae infection develop mild or severe pneumonia.Case Summary:Herein, we retrospectively reviewed 2 pediatric cases caused by macrolide-resistant M pneumoniae, but with markedly different severity of pneumonia. First, we compared the clinical courses of the patients, then isolated the pathogens and tested their response to macrolides, then finally, carried out whole genome sequencing of these isolates. Despite the difference in clinical presentation of the infection, both isolates exhibited a high level of resistance to macrolide antibiotics. Analysis of clinical data showed that the erythrocyte sedimentation rate in blood samples of the patients in the early stages of disease varied greatly. Genome sequence analysis revealed single nucleotide polymorphisms mainly focused on adhesin P1, which is involved in the pathogenicity of M pneumoniae.Conclusion:The differences of erythrocyte sedimentation rate in the early stage of M pneumoniae pneumonia and mutations in P1 protein may help us to distinguish between severe or mild disease after infection with macrolide-resistant M pneumoniae. These findings could lead to the development of screening assays that will allow us to distinguish severe or mild M pneumoniae pneumonia early.
外文关键词：adhesion P1； erythrocyte sedimentation rate； macrolide-resistant Mycoplasma pneumoniae； single nucleotide polymorphisms； whole genome sequencing
作者：Li SL； Sun HM； Liu F等
作者单位：首都儿科研究所
期刊名称：MEDICINE
期刊影响因子：2.133
出版年份：2016
出版刊次：9
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