Abstract：
OBJECTIVE: To investigate macrolide-resistant Mycobacterium pneumoniae (MRMP) pneumonia in children and construct a logistic regression model for mutations in the Mycoplasma pneumoniae drug-resistant gene.
METHODS: Clinical data of 281 children were analyzed. Sequencing confirmed a mutation at the A2063G locus of the 23 S rRNA gene in 227 children (A2063G group); 54 children showed no mutations (non-MRMP [NMRMP] group). We compared clinical features, laboratory tests, imaging, and bronchoscopy results and constructed a multifactorial logistic regression model to analyze risk and protective factors.
RESULTS: The A2063G group had longer durations of fever and hospitalization before admission, a higher proportion of treatment with sodium methylprednisolone succinate (MPS)/dexamethasone, longer time to discontinue hormones, and higher probability of combined infections. Monocyte percentage was significantly higher in the A2063G group. Imaging suggested a higher incidence of infections in the right lung compared to both lungs. Univariate analysis revealed fever duration before admission, hormone dose and duration, monocyte percentage, and mixed infections as risk factors for Mycoplasma pneumoniae infection with the A2063G mutation. The logistic regression model showed that mixed infections were an independent risk factor for the A2063G locus mutation, whereas hormone dose was a protective factor.
CONCLUSIONS: A prevalence of macrolide resistance of 80.8% among children was observed in the region. Logistic regression analysis revealed that co-infection with other respiratory pathogens is an independent risk factor for the development of resistance genes, while the use of hormone dosage acts as a protective factor.
METHODS: Clinical data of 281 children were analyzed. Sequencing confirmed a mutation at the A2063G locus of the 23 S rRNA gene in 227 children (A2063G group); 54 children showed no mutations (non-MRMP [NMRMP] group). We compared clinical features, laboratory tests, imaging, and bronchoscopy results and constructed a multifactorial logistic regression model to analyze risk and protective factors.
RESULTS: The A2063G group had longer durations of fever and hospitalization before admission, a higher proportion of treatment with sodium methylprednisolone succinate (MPS)/dexamethasone, longer time to discontinue hormones, and higher probability of combined infections. Monocyte percentage was significantly higher in the A2063G group. Imaging suggested a higher incidence of infections in the right lung compared to both lungs. Univariate analysis revealed fever duration before admission, hormone dose and duration, monocyte percentage, and mixed infections as risk factors for Mycoplasma pneumoniae infection with the A2063G mutation. The logistic regression model showed that mixed infections were an independent risk factor for the A2063G locus mutation, whereas hormone dose was a protective factor.
CONCLUSIONS: A prevalence of macrolide resistance of 80.8% among children was observed in the region. Logistic regression analysis revealed that co-infection with other respiratory pathogens is an independent risk factor for the development of resistance genes, while the use of hormone dosage acts as a protective factor.
摘要：
目的：了解儿童大环内酯类药物耐药肺炎分枝杆菌(MRMP)肺炎,建立肺炎支原体耐药基因突变的Logistic回归模型。
方法：对281例儿童的临床资料进行分析。测序证实227名儿童（A2063G组）的23SrRNA基因的A2063G基因座发生突变；54名儿童未显示突变（非MRMP[NMRMP]组）。我们比较了临床特征，实验室测试,成像,和支气管镜检查结果，并构建多因素logistic回归模型分析风险和保护因素。
结果：A2063G组入院前发热和住院时间较长，甲基强的松龙琥珀酸钠（MPS）/地塞米松的治疗比例更高，停止荷尔蒙的时间更长，合并感染的可能性更高。单核细胞百分比在A2063G组中显著增高。影像学显示，与双肺相比，右肺感染的发生率更高。单因素分析显示入院前发热持续时间，激素剂量和持续时间，单核细胞百分比，和混合感染为A2063G突变的肺炎支原体感染的危险因素。logistic回归模型显示混合感染是A2063G位点突变的独立危险因素,而激素剂量是一个保护因素。
结论：该地区儿童大环内酯耐药率达到80.8%。Logistic回归分析显示,与其他呼吸道病原体共感染是耐药基因发生的独立危险因素,而使用激素剂量作为保护因素。
方法：对281例儿童的临床资料进行分析。测序证实227名儿童（A2063G组）的23SrRNA基因的A2063G基因座发生突变；54名儿童未显示突变（非MRMP[NMRMP]组）。我们比较了临床特征，实验室测试,成像,和支气管镜检查结果，并构建多因素logistic回归模型分析风险和保护因素。
结果：A2063G组入院前发热和住院时间较长，甲基强的松龙琥珀酸钠（MPS）/地塞米松的治疗比例更高，停止荷尔蒙的时间更长，合并感染的可能性更高。单核细胞百分比在A2063G组中显著增高。影像学显示，与双肺相比，右肺感染的发生率更高。单因素分析显示入院前发热持续时间，激素剂量和持续时间，单核细胞百分比，和混合感染为A2063G突变的肺炎支原体感染的危险因素。logistic回归模型显示混合感染是A2063G位点突变的独立危险因素,而激素剂量是一个保护因素。
结论：该地区儿童大环内酯耐药率达到80.8%。Logistic回归分析显示,与其他呼吸道病原体共感染是耐药基因发生的独立危险因素,而使用激素剂量作为保护因素。
