儿童非重症肺炎支原体肺炎中耐大环内酯类抗生素的相关因素分析  

Factors of Resistance to Macrolide Antibiotics in Children with Non Severe Mycoplasma Pneumoniae Pneumonia

作　　者：李闪闪 李洁 Li Shanshan;Li Jie(Lu’an Hospital of Anhui Medical University,Anhui Lu’an 237000,China)

机构地区：[1]安徽医科大学附属六安医院,安徽六安237000

出　　处：《儿科药学杂志》2025年第4期1-4,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨儿童非重症肺炎支原体肺炎(N-SMPP)中耐大环内酯类抗生素的相关因素。方法:回顾性分析2023年4月至2024年8月在安徽省六安市人民医院住院的85例N-SMPP患儿临床资料,所有患儿均行支气管镜检查及支气管肺泡灌洗治疗并送检病原微生物靶向测序(t NGS)。将35例耐大环内酯类肺炎支原体肺炎(MPP)患儿作为观察组,其余50例患儿作为对照组。比较两组患儿一般资料,采用多因素logistic回归分析影响耐药发生的因素。结果:两组患儿性别、年龄、影像学表现、白细胞、丙氨酸氨基转移酶水平、天冬氨酸氨基转移酶水平、住院时间比较差异无统计学意义(P>0.05);中性粒细胞计数、C反应蛋白、血沉(ESR)、乳酸脱氢酶(LDH)水平,大环内酯类药物无反应性比较差异有统计学意义(P<0.05)。多因素logistic回归分析显示,ESR、LDH水平升高及大环内酯类药物无反应性是大环内酯类抗菌药物耐药的危险因素(P<0.05)。结论:依据ESR、LDH水平升高及大环内酯类药物无反应性,鉴别出耐大环内酯类MPP,对临床医师判断患儿病情和制定治疗方案具有重要意义。Objective:To probe into the related factors of macrolide resistance in children with non severe Mycoplasma pneumoniae pneumonia(N-SMPP).Methods:Retrospective analysis of 85 children with N-SMPP hospitalized in Lu’an People’s Hospital of Anhui from Apr.2023 to Aug.2024.All the children were treated with bronchoscopy and bronchoalveolar lavage and submitted for targeted next-generation sequencing(tNGS).A total of 35 cases of macrolide-resistant M.pneumoniae pneumonia(MPP)were extracted as the observation group,while the remaining 50 patients served as the control group.General clinical data of two groups were compared,and the factors affecting drug resistance were analyzed by multiple logistic regression.Results:There were no significant differences in gender,age,imaging findings,white blood cells,alanine aminotransferase level,aspartate aminotransferase level and length of stay between two groups(P>0.05).There were statistically significant difference in neutrophil count,C-reactive protein,erythrocyte sedimentation rate(ESR),lactate dehydrogenase(LDH)levels and non-responsiveness of macrolide between two groups(P<0.05).Multivariate logistic regression analysis showed that ESR,elevated LDH and non-responsiveness of macrolide were risk factors for macrolide resistance(P<0.05).Conclusion:According to ESR,elevated LDH level and non-responsiveness of macrolide,macrolide-resistant MPP can be identified,which is of great significance for guiding clinicians to judge the condition of children and formulate treatment regimens.

关 键 词：儿童 肺炎支原体肺炎 耐药基因检测 大环内酯类 无反应性 

分 类 号：R725.1[医药卫生—儿科]