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Clin Respir J. 2017 Nov;11(6):931-934. doi: 10.1111/crj.12439. Epub 2016 Feb 1.

Atopy: a risk factor of refractory mycoplasma pneumoniae pneumonia?

Author information

1
Department of Pediatric Respirology & Immunology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.

Abstract

OBJECTIVE:

To investigate the relationship of pathogen DNA copies with clinic and laboratory features among children with Mycoplasma pneumoniae (MP) pneumonia.

METHODS:

A total of 95 enrolled children with MP pneumonia were assigned into the high-MP-load group (>106 /mL) and the low-MP-load group (≤106 /mL) according to MP-DNA copies in bronchoalveolar lavage fluid (BALF). Clinical characteristics and any allergy history were collected. Aeroallergens and food allergens were detected with a skin test. Serum IgE and eosinophil cationic protein (ECP) were assessed using enzyme immunoassay. BALF levels of IL-4, IFN-γ, IL-8 and TNF-α were assessed by ELISA.

RESULTS:

Compared with the low-MP-load group, 72.7% in the high-MP-load group developed refractory MP pneumonia who failed to respond to at least 1-week treatment with macrolides (72.7% vs 41.9%, P = 0.005). More children in the high-load group than those in the low-load group presented with extrapulmonary manifestations, lung consolidation, pleural effusion and atopic conditions including any allergy history, positive findings of aeroallergen test and increased serum IgE and ECP (P < 0.05). A significant higher BALF IL-4 level was seen in the high-load group versus the low-load group (23.00 ± 11.24 vs 14.68 ± 7.12; pg/mL; P < 0.01). There were no significant differences in BALF levels of IFN-γ, IL-8 and TNF-α between the two groups (P > 0.05).

CONCLUSION:

Atopy may be a risk factor for the presence and severity of refractory MP pneumonia due to the high pathogen load in airway.

KEYWORDS:

DNA copy numbers; atopy; bronchoalveolar lavage fluid; mycoplasma pneumoniae; refractory mycoplasma pneumoniae pneumonia

PMID:
26683420
DOI:
10.1111/crj.12439
[Indexed for MEDLINE]

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