Expert consensus on the diagnosis and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children  

作　　者：Ying-Shuo Wang Yun-Lian Zhou Guan-Nan Bai Shu-Xian Li Dan Xu Li-Na Chen Xing Chen Xiao-Yan Dong Hong-Min Fu Zhou Fu Chuang-Li Hao Jian-Guo Hong En-Mei Liu Han-Min Liu Xiao-Xia Lu Zheng-Xiu Luo Lan-Fang Tang Man Tian Yong Yin Xiao-Bo Zhang Jian-Hua Zhang Hai-Lin Zhang De-Yu Zhao Shun-Ying Zhao Guo-Hong Zhu Ying-Xue Zou Quan Lu Yuan-Yuan Zhang Zhi-Min Chen 

机构地区：[1]Department of Pulmonology,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China [2]Department of Child Health Care,Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,China [3]Department of Pediatric Pulmonology and Immunology,West China Second University Hospital,Sichuan University,Chengdu 610041,China [4]Department of Pediatrics,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China [5]Department of Pulmonology,Shanghai Children’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200062,China [6]Department of Pulmonary and Critical Care Medicine,Kunming Children’s Hospital,Kunming 650034,China [7]Department of Respiratory Medicine,Children’s Hospital of Chongqing Medical University,Chongqing 400014,China [8]Department of Pulmonology,Children’s Hospital of Soochow University,Suzhou 215003,China [9]Department of Pediatrics,Shanghai General Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200080,China [10]Department of Respiratory Medicine,Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430015,China [11]Department of Respiratory Medicine,Children’s Hospital of Nanjing Medical University,Nanjing 210008,China [12]Department of Respiratory Medicine,Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China [13]Department of Respiratory Medicine,Children’s Hospital of Fudan University,Shanghai 201102,China [14]Department of Pediatric Pulmonology,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 201102,China [15]Department of Pediatric Respiratory Medicine,The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China [16]National Clinical Research Center for Respiratory Diseases,Beijing

出　　处：《World Journal of Pediatrics》2024年第9期901-914,共14页世界儿科杂志（英文版）

基　　金：supported by the grants from Key R&D Projects of Zhejiang Province(2023C03009 and 2024C03177).

摘　　要：Background Mycoplasma pneumoniae(M.pneumoniae)is a significant contributor to community-acquired pneumonia among children.Since 1968,when a strain of M.pneumoniae resistant to macrolide antibiotics was initially reported in Japan,macrolide-resistant M.pneumoniae(MRMP)has been documented in many countries worldwide,with varying incidence rates.MRMP infections lead to a poor response to macrolide antibiotics,frequently resulting in prolonged fever,extended antibiotic treatment,increased hospitalization,intensive care unit admissions,and a significantly higher proportion of patients receiving glucocorticoids or second-line antibiotics.Since 2000,the global incidence of MRMP has gradually increased,especially in East Asia,which has posed a serious challenge to the treatment of M.pneumoniae infections in children and attracted widespread attention from pediatricians.However,there is still no global consensus on the diagnosis and treatment of MRMP in children.Methods We organized 29 Chinese experts majoring in pediatric pulmonology and epidemiology to write the world’s first consensus on the diagnosis and treatment of pediatric MRMP pneumonia,based on evidence collection.The evidence searches and reviews were conducted using electronic databases,including PubMed,Embase,Web of Science,CNKI,Medline,and the Cochrane Library.We used variations in terms for“macrolide-resistant”,“Mycoplasma pneumoniae”,“MP”,“M.pneumoniae”,“pneumonia”,“MRMP”,“lower respiratory tract infection”,“Mycoplasma pneumoniae infection”,“children”,and“pediatric”.Results Epidemiology,pathogenesis,clinical manifestations,early identification,laboratory examination,principles of antibiotic use,application of glucocorticoids and intravenous immunoglobulin,and precautions for bronchoscopy are highlighted.Early and rapid identification of gene mutations associated with MRMP is now available by polymerase chain reaction and fluorescent probe techniques in respiratory specimens.Although the resistance rate to macrolide

关 键 词：CHILD Macrolide-resistant Mycoplasma pneumoniae RECOMMENDATION Diagnosis Treatment 

分 类 号：R725.1[医药卫生—儿科]