社区获得性肺炎肺炎支原体的流行及临床谱分析

Mohd Kashif Ali, D. I. Khan, Akansha Mittal, Samreen Khan, Swaleha Akhtar
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摘要

社区获得性肺炎一直是一个严重的健康问题,尤其是在儿童年龄组中,被认为是导致住院的主要原因之一[1]。它是发展中国家儿童呼吸道疾病和死亡的一个重要原因。它是一种广泛存在的细菌病原体,与多种临床特征有关,包括肺和肺外表现。但由于诊断检测通常基于血清学或非标准化的分子技术,因此对肺炎支原体引起的住院社区获得性肺炎(CAP)的患病率和流行病学知之甚少[6]。由于其广泛的流行和致命的并发症,有必要确定肺炎支原体病例并对其进行最佳治疗,以尽量减少长期后果。材料与方法本研究旨在招募阿里格尔贾瓦哈尔·拉尔·尼赫鲁医学院附属医院门诊和IPD 1年(2019年10月- 2020年10月)1-14岁的社区获得性肺炎患者,评估其中肺炎支原体的患病率。结果32例(100%)社区获得性肺炎患者中有5例(15.62%)经血清学诊断为肺炎支原体感染,患者以1 ~ 5岁年龄组居多,临床特征多变,以呼吸急促、发热、咳嗽为主要症状,影像学表现以弥漫性网状和肺叶实变为最常见。结论基于血清学的社区获得性肺炎病例中肺炎支原体的患病率较低。然而,由于血清学不是100%的敏感和特异性,并且滴度可以从最初7天完全不存在到疾病一周后高度可检测到,因此不应仅根据血清学排除诊断。由于疾病的严重性,必须始终牢记肺炎支原体的鉴别诊断。
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Prevalence and Clinical Spectrum of Mycoplasma pneumoniae in Community-acquired Pneumonia
ABSTRACT: Introduction Community-acquired pneumonia has been a serious health issue, particularly among the pediatric age group, and is considered to be one of the major causes responsible for hospital admissions [1]. It is a substantial cause of respiratory illness and mortality in children in developing countries. It is a widespread bacterial pathogen that has been associated with a variety of clinical features, including pulmonary and extrapulmonary manifestations. But as diagnostic testing is typically based on serology or non-standardized molecular techniques, the prevalence and epidemiology of hospitalized community-acquired pneumonia (CAP) owing to Mycoplasma pneumoniae are poorly recognized [6]. Because of its ample prevalence and fatal complications, there is a need to identify cases of Mycoplasma pneumonia and treat them optimally to minimize the long-term consequences. Material and Method This study aims to recruit the cases of community-acquired pneumonia from the OPD and IPD of Jawahar Lal Nehru Medical College Hospital, AMU, Aligarh, for one year (October 2019–October 2020) in patients within 1–14 years of age and assess the prevalence of Mycoplasma pneumonia among them. Result Five (15.62%) of the total of thirty-two (100%) patients with community-acquired pneumonia had Mycoplasma pneumoniae infection diagnosed based on serology, with the majority of patients in the 1–5 year age group and variable clinical characteristics, with tachypnea, fever, and cough being the most prominent symptoms and diffuse reticular pattern and lobar consolidation being the most common radiological findings. Conclusions It has been concluded from the above study that the prevalence of Mycoplasma pneumoniae in community-acquired pneumonia cases based on serology is low. However, because serology is not 100% sensitive and specific, and titers can range from complete absence for the first 7 days to highly detectable after one week of illness, the diagnosis should not be ruled out solely based on serology. Owing to the severity of the disease, a differential diagnosis of M. pneumoniae must always be kept in mind.
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