Effect of 23S rRNA gene mutations in Mycoplasma pneumoniae on severity of community-­acquired pneumonia in young adult patients treated at the Smolensk military hospital

Abstract

Objective. To evaluate effect of 23S rRNA gene mutations in Mycoplasma pneumoniae on severity of community-acquired pneumonia (CAP) in young adult patients. Materials and Methods. A total of 42 case histories of young adult patients with CAP treated at the Smolensk military hospital over the period of 25 October 2017 to 25 December 2019 were reviewed. «AmpliSens® Mycoplasma pneumoniae/Chlamydophila pneumoniae-FL» real-time PCR kit was used to detect M. pneumoniae from nasopharyngeal swabs collected prior to antimicrobial therapy. Testing for 23S rRNA gene mutations conferring macrolide resistance was performed by real-time PCR melt curve analysis (patent no. 2646123) and confirmed by DNA sequencing. Results. All patients had a clinical picture of non-severe CAP on hospital admission. All patients were treated with standard doses of azithromycin or clarithromycin. No respiratory failure or any other complications were observed. Macrolide-resistant genotype of M. pneumoniae was detected in 4 (9.5%) patients. Clinical, laboratory and radiological resolution of pneumonia in all cases occurred on day 10– 16, regardless of the presence of macrolide-resistant genotype. Conclusions. There were no differences in clinical course of severity between CAP caused by M. pneumoniae with 23S rRNA gene mutation and CAP caused by wild-type M. pneumoniae The presence of mutations in the 23S rRNA gene of M. pneumoniae did not worsen the clinical course of CAP.

Clinical characteristics and changes in serum CXCL10 and CXCL16 levels in patients with severe mycoplasma pneumonia

“…According to the 2015 Expert Consensus on the Diagnosis and Treatment of MPP in Children and the 2019 Chinese Expert Consensus on Laboratory Diagnosis of Respiratory Tract Infection in Children with MP, the diagnostic criteria for MPP are as follows: During the acute and recovery stages, double serum specific Immunoglobulin G (IgG) levels increase fourfold or more; the serum specific Immunoglobulin G (IgM) antibody titer exceeds 1:60; and MP tested positive for Deoxyribonucleic acid (DNA) or Ribonucleic acid (RNA). [9][10][11] According to the diagnostic criteria of MPP, when a patient's characteristics meet 1 of them and clinical features of pneumonia appear, the patient is included in the Q group. According to the 2013 Children's CAP Management Guidelines and the 2019 Children's CAP Diagnosis and Treatment Guidelines, the diagnostic criteria for SMPP are as follows.…”